Written simulation of patient-doctor encounters. 1. Research instrument for registration of the performance of general practitioners.

A written simulation of patient-doctor encounters is described, involving five patients with vague complaints, an 'instruction' patient with sinusitis and a 'test' patient with acute appendicitis. Nineteen general practitioners were confronted with it. The extent to which the simulation distorted reality and the implications of such distortions were considered in an attempt to assess the content validity. The conclusion was that the simulation gave a realistic impression of the general practitioners' diagnostic and therapeutic approach to patients with vague complaints. The searching procedures in relation to the complaint and the patient's perception of the complaint were adequately depicted, and the therapeutic procedures approximated closely to reality. There was some distortion in the attention paid to psychosocial aspects as these were given more attention in the simulation than they receive in reality.