title: Training and validation of standardized patients for evaluation of general practitioners' performance in management of obesity and overweight.
abstract: BACKGROUND
  Standardized patient (SP) can serve as a valuable tool to measure the physician performance in actual clinical settings, but it has not been validated for obesity/overweight disorders. This study has been conducted to describe the process of creating reliable and valid SPs for evaluation of general-practitioners' management of obesity/overweight in Iran.
  
  
  METHODS
  A total of 6 obese/overweight volunteers (potential SPs) took part in training. Three scenarios, along with corresponding checklists including 102 items representing different aspects of diagnosis and treatment of obesity/overweight, were developed by an expert group. The SPs were trained using role playing method. During this part, one of the SPs failed. The SPs' portrayal of their respective scenario was online watched in another room and the checklist filled independently by the physician, research assistant and other SPs. The reliability of the checklist to be used by the SPs was assessed by Cronbach's alpha. The overall inter-rater agreement was calculated by the intraclass correlation coefficient statistic for total scores.
  
  
  RESULTS
  The 5 eligible SPs were all women between 20 years and 39 years of age. Inter-rater agreement between the SPs' total scores was 0.899, value (95% confidence intervals) were 11.8 (0.68-0.98) and P value was <0.001. The Cronbach's alpha for reliability of completed checklists was 0.91.
  
  
  CONCLUSIONS
  SP could be a powerful instrument for evaluating medical performance of general practitioners in the field of obesity/overweight management. Further research is needed to find the more aspects of training and validation of unannounced SPs in this field.
authors.affiliation: Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Changiz
authors.affiliation: Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Jamshidian
authors.affiliation: Department of Clinical Nutrition, School of Nutrition and Food Sciences, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohamad Hassan
authors.initials: MH
authors.lastname: Entezari
authors.affiliation: Department of Medical Education, School of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Nazila
authors.initials: N
authors.lastname: Kassaian
keywords: Obesity; performance; standardized patient