The Mental Status Exam: An Online Teaching Exercise Using Video-Based Depictions by Simulated Patients

Martin, Andrés; Jacobs, Asaf; Krause, Robert; Amsalem, Doron

doi:10.15766/mep_2374-8265.10947

Cited by 10 publications

(7 citation statements)

References 15 publications

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“…Hiring standardised patients for formative assessments and repetitive practice is costly (Shah et al , 2012; Gutiérrez-Maldonado et al , 2014), and virtual psychiatric assessments could overcome this. The use of virtual patients in formative assessments has been favourably commented on by the participant (Martin et al , 2020; Gutiérrez-Maldonado et al , 2014), and post-training assessments presented significant improvement in skills compared to pre-training assessments (Wilkening et al , 2017).…”

Section: Resultsmentioning

confidence: 99%

Training for psychiatric assessments using virtual simulation

Stewart

Mashmous

2023

JMHTEP

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Purpose The changing clinical landscape in psychiatry, both before and after the pandemic, has impacted students’ direct contact with psychiatric patients. It is imperative, therefore, that medical education keeps pace with evolving clinical pathways to ensure that clinicians are always appropriately trained not just for common presentations but also for low-prevalence, high-risk situations. Simulated-based training is well established. However, it is not without its limitations, many of which could be overcome with the use of virtual simulation. This study aims to analyse the use of virtual simulation within medical education to train clinicians in psychiatric assessments. Design/methodology/approach A scoping review was undertaken with a comprehensive literature search of the six most relevant online peer-reviewed databases, including PubMed, PsycINFO, CINAHL, Medline, EMBASE and Cochrane. All published papers in English that discussed simulation in teaching psychiatric assessments were included. Findings Virtual patients can be used for educational, diagnostic and therapy purposes attributable to advances in speech-recognition technology. Virtual simulations are well received and positively affect clinicians’ knowledge and skill development. Educational faculties should consider using virtual simulation technologies to improve learning outcomes. Further studies should enhance the fidelity and quality of virtual assessment simulation situations, mainly focusing on the virtual patient’s empathy, gesturing and body language to enable this evidence-based tool to be used effectively and efficiently for the benefit of future patient care. Originality/value The changing clinical landscape in psychiatry, both before and after the pandemic, has impacted students’ direct contact with psychiatric patients. This scoping review has reviewed the use of virtual simulation-based education to train clinicians for psychiatric assessments. To the best of the authors’ knowledge, this work has not been conducted before.

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Section: Resultsmentioning

confidence: 99%

Training for psychiatric assessments using virtual simulation

Stewart

Mashmous

2023

JMHTEP

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“…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).…”

Section: Practical Implementationmentioning

confidence: 88%

Simulation Training in Psychiatry for Medical Education: A Review

et al. 2021

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Despite recognised benefits of Simulation-Based Education (SBE) in healthcare, specific adaptations required within psychiatry have slowed its adoption. This article aims to discuss conceptual and practical features of SBE in psychiatry that may support or limit its development, so as to encourage clinicians and educators to consider the implementation of SBE in their practice. SBE took off with the aviation industry and has been steadily adopted in clinical education, alongside role play and patient educators, across many medical specialities. Concurrently, healthcare has shifted towards patient-centred approaches and clinical education has recognised the importance of reflective learning and teaching centred on learners' experiences. SBE is particularly well-suited to promoting a holistic approach to care, reflective learning, emotional awareness in interactions and learning, cognitive reframing, and co-construction of knowledge. These features present an opportunity to enhance education throughout the healthcare workforce, and align particularly well to psychiatric education, where interpersonal and relational dimensions are at the core of clinical skills. Additionally, SBE provides a strategic opportunity for people with lived experience of mental disorders to be directly involved in clinical education. However, tenacious controversies have questioned the adequacy of SBE in the psychiatric field, possibly limiting its adoption. The ability of simulated patients (SPs) to portray complex and contradictory cognitive, psychological and emotional states has been questioned. The validity of SBE to develop a genuine empathetic understanding of patients, to facilitate a comprehensive multiaxial diagnostic formulation, or to develop flexible interpersonal skills has been criticised. Finally, SBE's relevance to developing complex psychotherapeutic skills is much debated, while issues such as symptom induction in SPs or patients involvement raise ethical dilemmas. These controversies can be addressed through adequate evidence, robust learning design, and high standards of practice. Well-designed simulated scenarios can promote a positive consideration of mental disorders and complex clinical skills. Shared guidelines and scenario libraries for simulation can be developed, with expert psychiatrists, patients and students involvement, to offer SPs and educators a solid foundation to develop training. Beyond scenario design, the nuances and complexities in mental healthcare are also duly acknowledged during the debriefing phases, providing a crucial opportunity to reflect on complex interpersonal skills or the role of emotions in clinicians' behaviour. Considered recruitment and support of SPs by clinical educators can help to maintain psychological safety and manage ethical issues. The holistic and reflexive nature of SBE aligns to the rich humanistic tradition nurtured within psychiatry and medicine, presenting the opportunity to expand the use of SBE to support a range of clinical skills and workforce competencies required in psychiatry.

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“…• (Video-taped) interactions in person or virtually with real/simulated or manikin patients [ 23 , 32 – 35 , 46 , 55 , 69 , 70 , 72 ]…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2022

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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.

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The Mental Status Exam: An Online Teaching Exercise Using Video-Based Depictions by Simulated Patients

Cited by 10 publications

References 15 publications

Training for psychiatric assessments using virtual simulation

Training for psychiatric assessments using virtual simulation

Simulation Training in Psychiatry for Medical Education: A Review

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

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