Examination of standardized patient performance: accuracy and consistency of six standardized patients over time

Objective: To explore the accuracy and consistency of standardized patient (SP) performance in the context of routine genetic counseling, focusing on elements beyond scripted case items including general communication style and affective demeanor.

Methods: One hundred seventy-seven genetic counselors were randomly assigned to counsel one of six SPs. Videotapes and transcripts of the sessions were analyzed to assess consistency of performance across four dimensions.

Results: Accuracy of script item presentation was high; 91% and 89% in the prenatal and cancer cases. However, there were statistically significant differences among SPs in the accuracy of presentation, general communication style, and some aspects of affective presentation. All SPs were rated as presenting with similarly high levels of realism. SP performance over time was generally consistent, with some small but statistically significant differences.

Conclusion and practice implications: These findings demonstrate that well-trained SPs can not only perform the factual elements of a case with high degrees of accuracy and realism; but they can also maintain sufficient levels of uniformity in general communication style and affective demeanor over time to support their use in even the demanding context of genetic counseling. Results indicate a need for an additional focus in training on consistency between different SPs.