Smith Stephen R, Cookson John, McKendree Jean, Harden Ronald M
Brown Medical School, Providence, RI 02912, USA.
Med Teach. 2007 Feb;29(1):33-7. doi: 10.1080/01421590701213406.
Historically, medical students learned the art and science of medicine from the patients they encountered. While students were highly motivated to learn through this approach, the serendipitous nature of real practice and the variability in the skills of their teachers proved to be liabilities for learning. This apprenticeship-style education was replaced by a more formal didactic curriculum during the twentieth century.
The power of computer technology enables medical educators to recapture the authenticity of patient-centred learning (PCL) through the creation of a virtual practice populated by a panel of virtual patients. In contrast to traditional problem-based learning cases, PCL virtual patients return for multiple visits with their student-doctors, demonstrating how diseases change over time, interact with other diseases and risk factors, and are influenced by psychosocial factors.
New approaches to pedagogy embodied in patient-centred learning allow the curriculum to be organized around the patients, both real and simulated.
从历史上看，医学生从他们接触的患者那里学习医学艺术与科学。虽然学生们通过这种方式学习的积极性很高，但实际临床实践的偶然性以及教师技能的差异被证明不利于学习。这种学徒式教育在20世纪被更正式的讲授式课程所取代。
计算机技术的力量使医学教育工作者能够通过创建由一组虚拟患者组成的虚拟临床实践来重现以患者为中心的学习（PCL）的真实性。与传统的基于问题的学习案例不同，PCL虚拟患者会与他们的学生医生进行多次复诊，展示疾病如何随时间变化、与其他疾病及风险因素相互作用以及受社会心理因素影响。
以患者为中心的学习所体现的新教学方法使课程能够围绕真实和模拟的患者进行组织。
