Effect of Competency-Oriented Multimodal Training on Standardized Patient Performance: A Prospective, Assessor-Blinded, Randomized Controlled Mixed-Methods Study

Abstract Background Standardized patients (SPs) support clinical teaching and assessment, but their value depends on authentic, accurate, and consistent performance and effective feedback. This mixed-methods research plan compares competency-oriented multimodal training (Combi-SP) with conventional training and explores SPs’ experiences of the training. Methods This study recruited 64 SPs, equally allocated to either Combi-SP or conventional training, with eight 45-minute class hours for each group. Objective performance was assessed at baseline, immediately post-training, and at six weeks via blinded video ratings. Linear mixed-effects models were used to evaluate changes in performance. A qualitative component was incorporated into the immediate post-training assessment: two open-ended questionnaire items investigated helpful training components, persistent challenges, and support requirements. Responses from 59 out of 63 questionnaire respondents were analysed using qualitative content analysis and synthesised with quantitative findings in a joint display. Results In this study, 63 SPs completed the immediate assessment and 60 completed follow-up. Combi-SP showed greater adjusted improvement in objective performance at both time points: 4.71 points immediately after training (95% CI, 2.25–7.16) and 4.43 points at six weeks (95% CI, 1.93–6.93). The four performance domains and self-efficacy also favored Combi-SP. Overall interactions for the two error-count outcomes were not statistically significant. Three qualitative themes concerned understanding the case and controlling disclosure, specific feedback and targeted practice, and training demands and refresher support. The joint display linked the score patterns to these experiences while retaining uncertainty about error reduction and longer-term transfer. Conclusions Competency-oriented multimodal training produced greater improvements in objective SP performance than conventional training, with part of the advantage retained at 6 weeks.