Sexual Health in Child and Adolescent Psychiatry: Multi-Site Implementation Through Synchronized Videoconferencing of an Educational Resource Using Standardized Patients

Abstract

Objective: Matters of sexuality and sexual health are common in the practice of child and adolescent psychiatry (CAP), yet clinicians can feel ill-equipped to address them with confidence. To address this gap in training and practice, we developed, implemented, and evaluated an educational module enhanced by videotaped depictions of expert clinicians interacting with professional actors performing as standardized patients (SPs).Methods: We developed an educational resource highlighting common issues of sexual health relevant to CAP practice, including sexual development, psychotropic-related side effects, and sexuality in children with autism. We wrote original scripts, based on which two clinicians interacted with three SPs. Digital recordings were edited to yield 5 clips with a cumulative running time of 20 min. The clips were interspersed during a 90-min session comprising didactic and interactive components. Due to the COVID-19 pandemic, we used synchronous videoconferencing, which allowed content dissemination to several training programs across the country.Results: We recruited 125 learners from 16 CAP training programs through the American Academy of CAP's Alliance for Learning and Innovation (AALI). Routine inquiry into adolescent patients' sexual function was uncommon, reported by only 28% of participants, with “awkward” and “uncomfortable” the most common terms mentioned in reference to the clinical task. The didactic intervention led to measurable improvements after 2 weeks in skills and knowledge (p = 0.004) and in attitudes (p < 0.001). The three items with the greatest improvement were: (a) availability of developmentally tailored resources; (b) comfort in addressing sexual development with underage patients; and (c) with parents or guardians of neuroatypical or developmentally disabled patients (p < 0.001 for each).Conclusions: A sexual health curriculum enriched by video-based examples can lead to measurable improvement in outcomes pertinent to the clinical practice of CAP. These educational materials are available for distribution, use and adaptation by local instructors. Our study also provides proof-of-principle for the use of multisite educational initiatives in CAP through synchronized videoconferencing.

Simulation Training in Psychiatry for Medical Education: A Review

“…To reach this consensus and improve the quality and inclusiveness of this library, the group of experts should be multidisciplinary, composed by recognised researchers and experienced practitioners, as well as expert real patients, and medical students. Recent work supports the relevance of skilled video clips of psychiatric SPs depicting psychopathology to teach mental status exam ( 14), sex education in child and adolescent psychiatry (15), electroconvulsive therapy (16). Furthermore, to prevent a rigid and limited portrayal for each mental disorder, this library may include several variations of a given disorder to cover different clinical presentations.…”

“…SPs do enhance the validity of simulations however, including for all other disorders. Digital libraries of videos for medical education could improve this validity, as reported in recent articles (14)(15)(16).…”

Cognitive‐behavioral therapy training for multidisciplinary inpatient psychiatric teams: A novel curriculum using animated simulations

“…Of note, simulation with child actors is possible under clear ethical guidelines (Budd et al, 2020). Simulation‐based videos have been usefully applied to teach affectively charged material in a supportive setting that facilitates psychiatric skill‐building (Drozdowicz et al, 2020; Kitay et al, 2020).…”

Making It Real: From Telling to Showing, Sharing, and Doing in Psychiatric Education

“…Finally, Communities of Practice 11,12 centers on gaining experience, knowledge, and problem-solving skills as part of a group of like-minded peers committed to a shared goal, such as the creation of cohesion and specific expertise as increasingly subspecialized professionals. As one concrete example, 13 clinician-educators focused on child psychiatric disorders (identity) may apply state-of-the-art skills in clinical practice and medical education (collaboration) by using simulated patients and distant learning tools (artifacts) to address their very specific collective needs (community).…”