Alsaad Ali A, Davuluri Swetha, Bhide Vandana Y, Lannen Amy M, Maniaci Michael J
Department of Internal Medicine, Mayo Clinic.
University of Miami, Coral Gables.
Adv Med Educ Pract. 2017 Jul 18;8:481-486. doi: 10.2147/AMEP.S134235. eCollection 2017.
Conducting simulations of rapidly decompensating patients are a key part of internal medicine (IM) residency training. Traditionally, mannequins have been the simulation tool used in these scenarios.
To compare IM residents' performance and assess realism in specific-simulated decompensating patient scenarios using standardized patients (SPs) as compared to mannequin.
Nineteen IM residents were randomized to undergo simulations using either a mannequin or an SP. Each resident in the two groups underwent four different simulation scenarios (calcium channel blocker overdose, severe sepsis, severe asthma exacerbation, and acute bacterial meningitis). Residents completed pretest and post-test evaluations as well as a questionnaire to assess the reality perception (realism score).
Nine residents completed mannequin-based scenarios, whereas 10 completed SP-based scenarios. Improvement in the post-test scores was seen in both groups. However, there were significantly higher post-test scores achieved with SP simulations in three out of the four scenarios (=0.01). When compared with the mannequin group, the SP simulation group showed a significantly higher average realism score (=0.002).
Applying SP-based specific-simulation scenarios in IM residency training may result in better performance and a higher sense of a realistic experience by medical residents.
对快速失代偿患者进行模拟是内科住院医师培训的关键部分。传统上，人体模型一直是这些场景中使用的模拟工具。
比较内科住院医师在使用标准化患者（SP）与人体模型的特定模拟失代偿患者场景中的表现，并评估逼真度。
19名内科住院医师被随机分配使用人体模型或标准化患者进行模拟。两组中的每位住院医师都要经历四种不同的模拟场景（钙通道阻滞剂过量、严重脓毒症、严重哮喘发作和急性细菌性脑膜炎）。住院医师完成了预测试和后测试评估以及一份用于评估现实感知（逼真度评分）的问卷。
9名住院医师完成了基于人体模型的场景，而10名完成了基于标准化患者的场景。两组在后测试分数上均有提高。然而，在四个场景中的三个场景中，标准化患者模拟的后测试分数显著更高（=0.01）。与人体模型组相比，标准化患者模拟组的平均逼真度评分显著更高（=0.002）。
在内科住院医师培训中应用基于标准化患者的特定模拟场景可能会使住院医师表现更好，并获得更高的真实体验感。
