使用虚拟患者提供临床推理反馈:系统回顾

IF 5.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Academic Medicine Pub Date : 2024-10-31 DOI:10.1097/ACM.0000000000005908
Robert Jay, John Sandars, Rakesh Patel, Jo Leonardi-Bee, Yasmin Ackbarally, Soham Bandyopadhyay, Dabean Faraj, Mary O'Hanlon, Jeremy Brown, Emma Wilson
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引用次数: 0

摘要

目的:虚拟病人(VP)越来越多地用于医疗保健专业教育,以支持临床推理(CR)的发展。然而,临床推理各组成部分的反馈程度尚不清楚,虚拟病人如何优化临床推理的发展也缺乏指导。本系统性综述旨在确定VP如何就CR提供反馈:方法:2023 年 3 月,使用从以前的系统综述中改编的术语(如医学教育、虚拟病人、基于病例的学习、计算机模拟)检索了七个数据库(MEDLINE、EMBASE、CINAHL、ERIC、PsycINFO、Scopus 和 ProQuest Dissertations)。检索的所有研究均介绍了虚拟学习平台在培养医学专业人员CR方面的应用,并提供了至少一个CR组成部分的反馈信息。进行了筛选、数据提取和质量评估。进行了叙述性综合,以描述用于衡量 CR 和提供 CR 反馈的方法:共检索到 6526 项结果,其中 72 项符合标准,但由于摘要(n = 37)中对干预措施的报告不足,因此只分析了 35 篇全文文章。自愿者制定的 CR 要素中最常见的是主导诊断(23 [65.7%])、管理或治疗计划(23 [65.7%])和信息收集(21 [60%])。对 CR 要素的探讨采用了多种方法,从重新定义的问题到自由文本和概念图:结论:关于使用虚拟语气提供 CR 反馈的研究主要集中在易于评估的 CR 要素上,而很少有研究描述了为评估 CR 要素(如问题表述、假设生成和诊断理由)而设计的虚拟语气。尽管反馈对学习至关重要,但很少有 VP 提供有关学习者使用自我调节学习过程的信息。教育工作者在设计或选择用于 CR 的 VP 时,必须考虑学习者群体的需求以及如何探索 CR 的不同组成部分,并应在发表的作品中明确说明 VP 的教学设计。
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The Use of Virtual Patients to Provide Feedback on Clinical Reasoning: A Systematic Review.

Purpose: Virtual patients (VPs) are increasingly used in health care professions education to support clinical reasoning (CR) development. However, the extent to which feedback is given across CR components is unknown, and guidance is lacking on how VPs can optimize CR development. This systematic review sought to identify how VPs provide feedback on CR.

Method: Seven databases (MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO, Scopus, and ProQuest Dissertations) were searched in March 2023 using terms (e.g., medical education, virtual patient, case-based learning, computer simulation) adapted from a previous systematic review. All studies that described VP use for developing CR in medical professionals and provided feedback on at least 1 CR component were retrieved. Screening, data extraction, and quality assessment were performed. Narrative synthesis was performed to describe the approaches used to measure and provide feedback on CR.

Results: A total of 6,526 results were identified from searches, of which 72 met criteria, but only 35 full-text articles were analyzed because the reporting of interventions in abstracts (n = 37) was insufficient. The most common CR components developed by VPs were leading diagnosis (23 [65.7%]), management or treatment plan (23 [65.7%]), and information gathering (21 [60%]). The CR components were explored by various approaches, from redefined questions to free text and concept maps.

Conclusions: Studies describing VP use for giving CR feedback have mainly focused on easy-to-assess CR components, whereas few studies have described VPs designed for assessing CR components, such as problem representation, hypothesis generation, and diagnostic justification. Despite feedback being essential for learning, few VPs provided information on the learner's use of self-regulated learning processes. Educators designing or selecting VPs for CR use must consider the needs of learner groups and how different CR components can be explored and should make the instructional design of VPs explicit in published work.

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来源期刊
Academic Medicine
Academic Medicine 医学-卫生保健
CiteScore
7.80
自引率
9.50%
发文量
982
审稿时长
3-6 weeks
期刊介绍: Academic Medicine, the official peer-reviewed journal of the Association of American Medical Colleges, acts as an international forum for exchanging ideas, information, and strategies to address the significant challenges in academic medicine. The journal covers areas such as research, education, clinical care, community collaboration, and leadership, with a commitment to serving the public interest.
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