Simulation-based education allows experiential learning without risk to patients. Interprofessional education aims to provide opportunities to different professions for learning how to work effectively together. Interprofessional simulation-based education presents many challenges, including the logistics of setting up the session and providing effective feedback to participants with different backgrounds and mental models. This paper aims to provide educators with a series of practical and pedagogical tips for designing, implementing, assessing, and evaluating a successful interprofessional team-based simulation session. The paper is organized in the sequence that an educator might use in developing an interprofessional simulation-based education session. Collectively, this paper provides guidance from determining interprofessional learning objectives and curricular design to program evaluation. With a better understanding of the concepts and pedagogical methods underlying interprofessional education and simulation, educators will be able to create conditions for a unique educational experience where individuals learn with and from other specialties and professions in a controlled, safe environment.

CONTEXT: Most medical doctors are likely to work with patients experiencing mental health conditions. However, there are often limited educational opportunities for medical doctors to achieve professional development in the field of psychiatry. Simulation training in psychiatry may be a useful tool to foster this development. OBJECTIVES:To assess the effectiveness of simulation training in psychiatry for medical students, post-graduate trainees, and medical doctors. METHODS:For this systematic review and meta-analysis, we searched 8 electronic databases and trial registries up to August 31, 2018. We manually searched key journals and the reference lists of selected studies. We included randomised and non-randomised controlled studies and single group prepost-test studies. Our main outcomes were based on Kirkpatrick levels. We included data only from Randomised Controlled Trials (RCTs) using random-effects models. RESULTS:From 46 571 studies identified, we selected 163 studies and combined 27 RCTs. Interventions included simulation by role-play (n=69), simulated patients (n=72), virtual reality (n=22), manikin (n=5) and voice simulation (n=2). Meta-analysis found significant differences at immediate post-test for simulation compared with active and inactive controls on attitudes (SMD=0.52 (95%CI 0.31; 0.73; I 2 = 0%) and 0.28 (95%CI 0.04; 0.53; I 2 = 52%), respectively); on skills (SMD=1.37 (95%CI 0.56; 2.18; I 2 =93%) and 1.49 (95%CI 0.39; 2.58; I 2 = 93%), respectively); on knowledge (SMD=1.22 (95%CI 0.57; 1.88; I 2 = 0%) and 0.72 (95%CI 0.14; 1.30; I 2 = 80%), respectively); and on behaviours (SMD= 1.07 (95%CI 0.49; 1.65; I 2 =68%) and 0.45 (95%CI 0.11; 0.79; I 2 =41%), respectively. Significant differences were found at three-month follow-up for patient benefit and doctors' behaviours and skills. CONCLUSIONS: Despite heterogeneity in methods and simulation interventions, our findings demonstrate the effectiveness of simulation training in psychiatry training.

ProblemTruth-telling is an important component of respect for patients’ self-determination, but in the context of breaking bad news, it is also a distressing and difficult task.InterventionWe investigated the long-term influence of a simulated patient-based teaching intervention, integrating learning objectives in communication skills and ethics into students’ attitudes and concerns regarding truth-telling. We followed two cohorts of medical students from the preclinical third year to their clinical rotations (fifth year). Open-ended responses were analysed to explore medical students’ reported difficulties in breaking bad news.ContextThis intervention was implemented during the last preclinical year of a problem-based medical curriculum, in collaboration between the doctor–patient communication and ethics programs.OutcomeOver time, concerns such as empathy and truthfulness shifted from a personal to a relational focus. Whereas ‘truthfulness’ was a concern for the content of the message, ‘truth-telling’ included concerns on how information was communicated and how realistically it was received. Truth-telling required empathy, adaptation to the patient, and appropriate management of emotions, both for the patient's welfare and for a realistic understanding of the situation.Lessons learnedOur study confirms that an intervention confronting students with a realistic situation succeeds in making them more aware of the real issues of truth-telling. Medical students deepened their reflection over time, acquiring a deeper understanding of the relational dimension of values such as truth-telling, and honing their view of empathy.