The use of standardized clients in research in the veterinary clinical setting

Abstract

This article describes the first use of undisclosed standardized clients (SCs) for research in the veterinary clinical setting. The study described here used SCs to investigate veterinarian-client communication during euthanasia discussions. Use of this methodology allowed us to avoid several ethical and logistical challenges associated with gathering observational data on sensitive subject matter. In medicine, standardized patients (SPs) are used extensively in teaching, medical school examinations, and licensing examinations. Increasingly, SPs are being used in research to evaluate physicians' performance in the clinical setting, including assessment of physician-patient communication. Several veterinary schools have recently Introduced SCs for teaching and evaluation of student veterinarians. Until now, however, SCs have not been used for research in the veterinary clinical setting. Two cases were designed to reflect common reasons for discussion of euthanasia in private practice. A random sample of 32 consenting veterinarians in southern Ontario saw each case. Appointments were audio-recorded and analyzed using a communication assessment tool adapted from human medicine. At the end of each appointment, the SC disclosed his or her identity and both veterinarian and SC completed questionnaires to describe their perceptions of the communication that took place. This article describes in detail the use of SCs in this study, including case design, training, preparation for visits, use of animal patients, and challenges faced. The use of SCs was shown to be a feasible method of assessing veterinarian-client communication in the clinical setting. © 2008 AAVMC.