Gordon James A, Oriol Nancy E, Cooper Jeffrey B
G.S. Beckwith Gilbert and Katharine S. Gilbert Medical Education Program in Medical Simulation, Harvard Medical School, Department of Medicine, Masschusetts General Hospital, Boston, Massachusetts 02114, USA.
Acad Med. 2004 Jan;79(1):23-7. doi: 10.1097/00001888-200401000-00007.
Realistic medical simulation has expanded worldwide over the last decade. Such technology is playing an increasing role in medical education not merely because simulator sessions are enjoyable, but because they can provide an enhanced environment for experiential learning and reflective thought. High-fidelity patient simulators allow students of all levels to "practice" medicine without risk, providing a natural framework for the integration of basic and clinical science in a safe environment. Often described as "flight simulation for doctors," the rationale, utility, and range of medical simulations have been described elsewhere, yet the challenges of integrating this technology into the medical school curriculum have received little attention. The authors report how Harvard Medical School established an on-campus simulator program for students in 2001, building on the work of the Center for Medical Simulation in Boston. As an overarching structure for the process, faculty and residents developed a simulator-based "medical education service"-like any other medical teaching service, but designed exclusively to help students learn on the simulator alongside a clinician-mentor, on demand. Initial evaluations among both preclinical and clinical students suggest that simulation is highly accepted and increasingly demanded. For some learners, simulation may allow complex information to be understood and retained more efficiently than can occur with traditional methods. Moreover, the process outlined here suggests that simulation can be integrated into existing curricula of almost any medical school or teaching hospital in an efficient and cost-effective manner.
在过去十年中，逼真的医学模拟技术已在全球范围内得到广泛应用。这项技术在医学教育中发挥着越来越重要的作用，这不仅是因为模拟课程有趣，还因为它们能为体验式学习和反思性思考提供更好的环境。高保真患者模拟器让各级学生能够在无风险的情况下“练习”医学，为在安全环境中整合基础科学和临床科学提供了自然的框架。医学模拟通常被描述为“医生的飞行模拟”，其基本原理、实用性和范围在其他地方已有阐述，但将这项技术融入医学院课程所面临的挑战却很少受到关注。作者报告了哈佛医学院如何在波士顿医学模拟中心工作的基础上，于2001年为学生建立了一个校内模拟项目。作为该过程的总体架构，教师和住院医师开发了一个基于模拟器的“医学教育服务”——就像其他任何医学教学服务一样，但专门设计用于帮助学生在临床导师的指导下根据需要在模拟器上学习。对临床前和临床学生的初步评估表明，模拟教学受到高度认可且需求日益增加。对于一些学习者来说，模拟教学可能比传统方法更能让复杂信息得到有效理解和记忆。此外，这里概述的过程表明，模拟教学可以以高效且经济有效的方式融入几乎任何医学院或教学医院的现有课程中。
