Impact of inaccuracies in standardized patient portrayal and reporting on physician performance during blinded clinic visits

Background: Standardized patients (SPs) can be used to conduct blinded assessment of quality of care. However, variability in patient performance may influence quality of care scores and undermine the value of this technique. Purpose: This study was carried out to determine if accuracy of SP portrayal and recording was associated with physician performance in blinded quality of care assessment. Methods: Double blind videotapes from 53 SP visits were scored and accuracy of SP portrayal and recording was correlated with visit quality of care scores. Results: SPs accurately presented the case content (96.45%) but were less accurate in recording physician actions (k = .71). Accuracy of recording had a significant negative impact on overall quality of care scores (r = .38), on scores for medical history, (r = .55), and patient education (r = .36). Conclusions: Quality of care scores were not influenced by inacccuracies in presentation, but physician performance measures that are based on SP reports will be positively biased by recording inaccuracies.