D'Alessandro Donna M, Lewis Tamra E, D'Alessandro Michael P
Department of Pediatrics, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242-1009, USA.
BMC Med Educ. 2004 Jul 19;4:10. doi: 10.1186/1472-6920-4-10.
Computer-based patient simulations (CBPS) are common, effective, instructional methods for medical students, but have limitations. The goal of this project was to describe the development of a CBPS designed to overcome some of these limitations and to perform an online evaluation.
In 1996, patients and families experiencing a common pediatric problem were interviewed, photographed and a chart review completed. A digital storytelling template was developed: 1. patient's story, evaluation and clinical course, 2. problem-based approach to the evaluation, and 3. discussion of disease process. The media was digitized and placed onto the Internet. The digital stories and a 10-question online survey were pilot tested. Online survey responses were collected from 1999-2003. Overall use of the digital stories was measured by computer server logs and by the number of hyperlinks to the CBPS.
Eight stories were created using this system. Over 4.5 years, 814,148 digital story pages were read by 362,351 users. Hyperlink citations from other websites to the CBPS were 108. Online survey respondents (N = 393) described the overall quality as excellent or very good (88.4%). The stores were clearly written (92%) at an appropriate level (91.4%). Respondents felt they could begin to evaluate a similar case presentation (95.4%), and would remember the case in the future (91%).
A new type of CBPS, the digital storytelling system, has been developed and evaluated which and appears to be successful in overcoming some of the limitations of earlier CBPS by featuring patient's stories in their own words, by focusing on problems rather than diseases, and by having stories that are quick for students to work through.
基于计算机的患者模拟（CBPS）是用于医学生的常见且有效的教学方法，但存在局限性。本项目的目标是描述一个旨在克服其中一些局限性的CBPS的开发过程，并进行在线评估。
1996年，对患有常见儿科疾病的患者及其家属进行了访谈、拍照，并完成了病历审查。开发了一个数字故事模板：1. 患者的故事、评估和临床过程；2. 基于问题的评估方法；3. 疾病过程的讨论。将这些素材数字化并放到互联网上。对数字故事和一个10道题的在线调查进行了预测试。收集了1999年至2003年的在线调查回复。通过计算机服务器日志和指向CBPS的超链接数量来衡量数字故事的总体使用情况。
使用该系统创建了8个故事。在4年半的时间里，362351名用户阅读了超过458148个数字故事页面。其他网站指向CBPS的超链接引用为108次。在线调查的受访者（N = 393）将总体质量描述为优秀或非常好（88.4%）。这些故事表述清晰（92%），难度适中（91.4%）。受访者表示他们能够开始评估类似的病例展示（95.4%），并且将来会记住这个病例（91%）。
已开发并评估了一种新型的CBPS，即数字故事讲述系统，它通过用患者自己的语言讲述故事、关注问题而非疾病以及让学生能够快速浏览故事等方式，似乎成功克服了早期CBPS的一些局限性。
