Gamble Andree, Bearman Margaret, Nestel Debra
Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Centre for Research in Assessment and Digital Learning, Deakin University, Melbourne, Victoria, Australia.
BMJ Simul Technol Enhanc Learn. 2021 Feb 8;7(5):390-396. doi: 10.1136/bmjstel-2020-000807. eCollection 2021.
Real patients in clinical placements are important for learning and may well be the 'gold standard'. However, simulated patients (SPs) are a viable alternative in the absence of this opportunity. While adult SPs contribute to health professions education, child and adolescent simulated patients (CASPs) are less common. This research aims to explore the perspectives of healthcare educators regarding the engagement of young SPs, specifically the identification of barriers and enablers to involving CASPs.
We used an interpretive paradigm of qualitative description. Thirteen interviewees, all educators involved in SP programmes, participated in semistructured interviews. Data were transcribed verbatim and analysed using an inductive thematic approach.
Not all participants saw value in engaging CASPs. A number of barriers and enablers to involving them were acknowledged in six themes: challenges and concerns; logistical barriers; benefits of CASPs; overcoming challenges; an ethical minefield; and child safety. Opinions differed with respect to feasibility and necessity for involving CASPs, particularly in the hospital setting where real patients are accessible. All participants articulated the critical importance of ensuring adequate support and adherence to ethical principles if CASPs were involved.
The involvement of CASPs in health professions education is a divisive issue. CASPs' ability to provide a realistic option for supporting learning is recognised yet perhaps not wholly perceived as a feasible alternative to real patients. Their engagement raises critical ethical, practical, logistical and financial challenges.
临床实习中的真实患者对学习很重要,很可能是“黄金标准”。然而,在没有这种机会的情况下,模拟患者(SPs)是一种可行的替代方案。虽然成人模拟患者有助于卫生专业教育,但儿童和青少年模拟患者(CASPs)则不太常见。本研究旨在探讨医疗保健教育工作者对年轻模拟患者参与情况的看法,特别是确定涉及儿童和青少年模拟患者的障碍和促进因素。
我们采用了定性描述的解释性范式。13名受访者均为参与模拟患者项目的教育工作者,他们参与了半结构化访谈。数据逐字转录,并采用归纳主题法进行分析。
并非所有参与者都认为让儿童和青少年模拟患者参与有价值。在六个主题中确认了一些涉及他们的障碍和促进因素:挑战与担忧;后勤障碍;儿童和青少年模拟患者的益处;克服挑战;道德雷区;以及儿童安全。对于让儿童和青少年模拟患者参与的可行性和必要性,意见存在分歧,特别是在可以接触到真实患者的医院环境中。所有参与者都明确表示,如果涉及儿童和青少年模拟患者,确保提供充分支持并遵守道德原则至关重要。
儿童和青少年模拟患者参与卫生专业教育是一个有争议的问题。儿童和青少年模拟患者为支持学习提供现实选择的能力得到认可,但可能并未被完全视为真实患者的可行替代方案。他们的参与引发了关键的伦理、实践、后勤和财务挑战。