Pritchard Shane A, Blackstock Felicity C, Nestel Debra, Keating Jenny L
S.A. Pritchard, BPhysio, Department of Physiotherapy, Monash University, PO Box 527, Frankston, Victoria 3199, Australia.
F.C. Blackstock, PhD, Department of Physiotherapy, La Trobe University, Melbourne, Victoria, Australia.
Phys Ther. 2016 Sep;96(9):1342-53. doi: 10.2522/ptj.20150500. Epub 2016 Mar 3.
Traditional models of physical therapy clinical education are experiencing unprecedented pressures. Simulation-based education with simulated (standardized) patients (SPs) is one alternative that has significant potential value, and implementation is increasing globally. However, no review evaluating the effects of SPs on professional (entry-level) physical therapy education is available.
The purpose of this study was to synthesize and critically appraise the findings of empirical studies evaluating the contribution of SPs to entry-level physical therapy education, compared with no SP interaction or an alternative education strategy, on any outcome relevant to learning.
A systematic search was conducted of Ovid MEDLINE, PubMed, AMED, ERIC, and CINAHL Plus databases and reference lists of included articles, relevant reviews, and gray literature up to May 2015.
Articles reporting quantitative or qualitative data evaluating the contribution of SPs to entry-level physical therapy education were included.
Two reviewers independently extracted study characteristics, intervention details, and quantitative and qualitative evaluation data from the 14 articles that met the eligibility criteria.
Pooled random-effects meta-analysis indicated that replacing up to 25% of authentic patient-based physical therapist practice with SP-based education results in comparable competency (mean difference=1.55/100; 95% confidence interval=-1.08, 4.18; P=.25). Thematic analysis of qualitative data indicated that students value learning with SPs.
Assumptions were made to enable pooling of data, and the search strategy was limited to English.
Simulated patients appear to have an effect comparable to that of alternative educational strategies on development of physical therapy clinical practice competencies and serve a valuable role in entry-level physical therapy education. However, available research lacks the rigor required for confidence in findings. Given the potential advantages for students, high-quality studies that include an economic analysis should be conducted.
物理治疗临床教育的传统模式正面临前所未有的压力。基于模拟（标准化）患者（SPs）的模拟教育是一种具有重大潜在价值的替代方案，且在全球范围内的应用正在增加。然而，尚无评估SPs对专业（入门级）物理治疗教育效果的综述。
本研究的目的是综合并批判性地评价实证研究的结果，这些研究评估了与无SP互动或替代教育策略相比，SPs对入门级物理治疗教育在任何与学习相关结果方面的贡献。
对Ovid MEDLINE、PubMed、AMED、ERIC和CINAHL Plus数据库以及截至2015年5月纳入文章的参考文献列表、相关综述和灰色文献进行了系统检索。
纳入报告定量或定性数据以评估SPs对入门级物理治疗教育贡献的文章。
两名评审员独立从符合纳入标准的14篇文章中提取研究特征、干预细节以及定量和定性评估数据。
随机效应合并荟萃分析表明，用基于SP的教育替代高达25%的基于真实患者的物理治疗师实践可产生相当的能力（平均差异 = 1.55/100；95%置信区间 = -1.08，4.18；P = 0.25）。定性数据的主题分析表明，学生重视与SPs一起学习。
为了能够合并数据做了一些假设，并且检索策略仅限于英文。
模拟患者在物理治疗临床实践能力发展方面似乎具有与替代教育策略相当的效果，并且在入门级物理治疗教育中发挥着重要作用。然而，现有研究缺乏对研究结果有信心所需的严谨性。鉴于对学生的潜在优势，应开展包括经济分析的高质量研究。
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