Instructional Design Strategies for Teaching the Mental Status Examination and Psychiatric Interview: a Scoping Review

Abstract

Objective The psychiatric mental status examination is a fundamental aspect of the psychiatric clinical interview. However, despite its importance, little emphasis has been given to evidence-based instructional design. Therefore, this review summarizes the literature from an instructional design perspective with the aim of uncovering design strategies that have been used for teaching the psychiatric interview and mental status examination to health professionals. Methods The authors conducted a scoping review. Multiple databases, reference lists, and the gray literature were searched for relevant publications across educational levels and professions. A cognitive task analysis and an instructional design framework was used to summarize and chart the findings. Results A total of 61 articles from 17 countries in six disciplines and three educational levels were identified for data extraction and analysis. Most studies were from the USA, presented as educational case reports, and carried out in undergraduate education in the field of psychiatry. Few articles described the instructional rationale for their curriculum. None of the studies compared the effectiveness of different instructional design components. Reported learning activities for each task domain (knowledge, skills, and attitudes) and for each step of an instructional design process were charted. Most articles reported the use of introductory seminars or lectures in combination with digital learning material (videos and virtual patients in more recent publications) and role-play exercises. Conclusions Educators in psychiatry should consider all task domains of the psychiatric interview and mental status examination. Currently, there is a lack of empirical research on expertise acquisition and use of instructional design frameworks in this context.

Will Interviewing Become a Lost Art?

“…Diagnostic interviews do not exist in a vacuum. They include introducing the interview and examination, decreasing patient anxiety about diagnosis and treatment, expressing empathy, establishing a therapeutic alliance, facilitating a complete report of symptoms and experiences, negotiating a treatment plan, and inspiring optimism, often under difficult and affectively charged circumstances [2,3]. As Endicott notes [4], achieving these goals is more likely with "good clinicians who 1) have had considerable prior experience with patients with the diagnoses of interest, 2) are aware of the intent of the items and criteria, 3) can recognize syndromes, 4) know when something doesn't sound 'right,' and 5) can detect and explore inconsistent or unclear responses.…”