同伴角色扮演在国外医患沟通技能培训中的应用与启示

doi:10.3760/cma.j.cn115259-20221229-01600

摘要/Abstract

摘要： 同伴角色扮演(peer role play,PRP)是一种基于模拟的教学方法,运用于医学教育领域,医学生相互扮演医生、患者、家属等模拟情景相关角色,已被证明是培养医学生医患沟通技能的有效方法。本文介绍了PRP的教学设计和实施,着重梳理了国外运用PRP培训医学生医患沟通技能所取得的效果,并总结了国外研究对我国PRP教学的启示:PRP教学需要重视医学生对不同角色的参与体验、需要完善的课程设计以及与其他教学方法联合应用,以期为我国医学生医患沟通技能的培训提供参考。

关键词: 学生,医科, 同伴角色扮演, 医患沟通, 技能培训

Abstract: Peer role play (PRP) is a teaching method based on simulation. When applied in the field of medical education, medical students play the role of doctors, patients, family members and other simulated scenario-related roles. PRP has been proved to be an effective method to train medical students' doctor-patient communication skills. This paper describes the instructional design and implementation of PRP, focusing on the results achieved by using PRP training medical students' doctor-patient communication skills abroad, and summarizes the lessons of foreign research on PRP teaching in China: PRP teaching needs to attach importance to the participation experience of medical students in different roles, perfect curriculum design, and combine application with other teaching methods, so as to improve the training of doctor-patient communication skills.

Key words: Students, medical, Peer role play, Doctor-patient communication, Skills training

中图分类号:

周艺, 蔡咏仪, 刘林红, 朱广员, 钱丹丹. 同伴角色扮演在国外医患沟通技能培训中的应用与启示[J]. 中华医学教育杂志, 2023, 43(9): 712-716.

Zhou Yi, Cai Yongyi, Liu Linhong, Zhu Guangyuan, Qian Dandan. Lessons of applying peer role play in doctor-patient communication skills training abroad[J]. Chinese Journal of Medical Education, 2023, 43(9): 712-716.

参考文献

[1] Gelis A, Cervello S, Rey R, et al. Peer role-play for training communication skills in medical students: a systematic review[J].Simul Healthc,2020,15(2):106-111. DOI: 10.1097/SIH.0000
000000000412.
[2] Levine HG, McGuire CH. The use of role-playing to evaluate affective skills in medicine[J].J Med Educ,1970,45(9):700-705. DOI: 10.1097/00001888-197009000-00008.
[3] Bosse HM, Schultz JH, Nickel M, et al. The effect of using standardized patients or peer role play on ratings of undergraduate communication training: a randomized controlled trial[J].Patient Educ Couns,2012,87(3):300-306. DOI: 10.1016/j.pec.2011.10.007.
[4] Lauerer E, Tiedemann E, Polak T, et al. Can smoking cessation be taught online? A prospective study comparing e-learning and role-playing in medical education[J].Int J Med Educ,2021,12:12-21. DOI: 10.5116/ijme.5ff9.bccc.
[5] Ayuob NN, Qadi MA, El Deek BS, et al. Evaluation of a communication skills training course for medical students using peer role-play[J].J Pak Med Assoc,2017,67(5):745-751.
[6] Park KY, Park HK, Hwang HS. Group randomized trial of teaching tobacco-cessation counseling to senior medical students: a peer role-play module versus a standardized patient module[J].BMC Med Educ,2019,19(1):231. DOI: 10.1186/s12909-019-1668-x.
[7] 袁响林, 潘俐, 瞿秋, 等. 角色扮演教学法在临床医学专业留学生老年医学教学中的应用[J].中华医学教育杂志,2020,40(4):283-287. DOI: 10.3760/cma.j.cn115259-20191005-00823.
[8] 郑延龙, 朱振刚, 常力, 等. 角色扮演教学方法在中医硕士专业学位研究生呼吸内科学教学中的应用[J].中华医学教育杂志,2017,37(2):282-285. DOI: 10.3760/cma.j.issn.1673-677X.2017.02.028.
[9] 王伟, 朱立新. 急诊环境下以实践教学为主的医患沟通专项培训研究[J].中华医学教育探索杂志,2021,20(5):565-569. DOI: 10.3760/cma.j.cn116021-20200411-00491.
[10] Bruce J, Marsha W, Emily C. 教学模式[M]. 荆建华, 宋富刚, 花清亮, 译. 北京: 中国轻工业出版社, 2009: 153.
[11] Landousse GP. Role Play[M]. London: Oxford University Press, 1987: 5.
[12] Simpson MA. How to use role-play in medical teaching[J].Med Teach,1985,7(1):75-82. DOI: 10.3109/01421598509036794.
[13] Mills JK, Dalleywater WJ, Tischler V. An assessment of student satisfaction with peer teaching of clinical communication skills[J].BMC Med Educ,2014,14:217. DOI: 10.1186/1472-6920-14-217.
[14] Chandawarkar RY, Ruscher KA, Krajewski A, et al. Pretraining and posttraining assessment of residents' performance in the fourth accreditation council for graduate medical education competency: patient communication skills[J].Arch Surg,2011,146(8):916-921. DOI: 10.1001/archsurg.2011.167.
[15] 王爱芬. 浅析角色扮演法及其在学生心理发展中的意义[J].教育理论与实践,2007(S2):91-93.
[16] 赵铁夫, 许学敏, 马涵英, 等. 标准化病人在医学生医患沟通模拟教学中的应用评价[J].卫生职业教育,2015,33(1):100-101.
[17] Sankarapandian V, Rehman SM, David KV, et al. Sensitizing undergraduate medical students to consultation skills: a pilot study[J].Natl Med J India,2014,27(5):276-279.
[18] Papadakis MA, Croughan-Minihane M, Fromm LJ, et al. A comparison of two methods to teach smoking-cessation techniques to medical students[J].Acad Med,1997,72(8):725-727. DOI: 10.1097/00001888-199708000-00021.
[19] 杨琳, 阮洪. 培训评估模型应用于医学培训的研究进展[J].护理研究,2018,32(18):2831-2834. DOI: 10.12102/j.issn.1009-6493.2018.18.003.
[20] 郭鹏军, 严慧萍, 吴晨曦, 等. 柯氏模型在继续医学教育评估中的运用[J].卫生职业教育,2009,27(16):22-23. DOI: 10.3969/j.issn.1671-1246.2009.16.010.
[21] Bosse HM, Nickel M, Huwendiek S, et al. Peer role-play and standardised patients in communication training: a comparative study on the student perspective on acceptability, realism, and perceived effect[J].BMC Med Educ,2010,10:27. DOI: 10.1186/1472-6920-10-27.
[22] King J, Hill K, Gleason A. All the world's a stage: evaluating psychiatry role-play based learning for medical students[J].Australas Psychiatry,2015,23(1):76-79. DOI: 10.1177/1039856214563846.
[23] Vollath SE, Bobak A, Jackson S, et al. Effectiveness of an innovative and interactive smoking cessation training module for dental students: a prospective study[J].Eur J Dent Educ,2020,24(2):361-369. DOI: 10.1111/eje.12507.
[24] Robbé IJ, Burnie R. Breaking with tradition: case studies and role-play[J].Med Educ,2012,46(11):1106-1107. DOI: 10.1111/medu.12004.
[25] Servotte JC, Bragard I, Szyld D, et al. Efficacy of a short role-play training on breaking bad news in the emergency department[J].West J Emerg Med,2019,20(6):893-902. DOI: 10.5811/westjem.2019.8.43441.
[26] Darrason M, Souquet PJ, Couraud S. Standardized vs peer-played patients for learning how to break bad news in lung cancer: a prospective crossover study[J].Respir Med Res,2021,80:100856. DOI: 10.1016/j.resmer.2021.100856.
[27] Bouaoud J, Michon L, Saintigny P. Teaching how to break bad news in oncology: in-class vs. virtual peer role-plays[J].Bull Cancer,2022,109(6):685-691. DOI: 10.1016/j.bulcan.2022.02.009.
[28] Yeung J. Adverse Event disclosure training for nursing students: peer role-play and simulated patients[J].Int J Nurs Educ Scholarsh,2019,16(1)DOI: 10.1515/ijnes-2019-0094.
[29] Koponen J, Pyörälä E, Isotalus P. Comparing three experiential learning methods and their effect on medical students' attitudes to learning communication skills[J].Med Teach,2012,34(3):e198-207. DOI: 10.3109/0142159X.2012.642828.
[30] Hammick M, Dornan T, Steinert Y. Conducting a best evidence systematic review. Part 1: from idea to data coding. BEME Guide No. 13[J].Med Teach,2010,32(1):3-15. DOI: 10.3109/01421590903414245.
[31] Luttenberger K, Graessel E, Simon C, et al. From board to bedside-training the communication competences of medical students with role plays[J].BMC Med Educ,2014,14:135. DOI: 10.1186/1472-6920-14-135.
[32] Dalwood N, Bowles KA, Williams C, et al. Students as patients: a systematic review of peer simulation in health care professional education[J].Med Educ,2020,54(5):387-399. DOI: 10.1111/medu.14058.
[33] Schneider A, Messerer D, Kühn V, et al. Randomised controlled monocentric trial to compare the impact of using professional actors or peers for communication training in a competency-based inverted biochemistry classroom in preclinical medical education[J].BMJ Open,2022,12(5):e050823. DOI: 10.1136/bmjopen-2021-050823.
[34] Laughey W, Sangvik Grandal N, Stockbridge C, et al. Twelve tips for teaching empathy using simulated patients[J].Med Teach,2019,41(8):883-887. DOI: 10.1080/0142159X.2018.1481283.
[35] Schlegel C, Woermann U, Shaha M, et al. Effects of communication training on real practice performance: a role-play module versus a standardized patient module[J].J Nurs Educ,2012,51(1):16-22. DOI: 10.3928/01484834-20111116-02.
[36] Mills JK, Dalleywater WJ, Tischler V. An assessment of student satisfaction with peer teaching of clinical communication skills[J].BMC Med Educ,2014,14:217. DOI: 10.1186/1472-6920-14-217.
[37] van Dalen J, Zuidweg J, Collet J. The curriculum of communication skills teaching at Maastricht Medical School[J].Med Educ,1989,23(1):55-61. DOI: 10.1111/j.1365-2923.1989.tb00812.x.
[38] Humair JP, Cornuz J. A new curriculum using active learning methods and standardized patients to train residents in smoking cessation[J].J Gen Intern Med,2003,18(12):1023-1027. DOI: 10.1111/j.1525-1497.2003.20732.x.