University of Exeter, Exeter, UK.
Clin Teach. 2024 Apr;21(2):e13681. doi: 10.1111/tct.13681. Epub 2023 Oct 20.
Breaking bad news is an imperative skill for clinical practice that health care professionals struggle with. Virtual patients have been adopted as a new teaching aide in medical education and have shown efficacy in teaching clinical skills; however, there is limited research for use in communication skills. Virtual patients are especially well-suited for difficult communication skills, as students can practice without risk to patients. This rapid review aimed to review literature observing the potential of virtual patients as an effective means to teach breaking bad news.
A systematic search strategy was applied for papers published between November 2012 and November 2022 on Medline and Embase databases. Following the application of inclusion criteria, three studies were included. The Medical Education Research Study Quality Instrument and Critical Appraisal Skills Programme checklist were used for quality appraisal of the studies. Tabular and narrative synthesis was used to present the findings.
The findings of the studies suggest that when teaching breaking bad news, virtual patients are valuable compared with no intervention and are not inferior compared with simulated patients. An unexpected benefit of virtual patients was videotaping. A barrier to learning was the lack of affect and interaction. More research into the design of virtual simulations and its integration into existing curricula is required.
Virtual patients are a valuable educational tool for breaking bad news; however, they are yet to replace existing educational approaches. There is a need for more large-scale, homogeneous studies to inform instructional design and curriculum integration.
传递坏消息是临床实践中的一项必要技能，医护人员对此深感困扰。虚拟患者已被采用作为医学教育中的一种新的教学辅助手段，并已证明在教授临床技能方面具有有效性；然而，在沟通技巧方面的应用研究有限。虚拟患者特别适合教授困难的沟通技巧，因为学生可以在不影响患者的情况下进行练习。本快速综述旨在回顾观察虚拟患者作为教授传递坏消息的有效手段的潜力的文献。
在 Medline 和 Embase 数据库中应用了系统搜索策略，以检索 2012 年 11 月至 2022 年 11 月期间发表的论文。在应用纳入标准后，纳入了三项研究。使用医学教育研究质量评估工具和批判性评估技能计划检查表对研究进行质量评估。使用表格和叙述性综合呈现研究结果。
这些研究的结果表明，在教授传递坏消息时，与无干预相比，虚拟患者具有价值，并且与模拟患者相比不逊色。虚拟患者的一个意外好处是录像。学习的一个障碍是缺乏情感和互动。需要进一步研究虚拟模拟的设计及其融入现有课程的问题。
虚拟患者是教授传递坏消息的一种有价值的教育工具；然而，它们尚未取代现有的教育方法。需要进行更多大规模、同质化的研究，以提供教学设计和课程整合的信息。
