Simulations in evaluation of training: a medical example using standardised patients

Abstract In the evaluation of the effectiveness of continuing medical education, observation of a change in physicians' practice offers sound evidence of learning. Such measurements are technically challenging and carry ethical issues of patient confidentiality and vulnerability. This study aimed to address these issues by evaluating the impact of a training program on the performance of family physicians in a simulated consultation with adolescents trained as standardised patients (SPs). One hundred and eight physicians were randomised into intervention or control group, and were tested pre-training, 6-months and 12-months post-training. Physicians rated self-perceived competency, SPs rated rapport and satisfaction, and confidentiality discussions and independent faculty observers rated clinical competency. All measures detected significant impact of the training on physicians' performance except for the SP's subjective rating on rapport and satisfaction. Results indicate the method is feasible and sensitive to changes in performance. Further research is needed to clarify questions raised about the SPs' subjective ratings.