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Eklics K, Csongor A, Hambuch A, Fekete JD. Diverse Integration of Simulated Patients in Medical Education for Communication, Language, and Clinical Skills in Hungary. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:301-312. [PMID: 38618523 PMCID: PMC11016270 DOI: 10.2147/amep.s438102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 03/11/2024] [Indexed: 04/16/2024]
Abstract
Medical education and communication training has been undergoing substantial changes recently in our globalized environment. Multidisciplinary simulation-based methods worldwide focus on improving effective clinical skills including history taking, physical examination, diagnostic skills, critical thinking, therapeutic skills, and others via interactions between medical students, trainees, and patients. Recently, Hungary has joined such global trends. The first simulated patient program in Hungary was developed at the University of Pécs Medical School in 2019 to aid effective patient-interviewing skills in language and communication classes. Under the supervision of linguists, communication specialists and medical professionals, the multidisciplinary program uses lay people to perform as simulated patients while using the languages of Hungarian, German, and English. Our simulated patient program plays a specific role in supporting students to learn languages for medical purposes, aiming to prepare them for handling the medical, linguistic, at the same, time emotional and sociocultural difficulties encountered while taking patient histories. Medical and linguistic experts evaluate student performance, provide feedback, and give tailored instruction so that students can advance their communicative and professional skills. This study discusses working formats and the role of constructive feedback exploring potential advantages and disadvantages, sharing ideas, and proposing recommendations on language- and communication-based integration of simulated patients. In our elective communication courses, undergraduate medical students learn to cope with a variety of patient situations through practicing medical emergencies, misunderstandings, and disagreements in a safe atmosphere provided by the MediSkillsLab. Among the benefits, we should emphasize that any course with a growing number of students can be accommodated by carefully designing the program, which allows for interprofessional collaboration. This program contributes to higher-quality medical education, promoting more skilled and compassionate healthcare specialists.
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Affiliation(s)
- Kata Eklics
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Csongor
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
| | - Anikó Hambuch
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
| | - Judit Diana Fekete
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
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Dahmen L, Linke M, Schneider A, Kühl SJ. Medical students in their first consultation: A comparison between a simulated face-to-face and telehealth consultation to train medical consultation skills. GMS JOURNAL FOR MEDICAL EDUCATION 2023; 40:Doc63. [PMID: 37881523 PMCID: PMC10594035 DOI: 10.3205/zma001645] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/07/2023] [Accepted: 07/07/2023] [Indexed: 10/27/2023]
Abstract
Objective A simulated conversation between a physician and a family member, i.e., a medical conversation, was changed from a conventional face-to-face conversation (SS 2019) to a telehealth conversation (SS 2020) due to the COVID-19 pandemic. The medical education conversation is part of the biochemistry seminar "From Genes to Proteins" which second semester human medicine students take. The objective of this study was to analyze to what extent the switch from face-to-face to telehealth conversations affected student satisfaction and motivation. Methodology In the seminar, students study biochemical as well as competency-oriented content, such as how to talk to family members. In the summer semester of 2019, students were trained how to talk to their patients' family members in a traditional conversation setting with the help of lay actors in a classroom format. In the summer semester of 2020, this conversation took place under comparable conditions, but in the form of an online telehealth conversation instead. Student satisfaction and motivation were surveyed by means of an evaluation questionnaire following the seminar in both semesters. Results Both conversation formats achieved a high level of satisfaction from students (school grade A-B). For some evaluation items, such as "realistic conversation simulation", the face-to-face conversation was perceived as more satisfying (Md=5.0, IQR=1.0) than the telehealth conversation (Md=5.0, IQR=2.0). In addition, the face-to-face conversation resulted in higher subjective motivation from students (Md=5.0, IQR=1.0) than that of the telehealth conversation (Md=4.0, IQR=2.0). Conclusion The high student satisfaction and acceptance of both didactic concepts leads to the conclusion that the simulated telehealth conversation is an adequate substitute for the simulation of a traditional face-to-face conversation with regard to the parameters that were studied.
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Affiliation(s)
- Lena Dahmen
- University of Ulm, Faculty of Medicine, Institute of Biochemistry and Molecular Biology, Ulm, Germany
| | - Maike Linke
- Dresden University of Technology, Carl Gustav Carus Faculty of Medicine, Psychosocial Medicine and Developmental Neurosciences, Dresden, Germany
| | - Achim Schneider
- University of Ulm, Faculty of Medicine, Dean of Studies Office, Ulm, Germany
| | - Susanne J. Kühl
- University of Ulm, Faculty of Medicine, Institute of Biochemistry and Molecular Biology, Ulm, Germany
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Luiz T, Elsenbast C, Breckwoldt J. [Emergencies-Infinite worlds? : Extended reality as a medium in the education, continuing and advanced training in emergency medicine]. DIE ANAESTHESIOLOGIE 2023:10.1007/s00101-023-01305-0. [PMID: 37389588 DOI: 10.1007/s00101-023-01305-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 05/19/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Simulation training is indispensable in emergency medicine, especially for enhancing patient safety. Methods and technologies used include a wide spectrum ranging from simple skill trainers to complex full-scale simulated environments integrating standardized patient actors. Limitations include the simulation of dynamic changes of clinical symptoms, the depiction of emotions and patient movements as well as complex environments, such as lively traffic. Extended reality (XR) holds the potential to overcome these limitations. METHODS/AIMS Starting with the technological basis and the didactic considerations in the field of XR, the paper reflects the potentials and limitations of this new technology in the domain of medical simulation training. Further focus is put on the integration of XR into existing training curricula. RESULTS The XR covers various technologies, ranging from PC-based applications that are similar to conventional computer games, over virtual realities enabling spatially freely navigable 3‑dimensional simulation (using closed 3D glasses: head mounted displays, HMD), to mixed-reality applications that combine virtual elements and real physical objects; however, technology alone does not stimulate learning. As with other simulation methods, it is crucial with XR to implement learning objectives, methods and technologies in a suitable teaching-learning arrangement and to familiarize teachers and students with the new technology. Evidence in the literature with respect to learning success is limited by the heterogeneity of technologies, target groups, teaching-learning arrangements and learning outcomes. Overall, significant increases can be shown for the intrinsic motivation of learners, and for high emotional participation (measured as perceived presence in the virtual environment). DISCUSSION Technological developments and the increasing use of digital media in emergency medical education and training favor the leap from XR-based pure demonstration projects to educational practice. Decisive for the educational success are the clear orientation towards concrete learning goals and a thorough familiarization with the new technology. CONCLUSION Simulation training based on XR expands the spectrum of existing simulation methods to integrate new dimensions of learning objectives. Further research on the effectiveness of this method is needed.
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Affiliation(s)
- Thomas Luiz
- Digital Healthcare, Fraunhofer IESE, Fraunhofer-Platz 1, 67663, Kaiserslautern, Deutschland.
| | - Christian Elsenbast
- Digital Healthcare, Fraunhofer IESE, Fraunhofer-Platz 1, 67663, Kaiserslautern, Deutschland
| | - Jan Breckwoldt
- Institut für Anästhesiologie, Universitätsspital Zürich, Zürich, Schweiz
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Steglich J, Hempel L, Jaspers S, Stoevesandt D, Weber M, Kunze C, Weihrauch-Blüher S, Kühnöl C, Woydt L. [Using simulated patients to test competency in child protection medicine in the third section of the medical examination]. Monatsschr Kinderheilkd 2022:1-5. [PMID: 36589716 PMCID: PMC9795424 DOI: 10.1007/s00112-022-01674-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/15/2022] [Indexed: 12/30/2022]
Abstract
During the COVID-19 pandemic, the third section of the medical examination could be performed with simulation patients. Simulations enable standardized examinations of medical competency according to the educational objectives of the national learning objectives catalogue. The evaluation of student's medical response to child abuse and neglect seems to be an appropriate opportunity to increase attention of prospective physicians for potential child abuse. The presented case reports the simulation of a pediatric nonaccidental trauma.
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Affiliation(s)
- Jonas Steglich
- Dorothea Erxleben Lernzentrum, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 12, 06112 Halle (Saale), Deutschland
| | - Linn Hempel
- Dorothea Erxleben Lernzentrum, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 12, 06112 Halle (Saale), Deutschland
| | - Susanna Jaspers
- Dorothea Erxleben Lernzentrum, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 12, 06112 Halle (Saale), Deutschland
| | - Dietrich Stoevesandt
- Dorothea Erxleben Lernzentrum, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 12, 06112 Halle (Saale), Deutschland
| | - Marko Weber
- Institut für Rechtsmedizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Christian Kunze
- Universitätsklinik und Poliklinik für Radiologie, Universitätsklinikum Halle, Halle (Saale), Deutschland
| | - Susann Weihrauch-Blüher
- Universitätsklinik und Poliklinik für Pädiatrie I, Universitätsklinikum Halle, Halle (Saale), Deutschland
| | - Caspar Kühnöl
- Universitätsklinik und Poliklinik für Pädiatrie I, Universitätsklinikum Halle, Halle (Saale), Deutschland
| | - Lina Woydt
- Institut für Rechtsmedizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
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Britz V, Koch Y, Schreckenbach T, Stefanescu MC, Zinßer U, Sterz J, Ruesseler M. Influence of using simulated or real patients on undergraduate medical students acquiring competencies in medical conversations in surgery: A prospective, controlled study. Front Surg 2022; 9:986826. [PMID: 36171816 PMCID: PMC9510648 DOI: 10.3389/fsurg.2022.986826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Communication with patients and their relatives as well as with colleagues and students is an essential part of every physician's daily work. An established method for teaching communication skills is using simulated patients (SPs). However, teaching with SPs is often subjectively perceived by medical students as less instructive than teaching with real patients (RPs). Studies that analyze the influence of SPs compared to RPs for acquiring competencies are lacking. The aim of the present study was therefore to investigate the impact of SPs on long-term learning success for communication skills compared to RPs. Material and Methods Study participants were undergraduate third-year medical students who attended a communication unit and were randomized into three groups. The first group trained the role-play part with a SP (SP-group). The second group trained with a SP but thought that the patient was a RP because the students and the tutors were told that they were a RP by the principal investigator (incognito patient group [IP-group]). The third group and their tutors trained with a RP and were told that the patient was a RP (real patient group [RP-group]). Five to 12 weeks after completing the training, the study participants completed a curricular summative objective standardized clinical examination. Results There were 146 students who participated in the study. There were no significant differences between the three study groups at the informed consent stations and for those conducting anamnesis interviews. Conclusion Communication skills training with SPs appears to be equivalent to training with RPs in terms of competency development in communication-based assessments in surgery. Therefore, SPs should be used in these curricula, especially at an early stage, to enable the students to practice adequate communication skills.
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Affiliation(s)
- Vanessa Britz
- Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University Frankfurt/Main, Frankfurt, Germany
| | - Yannic Koch
- Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University Frankfurt/Main, Frankfurt, Germany
| | - Teresa Schreckenbach
- Department of General, Visceral, Transplantation and Thoracic Surgery, Goethe University Frankfurt/Main, University Hospital Frankfurt, Frankfurt, Germany
| | - Maria Christina Stefanescu
- Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University Frankfurt/Main, Frankfurt, Germany
- Department of Pediatric Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Uwe Zinßer
- Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University Frankfurt/Main, Frankfurt, Germany
| | - Jasmina Sterz
- Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University Frankfurt/Main, Frankfurt, Germany
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
- Correspondence: Jasmina Sterz
| | - Miriam Ruesseler
- Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University Frankfurt/Main, Frankfurt, Germany
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Sterz J, Gutenberger N, Stefanescu MC, Zinßer U, Bepler L, Linßen S, Schäfer V, Carstensen P, Verboket RD, Adili F, Ruesseler M. Manikins versus simulated patients in emergency medicine training: a comparative analysis. Eur J Trauma Emerg Surg 2021; 48:3793-3801. [PMID: 34331074 PMCID: PMC9532276 DOI: 10.1007/s00068-021-01695-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/30/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Every physician must be able to sufficiently master medical emergencies, especially in medical areas where emergencies occur frequently such as in the emergency room or emergency surgery. This contrasts with the observation that medical students and young residents often feel insufficiently prepared to handle medical emergencies. It is therefore necessary to train them in the treatment of emergency patients. The aim of this study is to analyze the influence of the assignment of manikin versus simulated patients during a training for undergraduate medical students on learning outcomes and the perceived realism. METHODS The study had a prospective cross-over design and took place in a 3-day emergency medicine training for undergraduate medical students. Students completed three teaching units ('chest pain', 'impaired consciousness', 'dyspnea'), either with manikin or simulated patient. Using a questionnaire after each unit, overall impression, didactics, content, the quality of practical exercises, and the learning success were evaluated. The gained competences were measured in a 6-station objective structured clinical examination (OSCE) at the end of training. RESULTS 126 students participated. Students rated simulated patients as significantly more realistic than manikins regarding the possibility to carry out examination techniques and taking medical history. 54.92% of the students would prefer to train with simulated patients in the future. Regarding the gained competences for 'chest pain' and 'impaired consciousness', students who trained with a manikin scored less in the OSCE station than the simulated patients-group. CONCLUSION Simulated patients are rated more realistic than manikins and seem to be superior to manikins regarding gained competence.
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Affiliation(s)
- Jasmina Sterz
- Department for Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, Frankfurt, Germany.,Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University, Frankfurt, Germany
| | - Niklas Gutenberger
- Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University, Frankfurt, Germany
| | - Maria-Christina Stefanescu
- Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University, Frankfurt, Germany
| | - Uwe Zinßer
- Medical Faculty, SP Training Center, Goethe University, Frankfurt, Germany
| | - Lena Bepler
- Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University, Frankfurt, Germany
| | - Svea Linßen
- Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University, Frankfurt, Germany
| | - Verena Schäfer
- Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University, Frankfurt, Germany
| | - Patrick Carstensen
- Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University, Frankfurt, Germany
| | - René Danilo Verboket
- Department for Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, Frankfurt, Germany
| | - Farzin Adili
- Division of Vascular and Endovascular Surgery, Department of Vascular Medicine, Klinikum Darmstadt, Darmstadt, Germany
| | - Miriam Ruesseler
- Department for Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, Frankfurt, Germany. .,Medical Faculty, Frankfurt Interdisciplinary Simulation Center FIneST, Goethe University, Frankfurt, Germany.
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Ludwig C, Stoevesandt D, Ludwig C, Fritsche V. Telephone-based communication training in the era of COVID-19. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc20. [PMID: 33659625 PMCID: PMC7899093 DOI: 10.3205/zma001416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/16/2020] [Accepted: 12/08/2020] [Indexed: 06/12/2023]
Abstract
Introduction: In the wake of the COVID-19 pandemic, alternatives to established and proven formats had to be found in university teaching within a very short time. In the case of the SkillsLab at the Dorothea Erxleben Lernzentrum Halle (Saale) at the Martin Luther University Halle (Saale)-Wittenberg, this meant in relation to the communication courses that a considerable proportion of the simulation participants of advanced age or with pre-existing conditions were suddenly no longer available for conversation simulations in teaching. Project description: In the course of the seminar "Conversation with relatives - dealing with relatives" in the 8th semester, the conversation simulation was therefore adapted at short notice and converted into a telephone conversation. Thus, the simulation subjects were able to participate remotely and the students had the opportunity to test their doctor-patient conversation skills with regard to telephone calls in a safe environment. Results: The focus on nonverbal techniques and the departure from the usual face-to-face setting was perceived by students and simulation subjects alike as a positive stimulus and particularly challenging. The lack of visual impressions had made empathic conversation more difficult. Discussion and Conclusions: The positive experiences from this project should be used to expand the communication curriculum in the future to include telephone-based conversations with simulation subjects. Ideally, it would then be possible for the simulation persons to be present in the future after the conversation for feedback mediation and group discussion.
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Affiliation(s)
- Clemens Ludwig
- Martin Luther University Halle-Wittenberg, Dorothea Erxleben Lernzentrum, SkillsLab, Halle (Saale), Germany
| | - Dietrich Stoevesandt
- Martin Luther University Halle-Wittenberg, Dorothea Erxleben Lernzentrum, SkillsLab, Halle (Saale), Germany
| | - Christiane Ludwig
- Martin Luther University Halle-Wittenberg, Dorothea Erxleben Lernzentrum, SkillsLab, Halle (Saale), Germany
| | - Vivien Fritsche
- Martin Luther University Halle-Wittenberg, Dorothea Erxleben Lernzentrum, SkillsLab, Halle (Saale), Germany
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Fritsche V, Siol AF, Schnabel KP, Bauer D, Schubert J, Stoevesandt D. Use of simulation patients in the third section of the medical examination. GMS JOURNAL FOR MEDICAL EDUCATION 2020; 37:Doc90. [PMID: 33364369 PMCID: PMC7740027 DOI: 10.3205/zma001383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/22/2020] [Accepted: 10/19/2020] [Indexed: 06/12/2023]
Abstract
In order to protect patients and students during the Covid 19 pandemic, the third section of the medical examination (M3) in Halle (Saale) was conducted in a modified form in accordance with the "Verordnung zur Abweichung von der Approbationsordnung für Ärzte bei einer epidemischen Lage von nationaler Tragweite" [1]. The one-day examination took place at the Dorothea Erxleben Learning Center (DELH) of the Martin Luther University Halle-Wittenberg on standardized simulation subjects. In contrast to previous years, all examiners were examined individually in internal medicine, surgery and their elective subject of the practical year. In the evaluations carried out, the standardized cases were assessed as consistent and fair by examiners and exam takers. Approximately 90% of the examiners could imagine to test a state examination with simulated patients again. After successful pilot testing, a study will be conducted in the coming exam to determine whether the substitution of real patients with simulated patients in the M3 exam can contribute to better standardization and objectivity while maintaining the same high level of acceptance in the exam. Whether the high acceptance will remain constant can only be checked in the course of the study.
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Affiliation(s)
- Vivien Fritsche
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Dorothea Erxleben Lernzentrum, Halle (Saale), Germany
| | - A. F. Siol
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Dorothea Erxleben Lernzentrum, Halle (Saale), Germany
| | - Kai P. Schnabel
- Universität Bern, Medizinische Fakultät, Institut für Medizinische Lehre, Bern, Switzerland
| | - Daniel Bauer
- Universität Bern, Medizinische Fakultät, Institut für Medizinische Lehre, Bern, Switzerland
| | - J. Schubert
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Dorothea Erxleben Lernzentrum, Halle (Saale), Germany
| | - D. Stoevesandt
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Dorothea Erxleben Lernzentrum, Halle (Saale), Germany
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Peters T, Thrien C. The digital use of simulated patients in times of the corona pandemic - considerations and proposals. GMS JOURNAL FOR MEDICAL EDUCATION 2020; 37:Doc93. [PMID: 33364372 PMCID: PMC7740014 DOI: 10.3205/zma001386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/28/2020] [Accepted: 10/23/2020] [Indexed: 06/12/2023]
Abstract
The corona pandemic has posed major challenges for teaching with simulated persons (SPs), which usually requires the physical presence of the participants. Within a short period of time, a large number of individual solutions were developed. The committee "Simulated Persons" of the Society for Medical Education has developed considerations and proposals in five areas to meet the qualitative challenges of the method. First and foremost, the safety of the SPs is at stake, both in terms of infection prevention and role-related stress to which the SPs are now exposed at home alone instead of the usual setting, where they are in a teaching building with the connection to the staff on site. Furthermore, it should be noted that the changed framework conditions also require a reflection on behalf of the learning objectives, since not all teaching scenarios with SPs can be transferred from a real setting to a digital environment. Furthermore, even under corona conditions, the constructive alignment must not be disregarded, i.e. the question of testability must be considered from the very beginning. Aspects of the technical infrastructure for all participants and compliance with data protection requirements must also be considered. Last but not least, the forced changes are also an opportunity to take a proactive approach to the topic of telemedicine in teaching.
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Affiliation(s)
- Tim Peters
- University of Applied Sciences, Department of Nursing Sciences, Bochum, Germany
| | - Christian Thrien
- University of Cologne, Cologne Interprofessional Skills Lab and Simulation Centre, Cologne, Germany
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Resende KA, Cavaco AM, Luna-Leite MD, Acacio BR, Pinto NN, Neta MD, Melo AC. Training and standardization of simulated patients for multicentre studies in clinical pharmacy education. Pharm Pract (Granada) 2020; 18:2038. [PMID: 33224323 PMCID: PMC7672484 DOI: 10.18549/pharmpract.2020.4.2038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/25/2020] [Indexed: 11/25/2022] Open
Abstract
Objective: To evaluate the training and standardization methods of multiple simulated
patients (SPs) performing a single scenario in a multicenter study. Methods: A prospective quasi-experimental study, using a multicenter approach,
evaluated the performance of five different individuals with the same
biotype during a simulation session in a high-fidelity environment. The SPs
training and standardization process consisted of four steps and six web or
face-to-face mediated: Step 1: simulation scenario design and pilot test.
Step 2: SPs selection, recruitment and beginning training (Session 1:
performance instructions and memorization request.) Session 2: check the
SPs’ performances and adjustments). Step 3 and session 3: training
role-play and performance’s evaluation. Step 4: SPs’
standardization and performances’ evaluation (Sessions 4 and 5: first
and second rounds of SPs’ standardization assessment. Session 6:
Global training and standardization evaluation. SPs performance consistency
was estimated using Cronbach’s alpha and ICC. Results: In the evaluation of training results, the Maastricht Simulated Patient
Assessment dimensions of SPs performances “It seems
authentic”, “Can be a real patient” and
“Answered questions naturally”, presented “moderate or
complete agreement” of all evaluators. The dimensions “Seems
to retain information unnecessarily”, “Remains in his/her role
all the time”, “Challenges/tests the student”, and
“Simulates physical complaints in an unrealistic way”
presented “moderate or complete disagreement” in all
evaluations. The SPs “Appearance fits the role” showed
“moderate or complete agreement” in most evaluations. In the
second round of evaluations, the SPs had better performance than the first
ones. This could indicate the training process’s had good influence
on SPs performances. The Cronbach’s alpha in the second assessment
was better than the first (varied from 0.699 to 0.978). The same improvement
occurred in the second round of intraclass correlation coefficient that was
between 0.424 and 0.978. The SPs were satisfied with the training method and
standardization process. They could perceive improvement on their role-play
authenticity. Conclusions: The SPs training and standardization process revealed good SPs reliability
and simulation reproducibility, demonstrating to be a feasible method for
SPs standardization in multicenter studies. The Maastricht Simulated Patient
Assessment was regarded as missing the assessment of the information
consistency between the simulation script and the SPs provision.
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Affiliation(s)
- Karina A Resende
- MSc. Federal University of São João Del-Rei. Divinópolis, MG (Brazil).
| | - Afonso M Cavaco
- PhD. Associate Professor in Social Pharmacy. Faculty of Pharmacy, University of Lisbon. Lisbon (Portugal).
| | - Márcia D Luna-Leite
- PhD. Foundation for Scientific and Technological Development in Health (FIOTEC). Rio de Janeiro, RJ (Brasil).
| | - Bianca R Acacio
- MSc. Federal University of Mato Grosso do Sul. Pioneiros, MS (Brasil).
| | - Núbia N Pinto
- Federal University of São João Del-Rei. Divinópolis, MG (Brazil).
| | - Maria D Neta
- MSc. Federal University of Piauí. Teresina, PI (Brasil)
| | - Angelita C Melo
- PhD. Associate Professor in Clinical Pharmacy. Federal University of São João Del-Rei. Divinópolis, MG (Brazil).
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Abstract
Medical education is a relatively young field of research that has been characterized by many innovations over the last 20 years. The main topics were the preparation of students for their medical work and imparting of profound knowledge about scientific contexts in medicine. For a long time, the main focus was on learning the necessary knowledge and skills; however, this is no longer considered sufficient. In order to carry out the work as a physician well, other qualities are also necessary, such as communication, collaboration, professionalism, science and reflectivity. Worldwide these aspects are being increasingly integrated into the learning objectives of medical schools and residency programs. The structure of medical studies at many universities has also changed. So-called vertical integration strengthens the integration of theoretical preclinical training and the clinical phase. This means that in the preclinical phase training is more practice-oriented and in the clinical phase a more structured form of training takes place. In the first years of study, students are prepared for the clinical phase by discussing patient cases and practicing skills in simulation centers. In addition, the clinical working environment is increasingly used as a learning environment. Developments have also been made regarding examinations: in addition to knowledge and skills, students and residents are now also assessed regarding performance in practice. Using more realistic assessments, e.g., Objective Structured Clinical Examinations and Workplace-based Assessments, students are evaluated more on their actual performance in practice. By means of the Entrustable Professional Activities method, students are gradually given more responsibility in order to prepare them for their future tasks.
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Affiliation(s)
- M Wijnen-Meijer
- TUM Medical Education Center, Fakultät für Medizin, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
| | - M Gartmeier
- TUM Medical Education Center, Fakultät für Medizin, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - P O Berberat
- TUM Medical Education Center, Fakultät für Medizin, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
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