good question...i have updated my post which at least partially answers your question but to summarize...nuanced skills used by seasoned clinicians are not given credit. eg 'its my pleasure to serve your health care needs' ...no credit...'thank you' , i've never heard it used , full credit' and its not typically used...that is to say...it is a skit, acting exercise, there is nothing wrong with my skills...on the contrary...advanced esp in my area were i would likely practice ultimately... also...actors may not identify with a candidate who might be older for example...they have a certain quota for scoring...if they score most or all they see' high' it is pointed out to them where they are too easy..so someone different is more likely to receive scrutiny. actors are asked to make valued judgements when they have no particular expertise in educational psychometric testing, sociology, psychology...these are points made in the articles listed in the resources of the attached doc.
i saw some actors several times...each time the phenomena of conformity to conscious or not, perceived norms comes more into play/...ie it becomes more difficult to pass each time a particular actor is seen...as they conscious of their being compared to other scores, and needing to conform to perceived score by other actors.
Poor design....some of the scenarios are not realistic, so it becomes difficult to say if the purpose of this scenario is to be tested by a sullen bitter pt...or what...i may have been spot on in previous encounter but trying to do something different b/c who knows..what they might be looking for...here is another essay mas o menos pointing out the flaws...again...although i recognized these flaws, not much searching was required to find psychometric people screaming the unintended consequences that invariably would be consequent. The rubric is contradictory, every pt knows they are entitled to a second opinion, if i suggest that they go to another doc to receive one...how does that say i' m confident....on and on and on......
the high pass rate is exactly what should be noted as your 'red flag" that something is amiss here....malitious...? incompetent...? or just plain NOT valid? which is sufficient for my suit to prevail.
oh yeah...there is no system of review...one can't say,'wait a minute..i did ask that question or it came about with an open-ended question and the actor failed to record it...special note is NBOME own research anticipated this actor issue and performed their own study to validate actor evaluations saying they correlate with the physician score...not in my case...red flag?
