Bryson-Brockmann W, Roll D
Department of Pediatrics, Winthrop-University Hospital, Mineola, New York 11501, USA.
Acad Med. 1996 Jan;71(1):78-85. doi: 10.1097/00001888-199601000-00021.
This paper presents an argument for more extensive use of single-case experimental research designs in medical education research. Single-case experimental designs consist of a group of experimental techniques that are widely used in the social sciences but are just beginning to be utilized by medical researchers. The method emphasizes reliable observations of behavior, repeated measurements of outcome, and individualized tailoring of objectives for each subject; all of these occur within a system that allows an experimental analysis to be conducted. Single-case designs are particularly useful when only small numbers of participants are available for a relatively long period of time. Trends in medical education toward individualized instruction, adult-centered learning, and fine-grained analyses of medical skills and knowledge make this field especially amenable to single-case experimental designs. Issues of internal and external validity, generality, practicality, and ethics are discussed, and several typical designs are illustrated. While the emergence of qualitative research methods in medical education may prove useful, single-case designs can maintain experimental science's emphasis on methodologic rigor, while allowing the flexibility often needed to conduct research in applied settings.
本文提出了一个在医学教育研究中更广泛使用单病例实验研究设计的观点。单病例实验设计由一组实验技术组成，这些技术在社会科学中被广泛使用，但医学研究人员才刚刚开始采用。该方法强调对行为的可靠观察、对结果的重复测量以及针对每个受试者的目标进行个性化定制；所有这些都发生在一个允许进行实验分析的系统内。当在相对较长的时间内只有少量参与者时，单病例设计特别有用。医学教育中朝着个性化教学、以成人学习为中心以及对医学技能和知识进行细粒度分析的趋势，使得这个领域特别适合单病例实验设计。本文讨论了内部和外部效度、普遍性、实用性和伦理问题，并举例说明了几种典型设计。虽然医学教育中定性研究方法的出现可能被证明是有用的，但单病例设计可以保持实验科学对方法严谨性的强调，同时允许在应用环境中进行研究时通常所需的灵活性。
