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标准化患者体验中的学生同理心:从批判性思维模拟模型应用概念。

Student empathy in standardized patient experiences: Applying concepts from a critical thinking emulation model.

机构信息

Department of Preventive and Community Dentistry, Iowa Oral Health Research Institute, Iowa City, Iowa, USA.

出版信息

J Dent Educ. 2023 Dec;87(12):1682-1691. doi: 10.1002/jdd.13352. Epub 2023 Aug 13.

Abstract

INTRODUCTION

Clinician empathy can improve patient outcomes, but the literature is scant on patient-based, student-led experiences to demonstrate the projection of empathy in patient interactions.

PURPOSE/OBJECTIVES: (1) Develop a learning guide for observable behaviors communicating emotional and cognitive empathy and (2) determine whether the learning guide can be used as a rubric for assessing empathy in a standardized patient experience.

METHODS

Eleven standardized patients assessed 80 D3 students using a 4-point interval scale on 19 behavioral criteria in four domains: Initiation (four criteria); Health History and Caries Risk (four criteria); Treatment Planning (six criteria); and Communication Skills (five criteria). Standardized patients also provided qualitative feedback.

RESULTS

Standardized patients completed all 1520 interval scales on the rubric and 94% of 320 open-ended entries. Students performed well. Of the 1520 criterion interval scales, 1242 (81.7%) were rated "excellent." Wilcoxon signed-rank tests revealed Initiation scores (Mean [M] = 3.82, Standard deviation [SD] = 0.28) and Treatment Planning scores (M = 3.82, SD = 0.36) were significantly higher than Health History Scores (M = 3.75, SD = 0.34; p < 0.05). Qualitative feedback also was overwhelmingly positive for Treatment Planning and more equivocal for Health History.

CONCLUSIONS

The emulation model for students to demonstrate observable aspects of empathy is viable as both a learning guide and evaluation rubric in a standardized patient format. The next steps include the development of a succinct skillset for reinforcement in the patient setting and continued discussion on what best captures core observable aspects of empathy.

摘要

简介

临床医生的同理心可以改善患者的治疗效果,但关于基于患者、学生主导的经验来展示同理心在医患互动中的体现的文献却很少。

目的/目标:(1)制定一份用于观察沟通情感和认知同理心的可观察行为的学习指南,(2)确定学习指南是否可用于评估标准化患者体验中的同理心。

方法

11 名标准化患者使用 4 分区间量表对 80 名 D3 学生的 19 项行为标准进行评估,分为四个领域:开始(四项标准);健康史和龋齿风险(四项标准);治疗计划(六项标准);和沟通技巧(五项标准)。标准化患者还提供了定性反馈。

结果

标准化患者完成了量表上的所有 1520 项区间评分,94%的 320 项开放性条目也完成了评分。学生表现良好。在 1520 项标准区间评分中,有 1242 项(81.7%)被评为“优秀”。Wilcoxon 符号秩检验显示,开始(Mean [M] = 3.82,Standard deviation [SD] = 0.28)和治疗计划(M = 3.82,SD = 0.36)的评分显著高于健康史(M = 3.75,SD = 0.34;p < 0.05)。定性反馈对于治疗计划也是压倒性的积极,而对于健康史则更为不确定。

结论

学生模拟展示同理心的可观察方面的模型在标准化患者模式中既可以作为学习指南,也可以作为评估量表,是可行的。下一步包括开发一个简洁的技能集,以在患者环境中进行强化,并继续讨论哪些方面能最好地捕捉同理心的核心可观察方面。

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