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时间胶囊医学:一项关于医学生慢性病教育沉浸式模拟的混合方法试点研究。

Time Capsule Medicine: A Mixed-Methods Pilot Study on Immersive Simulation for Chronic Disease Education in Medical Students.

作者信息

Conte Andreas, Jerjes Waseem

机构信息

Faculty of Life Sciences & Medicine, King's College London, London SE1 1UL, UK.

Faculty of Medicine, Imperial College London, London SW7 2AZ, UK.

出版信息

Clin Pract. 2025 Apr 9;15(4):78. doi: 10.3390/clinpract15040078.


DOI:10.3390/clinpract15040078
PMID:40310311
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12025795/
Abstract

: Chronic diseases require long-term and multidimensional care, but traditional medical education has emphasised acute care and episodic interventions. This gap limits the understanding of future clinicians about the complexity of managing chronic conditions over decades. This mix-methods quantitative-qualitative pilot study describes "Time Capsule Medicine", an innovative educational framework in which medical students acted out the progressive challenges that patients with chronic illnesses might face over a continuous period of 20 years. This paper aims to report the outcomes of this innovative educational technique. : Thirty final-year medical students were engaged in the three-phase programme which included preparation, immersive simulation, and reflection and evaluation. The preparation consisted of online workshops in chronic disease progression, age-related changes, and continuity of care, while the immersive simulation featured appropriate role-play exercises in small groups that simulated the chronic disease process across four five-year increments. The reflection and evaluation consisted of debriefing sessions and reflective journals, while pre- and post-simulation questionnaires tested learning outcomes. The physical constraints included weighted garments with visual impairments simulating the age-related limitations. : A gender- and ethnically diverse cohort of thirty final-year medical students from three medical schools in North London participated in the programme. The simulation significantly enhanced students' confidence in managing long-term disease trajectories (pre-simulation score: 2.8 ± 0.9; post-simulation score: 4.3 ± 0.6; < 0.01) and understanding of age-related challenges (from 3.1 ± 1.0 to 4.5 ± 0.5; < 0.01). Empathy scores increased from 3.0 ± 0.9 to 4.7 ± 0.5 < 0.01. The qualitative analysis showed an increased appreciation of the continuity of care, recognition of systemic barriers, and insights into the emotional burdens of chronic conditions. For many students, the simulation was transformative, changing the way they approached holistic, patient-centred care. : This experiential learning approach has succeeded in effectively addressing one of the most important gaps known in traditional medical education in developing empathy, understanding, and confidence in the long-term management of chronic diseases. The integration of similar simulations into medical curricula may adequately arm future clinicians with the complexities of continuity of care and patient management. Further studies need to be performed exploring scalability and its impact on long-term clinical practice.

摘要

慢性病需要长期的多维度护理,但传统医学教育一直强调急性病护理和阶段性干预。这种差距限制了未来临床医生对慢性病几十年管理复杂性的理解。这项混合方法的定量-定性试点研究描述了“时间胶囊医学”,这是一种创新的教育框架,医学生在其中模拟了慢性病患者在连续20年中可能面临的渐进性挑战。本文旨在报告这种创新教育技术的成果。30名医学专业最后一年的学生参与了这个三阶段项目,包括准备、沉浸式模拟以及反思与评估。准备阶段包括关于慢性病进展、与年龄相关的变化以及护理连续性的在线研讨会,而沉浸式模拟则以小组形式进行适当的角色扮演练习,模拟了四个五年阶段的慢性病过程。反思与评估包括汇报会和反思日志,同时模拟前后的问卷调查测试了学习成果。身体限制包括带有视觉障碍的加重衣物,模拟与年龄相关的限制。来自伦敦北部三所医学院的30名医学专业最后一年的学生组成了一个性别和种族多样化的群体参与了该项目。模拟显著增强了学生管理长期疾病轨迹的信心(模拟前得分:2.8±0.9;模拟后得分:4.3±0.6;<0.01)以及对与年龄相关挑战的理解(从3.1±1.0提高到4.5±0.5;<0.01)。同理心得分从3.0±0.9提高到4.7±0.5(<0.01)。定性分析表明,学生对护理连续性的认识增强,对系统性障碍的认识提高,对慢性病情感负担有了更深入的理解。对许多学生来说,这次模拟具有变革性,改变了他们进行整体的、以患者为中心的护理的方式。这种体验式学习方法成功地有效解决了传统医学教育中已知的最重要差距之一,即培养对慢性病长期管理的同理心、理解和信心。将类似的模拟纳入医学课程可能会让未来的临床医生充分应对护理连续性和患者管理的复杂性。需要进一步开展研究,探索其可扩展性及其对长期临床实践的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bbc/12025795/e8b6d43e2011/clinpract-15-00078-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bbc/12025795/b3c04eddc396/clinpract-15-00078-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bbc/12025795/b1be54f28a73/clinpract-15-00078-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bbc/12025795/d7e9c77ed83c/clinpract-15-00078-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bbc/12025795/e8b6d43e2011/clinpract-15-00078-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bbc/12025795/b3c04eddc396/clinpract-15-00078-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bbc/12025795/b1be54f28a73/clinpract-15-00078-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bbc/12025795/d7e9c77ed83c/clinpract-15-00078-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bbc/12025795/e8b6d43e2011/clinpract-15-00078-g004.jpg

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本文引用的文献

[1]
Effectiveness of Scenario-based Roleplay as a Method of Teaching Soft Skills for Undergraduate Medical Students.

Int J Appl Basic Med Res. 2024

[2]
Public perceptions of artificial intelligence in healthcare: ethical concerns and opportunities for patient-centered care.

BMC Med Ethics. 2024-6-22

[3]
The use of role-play in the learning of medical terminology for online and face-to-face courses.

Adv Physiol Educ. 2024-9-1

[4]
Mediating role of physician's empathy between physician's communication and patient's satisfaction.

J Family Med Prim Care. 2024-4

[5]
The impact of empathy on medical students: an integrative review.

BMC Med Educ. 2024-4-25

[6]
Exploring experiential learning within interprofessional practice education initiatives for pre-licensure healthcare students: a scoping review.

BMC Med Educ. 2024-2-13

[7]
The Burden of Chronic Disease.

Mayo Clin Proc Innov Qual Outcomes. 2024-1-20

[8]
Stepping into the shoes of older people: a scoping review of simulating ageing experiences for healthcare professional students.

Age Ageing. 2023-12-1

[9]
Impact of using peer role-playing on the clinical skills performance of pediatric trainees.

BMC Med Educ. 2023-9-8

[10]
Contribution of Medical Education through Role Playing in Community Health Promotion: A Review.

Iran J Public Health. 2023-6

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