title: Simulated patients in the community pharmacy setting. Using simulated patients to measure practice in the community pharmacy setting.
abstract: BACKGROUND
  Performance measurement and quality of care in community pharmacy settings is problematic because of the lack of formal patient registration and the resultant risk of selection bias. Although simulated patients have been used for teaching and education purposes, particularly in medical settings, their use as a research tool requires exploration in other health settings. The purpose of this paper is to describe how we used simulated patients to measure professional performance of community pharmacy staff.
  
  
  METHODS
  Sixty pharmacies participated in a randomised controlled trial (RCT) to evaluate the effectiveness and efficiency of two guideline implementation strategies in the community pharmacy setting. The primary outcome measure for the study was derived from assessment forms completed by simulated patients following covert visits to participating pharmacies.
  
  
  RESULTS
  Of the 420 simulated patient visits scheduled, 384 (91%) were completed. Nine visits were reported by pharmacy staff using reply-paid postcards, four of which concurred with known SP visits. Each detected visit was made by a different SP. In a post-intervention survey, 26 (52%) pharmacists stated they had been apprehensive about the use of simulated patients as part of the study, however, 41 (82%) pharmacists agreed that SP visits were an acceptable research method to use in a community pharmacy setting.
  
  
  CONCLUSIONS
  Simulated patients are a feasible method of assessing professional performance in community pharmacy settings and overcome the methodological problems of other measurement methods. Further research is needed to assess the reliability and validity of simulated patients.
authors.affiliation: Department of General Practice and Primary Care, University of Aberdeen, Westburn Road, Aberdeen, AB25 2AY, UK. m.c.watson@abdn.ac.uk
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Watson
authors.forename: John R
authors.initials: JR
authors.lastname: Skelton
authors.forename: Christine M
authors.initials: CM
authors.lastname: Bond
authors.forename: Phil
authors.initials: P
authors.lastname: Croft
authors.forename: Connie M
authors.initials: CM
authors.lastname: Wiskin
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Grimshaw
authors.forename: Jill
authors.initials: J
authors.lastname: Mollison
mesh_terms: D000328:Adult; D003157:Community Pharmacy Services / Q000592:standards* / Q000706:statistics & numerical data; D004512:Education, Pharmacy / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D005791:Patient Care / Q000592:standards* / Q000706:statistics & numerical data; D010594:Pharmacies / Q000592:standards* / Q000706:statistics & numerical data; D010595:Pharmacists / Q000592:standards / Q000706:statistics & numerical data; D010865:Pilot Projects; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D012606:Scotland; D011795:Surveys and Questionnaires