The advantages and challenges of unannounced standardized patient methodology to assess healthcare communication

Patient Educ Couns. 2011 Mar;82(3):318-24. doi: 10.1016/j.pec.2011.01.021.


Objective: This paper provides an overview of the implementation of using unannounced standardized patients (USPs) to conduct health communication research in clinical settings.

Methods: Certain types of health communication situations are difficult to capture because of their rarity or unpredictable nature. In primary care the real reasons for a visit are frequently unknown until the consultation is well under way. Therefore, it is logistically difficult for communication studies to capture many real-time communications between patients and their physicians. Although the USP methodology is ideal for capturing these communication behaviors, challenges to using this method include developing collaborative relationships with clinical practices, logistical issues such as safeguarding the identity of the USP, training USPs and creating their identities, maintaining fidelity to the role, and analyzing the resultant data.

Results: This paper discusses the challenges and solutions to USP implementation. We provide an example of how to implement a USP study using an on-going study being conducted in primary care practices.

Conclusion: This paper explores the advantages and challenges as well as strategies to overcome obstacles to implementing a USP study.

Practice implications: Despite the challenges, USP methodology can contribute much to our understanding of health communication and practice.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Clinical Competence
  • Health Communication*
  • Health Services Research
  • Humans
  • Patient Simulation*
  • Physician-Patient Relations*
  • Physicians
  • Primary Health Care / methods
  • Research Design