STANDARDIZED PATIENT-BASED TRAINING AND CLINICAL DIAGNOSTIC COMPETENCE AMONG MEDICAL STUDENTS: A RANDOMIZED COMPARATIVE STUDY.

AIM OF THE STUDY: The aim of this study was to compare standardized patient-based training with traditional didactic and manikin-based instruction in developing clinical diagnostic competence among mid-level medical students, and to assess whether baseline academic performance influenced this effect. MATERIAL AND METHODS: A single-center randomized comparative educational study was conducted among 498 medical students. Participants were assigned to either standardized patient-based training or traditional didactic and manikin-based instruction. Clinical diagnostic performance was assessed using the Objective Structured Clinical Examination (OSCE). Baseline academic performance was evaluated by grade point average (GPA). Subgroup analyses were performed according to academic performance. Statistical significance was set at p<0.05, and effect size was calculated using Cohen's d. RESULTS: Baseline GPA was comparable between groups. Students trained with standardized patients achieved higher OSCE scores than those receiving traditional instruction, with mean scores of 8.39 and 6.93, respectively. The effect size was large (Cohen's d=1.07). The greatest benefit was observed among students with average or lower baseline GPA, whereas high-performing students showed comparable outcomes across instructional modalities. Questionnaire responses from students in the standardized patient-based training group, lecturers and OSCE examiners favored standardized patient-based training for diagnostic reasoning, communication skills and clinical confidence, while manikin-based instruction was preferred for procedural skills. CONCLUSIONS: Standardized patient-based training was associated with improved clinical diagnostic performance, particularly among students with average or lower academic standing. These findings support the integration of standardized patients into hybrid clinical curricula to strengthen diagnostic competence and communication skills.