Simek-Downing L, Quirk M E, Letendre A J
Fam Med. 1986 Nov-Dec;18(6):358-60.
This research project investigates the value of using simulated v. real patients in teaching interviewing skills to third- and fourth-year medical students on a clerkship in family and community medicine. Sixty-four medical students (38 males, 28 females) were asked to make a videotaped patient interview at the beginning of the clerkship. Forty-one of the students interviewed trained, simulated patients and 22 interviewed real patients at their clerkship site. Students received feedback and faculty teaching of interviewing skills after the first interview. All students made another videotaped interview with a simulated patient at the conclusion of the clerkship. All interviews, pre- and post-clerkship, were scored for interviewing skills, focal areas, and nonverbal language. Multivariate and univariate analyses of pre- and post-interviews found simulated patients to be of most value in teaching medical students verbal interviewing skills and real patients to be of most value in teaching the focal content areas of the interview. Recommendations were made to include use of both simulated and real patients in the teaching of medical interviewing.
本研究项目调查了在家庭和社区医学实习中，使用模拟患者与真实患者来教授三、四年级医学生问诊技巧的价值。64名医学生（38名男性，28名女性）在实习开始时被要求进行一次患者问诊录像。其中41名学生采访了经过培训的模拟患者，22名学生在其实习地点采访了真实患者。第一次采访后，学生们收到了关于问诊技巧的反馈及教师指导。在实习结束时，所有学生都与一名模拟患者进行了另一次问诊录像。实习前后的所有采访都针对问诊技巧、重点领域和非语言交流进行了评分。对采访前后的多变量和单变量分析发现，模拟患者在教授医学生言语问诊技巧方面最有价值，而真实患者在教授问诊重点内容领域方面最有价值。研究建议在医学问诊教学中同时使用模拟患者和真实患者。
