Furman Gail E
Clinical Skills Evaluation Collaboration, National Board of Medical Examiners, Philadelphia 19147, USA.
Kaohsiung J Med Sci. 2008 Dec;24(12):651-5. doi: 10.1016/S1607-551X(09)70031-2.
For over 30 years, medical educators have used standardized patients (SPs), laypersons trained to portray a patient case in a realistic manner, to teach and to assess clinical skills. All medical schools in the US have SP programs in place, and the US and Canada require national examinations using SPs to assess the competency of those wishing to obtain licensure to practice medicine in these countries. To ensure a valid and reliable examination, unwanted variance that can be introduced by SP performance must be addressed. The goal of SP training is to imbue the SP with the characteristics, mannerisms and history of a real patient so that the portrayal is consistent and accurate. The challenge is to ensure consistent portrayal of each case with sufficient realism to elicit the expected clinical performance and to ensure standardized SP performance across multiple examinees. This paper considers the quality assurance methods applied to training the SP trainers and the protocols used to train the SPs, to ensure that the SP performances are sufficiently accurate and standardized, and that the evaluators completing the checklists and scales used for scoring do so correctly and consistently.
30多年来，医学教育工作者一直使用标准化病人（SPs），即经过培训能够逼真地扮演患者病例的非专业人员，来进行临床技能教学和评估。美国所有医学院校都设有标准化病人项目，并且美国和加拿大要求使用标准化病人进行国家考试，以评估那些希望在这些国家获得行医执照者的能力。为确保考试的有效性和可靠性，必须解决标准化病人表现可能引入的不必要差异。标准化病人培训的目标是使标准化病人具备真实患者的特征、举止和病史，以便其扮演一致且准确。挑战在于确保每个病例的扮演具有足够的逼真度，以引发预期的临床反应，并确保在多个考生中标准化病人的表现一致。本文探讨了应用于培训标准化病人培训师的质量保证方法以及用于培训标准化病人的方案，以确保标准化病人的表现足够准确和标准化，并且完成用于评分的检查表和量表的评估人员能够正确且一致地进行评分。
