Baillie Sarah, Pierce Stephanie E, May Stephen A
Veterinary Education, Royal Veterinary College, Hertfordshire, UK.
J Vet Med Educ. 2010 Fall;37(3):248-53. doi: 10.3138/jvme.37.3.248.
Teaching and learning in a clinical setting is important in veterinary and medical training but presents many challenges, including providing enough hands-on experience while not putting patients (animal or human) at risk. Some of the issues have been addressed with the introduction of clinical skills laboratories and communication skills training using role play. However, in both instances skills are learned in isolation, whereas the real task requires the integration of many skills including technical competencies, effective communication, decision making, and professionalism. In our study, we trialed "contextualized simulation" by combining role play with a simulator, the haptic cow, in a small-group tutorial, the Simulated Fertility Visit. Students took turns as the veterinarian; they had to establish the cow's history from the farmer (a role player), palpate the simulation, make a diagnosis, and decide on treatment, if appropriate. We included scenarios varying from common cases to challenging situations. The tutorial was introduced in the farm-animal clinical rotation, and feedback was gathered from students by means of a questionnaire. The tutorial was attended by 178 students (98% of that year's students), and 151 questionnaires were returned (85% response rate). Students reported that the tutorial was a positive learning experience and recognized that it presented an opportunity to integrate the skills needed for clinical work. Student feedback suggests that contextualized simulation provides a valuable complement to clinical cases, and we recommend extending this teaching method to other clinical scenarios and species, particularly because it provides a safe environment in which to experience, and learn from, mistakes.
在临床环境中的教学与学习在兽医和医学培训中很重要，但也带来了许多挑战，包括在不使患者（动物或人类）面临风险的情况下提供足够的实践经验。随着临床技能实验室的引入以及使用角色扮演进行沟通技能培训，一些问题得到了解决。然而，在这两种情况下，技能都是孤立学习的，而实际任务需要整合多种技能，包括技术能力、有效沟通、决策和专业素养。在我们的研究中，我们在一个名为“模拟生育就诊”的小组辅导中，通过将角色扮演与模拟器“触觉奶牛”相结合，试用了“情境模拟”。学生轮流扮演兽医；他们必须从农民（一名角色扮演人员）那里了解奶牛的病史，触摸模拟奶牛进行检查，做出诊断，并在适当的时候决定治疗方案。我们纳入了从常见病例到具有挑战性情况的各种场景。该辅导在农场动物临床轮转中进行，并通过问卷调查收集学生的反馈。178名学生参加了该辅导（占当年学生的98%），共收回151份问卷（回复率为85%）。学生们报告说，该辅导是一次积极的学习经历，并认识到它提供了一个整合临床工作所需技能的机会。学生反馈表明，情境模拟为临床病例提供了有价值的补充，我们建议将这种教学方法扩展到其他临床场景和物种，特别是因为它提供了一个安全的环境，在其中可以体验并从错误中学习。
