Gupta Akriti, Singh Satendra, Khaliq Farah, Dhaliwal Upreet, Madhu S V
Department of Physiology, University College of Medical Sciences and Guru Teg Bahadur Hospital , Delhi , India.
Medical Education Unit, University College of Medical Sciences and Guru Teg Bahadur Hospital , Delhi , India.
Adv Physiol Educ. 2018 Mar 1;42(1):15-20. doi: 10.1152/advan.00110.2017.
In the country presently, preclinical medical students are not routinely exposed to real patients. Thus, when they start clinical postings, they are found to have poor clinical reasoning skills. Simulated virtual patients (SVPs) can improve clinical skills without endangering real patients. This pilot study describes the development of two SVPs in endocrine physiology and their validation in terms of acquisition of clinical knowledge and student engagement. Two SVPs, Nandini Sharma (unintentional weight gain) and Sunil Yadav (polyuria), were created and published on the i-Human Patients platform through an iterative, interdisciplinary, and transdisciplinary collaborative process using the conceptual framework of Kim et al. (Kim S, Phillips WR, Pinsky L, Brock D, Phillips K, Keary J. Med Educ 40: 867-876, 2006). After internal and external peer validation, the SVPs were piloted on 40 students (20 students per virtual patient) over 2 wk. A cognitive pretest was conducted before exposure, and a posttest soon after. Faculty and student feedback were collected. Faculty found SVPs authentic, helpful as teaching-learning tools, and useful for giving feedback and for assessment. Students found SVPs more engaging than paper cases and helpful in developing clinical reasoning and in imparting clinical exposure. Pretest and posttest scores indicated knowledge gain ( P < 0.01). Although challenging to create, SVPs created on the i-Human Patients platform improved learning in endocrine physiology and were well accepted by students and faculty as a means to provide early clinical exposure. More SVPs can be developed through collaboration between stakeholder departments and integrated into the curriculum for greater benefit.
目前在该国，临床前医学生没有常规接触真实患者。因此，当他们开始临床实习时，发现他们的临床推理能力较差。模拟虚拟患者（SVP）可以提高临床技能，而不会危及真实患者。这项试点研究描述了两个内分泌生理学SVP的开发及其在临床知识获取和学生参与度方面的验证。通过使用Kim等人的概念框架（Kim S，Phillips WR，Pinsky L，Brock D，Phillips K，Keary J.Med Educ 40：867 - 876，2006），通过迭代、跨学科和跨领域的协作过程，创建了两个SVP，Nandini Sharma（无意体重增加）和Sunil Yadav（多尿），并在i-Human Patients平台上发布。经过内部和外部同行验证后，在两周内对40名学生（每个虚拟患者20名学生）进行了SVP试点。在接触前进行了认知预测试，接触后不久进行了后测试。收集了教师和学生的反馈。教师认为SVP真实、作为教学工具很有帮助，并且对提供反馈和评估很有用。学生发现SVP比纸质病例更具吸引力，有助于培养临床推理能力和提供临床接触机会。预测试和后测试分数表明知识有所增加（P < 0.01）。尽管创建SVP具有挑战性，但在i-Human Patients平台上创建的SVP改善了内分泌生理学的学习，并且作为提供早期临床接触的一种手段，受到了学生和教师的广泛接受。通过利益相关部门之间的合作可以开发更多的SVP，并将其纳入课程以获得更大的益处。
