Galland J, Abbara S, Terrier B, Samson M, Tesnières A, Fournier J P, Braun M
Département de médecine interne et d'immunologie clinique, CHRU de Nancy-Brabois, bâtiment Philippe-Canton, rue du Morvan, 54511 Vandœuvre-les-Nancy, France; Faculté de médecine de Nancy, centre universitaire d'enseignement par la simulation médicale, université de Lorraine, Nancy, France.
Service de médecine interne, centre de référence des maladies lysosomales, université Paris 7 Diderot, hôpital Beaujon, Assistance publique-Hôpitaux de Paris (AP-HP), 100, boulevard du Général-Leclerc, 92110 Clichy, France.
Rev Med Interne. 2018 Jun;39(6):414-420. doi: 10.1016/j.revmed.2017.11.011. Epub 2018 Mar 13.
Simulation-based learning (SBL) is developing rapidly in France and the question of its use in the teaching of internal medicine (IM) is essential. While HAS encourages its integration into medical education, French Young Internists (AJI) set up a working group to reflect on the added-value of this tool in our specialty. Different sorts of SBL exist: human, synthetic and electronic. It enables student to acquire and evaluate technical skills (strengths, invasive procedures, etc.) and non-technical skills (relational, reasoning…). The debriefing that follows the simulation session is an essential time in pedagogical terms. It enables the acquisition of knowledge by encouraging the students' reflection to reshape their reasoning patterns by self-correcting. IM interns are supportive of its use. The simulation would allow young internists to acquire skills specific to our specialty such as certain gestures, complex consulting management, the synthesis of difficult clinical cases. SBL remains confronted with human and financial cost issues. The budgets allocated to the development and maintenance of simulation centres are uneven, making the supply of training unequal on the territory. Simulation sessions are time-consuming and require teacher training. Are faculties ready to train and invest their time in simulation, even though the studies do not allow us to conclude on its pedagogical validity?
基于模拟的学习（SBL）在法国发展迅速，其在内科医学（IM）教学中的应用问题至关重要。虽然法国卫生高级管理局鼓励将其纳入医学教育，但法国年轻内科医生（AJI）成立了一个工作组，以思考该工具在我们专业中的附加值。存在不同类型的SBL：真人模拟、虚拟模拟和电子模拟。它使学生能够获得和评估技术技能（如操作技能、侵入性操作等）和非技术技能（人际关系、推理……）。模拟课程后的总结讨论在教学方面是一个重要环节。它通过鼓励学生反思，以自我纠正的方式重塑其推理模式，从而促进知识的获取。内科实习医生支持其使用。模拟将使年轻内科医生获得我们专业特有的技能，如某些操作手法、复杂会诊管理、疑难临床病例的综合分析。SBL仍然面临人力和资金成本问题。分配给模拟中心建设和维护的预算不均衡，导致各地的培训资源供应不平等。模拟课程耗时且需要教师培训。尽管研究尚未让我们得出关于其教学有效性的结论，但各医学院是否准备好投入时间进行模拟培训和投资呢？
