Simulated patients’ role-portrayal in the clinical skills part of the Swiss federal licensing exam is of high quality and improves further over time as measured with the FAIR OSCE instrument

In conclusion, the research demonstrated a continuous improvement and high quality of SP role-portrayal in the Swiss FLE over five years. Well-trained SPs, assessed using the FAIR OSCE instrument, play a crucial role in maintaining the standardized and high-quality nature of clinical skills exams in a high-stakes context. Further research could explore additional factors influencing overall exam quality and address potential biases in SP educator ratings.