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多源评估一项针对医学生使用标准化患者进行访谈/采集临床病史的教育项目。

Multi-source evaluation of an educational program aimed at medical students for interviewing/taking the clinical history using standardized patients.

机构信息

Francisco de Vitoria University, Faculty of Health Sciences, School of Medicine, Madrid, Spain.

出版信息

GMS J Med Educ. 2021 Feb 15;38(2):Doc40. doi: 10.3205/zma001436. eCollection 2021.

Abstract

Simulations with standardized patients (SP) have long been used for teaching/assessing communication skills. The present study describes and evaluates an experiential training methodology aimed at medical students and based on interviews with standardized simulated patients. The training was focused on developing basic communication skills and taking medical histories. Longitudinal observational study of a cohort of third-year medical students. Three interviews with SP were carried out and videotaped. These interviews were assessed by the students, the SPs and the professors of the relevant subject areas. 83 students conducted the interviews. The self-evaluations performed by the students showed an improvement between the first and third interviews, as demonstrated by the increase of 6.7% (CI 95%=3.6-10.0%) (p<0.001) in the percentage of detected items. The SPs stated an improvement of 8.5% (CI 95%=2.9-14.1) (p=0.003) from the first to the third interview regarding the percentage of students that showed a level of interest in, and ease with, the patients' concerns. Finally, the teachers found a mean percentage of items identified in the third written clinical history of 61.4% (CI 95%=59.1-63.7) of the total available. This educational program, carried out with standardized simulated patients, showed positive signs of improvement from the first to the third interview, in both the student self-evaluations and the level of interest and ease perceived by the SPs. Additionally, the mean level of information recorded in the written medical histories was considered to be acceptable.

摘要

使用标准化患者(SP)进行模拟已经长期用于教授/评估沟通技巧。本研究描述并评估了一种针对医学生的体验式培训方法,该方法基于与标准化模拟患者的访谈。培训重点是发展基本的沟通技巧和采集病史。

对三年级医学生队列进行的纵向观察研究。与 SP 进行了三次访谈并进行了录像。学生、SP 和相关学科领域的教授对这些访谈进行了评估。

83 名学生进行了访谈。学生进行的自我评估显示,第一次和第三次访谈之间有所改善,通过增加 6.7%(95%CI 3.6-10.0%)(p<0.001)来证明,即发现项目的百分比增加了。SP 表示,从第一次到第三次访谈,在学生对患者关注的兴趣程度和舒适度方面,有 8.5%(95%CI 2.9-14.1)(p=0.003)的提高。最后,教师在第三次书面临床病史中发现了 61.4%(95%CI 95%=59.1-63.7)的可利用项目的平均百分比。

这个教育计划,与标准化模拟患者一起进行,在学生自我评估和 SP 感知的兴趣和舒适度方面,从第一次到第三次访谈都显示出积极的改善迹象。此外,书面病历中记录的信息的平均水平被认为是可以接受的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8629/7958917/8a79d07b4b8c/JME-38-40-t-001.jpg

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