Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2019 Jun;82(6):464-468. doi: 10.1097/JCMA.0000000000000109.
Problem-based learning (PBL) has been widely adopted in medical education; however, its application has been questioned due to the lack of interaction with a real patient. Standardized patients (SPs) might solve this problem. Herein, we tested the impact of integrating SPs in a PBL tutorial.
In 2017, a total of 313 students, 66 facilitators, and 36 SPs were enrolled at National Yang-Ming University, Taiwan. The SPs presented the symptoms/signs of the cases then the students interviewed them to obtain the detail history. All students, facilitators, and SPs were invited to complete the questionnaires before and after this program.
Most SPs considered that both the second-year dental medical student and third-year medical students participated actively and were competent enough but students and facilitators considered that the fourth-year medical students might be more prepared. Overall, the students thought highly of the interactions with the SPs. Only about one-fifth felt that this design caused unnecessary pressure among the students and facilitators. They agreed that this program significantly inspired the student's learning motivation (pre- vs post-course: 4.1 ± 0.7 vs 4.3 ± 0.7, p < 0.001), increased their confidence level in interviewing patients (4.0 ± 0.8 vs 4.2 ± 0.7, p < 0.001), and encouraging critical thinking (4.0 ± 0.7 vs 4.2 ± 0.7, p < 0.001).
The SPs, facilitators, and students had different viewpoints with regards to integrating SPs in the PBL tutorial. However, a majority agreed that this design enhanced the motivation of students and supported such an application in PBL tutorials.
基于问题的学习(PBL)已在医学教育中广泛应用;然而,由于缺乏与真实患者的互动,其应用受到了质疑。标准化患者(SP)可能解决这个问题。在此,我们测试了在 PBL 辅导中整合 SP 的影响。
2017 年,台湾阳明大学共招募了 313 名学生、66 名辅导员和 36 名 SP。SP 呈现病例的症状/体征,然后学生对他们进行访谈以获取详细病史。所有学生、辅导员和 SP 都被邀请在该项目前后完成问卷。
大多数 SP 认为,二年级牙医学学生和三年级医学生都积极参与,能力足够,但学生和辅导员认为,四年级医学生可能准备更充分。总体而言,学生对与 SP 的互动评价很高。只有约五分之一的人认为这种设计给学生和辅导员带来了不必要的压力。他们认为该课程显著激发了学生的学习动机(课前 vs 课后:4.1 ± 0.7 vs 4.3 ± 0.7,p < 0.001),增加了他们对患者访谈的信心水平(4.0 ± 0.8 vs 4.2 ± 0.7,p < 0.001),并鼓励批判性思维(4.0 ± 0.7 vs 4.2 ± 0.7,p < 0.001)。
SP、辅导员和学生对于在 PBL 辅导中整合 SP 有不同的看法。然而,大多数人认为这种设计增强了学生的学习动机,并支持在 PBL 辅导中应用这种设计。