Mavis Brian, Turner Jane, Lovell Kathryn, Wagner Dianne
Office of Medical Education Research and Development, College of Human Medicine, Michigan State University, East Lansing, 48824-1316, USA.
Teach Learn Med. 2006 Spring;18(2):130-6. doi: 10.1207/s15328015tlm1802_7.
In an effort to expand preclinical formative assessments, our medical school has implemented additional simulated encounters using faculty members and students in addition to actors to portray standardized patients (SP). This report focuses on the implementation of this strategy. In addition, a preliminary evaluation of the fidelity of the simulated clinical encounters based on SP type is reported.
Three new performance-based assessments were added to the second-year curriculum; each was associated with specific content in the problem-based learning curriculum. The training of student and faculty SPs was modeled after an existing training program for another assessment event.
To determine the impact of SP type on students' experiences, 313 students completed a 9-item anonymous questionnaire after each performance assessment; items were rated on a 5-point scale. Faculty members and students who were SPs also completed a brief satisfaction questionnaire. Faculty SPs were most intimidating to students, but they provided students with the most helpful feedback. Students were less anxious when peers were SPs, but they rated the encounter as a less valuable simulation. There was no difference in students' ratings of confidence in their diagnosis or the extent to which SP type inhibited their performance.
Students and faculty benefited from their SP experience. A combination of SP types can provide a broad range of cost-effective preclinical learning experiences. Students, faculty, and actors as SPs each have specific strengths and weaknesses related to cost, training needs, feedback quality, and simulation fidelity. The goals of the encounter should guide the choice of SP type.
为了扩大临床前形成性评估，我们医学院除了使用演员来扮演标准化病人（SP）外，还安排了教员和学生参与额外的模拟问诊。本报告重点介绍该策略的实施情况。此外，还报告了基于SP类型对模拟临床问诊逼真度的初步评估。
在二年级课程中增加了三项基于表现的新评估；每项评估都与基于问题的学习课程中的特定内容相关。学生和教员标准化病人的培训仿照了针对另一项评估活动的现有培训计划。
为了确定SP类型对学生体验的影响，313名学生在每次表现评估后完成了一份9项的匿名问卷；各项按5分制评分。担任标准化病人的教员和学生也完成了一份简短的满意度问卷。教员标准化病人对学生最具威慑力，但他们给学生提供的反馈最有帮助。当同龄人作为标准化病人时，学生的焦虑感较低，但他们认为这种问诊作为模拟的价值较低。学生对自己诊断的信心评分或SP类型对其表现的抑制程度方面没有差异。
学生和教员都从他们作为标准化病人的经历中受益。多种类型的标准化病人可以提供广泛且经济高效的临床前学习体验。学生、教员和作为标准化病人的演员在成本、培训需求、反馈质量和模拟逼真度方面各有特定的优势和劣势。问诊的目标应指导标准化病人类型的选择。
