Analogue Patients

Analogue patients (APs) are individuals instructed for research purposes to imagine themselves in the position of a patient as portrayed in a written or recorded medical interaction. Subsequently, their experience or evaluation of and/or response to the interaction is assessed. Well thought-out use of APs in patient-clinician communication research may enlighten the mechanisms underlying medical interactions, and thereby increase our ability to improve these interactions to the benefit of patients, their informal caregivers, and clinicians. Commonly, APs participate in experimental studies in which they are randomized to evaluate scripted variants of a medical interaction, so-called vignettes. Sometimes, APs are involved to observe recordings of actual consultations. Involving APs rather than real patients allows for systematically testing the effect of variations in healthcare clinicians' communicative behavior, which may be unethical in real clinical practice. Moreover, researchers may use APs for practical (e.g., easier recruitment) or methodological (e.g., less socially desirable answers) reasons. A point of consideration is that the use of APs reduces ecological validity of the study. That is, findings cannot straightaway be extrapolated to real clinical consultations. Ecological validity will depend on APs' ability to engage with a vignette. Hence, attention to procedures to assess and enhance APs' level of engagement is necessary. Further research is needed to fully understand how APs' engagement, and thus the validity of using APs, can be improved.