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Objective:To explore the application effect of Assessmen-Diagnosis-Plan-Implementation-Evaluation(ADPIE) teaching model based on skill competition in the teaching of "basic nursing" skills in higher vocational colleges.Methods:This was a quasi experimental study. Convenience sampling method was adopted to select students from two classes of 2021 vocational nursing major of Pingxiang Health Vocational College from February to July 2022 as the research objects, among which 53 nursing students from Class 9 were selected as the experimental group and 55 nursing students from Class 13 were selected as the control group. The experimental group was taught based on the ADPIE teaching mode of skill competition. The control group was taught according to the conventional teaching mode, and the academic record and humanistic care ability of the nursing students in the two groups were compared.Results:The three dimensions of humanistic care ability in experimental group were cognition (70.82 ± 9.20) points, courage (59.58 ± 6.04) points, patience (57.17 ± 5.26) points, total score (187.57 ± 20.50) points. They were higher than those in the control group,which were (67.40 ± 8.83), (55.98 ± 9.03), (54.37 ± 5.96) and (177.75 ± 20.82) points, and there were statistical differences between the groups (t values were 2.61 to 3.42, all P<0.05). In addition, the three dimensions of academic performance: ordinary score (6.10 ± 1.22)points, course score (57.10 ± 6.27) points, objective structured clinical examination (OSCE) score (27.09 ± 2.13)points, total score (90.29 ± 9.69) points, they were also higher than those of the control group (5.06 ± 1.33), (52.73 ± 5.44), (25.35 ± 3.29), and (83.14 ± 10.06), and the differences between groups were statistically significant ( t values were 2.52-3.34, All P<0.05). Conclusions:ADPIE teaching model based on skills competition can improve the course scores and humanistic care ability of nursing students, and the teaching effect is significant.
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Objective:To evaluate the effect of teacher simulate standardized patient (TSSP) consultation training in pediatric practical teaching.Methods:A total of 120 interns from the five-year clinical medicine major of Batch 2015 were randomly divided into experimental group and control group. In the experimental group, 60 interns were trained by TSSP for consultation after admission. After the training, the clinical parents of the children were consulted and the children were physically examined under the guidance of teachers. In the control group, 60 interns were trained according to the same requirements, but TSSP consultation training was not included. At the end of the practice, the performance, operation skills and medical record writing ability of the interns were compared, and the satisfaction of the experimental group was investigated. SPSS 25.0 software was used for t test and chi-square test. Results:The medical record writing results of the experimental group were (96.15±3.00) points, significantly higher than that of the control group [(81.02±3.29) points], and the differences were statistically significant ( t = 26.38; P < 0.001). In the mini-clinical evaluation exercise (Mini-CEX), the scores of medical history collection, communication skills, humanistic care and physical examination were significantly higher than those of the control group ( t= 15.41, 17.67, 15.39 respectively; all P < 0.001). The experimental group had high satisfaction with the teaching method of TSSP consultation training. Conclusion:TSSP consultation training improves the intern medical record writing ability, doctor-patient communication ability, clinical operation ability, stimulates the learning interest of interns, trains the trainee doctors humanistic consciousness, integrates into the ideological and political education, effectively ensures the quality of practical teaching of pediatrics, and obtains recognition from intern, which is worth promoting.
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Due to the reduction of patient cooperation and the limitation of clinical diseases, general practitioners lack effective acceptation training in the training process. To improve this situation, this study applies teacher standardized patients (TSP) combined case-based learning (CBL) to the acceptation ability training of general practitioners in medically unexplained physical symptoms (MUPS). And the acceptation ability and communication ability of 15 general practitioners were evaluated before, during and after the training. It shows that the application of "TSP + CBL" in the acceptation ability training of general practitioners in MUPS can effectively improve the acceptation ability and communication ability of general practitioners.
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In view of the problems existing in the probation teaching of obstetrics and gynecology, such as patients' non-cooperation, few cases and few practical opportunities. This study discusses the application effect of case teaching based on "Rain Classroom" and standardized patients in the obstetrics and gynecology probation course. The teaching is carried out by carefully selecting cases, refining pre-class preparation, adopting various teaching forms, and carrying out evaluation after class. In order to evaluate the teaching effect, an anonymous survey was carried out among 330 undergraduate interns majoring in clinical medicine, prevention, and forensic medicine in Batch 2015. The results showed that 210 (93.8%) of 224 (67.9%) students who participated in the survey believed that this method could promote learning enthusiasm and 200 students (89.3%) thought it could activate classroom atmosphere more than traditional teaching; most students thought it improved students' communication ability (163, 72.8%), clinical practice ability (189, 84.4%), and ability to analyze and solve problems (171, 76.3%) and deepening the understanding, mastery and application of knowledge (158, 70.5%). It shows that this method can improve the teaching effect of obstetrics and gynecology probation course to a certain extent.
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Objective:To analyze and discuss the application value and teaching effect of simulate patients (SP)-assisted problem-based learning (PBL) combined with team-based learning (TBL) mode in pediatric first aid teaching, in order to provide a new reference for the reform of standardized residency training and teaching mode of pediatrics in the new era in China.Methods:A total of 103 residents who participated in the standardized training in the Department of Pediatrics of Hunan Children's Hospital from January 2018 to December 2020 were selected as the research objects, and they were divided into the control group (50 cases) and the experimental group (53 cases). The control group adopted the previous teaching mode of residents, while the experimental group adopted the SP-assisted PBL combined with TBL mode. In this study, SPSS 22.0 software was used for t test and chi-square test. Results:The examination scores of the experimental group in the theoretical knowledge of pediatric first aid, clinical thinking and skills, and application of pediatric first aid skills were higher than those in the control group [(86.98±3.42), (85.69±5.13), (89.62±4.75)] vs. [(77.23±4.16), (81.16±3.96), (76.54±5.78)], with statistically significant differences between the two groups ( P<0.05). The questionnaire survey showed that the clinical thinking and pediatric emergency skills, doctor-patient communication ability, teamwork ability and other aspects of the experimental group were significantly better than those of the control group ( P<0.05). Conclusion:The SP-assisted PBL combined with TBL mode can produce positive effects in the standardized residency training of pediatrics, which will help residents better master pediatric first aid skills, improve their clinical comprehensive capabilities, and be more conducive to improving the quality of pediatric residency training, which is worth promoting in the new era.
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Student standardized patient refers to that students are trained to become standardized patients, and then they are applied to clinical teaching or examinations. The training of student standardized patients in China started late, but the development is relatively balanced and rapidly in recent years. Although an outline-style standardized teaching model has not yet been formed, the basic training framework of "basic training-case-specific training-training assessment" tends to be consistent, and different universities have certain specific innovations. The review combs the literature on the current training mode of student standardized patients in China, summarizes the innovations in four aspects: training population, training mode, training purpose and application method, then makes the conclusion about the objective problems and subjective difficulties faced by the current training, and proposes corresponding countermeasures and prospects.
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The application of "standardized patient" in clinical teaching of our country has the irreplaceable function, but it is still unavoidably challenged by ethics. From two aspects of medical ethics and teaching ethics, this paper puts forward the ethical basis for the justification of standardized patient application. And in order to ensure that the legitimate interests of standardized patients are not infringed, clinical teachers applying standardized patients must follow the principles of respect, protection of privacy and ethical supervision. Only in a legal and reasonable vision, can we promote the orderly development of standardized patients, and provide services for more doctors, medical students and patients.
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Objective:To explore the application effects of standardized patient (SP) and breast visual palpation simulation system on clinical probation of breast surgery for medical students.Methods:A total of 110 students were randomly divided into experimental group and control group, and each group was further divided into 5 subgroups. In the experimental group, SP scripts of five common diseases in breast surgery department were designed according to the syllabus before probation, and the teachers were trained. During the probation, we first talked about the characteristics of disease diagnosis and treatment, and then the five subgroups collected the history of the disease according to the SP of different diseases mentioned above, and checked the corresponding lesions on the breast visual palpation simulation system. In the physical examination, SP responded to the students' questions. The control group also talked about the above-mentioned five diseases during the probation, and then the five subgroups carried out history collection and physical examination for specific patients in the hospital. Finally, the teaching effects were analyzed through medical record writing, theoretical examination, physical examination and student evaluation. SPSS 26.0 was used for chi-square test (or Fisher exact test) and Mann-Whitney U test. Results:There was no significant difference in the theoretical examination between the two groups. It was demonstrated that the correct rate of experimental group was significantly higher than that of the control group in medical history collection, especially in the main symptoms, incentives, aggravation and remission factors, accompanying and differential symptoms and so on. And the positive results of breast, nipple and axillary lymph node palpation in the experimental group were significantly higher than those in the control group through the physical examination operation of breast visual palpation simulation system. The analysis of students' evaluation showed that the teaching efficiency of the experimental group increased, and the students' satisfaction was improved (satisfaction rate: 92.73% vs. 76.36%).Conclusion:The application of SP and breast visual palpation simulation system in breast surgery probation teaching can not only protect the privacy of clinical patients, but also improve the teaching effects, which can be popularized in the clinical teaching of breast surgery.
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Objective We used standardized patients to evaluate the accuracy and explore the influencing factors of the diagnosis of unstable angina pectoris and type 2 diabetes by primary healthcare providers in Sichuan rural areas,aiming to provide a scientific basis for improving the diagnosis accuracy of primary healthcare providers for the two chronic diseases. Methods A multi-stage stratified random cluster sampling method was adopted to select 100 villages from 50 townships in 5 districts/counties in Zigong city,Sichuan province. General and internal medicine practioners who were on duty on the survey day were enrolled in the survey.Two rounds of data collection were conducted.In the first round,the basic information of providers from township health centers and village clinics was collected.One month after the the first survey,standardized patients were used to collect the information related to the diagnosis of unstable angina pectoris and type 2 diabetes by rural primary providers.Logistic regression was carried out to analyze the factors influencing the diagnosis accuracy. Results A total of 172 rural primary healthcare providers were enrolled in the survey,who completed 186 standardized patient visits and showed the correct diagnosis rate of 48.39%.Specifically,the correct diagnosis rates of unstable angina pectoris and type 2 diabetes were 18.68%(17/91) and 76.84%(73/95),respectively.The providers with medical practitioner qualifications were more likely to make correct diagnosis(OR=4.857,95%CI=1.076-21.933, P=0.040).The providers who involved more necessary consultation and examination items in the diagnosis process had higher probability of correct diagnosis(OR=1.627,95%CI=1.065-2.485, P=0.024).Additionally,the providers were more likely to make a correct diagnosis for type 2 diabetes than for unstable angina pectoris(OR=6.306,95%CI=3.611-11.013, P<0.001). Conclusions The overall diagnosis accuracy of unstable angina pectoris and type 2 diabetes was relatively low among primary healthcare providers in Sichuan rural areas.The training of diagnosis process can be taken as a key for improving providers' practice ability so as to increase the diagnosis accuracy of chronic diseases.
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Humans , Angina, Unstable , China , Chronic Disease , Diabetes Mellitus, Type 2/diagnosis , Health Personnel , Primary Health Care , Surveys and QuestionnairesABSTRACT
Background: Clinical skills simulation (CSS) is an important tool in teaching and learning. The literature review showed a scarcity of research data regarding the use of CSS,in teaching, especially in dentistry. The use of CSS in dental teaching was found restricted to the use of low fidelity typhodonts fitted to phantom heads used in teaching cavity preparation and crown cutting. Aim: The aim of the study was to determine the efficacy of CSS using standardized patient in teaching behavior management and modification skills to dental undergraduate students. Settings and Design: This double-blinded, randomized controlled trial was undertaken among 3rd year dental undergraduate students, and the study was undertaken at the Department of Pediatric and Preventive Dentistry. Materials and Methods: Fifty, 3rd year BDS students were randomly allotted to simulation and nonsimulation groups. Baseline data regarding their knowledge in the behavior management of child patients were assessed. Simulation group was further divided into group of six students and underwent CSS with standardized patient. Pretest and posttest knowledge regarding behavior management was assessed in the simulation group using questionnaires approved by an expert committee. The results were analyzed to see if there is any improvement in their knowledge after CSS. Students in simulation and nonsimulation groups were assessed for their behavior management skills during patient management, by an independent observer, using a checklist. Statistical Analysis: Mean, standard deviation (SD), and unpaired student t-test were done to assess the baseline knowledge of students who participated in the study. Mean, SD, and paired t-test were used to compare the pretest and posttest score of students who underwent simulation. Mean, SD, and unpaired t-test were used to compare the behavior management skills of both groups of students. Results and Conclusions: The knowledge of students in both groups before the study was comparable with no statistically significant differences. There was a statistically significant improvement in the knowledge of students who underwent CSS regarding behavior management of child patients. The unpaired Student's t-test showed a significant difference in the behavior management skill of dental undergraduate students when treating a child patient. The students who underwent CSS fared better compared to students who were taught behavior management methods by traditional methods only. Clinical skill simulation using standardized patient is an effective adjunct to be used along with traditional method of teaching while teaching behavior management and modification skills to dental undergraduate students.
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Objective:To study the effect of micro-course teaching combined with teacher standardized patient combined with objective structured clinical examination (TSP/OSCE) on clinical practice teaching of pediatric nursing.Methods:Forty nurses who performed clinical practice in Pediatrics Department from February 2019 to July 2019 were selected as the control group, and traditional teaching was adopted in the group. In addition, 42 nurses who performed clinical practice in Pediatrics Department from August 2019 to January 2020 were selected as the research group, and the micro-course teaching combined with TSP/OSCE mode teaching was adopted in the group. Two groups of nurses' theoretical and practical skills assessment results were analyzed, and a questionnaire survey was conducted to assess nurses' satisfaction with the teaching of pediatric nursing clinical practice training mode. SPSS 22.0 was used for t test and chi-square test. Results:The research group nurses' theoretical and practical skills assessment scores were better than those of the control group, and the difference was statistically significant ( P=0.000).The nurses in the research group were more satisfied than those in the control group with such eight aspects as improving practical skills, emergency response capabilities, humanistic care and service capabilities, communication skills, and stimulating their interest in nursing learning. There were statistically significant differences ( P<0.05). Conclusion:The use of micro-teaching combined with TSP/OSCE mode in the clinical practice teaching of pediatric nursing can improve nurses' clinical practice ability and increase nurses' satisfaction in pediatric training.
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Objective:To explore the effect of student standardized patients in experimental teaching of Internal Medicine Nursing. Methods:Totally 440 undergraduate students in Batch 2016 from the Nursing Department of Chengdu Medical College were divided into 9 groups with 5-6 students in each group. The situational teaching method of students' standardized patients playing clinical cases was adopted in internal medicine experimental teaching, and the teaching effect was evaluated by the questionnaire survey after the class.Results:More than 90.45% (398/440) of the students thought that this teaching method could enhance the ability of knowledge understanding and memorizing, 91.36% (402/440) of them thought that it could improve their corporation with classmates, 90.23% (397/440) of them thought that various abilities such as clinical thinking could be improved, and 87.27% (384/440) of them were satisfied with it.Conclusion:Applying standardized patients to the experimental teaching of internal medicine nursing is effective and can stimulate students' learning enthusiasm, thus improving the teaching effect.
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Objective:To enhance the comprehensive learning and clinical practice capabilities of intravenous therapy specialized nurses based on the "Internet+" and standardized patient (SP) multidisciplinary linkage teaching.Methods:In this study, 54 nurses who took training of the intravenous therapy specialists in Chaoyang Hospital affiliated to Capital Medical University from July 2019 to December 2019 were selected as research subjects and randomly divided into a control group and a study group, with 27 ones in each group. The control group used traditional training of intravenous therapy specialized nurse, and the research group used the multidisciplinary linkage model of "Internet+" and SP. After the training, the nurses were assessed for theoretical and practical operation and satisfaction surveys, and the incidence of venous catheterization complications during the training of the two groups of nurses was counted. SPSS 22.0 was used for t test and chi-square test. Results:There was no statistically significant difference between the two groups of nurses in the theoretical assessment of basic knowledge and professional knowledge ( P>0.05). The total score of case analysis and theoretical assessment of the study group was higher than that of the control group, and the difference was statistically significant ( P<0.001). The nurses of the study group scored higher than the control group did in such 8 aspects, namely, central venous catheter (CVC) maintenance, peripherally inserted central catheter (PICC) placement, PICC maintenance, infusion port maintenance, peripheral venous catheters, aseptic technique, prevention and treatment of catheterization complications, and health education, with statistically significant differences ( P<0.05). There were statistically significant differences in the average score of nurse satisfaction between the two groups [(85.4±3.7) vs. (95.7±2.6)], and in the incidence of complications between the two groups ( χ2=4.618, P=0.032). Conclusion:"Internet+" and SP multidisciplinary linkage teaching helps to enhance the comprehensive learning and clinical practice ability of intravenous therapy specialized nurses, reduce the incidence of complications, enable patients to receive high-quality intravenous infusion therapy and care, and ensure the safety of patients.
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Objective:To investigate the current situation of standardized patient programs and standardized patient educators in China, and to analyze the existing problems in the implementation.Methods:Questionnaire survey was used in this study. The questionnaire was made by Delphi method, and distributed via E-mails or through the internet to medical colleges, affiliated hospitals and general hospitals across the country. Microsoft Office Excel 2016 was used for data reduction and analysis and cartography.Results:A total of 94 medical colleges and hospitals of 27 provinces and municipalities participated in the survey, of which 43.62% had carried out standardized patient programs. The primary factor affecting the program implementation was the lack of standardized patient educators. The existing trainers were mainly clinicians or nurses, and the main way of training the educators was to send them to other universities for learning. A majority of respondents (94.68%) think it is necessary to establish and formulate a unified national certification system for standardized patient educators.Conclusion:The development of standardized patient program is unbalanced in China, and the lack of standardized patient educators has become the primary factor restricting the development. In order to make standardized patients a greater role in medical education, we should encourage different types of personnel to join in the standardized patient training team, to clarify the responsibilities of standardized patient educators, to standardize the process of trainers training, and to establish the certification system of standardized patient educators.
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RESUMEN Introducción: Actualmente, la simulación clínica ha transformado la enseñanza de la medicina favoreciendo el aprendizaje experiencial y significativo de los médicos en formación, por lo que el objetivo de este estudio es evaluar el desempeño del profesionalismo y la comunicación, durante un escenario de simulación clínica con paciente estandarizado para estudiantes del quinto grado de la licenciatura de Médico Cirujano de la Facultad de Medicina de la Universidad Nacional Autónoma de México. Métodos: Es un estudio observacional, descriptivo y transversal, se obtuvo una muestra n=387 (45.6% del total) estudiantes de quinto grado de la Licenciatura de Medicina de la universidad. Se utilizó un escenario de simulación clínica con pacientes estandarizados, además de una rúbrica para evaluar el profesionalismo y la comunicación. Se realizó el cálculo estadístico con análisis de porcentajes por ítem y categoría. Resultados: Se realizó la base de datos y análisis estadístico con Excel de los 387 estudiantes y se encontró que la competencia profesionalismo es excelente en el 62%, bueno en el 33 % y deficiente en el 5% de la población, mientras que en comunicación es excelente en 60%, bueno en 37% y deficiente en 3%. Discusión: Se demuestra que en la relación médico-paciente existe justicia social, respeto y confidencialidad, pero carece de la conservación del principio de autonomía del paciente, empatía y compasión. Es posible evaluar el desempeño del profesionalismo y comunicación a través de la simulación clínica.
ABSTRACT Introduction: Currently, clinical simulation has changed the teaching of medicine in favor of the experiential, meaningful based learning of doctors in training, that is why the objective of this study is to evaluate the performance of professionalism and communication in a scenario of clinical simulation with a standardized patient for 5th grade students of the degree of medical surgeon of the UNAM School of Medicine. Methods: It is an observational, descriptive and cross-sectional study. A sample n = 387 (45.6% of the total) was obtained from fifth year students of the UNAM medical degree. A clinical simulation scenario with standardized patients was used, as well as a rubric to evaluate professionalism and communication. The statistical calculation was performed with the analysis of percentages by item and category. Results: The database and statistical analysis of the 387 students was made with Excel, finding that the competence of professionalism is excellent in 62%, good in 33% and deficient in 5% of the population, while in the competence of communication is excellent in 60%, good in 37% and deficient in 3%. Discussions: It is demonstrated that there is social justice, respect and confidentiality in the doctor-patient relationship, but there is a lack at the time of maintaining the patient's autonomy, empathy and compassion principle. It is possible to evaluate the performance of professionalism and communication through clinical simulation.
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Due to pediatric patients,there are the absence of clinical cases and the conflict between physicians and patients during teaching. Formative assessment(FA)is a teaching method to provide feedback and correctives at each stage in the teaching-learning process,which has been applied in clinical training for medical students and resident standardizing training recent years. Standardized patient(SP)is a simulated teaching tool,and when SPs are introduced in formative assessment by applied to history taking,patient education and counseling and communication skills. The combination not only solves the scarcity of clinical cases,but avoids doctor-patient contradiction. Therefore,SPs provide a broader application prospect for formative assessment. In fact,the combination offers new ideas for pediatric teaching.
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Objective To investigate the teaching effect of standardized patient teaching model in the practice teaching of emergency medicine. Methods A total of 50 standardized training residents were randomly divided into experimental group and control group during the process of medical history collection and special physical examination. The residents in the experimental group were taught with the standardized patient teaching model, and those in the control group were taught with the model of traditional theory teaching followed by clinical practice. Assessment was performed after the course was completed. Results Compared with the control group, the experimental group had significantly higher scores of medical history collection and physical examination (P<0.05). The experimental group also had significantly higher scores of communication and humanistic concern than the control group (P<0.05). The questionnaire survey showed that the medical students preferred the standardized patient teaching model, and they thought such model could improve doctor-patient communication ability and clinical practice ( P<0 . 05 ) . Conclusion The standardized patient teaching model can significantly improve the effect of practice teaching of emergency medicine and plays an important role in improving the clinical skills of medical students in emergency.
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Objective To explore the application of standardized patients (SP) in practice course of diagnostics.Methods The two classes of 135 students majoring in clinical medicine were selected as research.After the practical course in inquiry,the questionnaires were used to compare the teaching effect between the traditional teaching and SP teaching.Meanwhile,the students evaluated and gave feedback on SP work.Results The questionnaires on teaching effect showed that 127 (94.8％) students believed that the SP teaching method could stimulate interest in inquiry,125 students (93.3％) thought it could increase the understanding and memory of the inquiry content.127 students (94.8％) thought it could improve the application ability of the inquiry method,128 students (95.5％) thought it could improve inquiry techniques,129 students (96.3％) thought it could enhance expression ability,89 students (66.4％) thought it could enhance cooperation with their classmates,117 students (87.3％) thought it could enhance the confidence in communication,115 students (85.8％) thought it could improve their ability in independent thinking and self-study,126 students (94.0％) thought it could improve the learning effect,117 (87.3％) students thought it could develop their clinical thinking ability,116 students (86.6％) thought it could improve the satisfaction to teaching form,111 students (82.8％) thought it could develop the ability to answer patients' problems in a manner which is easy for patients to understand,and 126 (94.0％) students thought it could improve the ability to interact with patients.All issues were significantly better than the traditional teaching method Compared with the traditional teaching method,the students' choices on various items have statistically significant differences (P＜0.05).Conclusion Applying SP teaching to the practice courses of diagnostics is helpful to improve the teaching effect and cultivate students' clinical thinking ability.Thus,it is a promising teaching method in medical undergraduate education and worthy of further discussion and popularization.
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According to the present situation and the current issues in the training of The Therapeutics of Acupuncture and Moxibustion Course, Teachers Standardized Patient(TSP) is suggested to be using in the training and the course assessments, to set up a high-quality TSP team and build up a practical teaching platform; combining the advantages from multiple teaching methods a carefully designed script, standardized training course, objective assessments as well as PBL and CBL, to improve the quality of practice teaching. Putting TSP in the classroom is the demand of the reformation of The Therapeutics of Acupuncture and Moxibustion Course, and it is also a vital approach and shortcut that leading to improve the teaching quality and to effectively create a clinical thought for medical students, especially in the shortage of medical resources nowadays.
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Objective To investigate the feasibility of student standardized patient (SSP) in practice. Methods Undergraduates majoring in TCM clinic in grade 2011 in Heilongjiang University of Chinese Medicine were set as subjects and were under the cultivation of new SSP teaching model and traditional teaching model respectively. Objective theory paper examination, clinical skill score and student subjective evaluation were used for the research on teaching efficacy. Results Students in the experimental group were better than their peers in the control group in the aspects of objective theory paper examination and clinical skill score (P<0.05), with good student feedback. Conclusion SSP combining simulated wards in teaching of TCM surgery can provide great help for the transformation of clinical students to clinical doctor, which should be a new teaching model in TCM surgery with further digging and promotion.