分析虚拟标准化患者评估医学生临床基本功的效果：一项前瞻性研究。

Analysis of virtual standardized patients for assessing clinical fundamental skills of medical students: a prospective study.

机构信息

The Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China.

West China Medical Simulation Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China.

出版信息

BMC Med Educ. 2024 Sep 10;24(1):981. doi: 10.1186/s12909-024-05982-2.

DOI:10.1186/s12909-024-05982-2

PMID:39256732

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11385815/

Abstract

BACKGROUND

History-taking is an essential clinical competency for qualified doctors. The limitations of the standardized patient (SP) in taking history can be addressed by the virtual standardized patient (VSP). This paper investigates the accuracy of virtual standardized patient simulators and evaluates the applicability of the improved system's accuracy for diagnostic teaching support and performance assessment.

METHODS

Data from the application of VSP to medical residents and students were gathered for this prospective study. In a human-machine collaboration mode, students completed exams involving taking SP histories while VSP provided real-time scoring. Every participant had VSP and SP scores. Lastly, using the voice and text records as a guide, the technicians will adjust the system's intention recognition accuracy and speech recognition accuracy.

RESULTS

The research revealed significant differences in scoring across several iterations of VSP and SP (p < 0.001). Across various clinical cases, there were differences in application accuracy for different versions of VSP (p < 0.001). Among training groups, the diarrhea case showed significant differences in speech recognition accuracy (Z = -2.719, p = 0.007) and intent recognition accuracy (Z = -2.406, p = 0.016). Scoring and intent recognition accuracy improved significantly after system upgrades.

CONCLUSION

VSP has a comprehensive and detailed scoring system and demonstrates good scoring accuracy, which can be a valuable tool for history-taking training.

摘要

背景

问诊是合格医生的一项基本临床能力。虚拟标准化患者（VSP）可以弥补标准化患者（SP）在问诊方面的局限性。本文旨在研究虚拟标准化患者模拟器的准确性，并评估改进后的系统在诊断教学支持和性能评估方面的准确性的适用性。

方法

本前瞻性研究收集了 VSP 应用于住院医师和学生的数据。在人机协作模式下，学生在 VSP 提供实时评分的情况下完成涉及 SP 病史采集的考试。每位参与者都有 VSP 和 SP 评分。最后，技术人员将根据语音和文本记录调整系统的意图识别准确性和语音识别准确性。

结果

研究表明，VSP 和 SP 的评分在多次迭代中有显著差异（p<0.001）。在不同的临床病例中，不同版本的 VSP 在应用准确性方面存在差异（p<0.001）。在培训组中，腹泻病例的语音识别准确性（Z=-2.719，p=0.007）和意图识别准确性（Z=-2.406，p=0.016）存在显著差异。系统升级后，评分和意图识别准确性显著提高。