Miles Anna, Hayden Sarah, Carnell Stephanie, Halan Shivashankar, Lok Ben
Speech Science, University of Auckland, Auckland, New Zealand.
Virtual Experiences Research Group, University of Florida, Gainesville, Florida, USA.
BMJ Simul Technol Enhanc Learn. 2020 Sep 11;7(4):239-245. doi: 10.1136/bmjstel-2020-000616. eCollection 2021.
Virtual patients have an established place in medical education but do virtual patient interviews train holistic clinicians or just diagnosticians? This study explored speech pathology students' virtual patient interviews using WHO International Classification of Functioning Disability and Health (ICF).
Eighteen speech pathology students in their final year of training participated. Students interviewed virtual patients with dysphagia (swallowing difficulties) as part of their curriculum. Student questions and patient responses were coded using established ICF coding. Codes were tallied and compared under categories of body structures, body functions, activities/participation and environmental factors. Flesch Reading Ease was calculated as a measure of health literacy.
Conversational turns primarily focused on the ICF component-activity and participation in both student questions and virtual patient responses: 0.03% body structures, 30% body functions-swallowing, 7% body functions-associated, 43% activities/participation and 19% environmental factors. Personal factors such as gender, ethnicity, age or socio-economic situation were not mentioned by student or patient. Patients commented on social impact on self and/or family, sometimes in the absence of targeted student questions. Student and virtual patient Flesch Reading Ease scores were congruent.
Speech pathology students naturally matched their virtual patient's health-literacy level and asked a range of medical and daily living questions. Virtual patients readily offered social impact information to student questions. Computer science: healthcare teams should consider creating virtual patients who challenge students to practise asking sensitive questions and in doing so develop holistic thinkers with competent communication skills.
虚拟患者在医学教育中已有一席之地,但虚拟患者访谈培训的是全面的临床医生还是仅仅是诊断医生呢?本研究使用世界卫生组织国际功能、残疾和健康分类(ICF)探讨了言语病理学专业学生的虚拟患者访谈情况。
18名处于培训最后一年的言语病理学专业学生参与了研究。作为课程的一部分,学生们对吞咽困难的虚拟患者进行了访谈。学生的问题和患者的回答使用既定的ICF编码进行编码。对编码进行统计并在身体结构、身体功能、活动/参与和环境因素类别下进行比较。计算弗莱什易读性得分作为健康素养的一项衡量指标。
对话轮次主要集中在ICF的活动和参与部分,无论是学生的问题还是虚拟患者的回答都是如此:身体结构占0.03%,吞咽相关的身体功能占30%,相关身体功能占7%,活动/参与占43%,环境因素占19%。学生或患者均未提及性别、种族、年龄或社会经济状况等个人因素。患者谈到了对自身和/或家庭的社会影响,有时在学生没有针对性提问的情况下也是如此。学生和虚拟患者的弗莱什易读性得分是一致的。
言语病理学专业学生自然地匹配了虚拟患者的健康素养水平,并提出了一系列医疗和日常生活问题。虚拟患者会针对学生的问题提供社会影响方面的信息。计算机科学:医疗团队应考虑创建能促使学生练习询问敏感问题的虚拟患者,从而培养具备良好沟通技能的全面思考者。