BACKGROUND: History-taking is an essential clinical competency for qualified doctors. The limitations of the standardized patient (SP) in taking history can be addressed by the virtual standardized patient (VSP). This paper investigates the accuracy of virtual standardized patient simulators and evaluates the applicability of the improved system\'s accuracy for diagnostic teaching support and performance assessment.
METHODS: Data from the application of VSP to medical residents and students were gathered for this prospective study. In a human-machine collaboration mode, students completed exams involving taking SP histories while VSP provided real-time scoring. Every participant had VSP and SP scores. Lastly, using the voice and text records as a guide, the technicians will adjust the system\'s intention recognition accuracy and speech recognition accuracy.
RESULTS: The research revealed significant differences in scoring across several iterations of VSP and SP (p < 0.001). Across various clinical cases, there were differences in application accuracy for different versions of VSP (p < 0.001). Among training groups, the diarrhea case showed significant differences in speech recognition accuracy (Z = -2.719, p = 0.007) and intent recognition accuracy (Z = -2.406, p = 0.016). Scoring and intent recognition accuracy improved significantly after system upgrades.
CONCLUSIONS: VSP has a comprehensive and detailed scoring system and demonstrates good scoring accuracy, which can be a valuable tool for history-taking training.

Using simulated patients to mimic 9 established noncommunicable and infectious diseases, we assessed ChatGPT\'s performance in treatment recommendations for common diseases in low- and middle-income countries. ChatGPT had a high level of accuracy in both correct diagnoses (20/27, 74%) and medication prescriptions (22/27, 82%) but a concerning level of unnecessary or harmful medications (23/27, 85%) even with correct diagnoses. ChatGPT performed better in managing noncommunicable diseases than infectious ones. These results highlight the need for cautious AI integration in health care systems to ensure quality and safety.

UNASSIGNED: Integrating life-threatening clinical simulations improves learning outcomes. This study assessed nursing students\' critical thinking factors before and after simulation, evaluated nursing clinical reasoning ability and learning satisfaction at two time points, and explored relationships and predictions among critical thinking, clinical reasoning, and satisfaction before and after simulation.
UNASSIGNED: Surveys and focus groups were used for this mixed-methods study.
UNASSIGNED: Quantitative findings revealed increased critical thinking scores for curiosity, skepticism, and systematicity; clinical reasoning; and satisfaction after simulation. Qualitative results supported these improvements and indicated enhanced curiosity for clinical knowledge and iterative phases of clinical reasoning. Students expressed satisfaction with the simulations. Objectivity significantly influenced clinical reasoning and satisfaction in nursing students following life-threatening simulations.
UNASSIGNED: Fostering a culture of critical thinking in life-threatening simulations is crucial. Educators must teach the importance of objectivity in clinical practice, encourage critical evaluation, and foster self-reflection in simulations. [J Nurs Educ. 2024;63(9):595-603.].

UNASSIGNED: Medical mis- and disinformation are on the rise and impact patient health outcomes. The complexity of modern medicine and health care delivery necessitates that care be delivered by an interprofessional team of providers well versed in addressing this increased prevalence of medical misinformation. Health professions educational curricula often lack opportunities for students to learn how to address medical misinformation, employ advanced communication techniques, and work collaboratively.
UNASSIGNED: Based on literature and our previous qualitative research, we created a module offering prework learning on COVID-19 and addressing misinformation through advanced communication techniques and interprofessional collaboration. After completing prework, students participated in a standardized patient encounter addressing COVID misinformation. Health professions student dyads completed a preencounter planning huddle and together interviewed a standardized patient. Students received global and checklist-based feedback from standardized patients and completed pre- and postsession self-assessments.
UNASSIGNED: Twenty students participated (10 third-year medical, nine third-year pharmacy, one fourth-year pharmacy). Key findings included the following: Nine of 15 survey questions demonstrated statistically significant improvement, including all three questions assessing readiness to have difficult conversations and six of 10 questions assessing interprofessional collaboration and team function.
UNASSIGNED: Students participating in this novel curriculum advanced their readiness to address medical misinformation, including COVID-19 vaccine disinformation, with patients and coworkers to improve health decision-making and patient care. These curricular methods can be customized for use with a range of health professions learners.

UNASSIGNED: Medical misinformation, which contributes to vaccine hesitancy, poses challenges to health professionals. Health professions students, while capable of addressing and advocating for vaccination, may lack the confidence to engage with vaccine-hesitant individuals influenced by medical misinformation.
UNASSIGNED: An interprofessional in-person simulation activity (90 minutes) using standardized patients was developed and instituted for students in medicine, nursing, pharmacy, and public health programs. Student volunteers were recruited from classes approximately halfway through their respective degree programs (i.e., second or third year of a 4-year program). Online simulation was used as a method to prepare for in-person simulation. Impact on students was assessed primarily through a postprogram student self-assessment.
UNASSIGNED: A total of 220 students participated in the program; 206 (94%) had paired data available to analyze. Following program participation, self-assessed abilities increased from pre to post, from 2.8 out of 5 (good) to 3.9 out of 5 (very good; p < .001). Ninety-eight percent of students felt that their ability to address medical misinformation was somewhat/much better after the activity, compared to before, and that their ability to address vaccine hesitancy was somewhat/much better. The overall program was rated highly, with mean scores for each program evaluation item >4 out of 5 (very good).
UNASSIGNED: An interprofessional cohort of students demonstrated improvement in self-assessed skills to participate in a conversation with an individual with hesitancy to receive vaccines and/or beliefs informed by misinformation. Students felt that this program was relevant and important to their professional development.

Background and Purpose: An education program to improve the delirium care competency of nurses is important as they play an integral role in caring for patients with delirium. This study aimed to examine the effects of a standardized patient (SP)-based delirium care education program on new graduate nurses\' performance and self-confidence. Methods: A waitlist control group with a crossover design was adopted. The SP-based delirium care education program was designed, implemented, and evaluated. Generalized estimating equations were used to analyze differences in performance and self-confidence scores between the intervention and waitlist control groups. Results: The education program was found to significantly affect rater-assessed performance, SP-assessed performance, and self-confidence when controlled for gender and age. Implications for Practice: An SP-based delirium care education program improved new graduate nurses\' performance and self-confidence in caring for patients with delirium. Nurse educators should provide experiential learning opportunities to ensure that recent nurse graduates have achieved optimal delirium care competency.

BACKGROUND: The condition of trauma patients and the urgent need for timely resuscitation present unique challenges to trauma teams. These difficulties are exacerbated for military trauma teams in combat environments. Consequently, there is a need for continued improvement of nontechnical skills (NTS) training for trauma teams. However, current approaches to NTS assessment rely on subjective ratings, which can introduce bias. Accordingly, objective methods of NTS evaluation are needed. Eye-tracking (ET) methods have been applied to studying communication, situation awareness, and leadership in many health care settings, and could be applied to studying physicians\' NTS during trauma situations. In this study, we aimed to assess the relationship between trauma team leaders\' objective gaze patterns and subjective expert NTS ratings during patient care simulations.
METHODS: After Institutional Review Board approval, 9 trauma teams from first-year post-graduate general surgery and emergency medicine residents were recruited to participate in 1 of 2 trauma simulations (a difficult airway case and a multi-patient trauma). Each scenario lasted approximately 15 minutes. All team leaders wore a mobile ET system to evaluate gaze metrics-time to first fixation (TTFF), average fixation duration (AFD), and total percentage of the scenario (TPS) focused on Areas of Interest (AOI), which included patient, care team, diagnostic equipment, and patient care equipment. Trained faculty raters completed the Non-Technical Skills for Surgeons (NOTSS) assessment tool and the Trauma Non-Technical Skills (T-NOTECHS) scale. One-way analysis of variance, Kruskal-Wallis, and appropriate post-hoc pairwise comparison tests were run to assess differences between ET metrics across AOI groups. Spearman\'s Rho tests were used to assess correlations between ET and subjective NTS ratings.
RESULTS: Compared to other NTS domains, trauma teams scored relatively poorly on communication across both T-NOTECHS (3.29$ \\pm $0.61, maximum = 5) and NOTSS (2.87$ \\pm $0.66, maximum = 4). We found significant differences in trauma team leaders\' TTFF between teammates and the patient (Team: 1.56 vs Patient: 29.82 seconds, P < .001). TTFF on the diagnostic equipment was negatively correlated (P < .05) to multiple measures of subjective NTS assessments. There were no significant differences in AFD between AOIs, and AFD on teammates was positively correlated (P < .05) to communication and teamwork. There were significant differences in TPS across most AOI pairs (P < .05), and the average TPS fixated was highest on the patient (32%). Finally, there were several significant correlations between additional ET and NTS metrics.
CONCLUSIONS: This study utilized a mixed methods approach to assess trauma team leaders\' NTS in simulated acute care trauma simulations. Our results provide several objective insights into trauma team leaders\' NTS behaviors during patient care simulations. Such objective insights provide a more comprehensive understanding of NTS behaviors and can be leveraged to guide NTS training of trauma physicians in the future. More studies are needed to apply these methods to capture NTS from a larger sample of teams in both simulated and real trauma environments.

暂无摘要。

UNASSIGNED: Shock is a life-threatening condition amongst hospitalized patients and requires urgent management to avoid mortality. Early exposure is vital for educational and patient safety purposes.
UNASSIGNED: We developed a 90-minute shock day session that provided internal medicine interns with a cognitive framework for the initial diagnosis and management of shock, which they applied to two simulations. The first simulation involved a patient with septic shock, and the second involved a patient with cardiogenic shock. Critical action checklists were used to assess learners and guide structured debriefs after each simulation. Medical decision-making and communication frameworks were presented through a presession video and a chalk talk. The curriculum was evaluated using pre- and postintervention surveys to assess knowledge and confidence.
UNASSIGNED: Forty-eight interns participated in the session in 2022 and 2023. We observed an increase in the percentage of learners correctly answering a knowledge-based question regarding the amount of fluid administered to a patient in septic shock (pre: 33%, post: 62%, p < .01), as well as increases in learner-reported confidence in leading a rapid response (pre: 9%, post: 62%) and in managing undifferentiated shock (pre: 13%, post: 56%), septic shock (pre: 20%, post: 83%), cardiogenic shock (pre: 2%, post: 54%), hemorrhagic shock (pre: 20%, post: 73%), and anaphylactic shock (pre: 22%, post: 54%, all ps < .01).
UNASSIGNED: Employing a variety of pedagogical methods, we demonstrated that intern knowledge and confidence regarding the management of a hypotensive patient during a rapid response can be increased through participation in our curriculum.

Bevezetés: Az orvosi kommunikációs készségek hatékony oktatásának széles körben elfogadott módszere a szimulációs betegek alkalmazásával végzett oktatás. A szimulációs betegek hozzájárulnak a klinikai készségek oktatásához és értékeléséhez is. Hazánkban intézményesített formában elsőként a Pécsi Tudományegyetem Általános Orvostudományi Karán indult 2019-ben a „Szimulációs Beteg” program a Kar mindhárom tannyelvű oktatásának támogatására. A program keretein belül laikus szimulációs betegek képzése és továbbképzése folyik magyar, angol és német nyelven. Célkitűzés: A program kari implementációjának fogadtatását négy évvel a program indulása után vizsgáltuk, magyar és nemzetközi hallgatóink körében. Tanulmányunkban a kutatás eredményeinek ismertetése mellett röviden bemutatjuk a program elméleti és gyakorlati vonatkozásait is. Módszer: Kutatásunk online kérdőíves felmérésre épült. A kérdőíves felmérés keresztmetszeti vizsgálattal, kényelmi mintavétellel történt a 2023. tavaszi szemeszterben. A kérdőív három skálája összesen 20 kérdésből áll. A zárt kérdéstípusok feleletválasztást, illetve rangsorolást tartalmaznak. A nyitott kérdések a pozitív tapasztalatok és a nehézségek szabad kifejtésére irányulnak. A vizsgálatot magyar, angol és német kommunikációs-szaknyelvi kurzusok hallgatói körében végeztük. A kutatásra 128 értékelhető válasz érkezett. Eredmények: Szignifikáns különbséget találtunk a három tannyelven tanuló csoportok értékelésében a szimulációs betegekkel folytatott konzultációk, valamint a visszajelzések megítélésében, illetve a szimulációs betegeket alkalmazó oktatás hatékonyságát illetően. A nyitott kérdésekre adott válaszokban a hallgatók a valós élethelyzetek gyakorlásának lehetőségét, a visszacsatolás jelentőségét, a magabiztosság növekedését, a szakmai fejlődést emelték ki. Következtetés: Korábbi kutatásokhoz hasonlóan a szimulációs betegeket alkalmazó módszertan bevezetését egyértelműen pozitívan fogadták hallgatóink. Jelen kutatásunk rámutatott ugyanakkor arra, hogy a különböző oktatási nyelven tanuló hallgatók eltérően súlyozzák a módszertan egyes elemeinek jelentőségét és kihatását a teljes tanulási folyamatra, illetve szakmai fejlődésükre nézve. Orv Hetil. 2024; 165(33): 1286–1294.