Assessment Through Simulated Conversations: Applications in Medical and Teacher Education

  • Johannes BauerEmail author
  • Martin Gartmeier
  • Anne B. Wiesbeck
Reference work entry


Simulated conversations (SC) are an established method for teaching and assessing professional communication competences and other clinically relevant skills in medical education. In SC, participants lead a simulated professional conversation about a predefined authentic case scenario with actors trained to portray a standardized role. Recently, the use of SC has expanded to teacher education, and it is of general relevance to all vocational and professional domains that require conversations between professional and client. The present chapter outlines the applications of SC in medical and teacher education and provides a generic blueprint of six key steps in designing SC assessments. The aim is to facilitate the transfer of SC assessments to other domains.


Communication Assessment Simulations Medicine Teaching 


  1. Adamo G (2003) Simulated and standardized patients in OSCEs: achievements and challenges 1992–2003. Med Teach 25(3):262–270CrossRefGoogle Scholar
  2. Aich G (2011) Professionalisierung von Lehrenden im Eltern-Lehrer-Gespräch: Entwicklung und Evaluation eines Trainingsprogramms (Professionalization of teachers in teacher-parent conversation: development and evaluation of a training program). Schneider-Verlag Hohengehren, BaltmannsweilerGoogle Scholar
  3. Association of Standardized Patient Educators (2017) The Global network for human simulation education.
  4. Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP (2000) SPIKES – a six-step protocol for delivering bad news: application to the patient with cancer. Oncologist 5(4):302–311. Scholar
  5. Barman A (2005) Critiques on the objective structured clinical examination. Ann Acad Med Singap 34(8):478–482Google Scholar
  6. Barrows HS (1987) Simulated (standardized) patients and other human simulations: a comprehensive guide to their training and use in teaching and evaluation. Health Sciences Consortium, Chapel HillGoogle Scholar
  7. Barrows HS, Abrahamson S (1964) The programmed patient: a technique for appraising student performance in clinical neurology. J Med Educ 39(8):802–805Google Scholar
  8. Bauer J, Gartmeier M, Wiesbeck AB, Moeller GE, Karsten G, Fischer MR, Prenzel M (2018) Differential learning gains in professional conversation training: a latent profile analysis of competence acquisition in teacher-parent and physician-patient communication. Learn Individ Differ 61(1):1–10. Scholar
  9. Blake KD, Gusella J, Greaven S, Wakefield S (2006) The risks and benefits of being a young female adolescent standardised patient. Med Educ 40(1):26–35. Scholar
  10. Blömeke S, Gustafsson J-E, Shavelson RJ (2015) Approaches to competence measurement in higher education. Z Psychol 223(1):1–2. Scholar
  11. Bond T, Fox CM (2015) Applying the Rasch model: fundamental measurement in the human sciences, 3rd edn. Routledge, LondonCrossRefGoogle Scholar
  12. Braun E, Athanassiou G, Pollerhof K (2016) Development of an instrument for measuring communicative competences. Paper presented at the 4th meeting of the Gesellschaft für Empirische Bildungsforschung (GEBF), Berlin, 7–11 Mar 2016Google Scholar
  13. Cai L, Yang JS, Hansen M (2011) Generalized full-information item bifactor analysis. Psychol Methods 16(3):221–248. Scholar
  14. Charles C, Gafni A, Whelan T (1999) Decision-making in the physician–patient encounter: revisiting the shared treatment decision-making model. Soc Sci Med 49(5):651–661. Scholar
  15. Chesser A, Cameron H, Evans P, Cleland J, Boursicot K, Mires G (2009) Sources of variation in performance on a shared OSCE station across four UK medical schools. Med Educ 43(6):526–532. Scholar
  16. Clark HH, Brennan SE (1991) Grounding in communication. In: Resnick LB, Levine JM, Teasley SD (eds) Perspectives on socially shared cognition. APA, Washington, pp 453–494Google Scholar
  17. Cleland JA, Abe K, Rethans J-J (2009) The use of simulated patients in medical education: AMEE guide no 421. Med Teach 31(6):477–486. Scholar
  18. Collins JP, Harden RM (1998) AMEE Medical Education Guide No. 13: real patients, simulated patients and simulators in clinical examinations. Med Teach 20(6):508–521CrossRefGoogle Scholar
  19. Dotger BH (2010) “I had no idea”: developing dispositional awareness and sensitivity through a cross-professional pedagogy. Teach Teach Educ 26(4):805–812. Scholar
  20. Dotger BH (2013) Clinical simulations for teacher development: a companion manual for teachers. Information Age Publishing, CharlotteGoogle Scholar
  21. Dotger BH, Ashby C (2010) Exposing conditional inclusive ideologies through simulated interactions. Teach Educ Spec Educ 33(2):114–130. Scholar
  22. Dotger BH, Harris S, Hansel A (2008) Emerging authenticity: the crafting of simulated parent-teacher candidate conferences. Teach Educ 19(4):337–349CrossRefGoogle Scholar
  23. Dotger BH, Dotger SC, Maher MJ (2010a) From medicine to teaching: the evolution of the simulated interaction model. Innov High Educ 35(3):129–141. Scholar
  24. Dotger S, Dotger BH, Tillotson J (2010b) Examining how preservice science teachers navigate simulated parent-teacher conversations on evolution and intelligent design. Sci Educ 94(3):552–570. Scholar
  25. Eckes T (2015) Introduction to many-facet Rasch measurement. Peter Lang, Frankfurt am MainGoogle Scholar
  26. Edgcumbe DP, Silverman J, Benson J (2012) An examination of the validity of EPSCALE using factor analysis. Patient Educ Couns 87(1):120–124. Scholar
  27. Engelhard GJ (2002) Monitoring raters in performance assessments. In: Tindal G, Haladyna TM (eds) Large-scale assessment programs for all students: validity, technical adequacy, and implementation. LEA, Mahwah, pp 261–287Google Scholar
  28. Evertson CM, Green JL (1986) Observation as inquiry and method. In: Wittrock MC (ed) Handbook of research on teaching, 3rd edn. Macmillan, New York, pp 162–213Google Scholar
  29. Fukkink R, Trienekens N, Kramer LC (2011) Video feedback in education and training: putting learning in the picture. Educ Psychol Rev 23(1):45–63. Scholar
  30. Furr RM, Bacharach VR (2013) Psychometrics: an introduction. Sage, Los AngelesGoogle Scholar
  31. Gaba DM (2004) The future vision of simulation in health care. Qual Saf Health Care 13(suppl_1):i2–i10. Scholar
  32. Gartmeier M, Bauer J, Fischer MR, Karsten G, Prenzel M (2011) Modellierung und Assessment professioneller Gesprächsführungskompetenz von Lehrpersonen im Lehrer-Elterngespräch. In: Zlatkin-Troitschanskaia O (ed) Stationen Empirischer Bildungsforschung. Traditionslinien und Perspektiven. VS-Verlag, Wiesbaden, pp 412–424CrossRefGoogle Scholar
  33. Gartmeier M, Bauer J, Noll A, Prenzel M (2012) Welchen Problemen begegnen Lehrkräfte beim Führen von Elterngesprächen? Die Deutsche Schule 104:374–382Google Scholar
  34. Gartmeier M, Bauer J, Fischer M, Hoppe-Seyler T, Karsten G, Kiessling C, Möller G, Wiesbeck A, Prenzel M (2015) Fostering professional communication skills of future physicians and teachers: effects of e-learning with video cases and role-play. Instr Sci 43(4):443–462. Scholar
  35. Gerich M, Schmitz B (2016) Using simulated parent-teacher talks to assess and improve prospective teachers’ counseling competence. J Educ Learn 5:285–301CrossRefGoogle Scholar
  36. Görlitz A, Bachmann C, Blum K, Höfer S, Peters T, Preusche I, Raski B, Rüttermann S, Wagner Menghin M, Kiessling C (2014) Lehren und Prüfen kommunikativer Kompetenzen im Medizinstudium – Ergebnisse einer Umfrage im deutschsprachigen Raum. In: Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA). Lehren und Prüfen kommunikativer Kompetenzen im Medizinstudium, HamburgGoogle Scholar
  37. Guiton G, Hodgson CS, Delandshere G, Wilkerson L (2004) Communication skills in standardized-patient assessment of final-year medical students: a psychometric study. Adv Health Sci Educ 9(3):179–187. Scholar
  38. Gwet KL (2014) Handbook of inter-rater reliability, 4th edn. Advanced Analytics, GaithersburgGoogle Scholar
  39. Harden RM (1990) Twelve tips for organizing an Objective Structured Clinical Examination (OSCE). Med Teach 12(3–4):259–264. Scholar
  40. Harden RM, Stevenson M, Downie WW, Wilson GM (1975) Assessment of clinical competence using objective structured examination. Br Med J 1(5955):447–451. Scholar
  41. Hargie O (2011) Skilled interpersonal communication. Routledge, LondonGoogle Scholar
  42. Hartig J, Klieme E, Leutner D (eds) (2008) Assessment of competences in educational contexts. Hogrefe, GöttingenGoogle Scholar
  43. Hertel S (2009) Beratungskompetenz von Lehrern: Kompetenzdiagnostik, Kompetenzförderung, Kompetenzmodellierung. In: Pädagogische Psychologie und Entwicklungspsychologie, vol 74. Waxmann, MünsterGoogle Scholar
  44. Horton WS, Keysar B (1996) When do speakers take into account common ground? Cognition 59(1):91–117. Scholar
  45. Iramaneerat C, Yudkowsky R, Myford CM, Downing SM (2008) Quality control of an OSCE using generalizability theory and many-faceted Rasch measurement. Adv Health Sci Educ 13(4):479–493. Scholar
  46. Khan KZ, Ramachandran S, Gaunt K, Pushkar P (2013) The Objective Structured Clinical Examination (OSCE): AMEE Guide No. 81. Part I: an historical and theoretical perspective. Med Teach 35(9):e1437–e1446. Scholar
  47. Lane C, Rollnick S (2007) The use of simulated patients and role-play in communication skills training: a review of the literature to August 2005. Patient Educ Couns 67(1):13–20CrossRefGoogle Scholar
  48. Langer I, Schulz von Thun F (2007) Messung komplexer Merkmale in Psychologie und Pädagogik: Ratingverfahren. In: Rost DH (ed) Standardwerke aus Psychologie und Pädagogik – Reprints, vol 4. vol 4 T4 – Ratingverfahren M4 – Citavi. Waxmann, MünsterGoogle Scholar
  49. Linacre ML (1989) Many-facet Rasch models. MESA Press, ChicagoGoogle Scholar
  50. Lurie SJ, Mooney CJ, Nofziger AC, Meldrum SC, Epstein RM (2008) Further challenges in measuring communication skills: accounting for actor effects in standardised patient assessments. Med Educ 42(7):662–668. Scholar
  51. Makoul G, Clayman ML (2006) An integrative model of shared decision making in medical encounters. Patient Educ Couns 60(3):301–312. Scholar
  52. May W, Park JH, Lee JP (2009) A ten-year review of the literature on the use of standardized patients in teaching and learning: 1996–2005. Med Teach 31(6):487–492. Scholar
  53. Newble D (2004) Techniques for measuring clinical competence: objective structured clinical examinations. Med Educ 38(2):199–203. Scholar
  54. Ortwein H, Fröhmel A, Burger W (2006) Einsatz von Simulationspatienten als Lehr-, Lern- und Prüfungsform. PPmP Psychotherapie Psychosomatik Medizinische Psychologie 56(1):23–29. Scholar
  55. Raykov T, Marcoulides GA (2006) A first course in structural equation modeling. LEA, MahwahGoogle Scholar
  56. Rees C, Sheard C, McPherson A (2004) Medical students’ views and experiences of methods of teaching and learning communication skills. Patient Educ Couns 54(1):119–121. Scholar
  57. Regehr G, MacRae H, Reznick RK, Szalay D (1998) Comparing the psychometric properties of checklists and global rating scales for assessing performance on an OSCE-format examination. Acad Med 73(9):993–997CrossRefGoogle Scholar
  58. Rethans J-J, Gorter S, Bokken L, Morrison L (2007) Unannounced standardised patients in real practice: a systematic literature review. Med Educ 41(6):537–549. Scholar
  59. Rogers CR (1951) Client-centered therapy. Houghton Mifflin, BostonGoogle Scholar
  60. Schirmer JM, Mauksch L, Lang F, Marvel MK, Zoppi K, Epstein RM, Brock D, Pryzbylski M (2005) Assessing communication competence: a review of current tools. Fam Med 37(3):184–192Google Scholar
  61. Seidel T, Prenzel M (2010) Beobachtungsverfahren: Vom Datenmaterial zur Datenanalyse. In: Holling H, Schmitz B (eds) Handbuch Statistik, Methoden und Evaluation. Hogrefe, Göttingen, pp 139–152Google Scholar
  62. Seidel T, Prenzel M, Kobarg M (eds) (2005) How to run a video study: technical report of the IPN video study. Waxmann, MünsterGoogle Scholar
  63. Shavelson RJ (2013) On an approach to testing and modeling competence. Educ Psychol 48(2):73–86CrossRefGoogle Scholar
  64. Shavelson RJ, Webb NM (1991) Generalizability theory: a primer. Sage, Thousand OaksGoogle Scholar
  65. tEach Assessment subgroup (2012) Assessment tools for communication skills. EACH, UtrechtGoogle Scholar
  66. United States Medical Licensing Examination (2015) Step 2 CS. Retrieved from
  67. Weinert FE (2001) Concept of competence: a conceptual clarification. In: Rychen S, Salganik LH (eds) Defining and selecting key competencies. Hogrefe, Seattle, pp 45–65Google Scholar
  68. Wiesbeck A (2015) An evaluation of simulated conversations as an assessment of pre-service teachers’ communication competence in parent-teacher conversations. Doctoral dissertation, Technical University of Munich, MunichGoogle Scholar
  69. Wiesbeck AB, Bauer J, Gartmeier M, Kiessling C, Moeller GE, Karsten G, Fischer MR, Prenzel M (2017) Simulated conversations for assessing professional conversation competence in teacher-parent and physician-patient conversations. J Educ Res Online 9(3):82–101Google Scholar
  70. Wilson M (2005) Constructing measures. Erlbaum, MahwahGoogle Scholar
  71. Wirtz M, Caspar F (2002) Beurteilerübereinstimmung und Beurteiler-Reliabilität. Hogrefe, GöttingenGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Johannes Bauer
    • 1
    Email author
  • Martin Gartmeier
    • 2
  • Anne B. Wiesbeck
    • 2
  1. 1.Educational ResearchUniversity of ErfurtErfurtGermany
  2. 2.Technical University of MunichMunichGermany

Section editors and affiliations

  • Esther Winther
    • 1
  1. 1.Vocational Education and TrainingUniversity of Duisburg-EssenDuisburgGermany

Personalised recommendations