The Influence of Ethnicity on Patient Satisfaction in a Standardized Patient Assessment

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To study possible differences in patient satisfaction ratings as a function of physician and patient ethnicity in a standardized patient (SP) performance-based assessment.


Data from 334,397 ECFMG® Clinical Skills Assessment (CSA®) simulated clinical encounters were analyzed. A between-groups analysis of covariance was conducted, with independent variables consisting of SP and candidate ethnicity.


Although a significant interaction between SP and candidate ethnicity was found, averaged over all encounters the SPs were equally satisfied with doctors from all cohorts. In general, SPs provided higher satisfaction ratings for racially concordant pairings. Among the ethnic groups of SPs, Asians were the least satisfied.


Satisfaction can vary as a function of the ethnicity of the SP. These results are similar to studies of actual patient encounters that show Asians as less satisfied than patients from other ethnic backgrounds. However, for assessment purposes, provided there is a reasonable mix of SPs, the effect is quite small.

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