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标准化病人在亲密伴侣暴力教学中的应用。

Standardized Patients to Teach Medical Students about Intimate Partner Violence.

机构信息

Emory University School of Medicine, Department of Emergency Medicine, Atlanta, GA.

出版信息

West J Emerg Med. 2010 Dec;11(5):500-5.

PMID:21293773
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3027446/
Abstract

OBJECTIVE

To use 360-degree evaluations within an Observed Structured Clinical Examination (OSCE) to assess medical student comfort level and communication skills with intimate partner violence (IPV) patients.

METHODS

We assessed a cohort of fourth year medical students' performance using an IPV standardized patient (SP) encounter in an OSCE. Blinded pre- and post-tests determined the students' knowledge and comfort level with core IPV assessment. Students, SPs and investigators completed a 360-degree evaluation that focused on each student's communication and competency skills. We computed frequencies, means and correlations.

RESULTS

Forty-one students participated in the SP exercise during three separate evaluation periods. Results noted insignificant increase in students' comfort level pre-test (2.7) and post-test (2.9). Although 88% of students screened for IPV and 98% asked about the injury, only 39% asked about verbal abuse, 17% asked if the patient had a safety plan, and 13% communicated to the patient that IPV is illegal. Using Likert scoring on the competency and overall evaluation (1, very poor and 5, very good), the mean score for each evaluator was 4.1 (competency) and 3.7 (overall). The correlations between trainee comfort level and the specific competencies of patient care, communication skill and professionalism were positive and significant (p<0.05).

CONCLUSION

Students felt somewhat comfortable caring for patients with IPV. OSCEs with SPs can be used to assess student competencies in caring for patients with IPV.

摘要

目的

在观察性结构临床考试(OSCE)中使用 360 度评估来评估医学生与亲密伴侣暴力(IPV)患者的舒适度和沟通技巧。

方法

我们使用 OSCE 中的 IPV 标准化患者(SP)遭遇来评估一组四年级医学生的表现。盲法预测试和后测试确定了学生对核心 IPV 评估的知识和舒适度。学生、SP 和调查员完成了一项 360 度评估,重点关注每个学生的沟通和能力技能。我们计算了频率、平均值和相关性。

结果

41 名学生在三个单独的评估期内参加了 SP 练习。结果表明,学生的舒适度在预测试(2.7)和后测试(2.9)中没有显著增加。尽管 88%的学生对 IPV 进行了筛查,98%的学生询问了伤害情况,但只有 39%的学生询问了言语虐待,17%的学生询问了患者是否有安全计划,13%的学生向患者传达了 IPV 是非法的。使用 1 分(非常差)和 5 分(非常好)的李克特评分,每位评估者的平均得分为 4.1(能力)和 3.7(整体)。培训师的舒适度与患者护理、沟通技巧和专业精神等特定能力之间的相关性呈正相关且具有统计学意义(p<0.05)。

结论

学生在照顾 IPV 患者方面感到有些舒适。使用 SP 的 OSCE 可用于评估学生照顾 IPV 患者的能力。

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本文引用的文献

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"Breaking bad news": standardized patient intervention improves communication skills for hematology-oncology fellows and advanced practice nurses.“告知坏消息”:标准化患者干预可提高血液肿瘤学住院医师和高级执业护士的沟通技巧。
J Cancer Educ. 2009;24(2):154-9. doi: 10.1080/08858190902854848.
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Quality of standardised patient research reports in the medical education literature: review and recommendations.医学教育文献中标准化病人研究报告的质量:综述与建议
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Domestic violence: a national simulation-based educational program to improve physicians' knowledge, skills and detection rates.家庭暴力:一项基于模拟的全国性教育项目,旨在提高医生的知识、技能和识别率。
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The Emergency Medicine Subinternship--an educator's guide to planning and administration.急诊医学实习轮转——教育工作者的规划与管理指南
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Use of standardized patients to enhance a psychiatry clerkship.使用标准化病人来加强精神病学临床实习。
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Domestic violence: increasing knowledge and improving skills with a four-hour workshop using standardized patients.家庭暴力:通过使用标准化病人的四小时工作坊增加知识并提高技能
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Do responses to an intimate partner violence screen predict scores on a comprehensive measure of intimate partner violence in low-income black women?对亲密伴侣暴力筛查的反应能否预测低收入黑人女性亲密伴侣暴力综合测量的得分?
Ann Emerg Med. 2003 Oct;42(4):483-91. doi: 10.1067/s0196-0644(03)00718-2.
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Validity and the OSCE.效度与客观结构化临床考试
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Setting defensible performance standards on OSCEs and standardized patient examinations.制定客观结构化临床考试(OSCE)和标准化患者检查的合理性能标准。
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The use of standardized patients within a procedural competency model to teach death disclosure.在程序能力模型中使用标准化患者来教授死亡告知。
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