The use of simulation to develop advanced communication skills relevant to psychiatry

Abstract

ObjectiveUsing simulation, we developed an advanced communication skill training programme with the objective of improving core psychiatry trainees’ confidence in managing difficult situations at work.DesignTwo simulation courses, comprising six scenarios, were developed for psychiatry core trainees (CTs) on the University College London Partners (UCLP) training scheme. Trainees were divided into small groups. Each trainee undertook two scenarios each. Feedback was delivered by facilitators, peers and the simulated patients. Written feedback was also given.SettingThe courses were delivered in a local postgraduate medical education centre.PatientsActors were used to simulate adult psychiatric patients and their relatives. Other scenarios involved actors portraying colleagues.InterventionsThe simulations offered an opportunity for experiential learning while the debriefs allowed for focused feedback on trainees’ communication styles.Main outcome measuresChanges in trainees’ perception of their ability to deal with difficult situations at work were measured. Semistructured interviews further explored trainees’ experience of the course and its educational impact.Results100% (n=39) of the trainees felt that their communication skills had improved after the training. 97% felt more able to defuse an angry/tense situation at work while 92% felt more able to deal with a difficult situation requiring sophisticated communication skills. 97% felt that regular simulation training would be valuable while 100% (n=24) of facilitators agreed that the experience was valuable to the trainees’ professional development. Qualitative analysis showed that trainees found the scenarios realistic, that the experience had led to an increased awareness of their communication style and that original improvements in confidence had translated to their clinical work.ConclusionsThe programme demonstrates that it is possible to use simulation in a simple, inexpensive and time-effective manner to provide realistic, enjoyable and educationally beneficial advanced communication skill training relevant to psychiatric practice.

Student interprofessional mental health simulation (SIMHS): evaluating the impact on medical and nursing students, and clinical psychology trainees

“…Simulation training can be flexibly tailored to the educational requirements of trainees rather than the patient (Gay et al, 2002). Numerous studies have highlighted the suitability of simulation as a teaching tool for mental health professionals at various stage of training, including students of medicine (Bennett et al, 2006;Birndorf & Kaye, 2002;Chur-Hansen & Koopowitz, 2002;Gay et al, 2002;Kowalski & Sathanandan, 2015;Krahn et al, 2002), nursing (Edward et al, 2007;Gough & Happell, 2009;Guise et al, 2012;Happell, 2008;Kameg et al, 2010;Shawler, 2008;Tiffen et al, 2009), and allied health professions (Coyle et al, 1998;Goulter, 2011). Greater exposure to simulated patients and scenarios in psychiatry rotations and medical training, from interviewing patients to team decision-making, has improved examination scores as well as knowledge and recognition of certain disorders (Bennett et al, 2006;Chur-Hansen & Koopowitz, 2002;Krahn et al, 2002).…”

Communication skills in the training of psychiatrists: A systematic review of current approaches

“…The next step for future studies would be to conduct either a large-scale RCT or interrupted time series study (potentially multisite to ensure adequate statistical power) with a follow-up assessment that measures skill retention over time and demonstrating skill retention 'in vivo' in clinical practice. There is a particular need to look at how skills translate to real-world practice outside the controlled setting of training and to determine what factors encourage or inhibit Kowalski and Sathanandan (2015) Training in confidence managing difficult situations at work. Six scenarios of varying mental health situations with simulated patients in one afternoon with small groups of three to four trainees.…”

“…In addition to the above quantitative data, qualitative responses were presented in the Kowalski and Sathanandan (2015) study and the Ikkos (2003) study. Neither of these studies employed a stringent qualitative methodology.…”

“…Because of the small sample size with insufficient power to conclude any reasonable findings, other sources of bias were unclear. Kowalski and Sathanandan (2015) presented findings from a one-group pretest/posttest study that included a qualitative component. Other potential bias may be present as teachers of the training intervention analysed both the data and the interviews.…”

Evaluating the effectiveness of video cases to improve patient-centeredness in psychiatry: a quasi-experimental study

“…However, the association is likely to be influenced by a variety of complex and unidentified factors, for example, exposure to stories in academia about psychiatry 33 , the students' previous experience with psychiatry 34 and the students' emotional engagement with the teaching format. 35 The construct of video cases, in contrast to text-based material, has the ability to convey emotion in the learner. 13 Video cases used to prepare firstand second-year students on how to meet and manage psychiatric patients have previously been found to influence students' emotional reactions and thus their learning experiences and perceptions.…”