RESUMEN
OBJECTIVE: Standardized patients (SPs) have been developed to measure practitioner performance in actual practice settings, but results have not been fully validated for psychiatric disorders. This study describes the process of creating reliable and valid SPs for unannounced assessment of general-practitioners' management of depression disorders in Iran. METHOD: Ten psychology and nursing students (potential SPs) took part in a five-session course involving training in dialogue and body language. Five scenarios, along with corresponding checklists representing common presentations of mood disorders in primary-care settings, were developed by an expert group. The SPs' role-play performance of their respective scenario was videotaped and scored independently by three psychiatrists according to an observational rating scale to assess validity. The role-play was repeated after 1 week with the same scenario and the same doctor, to assess test-retest reliability. The reliability of each checklist to be used by the SPs was assessed by testing interrater reliability between groups of SPs. RESULTS: The cutoff score for the SPs' portrayal validity was 90% or above for all SPs. Mean interrater reliability for the checklists was acceptable for the SPs watching the same videos and filling in the checklists, while the mean kappa for assessing concurrent validity in filling in the checklists was lower. The test-retest performance for assessing reliability resulted in a mean kappa of 0.72. All SPs except one, who was not recruited, performed acceptably well. CONCLUSION: The authors have demonstrated a thorough validation of the technique of using standardized patients in the portrayal of depressive disorders in primary-care settings in Iran, which creates confidence in employing this technique to evaluate doctors' performance, for example, after an educational intervention. Similar methods of validation can be used for SPs' portrayal of other psychiatric disorders.
Asunto(s)
Trastorno Depresivo/diagnóstico , Trastorno Depresivo/psicología , Países en Desarrollo , Medicina General/educación , Simulación de Paciente , Determinación de la Personalidad/estadística & datos numéricos , Psiquiatría/educación , Adulto , Competencia Clínica , Curriculum , Trastorno Depresivo/etnología , Femenino , Humanos , Masculino , Psicometría/estadística & datos numéricos , Reproducibilidad de los Resultados , Desempeño de PapelRESUMEN
OBJECTIVE: The use of standardized patients in Objective Structured Clinical Examinations in the assessment of psychiatric residents has increased in recent years. The aim of this study is to investigate the experience of psychiatry residents and examiners with standardized patients in Iran. METHOD: Final-year residents in psychiatry participated in this study. Experienced examiners were asked to complete a questionnaire concerning the ability of standardized patients to realistically portray psychiatric patients. RESULTS: Standardized patients can convincingly portray psychiatric disorders and act according to the requested complex scenarios. CONCLUSIONS: According to these findings, the authors recommend the use of standardized patients in OSCEs for psychiatric board certification exams.