Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Clinical Skills and Standardized Patient Program, Duke University School of Medicine, Durham, North Carolina, USA.
Teach Learn Med. 2020 Apr-May;32(2):139-149. doi: 10.1080/10401334.2019.1652180. Epub 2019 Aug 22.
Virtual standardized patients (SPs) are becoming increasingly common in medical education, though one limitation of SPs is the artificiality of computer-based simulators. Past research on the use of SPs has not clearly established whether learners have different emotional responses to real SPs (SPs) compared with SPs; however, understanding learners' emotional responses to SPs is important in providing realistic learning experiences and establishing the validity of this teaching and assessment tool. This study compared the emotional experiences of individuals who interacted with SPs and SPs. Sixty medical students at a medical school in the southeastern United States participated in the study. Participants were randomly assigned to deliver bad news to an SP or SP. The SP for this study used a hybrid intelligence model that allowed a person to "inhabit" the SP. Salivary cortisol and a self-report measure of mood-the Profile of Mood States, Second Edition (POMS 2)-were gathered before and after delivering the bad news. The SP and 2 independent evaluators rated the behavioral performance of each participant in real and virtual conditions. Participants also rated the performance of the SP. Participants in both conditions reported increased negative emotionality on the POMS 2 following the SP interaction. There were no significant between-group differences on the POMS 2 or salivary cortisol concentration following the SP interaction. Ratings by the SP and independent evaluators indicated that participants performed similarly on most interpersonal dimensions, except tone of voice. Participants perceived the SP as less realistic than the SP. These results suggest that medical students may have similar emotional and behavioral responses when delivering bad news to a SP when compared to an SP. These findings provide support for the continued use of SPs in training learners to deliver bad news and other communication-based skills and to assess their performance on these tasks.
虚拟标准化患者（SP）在医学教育中越来越常见，尽管 SP 的一个限制是基于计算机的模拟器的人为性。过去关于 SP 使用的研究并没有明确确定学习者对真实 SP（SP）与 SP 的情感反应是否不同；然而，了解学习者对 SP 的情感反应对于提供真实的学习体验和建立这种教学和评估工具的有效性非常重要。本研究比较了与 SP 互动的个体的情感体验和 SP。美国东南部一所医学院的 60 名医学生参加了这项研究。参与者被随机分配向 SP 或 SP 传达坏消息。本研究的 SP 使用了一种混合智能模型，允许一个人“居住”在 SP 中。在传达坏消息前后收集唾液皮质醇和心境的自我报告测量-第二版心境量表（POMS 2）。SP 和 2 位独立评估者对每位参与者在真实和虚拟条件下的行为表现进行了评分。参与者还对 SP 的表现进行了评分。在 SP 互动后，两种情况下的参与者在 POMS 2 上报告的负面情绪都增加了。在 SP 互动后，POMS 2 或唾液皮质醇浓度没有显着的组间差异。SP 和独立评估者的评分表明，参与者在大多数人际维度上的表现相似，除了语调。参与者认为 SP 不如 SP 真实。这些结果表明，与 SP 相比，医学生在向 SP 传达坏消息时可能会有类似的情绪和行为反应。这些发现为继续使用 SP 培训学习者传达坏消息和其他基于沟通的技能以及评估他们在这些任务上的表现提供了支持。
