Can standardized patients predict real‐patient satisfaction with the doctor‐patient relationship?

The doctor‐patient relationship is an important determinant of patient satisfaction and of health outcome, particularly in chronic disease. Because faculty ratings have not been found to be valid predictors of patient perceptions, we evaluated the validity of using standardized‐patient (SP) ratings to measure this important aspect of competence. In a sample of 26 (87%) consenting internal medicine residents, we found that resident communication scores produced by SP rating were significantly lower than those produced by real‐patient (RP) rating (p = .0001). The rank‐order correlation between SP and RP resident score was .42 (p = .03). After adjustment for the effects of patient population and clinic on resident satisfaction scores, the correlation between SP and RP ratings was .51 (p = .007). We concluded that SP rating was a valid predictor of a resident's ranking based on RP evaluation but would not be a sensitive enough measure to predict residents who were in the lowest quartile of RP rating.