Maiburg Bas H J, Rethans Jan-Joost E, van Erk Ingrid M, Mathus-Vliegen Lisbeth M H, van Ree Jan W
Department of General Practice, Maastricht University, Maastricht, The Netherlands.
Med Educ. 2004 Dec;38(12):1229-35. doi: 10.1111/j.1365-2929.2004.02015.x.
Incognito standardised patients (SPs) have only been used to represent new patients so far. The few trials with incognito SPs provide little detail on the method used for fielding them.
To establish the feasibility of introducing SPs as 'known' patients (i.e. patients who have previously visited the practice) into practices, to indicate the required practice preparations, and to describe the various aspects of using SPs in a pretest/post-test design.
We used incognito SPs as known patients in a controlled trial to assess the practice behaviour of 49 trainees. The SPs received a 2-day training in role playing and completing checklists. We compiled comprehensive practice information folders of each practice to be visited. Real personal data and faked medical data of SPs were inserted in the filing system of each practice to be visited. Apart from SP roles with slightly different reasons-for-encounter and different SPs, the same training protocol, checklists and practice information folders were used in the post-test.
The SPs carried out 287 visits in 50 practices. All practices prepared the patient records for the SP visits in a fairly authentic practice style. Trainees detected the SP in 74 visits. The main reasons for detection were imperfections in patient records and aspects of SP roles or role playing.
Fielding incognito SP visits as known patients was feasible but labour-intensive. Preparing the SP patient records and familiarising SPs with the interior of practices represented new elements in the use of SPs. The pretest/post-test format made their use more efficient instead of complicating it.
迄今为止，隐匿标准化患者（SPs）仅用于代表新患者。少数使用隐匿SPs的试验几乎没有详细说明招募他们的方法。
确定将SPs作为“已知”患者（即之前就诊过该医疗机构的患者）引入医疗机构的可行性，指出所需的医疗机构准备工作，并描述在预测试/后测试设计中使用SPs的各个方面。
在一项对照试验中，我们将隐匿SPs作为已知患者，以评估49名实习生的医疗行为。SPs接受了为期两天的角色扮演和填写检查表的培训。我们为每个要就诊的医疗机构编制了综合的医疗机构信息文件夹。将SPs的真实个人数据和伪造的医疗数据插入每个要就诊的医疗机构的档案系统中。除了就诊原因略有不同的SP角色和不同的SPs外，后测试中使用了相同的培训方案、检查表和医疗机构信息文件夹。
SPs在50个医疗机构进行了287次就诊。所有医疗机构都以相当真实的医疗风格为SPs就诊准备了患者记录。实习生在74次就诊中发现了SPs。发现的主要原因是患者记录存在缺陷以及SP角色或角色扮演方面的问题。
将隐匿SPs就诊作为已知患者进行招募是可行的，但劳动强度大。准备SP患者记录并使SPs熟悉医疗机构内部情况是使用SPs的新元素。预测试/后测试形式使它们的使用更有效，而不是更复杂。
