Evaluating Principal Preparation Candidate Competence Using Medical School Methodology 109
standardized across learners and tested for reliability. Learners progress through levels of
difficulty by developing scenarios matched to curriculum goals and objectives (Silverman,
Kurtz, & Draper, 1997).
Standardized Patients and Clinical Practice Examinations have been used at ECU since
- Initially, the methodology was used for teaching in small groups for the Department of
Family Medicine in the ECU School of Medicine (SOM). In the 1990s the SOM collaborated
with the North Carolina Medical Schools Consortium on a grant from the Macy Foundation to
study the feasibility of a state-wide standardized clinical practice assessment. Also in the
1990s, the National Board of Medical Examiners (NBME) began researching the use of
standardized patients as a component of the medical licensure examination. The ECU School
of Medicine served as a research site for the NBME and several faculty of the Office of
Clinical Skills Assessment and Education (OCSAE) served on committees for the
development of the USMLE.
Since the early 2000s ECU expanded application of standardized patient methodology
throughout all four years of medical school, Graduate Medical Education, the School of
Nursing, the Physician’s Assistant Program, the Departments of Occupational Therapy,
Recreation and Leisure Studies, Rehabilitation Services, Marriage and Family Therapy
Program, as well as the School of Social Work. In the last fiscal year, the OCSAE provided
over 7,000 standardized patient encounters to over 400 learners.
The value of a clinical practice exam as an assessment tool is enormous. The CPX
provides an opportunity for all learners to experience standardized encounters replicated over
multiple iterations with consistency and accuracy. Learners see how their performance
compares to others who encounter the same case as well as see how an alternative approach
produces different results (Silverman et al., 1997).
DEVELOPMENT OF THE PRINCIPAL LEADERSHIP EXAMINATION (PLE)
In early 2007, a group of College of Education faculty members approached faculty of the
OCSAE with the idea of developing a clinical practice examination. This examination
became the Principal Leadership Examination (PLE). The first activity undertaken by the
combined faculty member team was to identify a variety of communication skills for
Principals and Assistant Principals in public schools in North Carolina based on objectives in
a Principal fellowship course. Based on this list of communication items (see Appendix), the
team then designed three relevant encounters representing common scenarios encountered by
Principals and Assistant Principals (see Table 1). Three was a trial number of cases used to
assess the feasibility and authenticity of this type of assessment for principal candidates.
College of Education faculty members on the team volunteered to participate in a pilot of the
PLE. This would allow the team to test the authenticity of the scenarios, the utility of the
checklist as well as the realism and reliability of the standardized patient, or as they were
called “standardized education personnel”. To conduct the PLE, the College of Education
provided participants, the OCSAE offered pro bono the use of facilities, staff, and
standardized patients to pilot this innovative use of standardized patients in principal
education and assessment. The facility, equipped with 18 examination rooms included
cameras and video-taping capabilities traditionally resembles a typical doctor’s office with
examination beds, wall-mounted equipment, sinks, and rolling stools. For the PLE, rooms
were converted to look like an office by simply masking the examination table and wall-
mounted medical equipment, adding a table to resemble a desk, and scattering office
accouterments (e.g., lamp, telephone) throughout the space. The actual PLE was composed of