The use of simulated patients in the assessment of actual clinical performance in general practice.

This pilot study assessed a novel approach to the evaluation of clinical performance in the practice setting, using actors trained to simulate real patients. Thirteen general practitioner teachers, 10 family medicine training programme registrars, and 10 recent graduates of the FMTP were recruited. They agreed to be consulted by an unknown simulated patient. Two young patients with classical migraine were selected. Two young actors, a male and a female, were trained to simulate their symptomatology and history. A scoring system was devised to broadly assess a single general practice first consultation, and the simulators were trained to score. Eighty-five percent of respondents were willing to take part in a further study. Seventy-three percent had no suspicion at all that the patient was simulated. The average consultation time was 17 minutes (range 4-40). The average score was 67% (range 10-100%). The diagnosis was made in every case and a wide variety of treatments were prescribed. This appears to be a practical and acceptable method of assessing clinical performance.