Objective: A clinician's ability to infer patients' thoughts and feelings is a critical component of high quality care. The goal of this article is to present a new test to measure this ability in clinicians, called the Test of Accurate Perception of Patients' Affect (TAPPA). Methods: Audiovisual clips were taken from patients' actual medical visits. The patients reviewed the videotape after the visit to identify their thoughts and feelings during the visit. This information was used to extract short audiovisual clips for which the correct answer was the patient's report of the thought or feeling associated with that clip. The TAPPA contains 48 audiovisual clips, each responded to in a multiple choice format. Results: The TAPPA showed good psychometric properties (optimal mean and good variance, adequate internal consistency, and strong re-test reliability) and convergent validity with other tests of emotion recognition. In addition, the test showed predicted better performance by female than male participants. Conclusion: The TAPPA promises to be a valuable tool for research and education on provider-patient relationships and quality of care. Practice implications: A tool for testing clinicians' understanding of patients' thoughts and feelings may contribute to better quality of care and to improved selection and training. (C) 2013 Elsevier Ireland Ltd. All rights reserved.