Clinical skills problems. A valid instrument for assessing competence?

Physician assistants are required to take the clinical skills problems (CSP) portion of the National Certifying Examination administered by the National Commission on Certification of Physician's Assistants (NCCPA). No comparable section exists in entry-level physician certification examinations because studies have shown that this type of examination is neither a valid nor a reliable indicator of clinical competence. A published account of the studies used to implement the CSP portion of the National Certifying Examination contained serious flaws, calling the research into question. Denial of certification based solely on failure on the CSP portion of the National Certifying Examination could be challenged legally. The CSP is invalid and unreliable, and should be eliminated.