Standardized patients in psychiatry – the best way to learn clinical skills?

Abstract

BackgroundStandardized patients (SP) have been successfully utilized in medical education to train students’ communication skills. At the Medical University of Vienna communication training with SPs in psychiatry is a mandatory part of the curriculum. In the training, the SP plays the role of four different patients suffering from depression/suicidal tendencies, somatoform disorder, anxiety disorder, or borderline disorder while the student attempts to gather the patient’s medical history. Both the instructor and SP then give the student constructive feedback afterwards.MethodThe aim of the study was to evaluate the quality of the SP’s roleplay and feedback, using a self-created questionnaire. Additionally, we wanted to gauge the differences between the students’ and teachers’ evaluations of the SP’s role playing performance and feedback.ResultsThe questionnaire was completed by 529 students and 29 teachers who attended the training. Overall, both students and teachers evaluated the SPs’ performance and feedback very well. In comparison to the responses given by the teachers, more students reported that the “SP overacted” while fewer students believed that the “SP could be a real patient”. The feedback given by the SP was evaluated similarly by students and teachers, suggesting that students are able to recognize the quality of constructive feedback. Furthermore, the SP’s quality of roleplaying was evaluated as the poorest while playing the psychiatric disorder “depression/suicidal tendencies.”ConclusionsOur study showed that students and teachers appreciate SPs’ competence of role play and of giving feedback. However, further studies should be performed to figure out why both students and teachers alike evaluated the played psychiatric disorder “depression/suicidal tendencies” to be the worst.

Let us integrate sexual health—do psychiatrists integrate sexual health in patient management?

“…For example, case-based e-learning programs and simulated patient (SP) contact might be implemented. Current literature demonstrates that case-based e-learning and especially training with SPs in medical education are valuable tools (Levine and Swartz 2008 ; McNaughton et al 2008 ), correlating with a high learners’ satisfaction (Himmelbauer et al 2018 ; Seitz and Löffler-Stastka 2015 ) and an improvement in learners’ understanding of certain topics and skills (Xie et al 2015 ). The SP might play different roles in various settings, so the student learns sexual health care in different medical fields like internal medicine, obstetrics, or psychiatry.…”

Does Case-based blended-learning expedite the transfer of declarative knowledge to procedural knowledge in practice?

“…3) simulated patient contact was designed and implemented initially in Psychiatry in 2013 [9,24]. In total, our e-CBL framework and platform saw publication of e-CBL cases for over 16 fields in pre-and post-graduate medical education.…”

“…Students were required to successfully complete the e-learning course by correctly answering all questions before taking part in the seminar. The SP seminar has the aim of applying and transforming procedural knowledge into procedural skills, while also allowing students to experience, document, and reflect on difficulties that arise from newly encountered dimensions of face-to-face communication with mentally ill patients [24]. Here the student is required to observe, give feedback, and perform a complete psychiatric consultation, including conducting a mental status examination and taking a psychiatric history, creating a clinical or diagnostic hypothesis, deciding on further case management, and finally suggesting relevant therapy options, thus integrating all previously acquired skills.…”

“…Actors learn their "roles" using prepared and anonymized patient case data. After the course, students are assessed by educators, peers, and themselves [24], with communication portfolios documenting their simulated consultations.…”

Does Case-based blended-learning expedite the transfer of declarative knowledge to procedural knowledge in practice?

“…Actors learn their "roles" using prepared and anonymized patient case data. After the course, students are assessed by educators, peers, and themselves(53), with communication portfolios documenting their simulated consultations.Data CollectionAnonymized OSCE scores of all medical students at the Medical University of Vienna who partook in the clinical psychiatry examination "Physician communication skills" [Ärztliche Gesprächsführung, ÄGF-C] of the 4 th year OSCE in the years 2013, 2015, and 2016 were retrospectively retrieved from university student records' electronic databases and analyzed. The data protection committee of the Medical University of Vienna, independent of anyone involved in this study, first anonymized all data before allowing access, and also approved this study.…”