虛擬病人在臨床訓練上的發展與應用──在護理教育的新展望

The Development and Application of Virtual Patient in Clinical Training: The New Horizon for Nursing Education

臨床護理實習訓練非常重要卻很難教，實作與病例訓練是必要的訓練。COVID-19嚴峻疫情席捲全球，迫使各國全面停止實體上課，改數位遠距學習，然而臨床實習及臨床技能測驗難以被數位科技取代。虛擬科技以自然語言與多媒體提供虛擬病人與環境，並全程記錄與提供回饋，讓護理學生模擬參與臨床互動溝通中，訓練入院護理的病史、身體評估和照護措施決策思辨知能，採用虛擬病人可代替紙本案例、真實病人、或標準化病人。在臨床教育上的應用包括：V-PBL（virtual problem-based learning）小組進行、臨床技能測驗及雲端虛擬診療訓練；當虛擬系統結合線上會議系統，可以克服距離及空間的攔阻，讓護理學生仍然能以團隊方式進行臨床問題思辨訓練，疫情期間尤其重要，即使不進醫院也能繼續接受互動實作型臨床訓練。總之，虛擬數位科技成為醫護擬真教育的輔助工具，提供了更多樣的臨床教育模式，可用於訓練或測驗，科技工具在教育場域的成功應用，需要依據學生的程度與既定的訓練目標，更重要的是要有教學的設計配套與教師的觀察與回饋，成功的臨床教育必可提升學員之臨床能力。

Clinical problem-solving training that involves hands-on practice with patients is regarded as an important yet challenging aspect of medical education. A majority of schools around the world have suspended face-to-face classes because of the COVID-19 pandemic. Although remote digital classes represent a widely adopted alternative approach to education, the format of these classes is poorly suited to clinical learning and examination. With advances in virtual technology using natural language processing and multimedia, virtual patients bring vivid clinical encounters with records and feedback and are able to facilitate learning in the realm of clinical problem-solving. Virtual patients may be used to replace paper cases, human patients, and standardized patients in clinical education. The related applications include virtual problem-based learning in group training, clinical skill examination, and cloud-based virtual training. Integrating online meeting systems with virtual patient systems effectively overcomes the barriers of learning related to distance and isolation. The cloud model is especially important in the pandemic period, as this model allows clinical team work training to continue outside of actual hospital settings. In conclusion, technology-assisted simulation has innovated clinical training and assessment. The success of technology-enhanced education relies on its alignment with students' level of training and targeted learning objectives, especially when coupled with observation and feedback. The success of clinical education will guarantee the improvement of students' clinical competency.