Virtual Standardized Patients for Assessing the Competencies of Psychologists
Virtual Standardized Patients for Assessing the Competencies of Psychologists
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用于评估心理学家能力的虚拟标准化患者
DOI：
10.4018/978-1-4666-5888-2.ch637
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
T. Parsons
中科院分区：
文献类型：
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作者：
T. Parsons
临床能力的发展包括具备完成临床任务所必需的知识和能力。临床医生的培训旨在将学生从新手提高到至少是合格临床医生的初级水平。每种技能都有发展轨迹（Spruill et al., 2004）。一个具有挑战性的任务是开发有效的方法来评估培训面试技巧和鉴别诊断。评估的一个领域侧重于多项选择题考试。虽然这样的测试已经被证明有可靠的结果，但选择题考试通常写得很差，倾向于基于回忆的知识，缺乏内容效度，并且包括选项的提示效应（Frederiksen, 1984）。另一种方法是利用论文为基础的考试，来衡量临床判断。作文题的一个明显的限制是涉及大量的时间和主观解释的可能性。也许在过去几十年里最广泛使用的方法是客观结构化临床检查（OSCE; Doig et al., 2000）。欧安组织为教育工作者提供客观和结构化的能力评估（哈登，1988）。欧安组织的一个限制是它涉及多个站点（Barrows， 1993年）。目前采用欧安组织的治疗培训系统采用真人（雇佣演员或学生）作为标准化的病人来描述有特定心理健康问题的病人。例如，几十年来，精神科医生的培训一直涉及使用标准化的病人。在20世纪60年代，Barrows和Abrahamson（1964）主张使用“程序化”患者（标准化患者）来评估学生在临床技能发展中的表现。在过去的十年中，美国医学院协会越来越支持在教学和评估学生临床技能时使用标准化患者（Yudkowsky, 2002）。此外，研究生医学教育认证委员会和国家医学检查委员会鼓励培训项目将标准化患者纳入临床技能发展评估。
The development of clinical competence involves having the requisite knowledge and abilities to accomplish clinical tasks. Training of clinicians aims to progress the student from novice to at least the initial level of a competent clinician. Each skill has a developmental trajectory (Spruill et al., 2004). A challenging task is that of developing effective methods for assessing the training interview skills and differential diagnoses. One area of assessment has focused on multiple-choice question examinations. While such tests have been shown to have reliable results, multiple-choice question examinations are often poorly written and tend to favor recall-based knowledge, lack content validity, and include cueing effect of the options (Frederiksen, 1984). Another approach is to make use of essay-based examination, to measure clinical judgment. An obvious limitation of essay questions is the large amount of time involved and the potential for subjective interpretation. Perhaps the most widely used approach over the past couple decades has been the Objective Structured Clinical Examination (OSCE; Doig et al., 2000). The OSCE offers educators an objective and structured competency assessment (Harden, 1988). A limitation of the OSCE is that it involves multiple stations (Barrows, 1993). Current therapeutic training systems that employ the OSCE resort to using real persons (hired actors or students) acting as standardized patients to portray patients with given mental health problems. Training of psychiatrists, for example, has involved the use of standardized patients for decades. In the 1960s, Barrows and Abrahamson (1964) argued for the use of a “programmed” patient (standardized patient) for appraising student performance in the development of clinical skills. In the past decade, the American Association of Medical Colleges has increasingly endorsed the use of standardized patients in teaching and evaluating students’ clinical skills (Yudkowsky, 2002). Further, the Accreditation Council for Graduate Medical Education and the National Board of Medical Examiners have encouraged training programs to incorporate standardized patients into assessments of clinical skill development.