Bearman M, Cesnik B, Liddell M
Centre of Medical Informatics, Monash University, Institute of Public Health, Clayton, Victoria, Australia.
Med Educ. 2001 Sep;35(9):824-32. doi: 10.1046/j.1365-2923.2001.00999.x.
Two types of virtual patient designs can be distinguished: a 'narrative' structure and a 'problem-solving' structure. This study compares the same virtual patient with two different structures within the domain of communication skills.
Two virtual patients were constructed around the same case, one emphasizing a narrative and one a problem-solving model. Use of these packages was trialled with undergraduate medical students over 2 years. Students were randomly assigned to tutorials using the virtual patients, and their communication skills were compared with baseline performance by a separate group. Outcome was assessed by evaluation of an interview with a simulated patient.
There was no significant difference between the three groups in overall communication skills. However there was a significant improvement in the communication skills of the narrative group when compared only with the problem-solving group. Additionally, various aspects of communication skills, such as use of open-ended questions and appropriate language, showed significant differences between the three groups.
There is some evidence to support the value of a narrative design for virtual patients which are to be used to teach communication skills, which encourages further investigation.
虚拟患者设计可分为两种类型:“叙事”结构和“解决问题”结构。本研究在沟通技巧领域内,对具有两种不同结构的同一虚拟患者进行比较。
围绕同一病例构建了两个虚拟患者,一个强调叙事,另一个强调解决问题的模式。在两年时间里,对本科医学生试用了这些软件包。学生被随机分配到使用虚拟患者的辅导课程中,他们的沟通技巧由另一组与基线表现进行比较。通过对与模拟患者的访谈评估结果。
三组在总体沟通技巧方面没有显著差异。然而,仅与解决问题组相比时,叙事组的沟通技巧有显著提高。此外,沟通技巧的各个方面(如使用开放式问题和恰当语言)在三组之间存在显著差异。
有证据支持用于教授沟通技巧的虚拟患者采用叙事设计的价值,这鼓励进一步研究。