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While the use of simulated patients for the assessement of medical students' skills is increasing there is little data on whether students perform differently vs real patients. The present study examined this issue using second-year medical students' ability to empathize with simulated and genuine patients. Forty second-year students each conducted two interviews which were audio-recorded and later rated by raters who had achieved a high degree of reliability using the 9-point accurate empathy scale (Truax, 1967). Ten students saw a genuine patient for each interview while ten students saw simulators on both occasions. Of the remaining twenty students, ten saw genuine patients at the first interview and simulated patients at the second session. This order was reversed for the remaining ten students. No significant differences were found in the levels of empathy between students' interaction with genuine or simulated patients. As the students were also unable to discriminate between the two groups of patients it was concluded that simulators represent a viable procedure given the skill to be assessed in the present research and the experience of the students.

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