Evaluating the performance of simulated patients: Development and validation of the Lisbon Assessment of Simulated...

Effective communication between doctors and patients is crucial for positive health outcomes and patient satisfaction. In medical education, simulated patients (SPs) play a pivotal role in developing these skills. The quality of SPs' performances and the feedback they provide significantly influence the learning process. However, current assessment tools tend to be too lengthy, overlapping or focused solely on either role-play or feedback, failing to differentiate their individual impacts. This study aimed to develop and validate a concise, reliable instrument to assess the performance of SPs in both domains separately.

The Lisbon Assessment of Simulated Patients (LASP) scale was developed with expert input to ensure content validity. Data were gathered through 629 questionnaires completed by 180 medical students and 15 tutors, who assessed 25 SPs. To determine the factor structure and model fit, exploratory and confirmatory factor analyses were conducted on split subsamples. Internal consistency was assessed using Cronbach's alpha and McDonald's omega. Additionally, descriptive statistics and item-domain correlations were analysed.

Factor analyses revealed a two-factor structure consisting of Role Play (4 items) and Feedback (6 items), which together accounted for 54% of the variance. The fit indices indicated an excellent model fit, with a CFI of 0.991, TLI of 0.988, and RMSEA of 0.020. The items demonstrated strong correlations with their respective domains, and the scale displayed good internal consistency, with a Cronbach's alpha of 0.82 overall, 0.72 for the Role Play domain, and 0.79 for the Feedback domain.

The LASP scale is a practical and psychometrically robust tool designed to assess the performance of simulated patients. It evaluates both role-play and the quality of feedback, allowing for targeted improvements in simulated encounters and enhancing the effectiveness of communication training. This concise and validated instrument supports ongoing quality assurance and faculty development in medical simulation programs.