医学教育中标准化病人的应用现状调查

A survey on the application status of standardized patients in medical education

目的了解标准化病人(standardized patients,SP)的医学教育应用现状,分析实施中存在的障碍,为推进SP参与教学提供参考。方法2019年12月至2020年2月,以网络能够检索到明确联系方式的开办临床医学专业教育的79所医学院校为研究对象,通过邮件向SP相关负责人发送调查表与知情同意书。采用描述性统计方法分析相关数据。结果收到64所院校回复的有效问卷,其中有37所(57.8%)院校在教学中应用了SP,培训SP的主要方法为情景演练、示教、看视频、现场观摩。37所院校中,SP主要应用于病史采集教学[29所(78.4%)]、客观结构化临床考试[28所(75.7%)]、医患沟通教学[27所(73.0%)]、体格检查教学[23所(62.2%)]。SP质量评估方式主要为教师反馈[27所(73.0%)]、学生反馈[26所(70.3%)]、自制评价表评估[11所(29.7%)]。SP应用的主要问题为SP队伍不稳定[27所(73.0%)]、缺乏统一规范的质量评价标准和课程培训[17所(45.9%)]。结论SP在我国医学教育中应用比较广泛。医学院校在医患沟通教学领域中已经开始重视SP的应用。今后需要加强SP培训的规范化,进一步推进SP在医学教育中的应用。

Objective:To understand the current situation of the application of standardized patients(SPs)in the field of medical education and analyze the obstacles in the process of implementation,so as to inform further promoting the use of SPs in medical education.Methods:From December 2019 to February 2020,79 medical universities offering five-year and long-term clinical medicine programs with clear contact information were selected as research subjects,and questionnaires and informed consent forms were sent by Email.Numerical data were analyzed by cross-table chi-square test or Fisher exact test.Results:This survey received valid questionnaires from 64 colleges and universities,37(57.8%)applied SPs in medical education,and 27(42.2%)had training departments for SPs.The main methods of training were situational exercises,teaching demonstrations,watching videos and on-the-spot observation.Among 37 colleges and universities,SPs were mainly used in medical history collection[29(78.4%)],Objective Structured Clinical Exams[28(75.7%)],doctor-patient communication[27(73.0%)]and physical examination teaching[23(62.2%)]respectively.Moreover,27(73.0%),26(70.3%)and 11(29.7%)colleges and universities respectively evaluated the quality of SPs through teacher feedback,student feedback and self-made evaluation forms.Lastly,27(73.0%)and 17(45.9%)colleges and universities respectively believed that there were unstable teams and lack of unified and standardized quality evaluation standards and course training in SPs.Conclusions:SPs are widely used in medical education in China,and attention has been paid to doctor-patient communication.It is expected for SPs to participate in teaching in improving doctor-patient relationship.In the future,it is necessary to overcome a series of obstacles and further promote the use of SPs to improve the communication skills of medical students.