da Cunha Oliveira Mônica, Silva Menezes Marta, Cunha de Oliveira Yasmin, Marques Vilas Bôas Lígia, Villa Nova Aguiar Carolina, Gomes Silva Mary
Bahiana School of Medicine and Public Health, Salvador, BA, Brazil.
PEC Innov. 2022 Nov 24;2:100106. doi: 10.1016/j.pecinn.2022.100106. eCollection 2023 Dec.
To analyze the medical students' perception about simulated consultations before and after training using the SPIKES protocol.
Quasi-experimental study, with a qualitative approach. It counted with the participation of 20 students as Simulated Physicians (SF), and 20 students as Simulated Patients (SP), all belonging to a medical course. Data were obtained from the responses given to a reflective question, applied before and after training with the SPIKES. The treatment and the analysis of the data were guided by the stages of thematic analysis.
In the category "Simulated Medical Student's Self-Perception", the subcategories "Nervousness and Insecurity" were predominant after the first consultation, while "Tranquility and Security" after the second consultation after training. In the category "Simulated Medical Student's Perception about the Educational Process", the subcategory "Reflective Learning" emerged in the students' speeches, especially after the second consultation. In the speeches of SP, it was evidenced the improvement of the care provided by SF after training.
The strategy used for the development of communication skills showed evidence of short-term effectiveness.
The research resulted in a teaching protocol for students in pre-clinical stages that involves four stages: simulation, self-assessment, feedback and new simulations.
分析医学生在使用SPIKES协议进行培训前后对模拟会诊的认知。
采用定性方法的准实验研究。20名学生作为模拟医生（SF），20名学生作为模拟患者（SP）参与研究，他们均来自某医学课程。数据来自于在使用SPIKES协议培训前后对一个反思性问题的回答。数据的处理和分析以主题分析阶段为指导。
在“模拟医学生的自我认知”类别中，第一次会诊后“紧张与不安全感”子类别占主导，而培训后的第二次会诊后“平静与安全感”占主导。在“模拟医学生对教育过程的认知”类别中，“反思性学习”子类别出现在学生的发言中，尤其是在第二次会诊后。在模拟患者的发言中，证明了培训后模拟医生提供的护理有所改善。
用于培养沟通技能的策略显示出短期有效性的证据。
该研究产生了一种针对临床前阶段学生的教学协议，包括四个阶段：模拟、自我评估、反馈和新的模拟。
