Communication skills in psychiatry training

Ditton-Phare, Philippa; Halpin, Sean; Sandhu, Harsimrat; Kelly, Brian; Vamos, Marina; Outram, Sue; Bylund, Carma L.; Levin, Tomer T.; Kissane, David W.; Cohen, Martin; Loughland, Carmel

doi:10.1177/1039856215590026

Cited by 15 publications

(9 citation statements)

References 24 publications

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“…24 Even within the behavioral sciences (eg, psychology, psychiatry, and social work)-fields that routinely employ communication as their "clinical procedure"-there is a paucity of literature supporting the "best" tools to assess communication skills; however, there is agreement that role-play with simulated patients, followed by video and peer feedback, is effective in improving trainee work-based performance. 32 Notable strengths of this study include the creation of a survey instrument aligned with consensus competencies and constructed by both PC and medical education experts. In addition, we applied rigorous psychometric principles for instrument validation.…”

Section: Discussionmentioning

confidence: 99%

A New Competency-Based Instrument to Assess Resident Knowledge and Self-Efficacy in Primary Palliative Care

Moyer

Morrison

Encandela

et al. 2019

Am J Hosp Palliat Care

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Context: There is a need to improve both primary palliative care (PPC) education and its assessment in graduate medical education (GME). We developed an instrument based on published palliative care (PC) competencies to assess resident competency and educational interventions. Objectives: To describe the development and psychometric properties of a novel, competency-based instrument to measure resident knowledge and self-efficacy in PPC. Methods: We created a 2-part instrument comprised of a knowledge test (KT) and a self-efficacy inventory (SEI) addressing 18 consensus, core PC resident competencies across 5 domains: pain and symptom management; communication; psychosocial, spiritual, and cultural aspects of care; terminal care and bereavement; and PC principles and practice. The instrument was distributed to 341 internal medicine residents during academic years 2015 to 2016 and 2016 to 2017. A standard item analysis was performed on the KT. Internal consistency (Cronbach α) and variable relationships (factor analysis) were measured for the SEI. Results: One hundred forty-four residents completed the survey (42% response). For 15 KT items, difficulty ranged from 0.17 to 0.98, with 7 items ranging 0.20 to 0.80 (typical optimum difficulty); discrimination ranged from 0.03 to 0.60 with 10 items ≥0.27 (good to very good discrimination). Cronbach α was 0.954 for 35 SEI items. Factor analysis of combined 2015 to 2016 items yielded 4 factors explaining the majority of variance for the entire set of variables. Conclusion: Our instrument demonstrates promising psychometric properties and reliability in probing the constructs of PC and can be further utilized in PC GME research to assess learners and evaluate PPC educational interventions.

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Section: Discussionmentioning

confidence: 99%

A New Competency-Based Instrument to Assess Resident Knowledge and Self-Efficacy in Primary Palliative Care

Moyer

Morrison

Encandela

et al. 2019

Am J Hosp Palliat Care

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“…Negative stressors exacerbate the harmful psychological effects of this mental health problem (Bolton, Gooding, Kapur, Barrowclough, & Tarrier, 2007). Such stressors may be external, for example, financial pressures (Beebe, 2002); internal, for example, different types of hallucinations (Docherty et al, 2015); or societal, for example, stigma (Ruesch et al, 2014) and hospitalisation procedures (Berry, Ford, Jellicoe-Jones, & Haddock, 2013, 2015. In addition, negative stressors are typically one of the first stages in pathways leading to suicidal thoughts and behaviours (Williams, 1997) with death by suicide and multiple suicide attempts being highly prevalent in people experiencing schizophrenia (Mork et al, 2012;Qin, 2011).…”

Section: Introductionmentioning

confidence: 99%

Psychological resilience in people experiencing schizophrenia and suicidal thoughts and behaviours

Gooding

Littlewood

Owen

et al. 2017

Journal of Mental Health

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“…Authors' reply: We thank Dr Tully for his thoughtful comments on the DEPSCREEN-INFO randomised controlled trial. 1 We share his conclusion about the need to better align mental health services with cardiac patient needs, [2][3][4] and we appreciate the studies he cited in his letter. However, these studies did not specifically investigate the efficacy of patient-targeted feedback after depression screening using a randomised controlled study design.…”

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confidence: 90%

“…Their focus on how to communicate about diagnosis and prognosis is particularly helpful, given that there can be a reluctance to disclose a diagnosis of psychosis for fear of causing harm. 2 As Ditton-Phare et al describe, they evaluated trainees' skills 'in vitro' using role plays with actors. While assessing trainees' skills interacting with actors (or simulated patients) is a useful tool in training, there are 'qualities of the psychiatrist-patient encounter that may be resistant to simulation'.…”

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confidence: 99%

Authors' reply

Löwe¹,

Gierk

Kohlmann

2017

Br J Psychiatry

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Depression is associated with poorer coronary heart disease (CHD) outcomes; however, routine screening for depression is controversial and difficult to implement in clinical practice, and randomised clinical trial (RCT) evidence is scarce. 1 The DEPSCREEN-INFO parallel group efficacy RCT reported by Löwe et al 2 randomised participants to written patient-targeted feedback versus no written patient feedback after depression screening. The sample comprised in-patients and outpatients with CHD, but also those with arterial hypertension. Löwe et al argued that the role of the patient within the depression screening process had not yet been studied. Previously, we reported two examples of depression screening involving patient, general practitioner and cardiologist feedback in heart failure 3 and cardiac surgery populations. 4 Our findings, and those of others, 5,6 diverge from Löwe et al's in terms of mental health service use. Lowe et al showed that 13% of participants contacted a psychotherapist, which might reflect generous health insurance benefits in Germany, including up to 2 years of psychotherapy. By comparison, in England an RCT for depression and CHD or diabetes by Coventry et al 5 revealed that 33% of individuals randomised to collaborative care did not attend any depression treatment session. Coventry et al 5 used the Improving Access to Psychological Therapy (IAPT) services in the English National Health Service (NHS). Other depression screening studies in CHD indicate that uptake of mental health services is 52% in the USA 6 and Australia, 4 with the latter study providing a rebate for mental health services similar to IAPT. Mounting evidence indicates incongruity between international efforts to improve depression care and the uptake of mental health services by the CHD patients we are targeting with depression screening. Integration of mental health services within cardiology and primary care services may be warranted. Clearly, more concerted efforts are required internationally to improve existing mental health services by adopting innovative methods such as 'blended' collaborative care, computerised cognitive-behavioural therapy (CBT) and telehealth. It remains crucial to better align mental health services with CHD patient needs in order to better engage CHD patients.

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Communication skills in psychiatry training

Cited by 15 publications

References 24 publications

A New Competency-Based Instrument to Assess Resident Knowledge and Self-Efficacy in Primary Palliative Care

A New Competency-Based Instrument to Assess Resident Knowledge and Self-Efficacy in Primary Palliative Care

Psychological resilience in people experiencing schizophrenia and suicidal thoughts and behaviours

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