Objective Using standardized patients (SP) to participate in plaster fixation examination,in order to simulate the more realistic clinical situation,make the simple skill test turn to a comprehensive examination which can simultaneously evaluate clinical knowledge,operative skills,and communication skills. Methods A total of 39 postgraduate year 1 (PGY1) surgery residents who had been trained in the Surgical School of Peking University First Hospital for 1 year were enrolled in the study. A test station of plaster fixation was set to simulate lateral malleolus fracture without displacement. The research object was three couple of examiner and SP. Through SP participate to simulate the real clinical situation,using assessment scales to evaluation the examination,compare the scores with examiner and SP,and check the consistency. At the same time,the objective measurement method was used to test the effect of plaster fixation. Results During the consultation process,94.9% (37/39) of the residents asked about the cause of the fracture. For physical examination,61.5% (24/39) of them examined whether the ankle was swollen,84.6% (33/39) examined tenderness,and 69.2% (27/39) examined the ankle activity. All residents recommended an ankle anteroposterior X-ray. Finally,97.4% (38/39) of them underwent a fracture diagnosis and 51.3% (20/39) of them chosen the posterior plaster fixation. There were significant differences between examiners and SP on scores. There was a high correlation between the scores of the operation results and the follow-up results in SP evaluation,but the scores of the examiners were not relevant. The scores of the examiners and SP had moderately relationship in the postoperative follow-up results. With SP participating,the maximum pressure under gypsum was lower than that of last year. Conclusions Using SP to simulate in the examination of plaster fixation can increase the authenticity and reliability of the test. It was more effectively to reflect the clinical competency of residents and the comprehensive ability of actual operation results.