title: Can we rely on simulated patients' satisfaction with their consultation for assessing medical students' communication skills? A cross-sectional study.
abstract: BACKGROUND
  In medical education, teaching methods offering intensive practice without high utilization of faculty resources are needed. We investigated whether simulated patients' (SPs') satisfaction with a consultation could predict professional observers' assessment of young doctors' communication skills.
  
  
  METHODS
  This was a comparative cross-sectional study of 62 videotaped consultations in a general practice setting with young doctors who were finishing their internship. The SPs played a female patient who had observed blood when using the toilet, which had prompted a fear of cancer. Immediately afterwards, the SP rated her level of satisfaction with the consultation, and the scores were dichotomized into satisfaction or dissatisfaction. Professional observers viewed the videotapes and assessed the doctors' communication skills using the Arizona Communication Interview Rating Scale (ACIR). Their ratings of communication skills were dichotomized into acceptable versus unacceptable levels of competence.
  
  
  RESULTS
  The SPs' satisfaction showed a predictive power of 0.74 for the observers' assessment of the young doctors and whether they reached an acceptable level of communication skills. The SPs' dissatisfaction had a predictive power of 0.71 for the observers' assessment of an unacceptable communication level. The two assessment methods differed in 26% of the consultations. When SPs felt relief about their cancer concern after the consultation, they assessed the doctors' skills as satisfactory independent of the observers' assessment.
  
  
  CONCLUSIONS
  Accordance between the dichotomized SPs' satisfaction score and communication skills assessed by observers (using the ACIR) was in the acceptable range. These findings suggest that SPs' satisfaction scores may provide a reliable source for assessing communication skills in educational programs for medical trainees (students and young doctors). Awareness of the patient's concerns seems to be of vital importance to patient satisfaction.
authors.affiliation: Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Postbox 1111-Blindern, Oslo, N-0317, Norway. tore.gude@medisin.uio.no.|Research Institute, Modum Bad, Oslo, Norway. tore.gude@medisin.uio.no.
authors.forename: T
authors.initials: T
authors.lastname: Gude
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. hilde.grimstad@ntnu.no.
authors.forename: H
authors.initials: H
authors.lastname: Grimstad
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, and St. Olav University Hospital, Pain Care Unit, Trondheim, Norway. are.holen@ntnu.no.
authors.forename: A
authors.initials: A
authors.lastname: Holen
authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway. tor.anvik@uit.no.
authors.forename: T
authors.initials: T
authors.lastname: Anvik
authors.affiliation: Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway. Anders.Barheim@igs.uib.no.
authors.forename: A
authors.initials: A
authors.lastname: Baerheim
authors.affiliation: Department of Clinical Medicine, Section for Psychiatry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway. ole.fasmer@psyk.uib.no.
authors.forename: O B
authors.initials: OB
authors.lastname: Fasmer
authors.affiliation: Department of Family Medicine, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway. per.hjortdahl@medisin.uio.no.
authors.forename: P
authors.initials: P
authors.lastname: Hjortdahl
authors.affiliation: Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Postbox 1111-Blindern, Oslo, N-0317, Norway. p.j.w.vaglum@medisin.uio.no.
authors.forename: P
authors.initials: P
authors.lastname: Vaglum
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D017046:Cost Savings / Q000379:methods; D003430:Cross-Sectional Studies; D004521:Educational Measurement / Q000379:methods / Q000592:standards; D005180:Faculty, Medical; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009664:Norway; D017060:Patient Satisfaction; D016544:Patient Simulation; D010817:Physician-Patient Relations; D014743:Videotape Recording; D055815:Young Adult