Charité-University Medicine Berlin, Germany.
Acad Med. 2012 Feb;87(2):179-84. doi: 10.1097/ACM.0b013e31823f7105.
This study explored third-year clinical teaching encounters from the perspective of the simulated patient (SP) participants.
In August through December 2008, to obtain data from SPs, the authors used retrospective Think Aloud (rTA) methodology on video recordings of teaching sessions in which the respective SPs had participated. While watching the video, SPs were instructed to speak aloud their thoughts in response to the question "What made you feel comfortable or uncomfortable during the session?" Recordings of rTA exercises were analyzed by qualitative content analysis.
From 27 teaching sessions with 23 different teachers, 269 relevant comments were extracted and categorized. SPs felt comfortable if the atmosphere was calm (10 comments), appropriate physical contact was established (8), the student attended to the patient (8), the student acted in a well-structured manner (7), and the role-play was well structured by the clinical teacher (7). SPs felt uncomfortable if they were excluded from communication (16), actions were not properly explained (14), students did not attend to the patient (10), students did not stay in their role (10), and everyone talked at the same time (8).
SPs highly valued a clear structure of the teaching setting and appropriate preparation and good communication skills on the students' part. Many of the aspects of teaching quality were found to be under the influence of the clinical teacher and may, therefore, be important for teacher training.
本研究从模拟患者(SP)参与者的角度探讨了第三年临床教学体验。
2008 年 8 月至 12 月,为了从 SP 处获取数据,作者使用回溯性出声思维(rTA)方法对 SP 参与的教学课程的录像进行分析。在观看视频时,要求 SP 针对“在课程中,哪些因素让您感到舒适或不舒适?”这个问题,大声说出自己的想法。通过定性内容分析对 rTA 练习的录音进行分析。
从 27 次教学活动(涉及 23 位不同的教师)中,共提取并分类了 269 条相关评论。如果课堂气氛平静(10 条评论)、建立了适当的身体接触(8 条评论)、学生关注患者(8 条评论)、学生表现出良好的结构化行为(7 条评论)、临床教师很好地组织了角色扮演(7 条评论),SP 会感到舒适。如果 SP 被排除在交流之外(16 条评论)、行动没有得到适当解释(14 条评论)、学生不关注患者(10 条评论)、学生不扮演角色(10 条评论)、大家同时发言(8 条评论),SP 会感到不舒服。
SP 高度重视教学环境的清晰结构以及学生适当的准备和良好的沟通技巧。教学质量的许多方面都受到临床教师的影响,因此,这可能是教师培训的重要内容。