Jacklin Simon, Chapman Stephen, Maskrey Neal
School of Pharmacy, Keele University, Keele, UK.
BMJ Simul Technol Enhanc Learn. 2019 Sep 19;5(4):215-217. doi: 10.1136/bmjstel-2018-000375. eCollection 2019.
Shared decision-making (SDM) involves a healthcare professional and a patient forming a congruent partnership, within which information is shared and decisions are made which align with the patient's values. SDM does not occur to the extent it ought to; SDM requires practice. Virtual reality could help facilitate this practice.
To pilot an interactive, high-fidelity virtual patient (VP) who simulates SDM within a primary care consultation.
Academic pharmacists and doctors were recruited from the Keele University. Participants completed prequestionnaires and postquestionnaires.
18 participants (14 pharmacists and 4 medical doctors) completed the study. 89% (n=16) suggested the VP was 'enjoyable' or 'highly enjoyable' to use and 72% (n=13) suggested it was 'very accessible'. There were diverse views about the way in which the user made their reply to the VP with ratings ranging from 'very poor' (n=2) to 'very good' (n=5); the modal rating was indifference (n=7). It seemed the multiple choice system caused the participants to feel restricted but it was unclear why those who liked the system did so.
The VP was found to be enjoyable and thought-provoking. The data suggest that this type of intervention could be useful at many different stages of a professional's career although the multiple-choice conversation style may be too restrictive for more experienced consulters.
共同决策（SDM）涉及医疗保健专业人员和患者形成一种一致的伙伴关系，在此过程中共享信息并做出符合患者价值观的决策。共同决策并未达到应有的程度；共同决策需要实践。虚拟现实可以帮助促进这种实践。
试用一个交互式、高保真的虚拟患者（VP），该虚拟患者在初级保健咨询中模拟共同决策。
从基尔大学招募学术药剂师和医生。参与者完成了问卷前测和问卷后测。
18名参与者（14名药剂师和4名医生）完成了研究。89%（n = 16）的人表示使用该虚拟患者“令人愉快”或“非常令人愉快”，72%（n = 13）的人表示它“非常容易使用”。对于用户回复虚拟患者的方式存在不同看法，评分从“非常差”（n = 2）到“非常好”（n = 5）不等；最常见的评分是无差异（n = 7）。似乎多项选择系统使参与者感到受限，但不清楚那些喜欢该系统的人为何如此。
发现该虚拟患者令人愉快且发人深省。数据表明，这种类型的干预在专业人员职业生涯的许多不同阶段可能有用，尽管多项选择对话方式对经验更丰富的咨询者来说可能限制过多。
