Rethans J J, van Boven C P
Br Med J (Clin Res Ed). 1987 Mar 28;294(6575):809-12. doi: 10.1136/bmj.294.6575.809.
To develop a better empirical basis for developing quality assessment in general practice three simulated patients made appointments with 48 general practitioners during actual surgery hours and collected facts about their performance. The simulated patients were indistinguishable from real patients and presented a standardised story of a symptomatic urinary tract infection. Two months later the same general practitioners received a written simulation about a patient who had the same urinary tract infection and were asked how they would handle this in real practice. Both results were scored against an existing consensus standard. The overall score for both methods did not show any substantial differences. A more differentiated analysis, however, showed that general practitioners performed significantly better with simulated patients. It also showed that general practitioners answering the written simulation performed significantly more unnecessary and superfluous actions. The results of this study show that the use of simulated patients seems to show the efficient performance of general practitioners in practice.
为了建立更好的实证基础以开展全科医疗质量评估，三名模拟患者在实际诊疗时间预约了48名全科医生，并收集了有关他们诊疗表现的事实。模拟患者与真实患者毫无差别，讲述了一个标准化的有症状尿路感染病例。两个月后，同样这些全科医生收到了一份关于患有相同尿路感染患者的书面模拟病例，并被问及他们在实际诊疗中会如何处理。两种结果均根据现有的共识标准进行评分。两种方法的总体得分没有显示出任何实质性差异。然而，更细致的分析表明，全科医生面对模拟患者时表现明显更好。分析还表明，回答书面模拟病例的全科医生实施了明显更多不必要和多余的行为。这项研究的结果表明，使用模拟患者似乎能展现全科医生在实际诊疗中的高效表现。
