標準病人與醫學教育

Standardized Patient and Medical Education

謝正源(Jane-Yane Shieh) ； 張博彥(Bor-Yann Chang) ； 高森永(Senyeong-Kao) ； 王如娥(Ju-O Carol Wang) ； 何善台(Shung-Tai Ho) ； 張聖原(Sun-Yran Chang)

《Journal of Medical Education》 8卷3期 (2004/09) Pp. 243-254

https://doi.org/10.6145/jme.200409_8(3).0002

摘要

醫學教育的主要目標之一爲培養具有良好臨床能力的醫學人才。臨床能力包含獲得病患病史的資訊收集能力、病患身體檢查、應用臨床醫學知識解決臨床問題、與病患及同儕有效率的溝通技巧、整合前述不同面向的問題進而解決臨床遭遇的各種問題等。而傳統的臨床技能評量方式著重於紙筆測驗，能否測得學生實際學習成效也成爲令人質疑之處。標準病人包含正常人或具有某種標準疾病型態之病人，被訓練以標準化的方式表演特定的疾病。其具有模擬病人症狀與疾病病程的能力，能將臨床個案做正確、完整及重複的演出，也具有與醫學生互動、評估臨床能力的方法。目前在美國、加拿大已廣泛地以標準病人做爲教學、評估醫學院學生、住院醫師學習成效及專業執照攷試之方法，故標准病人方法值得國內醫學教育界參攷應用。本文主要著重於標準病人之。探討有關標準病人設計、選擇標準病人、訓練團隊、標準病人之訓練等實際做法，並提出國內、外目前標準病人實施現況，更進而提出對於標準病人於國內如何運用之淺見，期能做爲發展標准病人教學方法之參攷。

關鍵字

標準病人 ； 臨床能力

並列摘要

One of the main goals of medical education is to improve students’ clinical competence. Clinical competence encompassed a wide variety of clinical skills, including the ability to obtain the history and to do physical examination, applying medical knowledge to clinical problems, effective use of communication skill with patients and peers, and the ability to integrate all of these abilities to solve problems during a clinical encounter. The traditional clinical examination in Taiwan uses mostly multiple choice questions. Whether this type of examination can effectively evaluate students is open to question. The standardized patient (SP) includes both normal people and actual patients with standard illnesses who have been coached to present their own illnesses in a standardized way. He can portray symptoms and progress of illnesses completely, correctly, and repeatedly. He can interact with, evaluate, and give feedback to students. The SP is therefore viewed as a excellent means for teaching and evaluating clinical competence. Currently, the trend toward using SPs to evaluate students’ clinical competence is growing in the USA and the Canada. The SP is therefore worthy of attention and application in Taiwan. This article discusses how to design SP tests, select SPs, and organize a training team, as well as the limits of SPs, and the trends in SP in our country and aboard. It is hoped that it will be of use to those developing SPs in Taiwan in the future. (Full text in Chinese)

並列關鍵字

standardized patient ； clinical competence

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