- 期刊
國外醫學生的虛擬病人臨床思辨訓練經驗
The Uses of Virtual Patients on Clinical Reasoning Training in International Medical Students
摘要
背景目的：跨國習醫常因為語言溝通與文化的隔閡，造成學習的困難，義守大學國際醫學生有兩年臨床實習，需要與台灣民眾互動，又臨床診斷關係病人安全與醫療品質，特別需要重視。本研究以智慧科技提供的虛擬病人（VP, Virtual Patient）可以英文跨越語言與地域差異，使臨床教育更具成效。研究方法：以英文案例虛擬病人帶出各樣疾病症狀，要求習醫者解決其問題，以問診、體檢、各種臨床檢驗、影像學與生理檢查等診療程序，學生由蒐集之資料、分析整理，而做出正確診斷，系統紀錄完整過程資料並立即結算成績，提供回饋指導。參加者為三、四年級自願參加的國際醫學生，以虛擬病人（VP-Based）PBL小組模式進行，由學生擔任主持人、紀錄者、打字者及組員，而教師觀察並給予回饋。最後學生填寫滿意度及自我評估問卷。研究結果：選用了IMT的V-DxM三個英文案例，共81位義守大學國際醫學生參加，獲得56份（填答率69.1%）問卷結果。問卷25項問題之平均滿意度為83.4% ± 0.09%。學生認為可以增強醫學知識以及臨床診斷能力、及增加解決病人問題的技能醫學知識；認為這種科技輔助的學習是必要的。學生自評可以學習到最多的是「解決病人問題的思辨能力」及「醫學知識」，其次是「問診及溝通」，較不足的是「醫療專業素養」，大約只有一半的學生認同對虛擬病人問診可以接近對真實病人的情境（51.8%）。「V-DxM虛擬診療訓練系統」基於經驗式學習教育理論而建構，而有助於學習者自我持續進步。結論：國際醫學生對此創新的VP-PBL教育訓練以異國語言進行，用於臨床診斷思辨能力訓練頗感滿意，可引起學習者學習動機，感受到自己解決病人問題（臨床診斷）能力及醫學知識的增加。
並列摘要
Background: Studying medicine across language and cultural boundary has been considered difficult. International medical students in I-Shou School of Medicine may face challenges on learning clinical reasoning with Taiwanese patients in their clinical years. The innovated V-DxM offers English interface and wide varieties of disease presentations, thus can be used to increase trainees' competency on clinical diagnoses. Methods: The study used V-DxM in PBL activities. The invited participants are year 3 and 4 International medical students in I-Shou School of Medicine. To solve virtual patients' problems the participants, as a group, started with medical interview, physical examination, laboratory investigations and concluded with a list of diagnoses. The ＂machine＂ generated students' scores and gave feedback immediately at the end. Finally, the teacher also delivered feedback, and students completed satisfaction and reflection questionnaires. Results: The participants were 81 medical students, with questionnaire response rate of 69.1% (56/81). The average satisfaction proportions were 83.4% ± 0.09%. The students responded the program can enhance their clinical competency mostly on clinical reasoning and medical knowledge, followed by interviews and communication. Conclusion: The English V-DxM was used successfully to teach and learn clinical reasoning and medical knowledge. The program was considered interesting and effective.