同伴角色扮演和标准化患者在沟通培训中的应用：基于学生视角的可接受性、现实性和效果感知的比较研究。
Peer role-play and standardised patients in communication training: a comparative study on the student perspective on acceptability, realism, and perceived effect.
机构信息
Clinic I General Paediatrics, Centre of Child and Adolescent Medicine, Heidelberg, Germany.
出版信息
BMC Med Educ. 2010 Mar 31;10:27. doi: 10.1186/1472-6920-10-27.
BACKGROUND
To assess the student perspective on acceptability, realism, and perceived effect of communication training with peer role play (RP) and standardised patients (SP).
METHODS
69 prefinal year students from a large German medical faculty were randomly assigned to one of two groups receiving communication training with RP (N = 34) or SP (N = 35) in the course of their paediatric rotation. In both groups, training addressed major medical and communication problems encountered in the exploration and counselling of parents of sick children. Acceptability and realism of the training as well as perceived effects and applicability for future parent-physician encounters were assessed using six-point Likert scales.
RESULTS
Both forms of training were highly accepted (RP 5.32 +/- .41, SP 5.51 +/- .44, n.s.; 6 = very good, 1 = very poor) and perceived to be highly realistic (RP 5.60 +/- .38, SP 5.53 +/- .36, n.s.; 6 = highly realistic, 1 = unrealistic). Regarding perceived effects, participation was seen to be significantly more worthwhile in the SP group (RP 5.17 +/- .37, SP 5.50 +/- .43; p < .003; 6 = totally agree, 1 = don't agree at all). Both training methods were perceived as useful for training communication skills (RP 5.01 +/- .68, SP 5.34 +/- .47; 6 = totally agree; 1 = don't agree at all) and were considered to be moderately applicable for future parent-physician encounters (RP 4.29 +/- 1.08, SP 5.00 +/- .89; 6 = well prepared, 1 = unprepared), with usefulness and applicability both being rated higher in the SP group (p < .032 and p < .009).
CONCLUSIONS
RP and SP represent comparably valuable tools for the training of specific communication skills from the student perspective. Both provide highly realistic training scenarios and warrant inclusion in medical curricula. Given the expense of SP, deciding which method to employ should be carefully weighed up. From the perspective of the students in our study, SP were seen as a more useful and more applicable tool than RP. We discuss the potential of RP to foster a greater empathic appreciation of the patient perspective.
背景
评估学生对同伴角色扮演（RP）和标准化患者（SP）沟通培训的可接受性、现实性和感知效果的看法。
方法
从德国一所大型医学院的 69 名预毕业学生中随机分配到两个小组，在儿科轮转期间接受 RP（n = 34）或 SP（n = 35）的沟通培训。在两个小组中，培训都涉及在探索和咨询生病儿童的父母时遇到的主要医学和沟通问题。使用六点李克特量表评估培训的可接受性和现实性，以及感知效果和对未来医患接触的适用性。
结果
两种培训形式都得到了高度认可（RP 5.32 ±.41，SP 5.51 ±.44，无统计学差异；6=非常好，1=非常差），并被认为具有高度现实性（RP 5.60 ±.38，SP 5.53 ±.36，无统计学差异；6=高度现实，1=不现实）。关于感知效果，参与 SP 组被认为更有价值（RP 5.17 ±.37，SP 5.50 ±.43；p <.003；6=完全同意，1=完全不同意）。两种培训方法都被认为对沟通技巧的培训很有用（RP 5.01 ±.68，SP 5.34 ±.47；6=完全同意；1=完全不同意），并且被认为对未来医患接触具有中等适用性（RP 4.29 ± 1.08，SP 5.00 ±.89；6=准备充分，1=准备不充分），SP 组的有用性和适用性评分更高（p <.032 和 p <.009）。
结论
从学生的角度来看，RP 和 SP 都是培训特定沟通技巧的有价值的工具。两者都提供了高度现实的培训场景，值得纳入医学课程。鉴于 SP 的费用，应该仔细权衡选择哪种方法。根据我们研究中的学生的观点，SP 被认为比 RP 更有用和更适用。我们讨论了 RP 促进对患者视角更大的同理心的潜力。
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