Huang Grace, Reynolds Robby, Candler Chris
Office of Educational Technology, Carl J Shapiro Institute for Education and Research at Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA.
Acad Med. 2007 May;82(5):446-51. doi: 10.1097/ACM.0b013e31803e8a0a.
"Virtual patients" are computer-based simulations designed to complement clinical training. These applications possess numerous educational benefits but are costly to develop. Few medical schools can afford to create them. The purpose of this inventory was to gather information regarding in-house virtual patient development at U.S. and Canadian medical schools to promote the sharing of existing cases and future collaboration.
From February to September 2005, the authors contacted 142 U.S. and Canadian medical schools and requested that they report on virtual patient simulation activities at their respective institutions. The inventory elicited information regarding the pedagogic and technical characteristics of each virtual patient application. The schools were also asked to report on their willingness to share virtual patients.
Twenty-six out of 108 responding schools reported that they were producing virtual patients. Twelve schools provided additional data on 103 cases and 111 virtual patients. The vast majority of virtual patients were media rich and were associated with significant production costs and time. The reported virtual patient cases tended to focus on primary care disciplines and did not as a whole exhibit racial or ethnic diversity. Funding sources, production costs, and production duration influenced the extent of schools' willingness to share.
Broader access to and cooperative development of these resources would allow medical schools to enhance their clinical curricula. Virtual patient development should include basic science objectives for more integrative learning, simulate the consequences of clinical decision making, and include additional cases in cultural competency. Together, these efforts can enhance medical education despite external constraints on clinical training.
“虚拟患者”是基于计算机的模拟程序，旨在辅助临床培训。这些应用具有诸多教育优势，但开发成本高昂。很少有医学院能够负担得起开发它们。这份清单的目的是收集有关美国和加拿大医学院校内虚拟患者开发的信息，以促进现有病例的共享和未来的合作。
2005年2月至9月，作者联系了142所美国和加拿大医学院，要求它们汇报各自机构的虚拟患者模拟活动。这份清单收集了有关每个虚拟患者应用的教学和技术特征的信息。这些学校还被要求汇报它们共享虚拟患者的意愿。
108所回复的学校中有26所报告称它们正在制作虚拟患者。12所学校提供了有关103个病例和111个虚拟患者的更多数据。绝大多数虚拟患者包含丰富的媒体内容，并且制作成本高昂、耗时较长。所报告的虚拟患者病例往往集中于初级保健学科，总体上并未呈现种族或民族多样性。资金来源、制作成本和制作时长影响了学校共享的意愿程度。
更广泛地获取这些资源并进行合作开发将使医学院能够加强其临床课程。虚拟患者的开发应纳入基础科学目标以实现更综合的学习，模拟临床决策的后果，并纳入更多文化能力方面的病例。尽管临床培训受到外部限制，但这些努力共同作用可以提升医学教育水平。
