Wykurz Geoff, Kelly Diana
Department of Community and Collaborative Practice, School of Integrated Health, University of Westminster, London NW1 3ET.
BMJ. 2002 Oct 12;325(7368):818-21. doi: 10.1136/bmj.325.7368.818.
To identify the roles and settings in which patients participate as teachers in medical education and the benefits to learners, their educational institutions, and participating patients.
Review of publications from 1970 to October 2001 providing descriptions, evaluations, or research of programmes involving patients as teachers in medical education.
1848 references were identified from various electronic databases. Applying inclusion criteria to abstracts generated 100 articles, from which 23 were selected after independent scrutiny.
13 articles discussed the role of patients in teaching physical examination skills, mostly musculoskeletal examination. Patients also taught pelvic and male genitorectal examination skills. Teaching roles varied, and 19 articles referred to patients' involvement as assessors. 18 articles described patients' training, with some patients being assessed. Reports of learners' experiences were all positive, many valuing the insights and confidence gained from practising skills on patients in a teaching role. Some learners preferred being taught by trained patients rather than doctors. Patients who were consulted enjoyed their teaching role. Several articles commented on the high quality of patients' teaching. Remuneration varied from payment of expenses to an hourly rate. Motivation for recruiting patients included the desire to reduce costs and the value attributed to the consumers' perspective.
Involving patients as teachers has important educational benefits for learners. Patients offer unique qualities that can enhance the acquisition of skills and change attitudes towards patients.
确定患者在医学教育中作为教师参与的角色和环境,以及对学习者、其教育机构和参与的患者的益处。
回顾1970年至2001年10月期间发表的文献,这些文献对医学教育中患者作为教师参与的项目进行了描述、评估或研究。
从各种电子数据库中识别出1848篇参考文献。对摘要应用纳入标准后产生了100篇文章,经过独立审查后从中选择了23篇。
13篇文章讨论了患者在教授体格检查技能(主要是肌肉骨骼检查)方面的作用。患者还教授盆腔和男性生殖泌尿系统检查技能。教学角色各不相同,19篇文章提到患者作为评估者的参与情况。18篇文章描述了患者的培训情况,一些患者接受了评估。学习者体验的报告都是积极的,许多人重视从以教学角色在患者身上练习技能中获得的见解和信心。一些学习者更喜欢由受过培训的患者而不是医生授课。接受咨询的患者喜欢他们的教学角色。几篇文章对患者教学的高质量进行了评论。报酬从支付费用到按小时计费不等。招募患者的动机包括降低成本的愿望以及对消费者视角的重视。
让患者作为教师参与对学习者具有重要的教育益处。患者具有独特的特质,可以增强技能的习得并改变对患者的态度。