标准患者与虚拟患者的诊断能力评估:卡塔尔世界杯8强波胆分析历史背景下的实验研究，马克西米利安·C·A·雷特迈尔，维多利亚·A·斯塔德勒，马蒂亚斯·A·西贝克，马蒂亚斯·A·费舍尔，弗兰克·A·费舍尔，马丁·R·R +医学教育研究所，慕尼黑大学附属医院，Pettenkoferstraße 8a，慕尼黑，80336，德国，49 089 4400 57428，maximilian.fink@yahoo.com %K临床推理%K医学教育%K基于绩效的评估%K模拟%K标准化患者%K虚拟患者%D背景:标准化患者(SPs)是几十年来临床教学中流行的评估方法之一，尽管它是资源密集型的。如今，模拟虚拟患者(vp)的使用越来越多，因为它们是永久可用的，并且完全可扩展到大量受众。然而，比较这些评估方法的差异效果的实证研究缺乏。同样，这些评估方法中与诊断能力相关的关键变量(即诊断准确性和证据生成)之间的关系仍需要进一步研究。目的:本研究的目的是比较在基于绩效的评估中使用sp和vp的感知真实性、认知负荷和诊断能力。本研究亦旨在探讨认知真实性、认知负荷和证据生成质量与诊断准确性的关系。方法:对86名医学生(平均26.03岁，SD 4.71)进行了呼吸困难病史调查。在这个重复测量研究中，参与者解决了三个SPs病例和三个VPs病例。 After each case, students provided a diagnosis and rated perceived authenticity and cognitive load. The provided diagnosis was scored in terms of diagnostic accuracy; the questions asked by the medical students were rated with respect to their quality of evidence generation. In addition to regular null hypothesis testing, this study used equivalence testing to investigate the absence of meaningful effects. Results: Perceived authenticity (1-tailed t81=11.12; P<.001) was higher for SPs than for VPs. The correlation between diagnostic accuracy and perceived authenticity was very small (r=0.05) and neither equivalent (P=.09) nor statistically significant (P=.32). Cognitive load was equivalent in both assessment methods (t82=2.81; P=.003). Intrinsic cognitive load (1-tailed r=−0.30; P=.003) and extraneous load (1-tailed r=−0.29; P=.003) correlated negatively with the combined score for diagnostic accuracy. The quality of evidence generation was positively related to diagnostic accuracy for VPs (1-tailed r=0.38; P<.001); this finding did not hold for SPs (1-tailed r=0.05; P=.32). Comparing both assessment methods with each other, diagnostic accuracy was higher for SPs than for VPs (2-tailed t85=2.49; P=.01). Conclusions: The results on perceived authenticity demonstrate that learners experience SPs as more authentic than VPs. As higher amounts of intrinsic and extraneous cognitive loads are detrimental to performance, both types of cognitive load must be monitored and manipulated systematically in the assessment. Diagnostic accuracy was higher for SPs than for VPs, which could potentially negatively affect students’ grades with VPs. We identify and discuss possible reasons for this performance difference between both assessment methods. %M 33661122 %R 10.2196/21196 %U //www.mybigtv.com/2021/3/e21196 %U https://doi.org/10.2196/21196 %U http://www.ncbi.nlm.nih.gov/pubmed/33661122