智慧型虛擬病人帶來臨床推理訓練的新視野

The paradigm shift with the uses of AI-enhanced virtual patients in the medical education for clinical reasoning

臨床診斷是提升醫療品質及確保病人安全的一個關鍵，學員需要經驗眾多病人情境的量與種類，又需被觀察與指導，傳統醫學教育教育與臨床實習不容易達到這些目的，COVID-19疫情造成空間隔離等多重問題，帶來了更大的學習困境。虛擬智慧型參與式擬真訓練，提供了虛擬病人、虛擬醫院及系統中的專家，可以讓學員隨時隨地演練臨床決策能力，在疫情中疫情後提供了臨床思辨教育的轉機。教學上的應用，可以將臨床思辨架構導入診療照護任務中的各步驟，例如: 病史詢問、進行檢查／檢驗探索、身體檢查、診斷分析及病歷寫作的教學訓練，藉此基礎而精進醫療人員之臨床診療能力。

 

Clinical diagnosis is a key determinant of health-care quality and patient safety. To attain proficiency, learners must hone their clinical reasoning through deliberate practice while being exposed to a large number and diverse range of patients. However, these goals are difficult to attain in traditional medical education and clinical internships. The emergence of the COVID-19 pandemic has further exacerbated these challenges. Thus, this study formulated an NLP-enhanced virtual simulation platform that allows students to practice with virtual patients, virtual hospital environments, and expert guidance behind the scenes. This platform allows hands-on practice in clinical decision-making anywhere anytime, thus presenting a novel avenue for educational enhancement during the pandemic as well as in the post-pandemic era. The virtual simulation training system can be used in the teaching of various clinical tasks, including history taking, physical examination, laboratory investigations, image studies, differential diagnosis, and medical documentation.