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[精神病学与心理治疗中使用模拟患者的临床教学。一项对照性试点研究]

[Clinical teaching with simulated patients in psychiatry and psychotherapy. A controlled pilot study].

作者信息

Wündrich M, Peters J, Philipsen A, Kopasz M, Berger M, Voderholzer U

机构信息

Abteilung für Psychiatrie und Psychotherapie, Universitätsklinikum, Hauptstrasse 5, 79104, Freiburg, Germany.

出版信息

Nervenarzt. 2008 Nov;79(11):1273-4, 1276, 1278, passim. doi: 10.1007/s00115-008-2493-3.

Abstract

Because of the new medical licensure act in Germany, much more bedside teaching than before is needed. For many of the relevant clinical pictures, few patients can be expected to undergo study lessons. That is why many universities use simulated patients (SP). In contrast to other disciplines such as internal medicine or surgery, there is not much literature about SP in psychiatry and psychotherapy. The objective of this pilot study was to evaluate if SP used for clinical teaching in addition to real patients are well accepted for simulation of psychiatric illnesses and clinical teaching. After randomization, one half of the 139 study medical students were taught using real patients and the other half using real patients and SP. The amounts of patient contact were equal in both groups. Using a questionnaire, pre- and postanalysis was carried out of answers about communication skills, the capability of addressing difficult subjects such as suicidality, and interest in psychiatry. The acceptance rate of SP was very high. Students' ratings of clinical teaching and their own performance, and their interest in future psychiatric work were significantly higher in the SP group. The results of this pilot study are very encouraging and indicate that the systematic use of SP in clinical psychiatric teaching is not only an appropriate alternative to real patients but also can lead to higher quality.

摘要

由于德国新的医学执照法案,现在比以往需要更多的床边教学。对于许多相关的临床病症,预计很少有患者会接受教学课程。这就是为什么许多大学使用模拟患者(SP)。与内科或外科等其他学科不同,关于精神病学和心理治疗中模拟患者的文献并不多。这项试点研究的目的是评估除真实患者外,用于临床教学的模拟患者对模拟精神疾病和临床教学是否能被很好地接受。随机分组后,139名参与研究的医学生中有一半使用真实患者进行教学,另一半则使用真实患者和模拟患者进行教学。两组的患者接触量相等。通过问卷调查,对关于沟通技巧、处理自杀倾向等棘手问题的能力以及对精神病学的兴趣的回答进行了前后分析。模拟患者的接受率非常高。在模拟患者组中,学生对临床教学及其自身表现的评分,以及他们对未来精神科工作的兴趣明显更高。这项试点研究的结果非常令人鼓舞,表明在临床精神病学教学中系统使用模拟患者不仅是真实患者的合适替代方法,而且还能带来更高的质量。

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