Sabzwari Saniya Raghib, Afzal Azam, Nanji Kashmira
Department of Family Medicine, The Aga Khan University, Karachi, Pakistan.
Department of Educational Development, The Aga Khan University, Karachi, Pakistan.
Educ Health (Abingdon). 2017 Jan-Apr;30(1):60-63. doi: 10.4103/efh.EfH_38_16.
The use of simulated patients in student assessment is supported by the Best Evidence Medical Education and U.S. Agency for Healthcare Research and Quality, and it provides a safe and effective alternative to real patients in many situations. To assess the validity and feasibility of moulage technique-where a cosmetically constructed rash is used on simulated patients-two dermatologic rashes were developed using moulage simulation on standardized patients at Aga Khan University Hospital for 3rd year medical summative Objective Structured Clinical Examination (OSCE).
Checklists for cases that focused on history taking of a skin rash were developed. These also included a description and identification of lesions, differential diagnosis, and basic management. Cases were first reviewed and approved by the Educational Committee and a dermatologist content expert. Stations were piloted to assess validity and feasibility. Simple nontoxic materials were used to develop the rash by faculty familiar with moulage simulation.
Sixty-four students were assessed on a Herpes Zoster case and 32 students on a Herpes Simplex case in morning and afternoon sessions. The total mean score obtained at all OSCE stations was 64.82 ± 10.22. Mean scores on the morning and afternoon dermatology stations were 62.72 ± 9.74 and 69.03 ± 9.98, respectively. Face validity for both stations was established through input of content experts. The internal reliability as measured by Cronbach's alpha between the checklist items on the morning and afternoon stations was acceptable at 0.60 (20 items) and 0.65 (18 items), respectively.
The use of moulage technique to develop dermatologic lesions on simulated patients may be utilized for student assessment.
最佳证据医学教育和美国医疗保健研究与质量局支持在学生评估中使用模拟患者，并且在许多情况下，它为真实患者提供了一种安全有效的替代方案。为了评估造型技术（即在模拟患者身上使用美容构建的皮疹）的有效性和可行性，在阿迦汗大学医院对标准化患者进行造型模拟，开发了两种皮肤科皮疹，用于三年级医学总结性客观结构化临床考试（OSCE）。
制定了专注于皮疹病史采集的病例检查表。这些检查表还包括病变的描述和识别、鉴别诊断以及基本管理。病例首先由教育委员会和皮肤科内容专家进行审查和批准。对各站点进行试点以评估有效性和可行性。由熟悉造型模拟的教员使用简单无毒材料来制作皮疹。
在上午和下午的场次中，对64名学生进行了带状疱疹病例评估，对32名学生进行了单纯疱疹病例评估。在所有OSCE站点获得的总平均分数为64.82±10.22。上午和下午皮肤科站点的平均分数分别为62.72±9.74和69.03±9.98。通过内容专家的意见确定了两个站点的表面效度。上午和下午站点检查表项目之间的内部信度，用Cronbach's alpha系数衡量，分别为0.60（20个项目）和0.65（18个项目），是可以接受的。
在模拟患者身上使用造型技术来形成皮肤科病变可用于学生评估。
