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虚拟患者在精神科住院医师研究生教育中的应用及相关培训成果:一项范围综述

Use of Virtual Patients and Related Training Outcomes in Postgraduate Psychiatry Residency Education: A Scoping Review.

作者信息

Hoo Kin Hwee Ryan, Shuy Yao Kang, Tay Jing Ling, Chew Qian Hui, Sim Kang

机构信息

Ministry of Health Holdings, Singapore, Singapore.

Agency of Integrated Care, Singapore, Singapore.

出版信息

Acad Psychiatry. 2025 Jul 10. doi: 10.1007/s40596-025-02174-y.

Abstract

OBJECTIVE

Virtual patients (VP) such as high-fidelity patient simulators/manikins, VP avatars, or human simulated patients have been increasingly used in health professions and psychiatry residency education. The authors aimed to review extant literature and summarize the different types of VP adopted, training contexts, and its impact according to the Kirkpatrick model for evaluation of training outcomes.

METHODS

The authors adopted the Joanna Briggs Institute methodology for evidence synthesis and used a five-step framework, searching several databases (MEDLINE, Web of Science, PsycInfo, PubMed, Scopus, and Cochrane) for pertinent articles published up to August 2024. Studies were included if they (1) were empirical studies involving use of VP in psychiatry residency training, (2) with evaluation of training outcomes, and (3) were published in English.

RESULTS

Overall, 31 articles met the inclusion criteria. Among studies that were mostly conducted in the West, human simulated patients were most used, followed by VP avatar and high-fidelity simulators/manikins. Most studies across specific topics (ranging from anxiety to psychotic and alcohol use disorders) reported outcomes up to level 3 of the Kirkpatrick model. Apart from user acceptability, other training outcomes included improvements in knowledge about the topics covered, clinical care competency related to history taking, risk assessment, use of psychotropic medications, and neurostimulation treatment.

CONCLUSIONS

Future studies may consider multi-site collaborations to examine the impact of such VP interventions in different psychiatry residency training environments, compare across different VP modalities, include assessments at higher Kirkpatrick levels of training outcomes, and monitor longitudinal changes in learner outcomes.

摘要

目的

高保真患者模拟器/人体模型、虚拟患者化身或真人模拟患者等虚拟患者已越来越多地应用于卫生专业和精神病学住院医师培训。作者旨在回顾现有文献,并根据柯克帕特里克培训效果评估模型总结所采用的不同类型的虚拟患者、培训背景及其影响。

方法

作者采用乔安娜·布里格斯研究所的证据综合方法,并使用一个五步框架,在多个数据库(MEDLINE、科学网、PsycInfo、PubMed、Scopus和Cochrane)中搜索截至2024年8月发表的相关文章。纳入的研究需满足以下条件:(1)是涉及在精神病学住院医师培训中使用虚拟患者的实证研究;(2)对培训效果进行评估;(3)以英文发表。

结果

总体而言,31篇文章符合纳入标准。在主要在西方进行的研究中,真人模拟患者使用最为频繁,其次是虚拟患者化身和高保真模拟器/人体模型。大多数针对特定主题(从焦虑症到精神病和酒精使用障碍)的研究报告的结果达到了柯克帕特里克模型的第3级。除了用户接受度外,其他培训成果还包括对所涵盖主题的知识有所增加、与病史采集、风险评估、精神药物使用和神经刺激治疗相关的临床护理能力有所提高。

结论

未来的研究可考虑开展多地点合作,以检验此类虚拟患者干预措施在不同精神病学住院医师培训环境中的影响,比较不同的虚拟患者模式,纳入柯克帕特里克培训效果更高水平的评估,并监测学习者成果的纵向变化。

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