Gippsland Medical School, Monash University, Melbourne, Australia.
Acad Med. 2010 May;85(5):889-93. doi: 10.1097/ACM.0b013e3181d749ac.
In this article, the authors consider the role of the patient in simulation-based training and assessment of clinical procedural skills. In recent years, there has been a progressive shift of emphasis from teacher-centered to student-centered education, resulting in a redefinition of approaches to medical education. Traditional models of transmission of information from an expert to a novice have been supplanted by a more student-centered approach. However, medical education is not a matter for teacher and student alone. At the center is always the patient, around whom everything must ultimately rotate. A further shift is occurring. The patient is becoming the focal point of medical teaching and learning. It is argued that this shift is necessary and that simulation in its widest sense can be used to support this process. However, sensitivity to what we are simulating is essential, especially when simulations purport to address patient perspectives. The essay first reviews the history of medical education "centeredness," then outlines ways in which real and simulated patients are currently involved in medical education. Patient-focused simulation (PFS) is described as a means of offering patients' perspectives during the acquisition of clinical procedural and surgical skills. The authors draw on their experiences of developing PFS and preliminary work to "authenticate" simulations from patient perspectives. The essay concludes with speculation on the value of a "complementarity" model that acknowledges the authentic and equal perspectives of patients, students, clinicians, and teachers.
在本文中，作者考虑了患者在基于模拟的临床操作技能培训和评估中的作用。近年来，教学重点已经从以教师为中心逐渐向以学生为中心转变，这导致了医学教育方法的重新定义。从专家向新手传授信息的传统模式已经被一种更加以学生为中心的方法所取代。然而，医学教育不仅仅是教师和学生的事情。始终处于中心位置的是患者，一切都必须围绕着患者展开。现在正在发生进一步的转变。患者正在成为医学教学和学习的焦点。有人认为这种转变是必要的，并且最广泛意义上的模拟可以用于支持这一过程。然而，对我们正在模拟的内容的敏感性至关重要，尤其是当模拟旨在解决患者的观点时。本文首先回顾了医学教育“以中心”的历史，然后概述了目前真实患者和模拟患者在医学教育中的参与方式。将患者为中心的模拟（PFS）描述为在获取临床操作和手术技能期间提供患者观点的一种方式。作者借鉴了他们在开发 PFS 和初步工作方面的经验，从患者的角度对模拟进行了“认证”。本文最后从承认患者、学生、临床医生和教师的真实和平等观点的“互补”模型的价值进行了推测。
