Uses and Limitations of Simulated Patients in Psychiatric Education

Abstract

SPs are useful additions to our educational toolbox but have intrinsic limitations for our field due to psychiatry's roots in the nature of empathy and the patient-psychiatrist relationship. Standardized patients are most appropriate for exposing trainees to a variety of psychopathologies and testing very discrete skills; the use of SPs is most problematic for teaching psychotherapy and assessing complex interpersonal skills, such as empathic responsiveness.

Simulation-Based Training for Residents in the Management of Acute Agitation: A Cluster Randomized Controlled Trial

“…This is particularly significant because simulation-based education has been less commonly utilized in psychiatry, as compared to its current ubiquity in other medical specialties [4,6]. There are a number of possible explanations for the relative dearth of simulations in psychiatry, including a perception that psychiatric topics do not lend themselves as well to a simulation environment as more procedural-based topics, a lack of evidence that simulationbased training is significantly more effective than the status quo (which is needed to justify the additional resources that simulation requires), and a lack of knowledge/experience among psychiatric educators in the development and implementation of simulations [7,28].…”

“…When simulation has been utilized in psychiatric education, it has most often been through the use of standardized or simulated patients [6][7][8]. However, to our knowledge, there have only been two small pilot studies describing the use of simulation to teach about the management of agitated patients, and in both cases, the outcome measures were limited to selfreports of improved skill and confidence [9,10].…”

Simulated Patients and Scenarios to Assess and Teach Psychiatry Residents

“…It can be useful to keep a particular patient or group of patients in mind when developing the scenarios in order to maintain a realistic portrayal. Additionally, Brenner points out that the use of simulated patients can be problematic for teaching psychotherapy and assessing complex interpersonal skills [9].…”

Pacientes simulados en la formación de los profesionales de salud: el lado humano de la simulación

“…Sin embargo, hay un llamado a "cuidar la brecha" entre la experiencia simulada y la no-simulada (con pacientes reales), especialmente en el aprendizaje de empatía, profesionalismo y en el caso del trabajo con pacientes con enfermedades psiquiátricas [37][38][39] . Se recomienda usar casos "simples" en los primeros encuentros de los estudiantes con PS, y luego incluir situaciones que sea difícil que los estudiantes las enfrenten en el mundo real: situaciones de emergencia o de poca frecuencia; entregar una mala noticia o discutir temas delicados como disfunción sexual; entregar un plan de manejo en común acuerdo con el paciente; ayudar a un paciente a un cambio en su estilo de vida, entre otras 40 .…”