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Purpose. To evaluate the effectiveness of binary content checklists in measuring increasing levels of clinical com-petence. Method. Fourteen clinical clerks, 14 family practice res-idents, and 14 family physicians participated in two 15-minute standardized patient interviews. An examiner rated each participant's performance using a binary con-tent checklist and a global process rating. The partici-pants provided a diagnosis two minutes into and at the end of the interview.

Results. On global scales, the experienced clinicians scored significantly better than did the residents and clerks, but on checklists, the experienced clinicians scored significantly worse than did the residents and clerks. Diagnostic accuracy increased for all groups between the two-minute and 15-minute marks without significant differences between the groups. Conclusion. These findings are consistent with the hy-pothesis that binary checklists may …