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Jensen RAA, Musaeus P, Pedersen K. Virtual patients in undergraduate psychiatry education: a systematic review and synthesis. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:329-347. [PMID: 37294380 DOI: 10.1007/s10459-023-10247-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/28/2023] [Indexed: 06/10/2023]
Abstract
Virtual patients are increasingly used in undergraduate psychiatry education. This article reports on a systematic review aimed at providing an overview of different approaches in this context, describing their effectiveness, and thematically comparing learning outcomes across different undergraduate programs. The authors searched PubMed, PsycInfo, CINAHL, and Scopus databases for articles published between 2000 and January 2021. Quantitative and qualitative studies that reported on outcomes related to learners' knowledge, skills, and attitudes following an intervention with virtual patients in undergraduate psychiatry education were reviewed. Outcomes were thematically compared, and a narrative synthesis of the different outcomes and effectiveness was provided. Of 7856 records identified, 240 articles were retrieved for full-text review and 46 articles met all inclusion criteria. There were four broad types of virtual patient interventions: case-based presentation (n = 17), interactive virtual patient scenarios (n = 14), standardized virtual patients (n = 10), and virtual patient videogames (n = 5). The thematic analysis revealed that virtual patients in psychiatry education have been used for learners to construe knowledge about symptomatology and psychopathology, develop interpersonal and clinical communicative skills, and to increase self-efficacy and decrease stigmatizing attitudes towards psychiatric patients. In comparison with no intervention, traditional teaching, and text-based interventions, virtual patients were associated with higher learning outcomes. However, the results did not indicate any superiority of virtual patients over non-technological simulation. Virtual patients in psychiatry education offer opportunities for students from different health disciplines to build knowledge, practice skills, and improve their attitudes towards individuals with mental illness. The article discusses methodological shortcomings in the reviewed literature. Future interventions should consider the mediating effects of the quality of the learning environment, psychological safety, and level of authenticity of the simulation.
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Affiliation(s)
- Rikke Amalie Agergaard Jensen
- Research Unit of Mental Health, Children and Adult, Aabenraa, Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
- Centre for Involvement of Relatives, Mental Health Services Region of Southern Denmark, Vejle, Denmark.
| | - Peter Musaeus
- Centre for Educational Development (CED), Aarhus University, Aarhus, Denmark
| | - Kamilla Pedersen
- Centre for Educational Development (CED), Aarhus University, Aarhus, Denmark
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Tan R, Yang Y, Huang T, Lin X, Gao H. Parent-child attachment and mental health in young adolescents: a moderated mediation analysis. Front Psychol 2023; 14:1298485. [PMID: 38187411 PMCID: PMC10768540 DOI: 10.3389/fpsyg.2023.1298485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction The parent-child attachment has a significant impact on adolescents' mental health. However, the influence of psychological quality and coping styles on this connection remains unknown. This study examined the relationship between parent-child attachment and adolescent mental health, by exploring the mediating role of psychological quality and the moderating role of coping styles. Methods A total of 633 young adolescents participated in this study after signing informed consent. They anonymously completed questionnaires including the Parent and Peer Attachment Scale (Parent Attachment Section), the Coping Styles Inventory for Middle School Students, the Brief Version of the Psychological Quality Inventory for Middle School Students, and the Chinese Middle School Students'Psychological Quality Inventory. After controlling for gender, grade, left-behind category, only-child status, and family structure. Results The moderated mediation model yielded the following findings: (a) parent-child attachment significantly and positively predicted adolescents'mental health; (b) psychological quality partially mediated the relationship between parent-child attachment and adolescents' mental health; (c) the association between psychological quality and mental health was moderated by task-focused coping. Discussion This moderation effect was more substantial for students with low task-focused coping behaviors, which aligns with the "exclusionary hypothesis" model. Therefore, our results indicate that parent-child attachment indirectly impacts mental health, influenced by internal and external factors. These findings carry significant implications for safeguarding and promoting adolescents' mental well-being.
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Affiliation(s)
- Rong Tan
- School of Psychology, Fujian Normal University, Fuzhou, China
| | | | - Tao Huang
- Department of Preschool Education, Jiangmen Preschool Education College, Jiangmen, China
| | - Xuanxuan Lin
- Institute of Education Sciences, Huazhong University of Science and Technology, Wuhan, China
| | - Hua Gao
- School of Psychology, Fujian Normal University, Fuzhou, China
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Richard O, Jollant F, Billon G, Attoe C, Vodovar D, Piot MA. Simulation training in suicide risk assessment and intervention: a systematic review and meta-analysis. MEDICAL EDUCATION ONLINE 2023; 28:2199469. [PMID: 37073473 PMCID: PMC10120456 DOI: 10.1080/10872981.2023.2199469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE Suicide is a major cause of preventable death worldwide. Adequate training in risk assessment and intervention is key to suicide prevention. The use of simulation (role plays, simulated patients, virtual reality…) for practical training is a promising tool in mental health. The purpose of this study was to assess the effectiveness of simulation training in suicide risk assessment and intervention for healthcare professionals and gatekeepers. METHODS We conducted a systematic review in Medline and PsycINFO up to 31 July 2021 of randomized controlled trials (RCTs), non-randomized controlled trials, and pre/post-test studies. RCTs were furthermore included in a meta-analysis. We assessed the methodological quality of all studies with the Medical Education Research Study Quality Instrument, and the Cochrane Risk of Bias tool 2.0 for RCTs. Primary outcomes were changes in Kirkpatrick criteria: attitudes, skills, knowledge, behaviors, and patient outcomes. RESULTS We included 96 articles representing 43,656 participants. Most pre/post-test (n = 65) and non-randomized controlled (n = 14) studies showed significant improvement in attitudes, skills, knowledge, and behaviors. The meta-analysis of 11 RCTs showed positive changes in attitudes immediately after training and at 2-4 months post-training; in self-perceived skills at 6 months post-training; but not in factual knowledge. Studies assessing benefits for patients are still limited. CONCLUSIONS The heterogeneity of methodological designs, interventions, and trained populations combined with a limited number of RCTs and studies on patients' outcomes limit the strength of the evidence. However, preliminary findings suggest that simulation is promising for practical training in suicidal crisis intervention and should be further studied.
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Affiliation(s)
- Océane Richard
- Department of child and adolescent psychiatry,Université Paris Cité, AP-HP, Academic Hospital Necker-Enfants Malades, Reference center for autism and learning disorders, Paris, France
| | - Fabrice Jollant
- Department of psychiatry, CHU Bicêtre, APHP, Le Kremlin-Bicêtre, France; Department of psychiatry, CHU Nimes, Nimes, France; Department of Psychiatry, School of Medicine, Paris-Saclay University, le Kremlin-Bicêtre, France; McGill University, McGill Group for Suicide Studies, Montreal, Canada; Moods Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France
| | - Grégoire Billon
- Mental helath simulation center, Maudsley Learning, South London and Maudsley NHS Foundation Trust, London, UK
| | - Chris Attoe
- Mental helath simulation center, Maudsley Learning, South London and Maudsley NHS Foundation Trust, London, UK
| | - Dominique Vodovar
- Université Paris Cité, UFR de médecine, 75010 Paris; UMRS 1144, Faculté de pharmacie, 75006 Paris; Centre AntiPoison de Paris, Paris
| | - Marie-Aude Piot
- Department of child and adolescent psychiatry, Université Paris Cité, AP-HP, Academic Hospital Necker-Enfants Malades Reference center for autism and learning disorders; Ilumens, Simulation Center; Paris-Saclay University, Paris, France
- CONTACT Marie-Aude Piot Department of child and adolescent psychiatry, Academic Hospital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France
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Ung TX, El-Den S, Moles RJ, O'Reilly CL. The Use of Mental Health Simulation in Pharmacy Practice and Education: A Systematic Review. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100058. [PMID: 37316135 DOI: 10.1016/j.ajpe.2023.100058] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/30/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To explore how mental health simulation has been used in the context of pharmacy practice and education, specifically what types of simulation techniques have been used, and which mental health-related content has been simulated. FINDINGS A literature search retrieved 449 reports, from which 26 articles pertaining to 23 studies were eligible for inclusion. Most studies were conducted in Australia. The most common type of simulation utilized was live simulated/standardized patient, followed by pre-recorded scenarios, role-play, and auditory simulation. While many study interventions included content relating to multiple mental illnesses and included activities other than simulation, the most simulated mental health content was enacting a person living with depression (with or without suicidal thoughts), mental health communication, followed by stress-induced insomnia, then hallucinations. Key outcomes from included studies were significantly improved student outcomes such as mental health knowledge, attitudes, social distance, and empathy scores, as well as highlighting the potential to further improve the mental healthcare skills of community pharmacists. SUMMARY This review demonstrates a varied use of techniques to simulate mental health in pharmacy practice and education. Future research is suggested to consider other simulation methods such as virtual reality and computer simulation, and to investigate how lesser-simulated mental health content such as psychosis could be incorporated. It is also recommended that future research provides greater detail on the development of the simulated content, such as involving people with lived experience of mental illness and mental health stakeholders in the development process to improve the authenticity of simulation training.
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Affiliation(s)
- Tina X Ung
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia.
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
| | - Rebekah J Moles
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
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Pedrollo LFS, Silva AC, Zanetti ACG, Vedana KGG. Creation and validation of a high-fidelity simulation scenario for suicide postvention. Rev Lat Am Enfermagem 2022; 30:e3699. [PMID: 36287402 PMCID: PMC9580988 DOI: 10.1590/1518-8345.6034.3699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE to create and validate a high-fidelity simulation scenario about the initial support to suicide bereaved people. METHOD a methodological research study to create and validate a simulation scenario about postvention. Its creation was based on scientific recommendations, the validation process was carried out by experts, based on an instrument developed by the authors; the data were statistically analyzed using the Content Validity Index and Gwet concordance coefficient. RESULTS the scenario was created to provide initial support to suicide bereaved people in the Primary Health Care context. As learning objectives, welcoming, health care and organization monitoring were proposed according to technical-scientific recommendations. The scenario was validated by 10 specialists in the themes of postvention (5 judges) and high-fidelity simulation (5 judges). The scenario items met the acceptance and reliability criteria (Content Validity Index = 0.80) and satisfactory concordance (Gwet coefficient = 0.640). CONCLUSION the study presented in full a scenario on postvention with innovative potential that can be used free of charge in clinical simulation development during training of different categories of health professionals, to act in support of suicide bereaved people.
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Affiliation(s)
- Laysa Fernanda Silva Pedrollo
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Aline Conceição Silva
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Ana Carolina Guidorizzi Zanetti
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Kelly Graziani Giacchero Vedana
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Durling P, Henni J, Mrozowich D, Rankin J, Barlow A, Grimminck R. A Mixed-Methods Realist Analysis of an Interdisciplinary Simulation Intervention for Psychiatry Residents. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:95-105. [PMID: 34613598 PMCID: PMC8493779 DOI: 10.1007/s40596-021-01524-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 08/10/2021] [Indexed: 05/30/2023]
Abstract
OBJECTIVES Simulation research in postgraduate psychiatry remains limited, with minimal studies on interdisciplinary involvement and mechanisms of change. To address these gaps, the authors implemented a mixed-methods realist analysis of an interdisciplinary simulation intervention administered to psychiatry residents. METHODS The University of Calgary implemented a simulation intervention for psychiatry residents. Eight junior residents participated in or observed 4 scenarios and eighteen senior residents participated in or observed 8 scenarios. Scenarios lasted 15 minutes with a pre-simulation orientation and post-scenario debrief. Most scenarios involved interdisciplinary staff. Scenarios included agitated and suicidal patients; treatment-related emergencies; and challenging conversations. All residents completed pre- and post-simulation surveys reporting confidence levels. Changes in confidence were analyzed using paired t tests and differences between junior and senior residents' confidence using ANOVA. Eleven residents participated in 2 focus groups. Transcripts were analyzed using a constant comparative model to identify contexts, mechanisms, outcomes, and the relationship between these realist categories. Key themes were extracted using generic theme analysis. RESULTS Aggregated survey data demonstrated statistically significant improvements in self-reported confidence for 7 of 8 proposed scenarios, with variations in confidence outcomes between junior and senior residents. Four themes emerged: (1) How Simulations Facilitate Learning, (2) The Role of Pre-simulation Instructions, (3) Factors Facilitating Confidence, (4) Positive Effects of Interdisciplinary Involvement. CONCLUSIONS This study identifies possible mechanisms for residents' self-reported improvements in learning and confidence, which may help programs tailor interventions. Furthermore, this study suggests there may be benefits to interdisciplinary simulations, with self-reported outcomes of improved collaboration and safety planning.
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Patel M, Hui J, Ho C, Mak CK, Simpson A, Sockalingam S. Tutors' Perceptions of the Transition to Video and Simulated Patients in Pre-clinical Psychiatry Training. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:593-597. [PMID: 34231192 PMCID: PMC8260018 DOI: 10.1007/s40596-021-01504-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/23/2021] [Indexed: 05/04/2023]
Abstract
OBJECTIVE The use of virtual learning in psychiatric education has been required to address COVID-19-related challenges. Research regarding the implementation of virtual teaching environments and standardized patients for simulation remains limited. Here, educators' outcomes were evaluated following a transition from in-person teaching with "real" patients, to a standardized patient-based simulation in pre-clerkship psychiatric clinical skills teaching for medical students. METHODS The Integrated Clinical Experiences course at the University of Toronto is a pre-clerkship clinical skills curriculum for second-year medical students. Four psychiatric clinical skills sessions were transitioned from in-person teaching to virtual teaching environments with standardized patient-based simulation. Educators (tutors) were assigned to teach groups of four to seven medical students, with a total of 45 groups. Tutors were then asked to complete an online questionnaire, and data was analyzed by quantitative and qualitative means. RESULTS Of 30 tutors, 21 (75.0%) had previously taught the course for an average of 6.52 ± 6.85 years. Twenty-four of 30 (80%) tutors described their ease of virtual teaching as "extremely easy" or "moderately easy". Twenty-three of 30 (76.6%) were "extremely satisfied" or "moderately satisfied" with standardized patient-based simulation. Various advantages and disadvantages of the virtual teaching environment with standardized patient-based simulation were identified. CONCLUSIONS The transition to a virtual teaching environment utilizing standardized patients in a pre-clerkship simulation-based curriculum did not result in significant challenges that would limit educators' use of these teaching tools. Implementation of virtual teaching environments with standardized patients may thus serve to address challenges related to COVID-19 and resource limitations.
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Affiliation(s)
- Mitesh Patel
- University of Toronto, Toronto, Ontario, Canada.
| | | | - Certina Ho
- University of Toronto, Toronto, Ontario, Canada
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Piot MA, Dechartres A, Attoe C, Romeo M, Jollant F, Billon G, Cross S, Lemogne C, Layat Burn C, Michelet D, Guerrier G, Tesniere A, Rethans JJ, Falissard B. Effectiveness of simulation in psychiatry for nursing students, nurses and nurse practitioners: A systematic review and meta-analysis. J Adv Nurs 2021; 78:332-347. [PMID: 34378236 DOI: 10.1111/jan.14986] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/24/2021] [Accepted: 07/15/2021] [Indexed: 11/30/2022]
Abstract
AIMS Mental disorders constitute one of the main causes of disease and disability worldwide. While nurses are often at the frontline of mental health care, they have limited access to dedicated psychiatric training opportunities. Simulation training may foster the development of the appropriate competencies required when supporting people with mental disorders. To evaluate the effectiveness of simulation training in psychiatry for nursing students, nurses and nurse practitioners. DESIGN Systematic review and meta-analysis. DATA SOURCES Eight electronic databases, trial registries, key journals and reference lists of selected studies were searched from inception to August 20, 2020 without language restriction. REVIEW METHODS We included randomized and non-randomized controlled studies and single group pre/post studies. Cochrane Risk of Bias tool 2.0 was used for randomized controlled study appraisal, and the Medical Education Research Study Quality instrument was completed for all other studies. Meta-analysis was restricted to randomized controlled studies. The other studies were synthesized narratively. The main outcomes were based on Kirkpatrick levels. RESULTS A total of 118 studies (6738 participants) were found. Interventions included simulated patients (n = 55), role-plays (n = 40), virtual reality (n = 12), manikins (n = 9) and voice simulations (n = 9). Meta-analyses based on 11 randomized controlled studies found a significant large effect size on skills at immediate post-test for simulation compared with active control; and a small and medium effect size on learners' attitudes for simulation compared with inactive control, at immediate post-test and at three-month follow-up respectively. Three quarters of non-randomized controlled studies and pre/post-tests assessing attitudes and skills showed significant differences, and three quarters of participants in randomized controlled studies and pre/post-tests showed significant differences in behaviours. Among the few studies assessing people with mental health outcomes, almost all reported significant differences. CONCLUSION These findings support the effectiveness of simulation training in psychiatric nursing throughout professional development grades, despite heterogeneity in methods and simulation interventions.
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Affiliation(s)
- Marie-Aude Piot
- Université de Paris, Institute Mutualiste Montsouris, Department of Psychiatry, Paris-Saclay University, UVSQ, INSERM 1018, CESP, Ilumens, Simulation Center, Paris, France
| | - Agnès Dechartres
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP. Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie de l'AP-HP (Cephepi), F75013, Paris, France
| | - Chris Attoe
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, London, UK
| | - Marie Romeo
- Université de Paris, Institute Mutualiste Montsouris, Department of Psychiatry, Paris-Saclay University, UVSQ, INSERM 1018, CESP, Ilumens, Simulation Center, Paris, France
| | - Fabrice Jollant
- Université de Paris, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Department of Psychiatry, Moods Team, INSERM UMR-1178, CESP, Paris, France.,Nîmes academic hospital (CHU), Nîmes, France.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Grégoire Billon
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, London, UK
| | - Sean Cross
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, London, UK
| | - Cédric Lemogne
- Université de Paris, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Carine Layat Burn
- Department of Orthopaedic Surgery, La Providence Hospital, Neuchâtel, Switzerland.,Department of Psychotherapy, Berger Psychotherapeutic Centre, Neuchâtel, Switzerland
| | - Daphné Michelet
- Department of Pediatric Anesthesia, CHU of Reims Hôpital Maison Blanche, Reims, France
| | - Gilles Guerrier
- Université de Paris, AP-HP, Cochin Hospital, Anaesthesiology Department, Ilumens, Simulation Center, Paris, France
| | - Antoine Tesniere
- Université de Paris, AP-HP, Cochin Hospital, Anaesthesiology Department, Ilumens, Simulation Center, Paris, France
| | - Jan-Joost Rethans
- Skillslab, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Bruno Falissard
- Public Health Department, School of Medicine, University Paris Saclay, INSERM 1018, CESP, Villejuif, Ile-de-France, France
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Abstract
Simulation-based medical education (SBME) provides experiential learning for medical trainees without any risk of harm to patients. Simulation is now included in most medical school and residency curricula. In psychiatric education, simulation programs are rapidly expanding and innovating. Major applications of SBME in psychiatry include achieving close observation of trainees with patients, preparing trainees for unstable patient scenarios, and exposing trainees to a broader range of psychopathology. This review article covers the history of SBME, simulation modalities, current use of SBME in psychiatry, a case study from one institution, and recommendations for incorporating simulation in psychiatry education.
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Affiliation(s)
- Shannon R McGue
- College of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 812, MSC 623, Charleston, SC 29425, USA
| | - Christine M Pelic
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC 29425, USA; Ralph H. Johnson VA Medical Center, 109 Bee Street, Charleston, SC 29401, USA
| | - Austin McCadden
- College of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 812, MSC 623, Charleston, SC 29425, USA
| | - Christopher G Pelic
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC 29425, USA.
| | - A Lee Lewis
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC 29425, USA
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McGough S, Heslop K. Developing Mental Health-Related Simulation Activities for an Australian Undergraduate Nursing Curriculum. J Nurs Educ 2021; 60:356-361. [PMID: 34077327 DOI: 10.3928/01484834-20210520-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Although simulation-based learning experiences have been widely used in nursing curricula to develop confidence, knowledge, and skills, the use of mental health-related simulation in undergraduate nursing education is sparse. METHOD This project aimed to develop a simulation activity that incorporated the National Safety and Quality Health Service standards in acute mental health for undergraduate nursing students to prepare them for their clinical practicum in mental health. Clinical confidence was evaluated using the Mental Health Clinical Confidence scale. RESULTS Mental health clinical confidence increased in students following the activity. CONCLUSION The findings show simulation activities that build on existing knowledge improve student confidence in providing care for people with mental health conditions. This article reports on the development and implementation of a mental health-related simulation-based learning experience in an undergraduate nursing program and builds on the existing knowledge of simulation-based learning in health care education. [J Nurs Educ. 2021;60(6):356-361.].
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Piot MA, Attoe C, Billon G, Cross S, Rethans JJ, Falissard B. Simulation Training in Psychiatry for Medical Education: A Review. Front Psychiatry 2021; 12:658967. [PMID: 34093275 PMCID: PMC8175985 DOI: 10.3389/fpsyt.2021.658967] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/20/2021] [Indexed: 12/03/2022] Open
Abstract
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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Affiliation(s)
- Marie-Aude Piot
- School of Medicine, Faculty of Health, University of Paris, Paris, France
- Department of Psychiatry, Institute Mutualiste Montsouris, Paris, France
- Epidemiological and Public Health Research Centre, Villejuif, France
| | - Chris Attoe
- Maudsley Simulation, South London and Maudsley National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Gregoire Billon
- Maudsley Simulation, South London and Maudsley National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Sean Cross
- Maudsley Simulation, South London and Maudsley National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Jan-Joost Rethans
- Skillslab, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Bruno Falissard
- Epidemiological and Public Health Research Centre, Villejuif, France
- Department of Public Health, School of Medicine, University Paris Saclay, Villejuif, France
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García-Mayor S, Quemada-González C, León-Campos Á, Kaknani-Uttumchandani S, Gutiérrez-Rodríguez L, Del Mar Carmona-Segovia A, Martí-García C. Nursing students' perceptions on the use of clinical simulation in psychiatric and mental health nursing by means of objective structured clinical examination (OSCE). NURSE EDUCATION TODAY 2021; 100:104866. [PMID: 33735749 DOI: 10.1016/j.nedt.2021.104866] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/16/2021] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In view of the rising incidence and prevalence of mental disorders, and the stigma often attached to persons with these pathologies, the question of specific, appropriate training for nursing students is one of great importance. Objective structured clinical examination (OSCE) and clinical simulation may provide a useful means of introducing the student to this environment. OBJECTIVES To examine the perceptions and satisfaction of nursing students after their participation in a targeted mental health course in which the main specialist skills were acquired via clinical simulation. DESIGN A quantitative, descriptive, transversal study was conducted, in which the participants in a mental health course completed a questionnaire on their satisfaction with the experience. PARTICIPANTS The study population consisted of 141 nursing students enrolled in a mental health course and currently in the third year of their Nursing Degree studies at the University of Málaga (Spain). RESULTS The overall satisfaction expressed was more than 8 out of 10 (mean score = 8.43, SD = 1.25) and the students' satisfaction with specific aspects of the procedure exceeded 4 out of 5. The study results show that these nursing students considered the methodology in question to be useful preparation for clinical practice (mean score = 4.78, SD = 0.45), that they appreciated the participation of an expert (mean score = 4.72, SD = 0.60) and that receiving the opinions of their peers about their performance was an enriching part of the experience (mean score = 4.54, SD = 0.64). CONCLUSIONS The participants reported a high degree of satisfaction with the OSCE procedure and observed that this method should be implemented more frequently. Debriefing is viewed as a vital contribution to the learning process and to the participants' satisfaction. However, further research is needed to study the impact of stress and anxiety on the acquisition of skills via OSCEs.
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Affiliation(s)
- Silvia García-Mayor
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Málaga, C/Arquitecto Francisco Peñalosa, 3 CP 29071, Spain.
| | - Casta Quemada-González
- Facultad de Ciencias de la Salud, Universidad de Málaga, C/Arquitecto Francisco Peñalosa, 3 CP 29071, Spain
| | - Álvaro León-Campos
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Málaga, C/Arquitecto Francisco Peñalosa, 3 CP 29071, Spain.
| | - Shakira Kaknani-Uttumchandani
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Málaga, C/Arquitecto Francisco Peñalosa, 3 CP 29071, Spain.
| | - Laura Gutiérrez-Rodríguez
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Málaga, C/Arquitecto Francisco Peñalosa, 3 CP 29071, Spain.
| | | | - Celia Martí-García
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Málaga, C/Arquitecto Francisco Peñalosa, 3 CP 29071, Spain.
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Kuyt K, Park SH, Chang TP, Jung T, MacKinnon R. The use of virtual reality and augmented reality to enhance cardio-pulmonary resuscitation: a scoping review. Adv Simul (Lond) 2021; 6:11. [PMID: 33845911 PMCID: PMC8040758 DOI: 10.1186/s41077-021-00158-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Virtual reality (VR) and augmented reality (AR) have been proposed as novel methods to enhance cardio-pulmonary resuscitation (CPR) performance and increase engagement with CPR training. A scoping review was conducted to map the global evolution of these new approaches to CPR training, to assess their efficacy and determine future directions to meet gaps in current knowledge. METHODS A standardised five-stage scoping methodology was used to (1) identify the research question, (2) identify relevant studies, (3) select the studies, (4) chart the data and (5) summarise the findings. The Kirkpatrick model levels of evidence were used to chart and assess the efficacy of each intervention reported. A multi-pronged search term strategy was used to search the Web of Science, PubMed, CINAHL and EMBASE databases up to June 2020. RESULTS A total of 42 articles were included in this review. The first relevant paper identified was published in 2009 and based on VR, from 2014 onwards there was a large increase in the volume of work being published regarding VR and AR uses in CPR training. This review reports Kirkpatrick level one to three evidence for the use of VR/AR-CPR. Inconsistencies in the specific language, keywords used and methodologies are highlighted. CONCLUSION VR and AR technologies have shown great potential in the area of CPR, and there is continuing evidence of new novel applications and concepts. As VR/AR research into CPR reaches an inflection point, it is key to bring collaboration and consistency to the wider research community, to enable the growth of the area and ease of access to the wider medical community.
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Affiliation(s)
- Katherine Kuyt
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Sang-Hee Park
- Korea Institute of Civil Engineering and Building Technology, Seoul, South Korea
| | - Todd P Chang
- Children's Hospital Los Angeles, Los Angeles, USA
| | - Timothy Jung
- Manchester Metropolitan University, Manchester, UK
| | - Ralph MacKinnon
- Manchester University NHS Foundation Trust, Manchester, UK.
- Manchester Metropolitan University, Manchester, UK.
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Participant Perspectives on the Contributions of Physical, Psychological, and Sociological Fidelity to Learning in Interprofessional Mental Health Simulation. Simul Healthc 2021; 15:141-146. [PMID: 32218087 DOI: 10.1097/sih.0000000000000425] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Simulation has been identified as a key training modality to enhance interprofessional care for patients with co-occurring physical and mental illnesses. Fidelity is an important instructional design consideration for interprofessional simulation; however, research examining the contribution of physical, psychological, and sociological fidelity in achieving learning outcomes remains limited. This qualitative study explored the relationship between fidelity and learning from the perspective of interprofessional simulation course participants. METHODS Semistructured interviews were conducted with participants from the Interprofessional Simulations of Patient Experiences Across the Care Continuum - Child and Youth course. Consistent with grounded theory, data collection and analysis proceeded in an iterative fashion and emergent themes were identified by the research team through a process of constant comparative analysis. RESULTS Data saturation was reached after 10 interviews. High psychological fidelity allowed participants to engage in the simulation scenarios in ways that were congruent with their professional roles, which supported individual practice change. Tasks that were too closely aligned with their clinical experiences sometimes, however, limited new learning opportunities. Selective manipulations of sociological fidelity seemed to support learning outcomes related to understanding and appreciating the roles and responsibilities of other health professionals. Physical fidelity was less essential. CONCLUSIONS Psychological and sociological fidelity were perceived by participants as being most critical to learning in interprofessional mental health simulation. Improving our understanding of how simulation works in this context is important to effectively direct the efforts of learners, instructors, and designers toward maximizing the benefit of simulation-based learning in a cost-efficient manner.
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Rakofsky JJ, Talbot TB, Dunlop BW. A Virtual Standardized Patient-Based Assessment Tool to Evaluate Psychiatric Residents' Psychopharmacology Proficiency. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2020; 44:693-700. [PMID: 32681418 PMCID: PMC7367158 DOI: 10.1007/s40596-020-01286-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 07/05/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES A virtual standardized patient-based assessment simulator was developed to address biases and practical limitations in existing methods for evaluating residents' proficiency in psychopharmacological knowledge and practice. METHODS The simulator was designed to replicate an outpatient psychiatric clinic experience. The virtual patient reported symptoms of a treatment-resistant form of major depressive disorder (MDD), requiring the learner to use various antidepressants in order for the patient to fully remit. Test scores were based on the proportion of correct responses to questions asked by the virtual patient about possible side effects, dosing, and titration decisions, which depended upon the patient's tolerability and response to the learner's selected medications. The validation paradigm included a novice-expert performance comparison across 4th year medical students, psychiatric residents from all four post-graduate year classes, and psychiatry department faculty, and a correlational analysis of simulator performance with the PRITE Somatic Treatments subscale score. Post-test surveys evaluated the test takers' subjective impressions of the simulator. RESULTS Forty-three subjects completed the online exam and survey. Total mean scores on the exam differed significantly across all the learner groups in a step-wise manner from students to faculty (F = 6.10, p = 0.0001). Total mean scores by residency class correlated with PRITE Somatic Therapies subscale scores (p < 0.01). The post-test survey mean Likert results ranged from 3.33 ± 1.20 to 4.4 ± 0.79, indicating neutral to favorable responses for use of the simulator. CONCLUSIONS This simulator demonstrated strong construct validity and high participant acceptability for assessing proficiency in the psychopharmacologic treatment of MDD.
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Thomas A, Lubarsky S, Varpio L, Durning SJ, Young ME. Scoping reviews in health professions education: challenges, considerations and lessons learned about epistemology and methodology. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2020; 25:989-1002. [PMID: 31768787 DOI: 10.1007/s10459-019-09932-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/14/2019] [Indexed: 05/21/2023]
Abstract
Scoping reviews are increasingly used in health professions education to synthesize research and scholarship, and to report on the depth and breadth of the literature on a given topic. In this Perspective, we argue that the philosophical stance scholars adopt during the execution of a scoping review, including the meaning they attribute to fundamental concepts such as knowledge and evidence, influences how they gather, analyze, and interpret information obtained from a heterogeneous body of literature. We highlight the principles informing scoping reviews and outline how epistemology-the aspect of philosophy that "deals with questions involving the nature of knowledge, the justification of beliefs, and rationality"-should guide methodological considerations, toward the aim of ensuring the production of a high-quality review with defensible and appropriate conclusions. To contextualize our claims, we illustrate some of the methodological challenges we have personally encountered while executing a scoping review on clinical reasoning and reflect on how these challenges could have been reconciled through a broader understanding of the methodology's philosophical foundation. We conclude with a description of lessons we have learned that might usefully inform other scholars who are considering undertaking a scoping review in their own domains of inquiry.
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Affiliation(s)
- Aliki Thomas
- School of Physical and Occupational Therapy, McGill University, 3654 Sir William Osler, Room 45, Montreal, QC, H3G 1Y5, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada.
- Institute of Health Sciences Education, McGill University, Montreal, QC, Canada.
| | - Stuart Lubarsky
- Institute of Health Sciences Education, McGill University, Montreal, QC, Canada
- Department of Neurology, Faculty of Medicine, Montreal, QC, Canada
| | - Lara Varpio
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Steven J Durning
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Meredith E Young
- Institute of Health Sciences Education, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
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Usability of mental illness simulation involving scenarios with patients with schizophrenia via immersive virtual reality: A mixed methods study. PLoS One 2020; 15:e0238437. [PMID: 32936813 PMCID: PMC7494071 DOI: 10.1371/journal.pone.0238437] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 08/17/2020] [Indexed: 11/19/2022] Open
Abstract
Objectives Schizophrenia is one of the most prevalent mental illnesses contributing to national burden worldwide. It is well known that mental health nursing education, including clinical placement, is still insufficient to reach the optimal level of competency in nursing students. This study suggests a new form of mental health virtual reality (VR) simulation that is user-friendly and engaging to improve education about schizophrenia, thereby improving its treatment. Method A mixed-methods study was conducted with a total of 60 nursing students, using 360-degree videos of five different scenarios reflecting clinical symptoms of schizophrenia patients and related treatment tasks delivered via head-mounted displays (HMDs). We used a 17-item quantitative questionnaire and a 7-item open-ended qualitative questionnaire to evaluate the ease of use and usefulness of the VR simulation program and to identify areas where further improvement is required. Results The VR simulation program was perceived as useful and exciting. Participants stressed that the high realism of the simulation increased their engagement in and motivation to learn about mental health nursing. Some participants made suggestions, such as further refining the picture and sound quality in order to achieve satisfactory educational outcomes. Conclusion VR simulation using 360-degree videos and HMDs could serve as an effective alternative form of clinical training in mental health nursing. Education could be enhanced by its benefits of being engaging and exciting, as reported by this study’s participants.
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Piot MA, Dechartres A, Attoe C, Jollant F, Lemogne C, Layat Burn C, Rethans JJ, Michelet D, Cross S, Billon G, Guerrier G, Tesniere A, Falissard B. Simulation in psychiatry for medical doctors: A systematic review and meta-analysis. MEDICAL EDUCATION 2020; 54:696-708. [PMID: 32242966 DOI: 10.1111/medu.14166] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/14/2020] [Accepted: 03/23/2020] [Indexed: 05/06/2023]
Abstract
CONTEXT Most medical doctors are likely to work with patients experiencing mental health conditions. However, educational opportunities for medical doctors to achieve professional development in the field of psychiatry are often limited. Simulation training in psychiatry may be a useful tool to foster this development. OBJECTIVES The purpose of this study was to assess the effectiveness of simulation training in psychiatry for medical students, postgraduate trainees and medical doctors. METHODS For this systematic review and meta-analysis, we searched eight electronic databases and trial registries up to 31 August 2018. We manually searched key journals and the reference lists of selected studies. We included randomised and non-randomised controlled studies and single group pre- and post-test studies. Our main outcomes were based on Kirkpatrick levels. We included data only from randomised controlled trials (RCTs) using random-effects models. RESULTS From 46 571 studies identified, we selected 163 studies and combined 27 RCTs. Interventions included simulation by role-play (n = 69), simulated patients (n = 72), virtual reality (n = 22), manikin (n = 5) and voice simulation (n = 2). Meta-analysis found significant differences at immediate post-tests for simulation compared with active and inactive control groups for attitudes (standardised mean difference [SMD] = 0.52, 95% confidence interval [CI] 0.31-0.73 [I2 = 0.0%] and SMD = 0.28, 95% CI 0.04-0.53 [I2 = 52.0%], respectively), skills (SMD = 1.37, 95% CI 0.56-2.18 [I2 = 93.0%] and SMD = 1.49, 95% CI 0.39-2.58 [I2 = 93.0%], respectively), knowledge (SMD = 1.22, 95% CI 0.57-1.88 [I2 = 0.0%] and SMD = 0.72, 95% CI 0.14-1.30 [I2 = 80.0%], respectively), and behaviours (SMD = 1.07, 95% CI 0.49-1.65 [I2 = 68.0%] and SMD = 0.45, 95% CI 0.11-0.79 [I2 = 41.0%], respectively). Significant differences in terms of patient benefit and doctors' behaviours and skills were found at the 3-month follow-up. CONCLUSIONS Despite heterogeneity in methods and simulation interventions, our findings demonstrate the effectiveness of simulation training in psychiatry training.
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Affiliation(s)
- Marie-Aude Piot
- Epidemiological and Public Health Research Centre, Villejuif, France
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Department of Psychiatry, Institute Mutualiste Montsouris, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
| | - Agnès Dechartres
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Pitié Salpêtrière, Département de Santé Publique, Paris, France
| | - Chris Attoe
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Fabrice Jollant
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Department of Psychiatry, GHU Paris Psychiatry and Neurosciences, Sainte-Anne Hospital Center, Paris, France
- Department of Psychiatry, Nîmes Academic Hospital (CHU), Nîmes, France
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Cédric Lemogne
- University of Paris, Faculty of Health, Medicine School, Paris, France
- University of Paris, INSERM, Institute of Psychiatry and Neurosciences of Paris (IPNP), Paris, France
- AP-HP.Centre-University of Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France
| | - Carine Layat Burn
- Department of Orthopaedic Surgery, La Providence Hospital, Neuchâtel, Switzerland
- Department of Psychotherapy, Berger Psychotherapeutic Centre, Neuchâtel, Switzerland
| | - Jan-Joost Rethans
- Institute for Education and Skills Lab, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Daphne Michelet
- Health Care Simulation Center iLumens, University of Paris, France
- Department of Pediatric Anesthesia, CHU of Reims Hôpital Maison Blanche, Reims, France
| | - Sean Cross
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Gregoire Billon
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Gilles Guerrier
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
- Department of Anaesthesiology, Cochin Hospital, AP-HP, Paris, France
| | - Antoine Tesniere
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
| | - Bruno Falissard
- Epidemiological and Public Health Research Centre, Villejuif, France
- Department of Public health, School of Medecine, University Paris Saclay, Villejuif, France
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Rivera-Segarra E, Carminelli-Corretjer P, Varas-Díaz N, Neilands TB, Yang LH, Bernal G. HIV and Depression: Examining Medical Students Clinical Skills. Front Psychiatry 2020; 11:240. [PMID: 32292361 PMCID: PMC7120025 DOI: 10.3389/fpsyt.2020.00240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 03/11/2020] [Indexed: 01/08/2023] Open
Abstract
Major depression is a prevalent psychiatric disorder among people living with HIV (PWH). Major depression symptoms, including suicidal ideation, can hinder clinical care engagement and anti-retroviral treatment adherence. Research suggests that inquiry about major depression symptomatology and suicidal ideation should be standard practice when offering primary care services to PWH. However, studies examining depression and suicidal ideation inquiry are scarce. This study's aim was to describe medical students' clinical skills for dealing with major depression symptomatology and suicidal ideation among PWH in Puerto Rico. A total of 100 4th year medical students participated in a Standardized Patient simulation with a trained actor posing as a PWH and with a previous major depression diagnosis. One-way frequency tables were used to characterize the sample and the percentage of each observed clinical skill. Two key findings stem from these results only 10% of the participants referred the patient to psychological/psychiatric treatment, and only 32% inquired about suicidal ideation. Our findings highlight the need for enhancing medical students' competencies regarding mental health issues, particularly when providing services to at risk populations such as PWH within primary care settings.
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Affiliation(s)
- Eliut Rivera-Segarra
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
| | | | - Nelson Varas-Díaz
- Department of Global and Sociocultural Studies, Florida International University, Miami, FL, United States
| | - Torsten B. Neilands
- Center for AIDS Prevention Studies, University of California at San Francisco, San Francisco, CA, United States
| | - Lawrence H. Yang
- College of Global Public Health, New York University, New York, NY, United States
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Gutiérrez-Puertas L, Márquez-Hernández VV, Gutiérrez-Puertas V, Granados-Gámez G, Aguilera-Manrique G. Educational Interventions for Nursing Students to Develop Communication Skills with Patients: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2241. [PMID: 32225038 PMCID: PMC7177717 DOI: 10.3390/ijerph17072241] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 12/04/2022]
Abstract
INTRODUCTION Nursing students establish therapeutic relationships with their patients and as future nursing professionals, they should be trained to be effective communicators. The objective of this systematic review was to know the impact of educational interventions on nursing students to develop their communication skills with patients. METHODS A systematic review of literature was carried out. The following databases were consulted: CINAHL, PubMed (Ovid Medline), SCOPUS and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review. As for inclusion criteria, published articles in English from 2000 to 2020 were included. The methodological rigor of the included articles was evaluated with the JBI Critical Appraisal Checklist for Randomized Controlled Trial or Quasi-Experimental Studies. Changes in communication skills with the patient after the implementation of an intervention were analyzed. RESULTS Of the included studies in this systematic review (N = 19), two studies were randomized controlled trials, others were single group quasi-experimental studies (N = 11) and two group quasi-experimental studies (n = 6). The majority of the studies were carried out in the USA (n = 7). The most frequent educational intervention was simulation (n = 11). As for the improvement of communication skills, 13 of the 19 articles found statistically significant differences in patient-centered communication skills of nursing students. CONCLUSIONS This systematic review provides preliminary evidence of the effectiveness of interventions used to train nursing students in patient-centered communication. Although all the interventions obtained significant results in communication skills, it has not yet been determined which methodology is more effective.
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Affiliation(s)
| | - Verónica V. Márquez-Hernández
- Department of Nursing, Physiotherapy and Medicine, Research Group for Health Sciences CTS-451, Universidad de Almeria, 04120 Almeria, Spain; (L.G.-P.); (V.G.-P.); (G.A.-M.)
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Zhou Z, Hu S, Zhao YZ, Zhu YJ, Wang CF, Gu X, Fan GX, He SS. Feasibility of Virtual Reality Combined with Isocentric Navigation in Transforaminal Percutaneous Endoscopic Discectomy: A Cadaver Study. Orthop Surg 2019; 11:493-499. [PMID: 31207133 PMCID: PMC6595140 DOI: 10.1111/os.12473] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/11/2018] [Accepted: 08/24/2018] [Indexed: 12/26/2022] Open
Abstract
Objectives Transforaminal percutaneous endoscopic discectomy (TPED) is one of the most commonly used minimally invasive spine surgeries around the world. However, conventional surgical planning and intraoperative procedures for TPED have relied on surgeons’ experience, which limits its standardization and popularization. Virtual reality (VR) is a novel technology for pre‐surgical planning in various fields of medicine, while isocentric navigation can guide intraoperative procedures for TPED. The present study aimed to explore the feasibility of applying VR combined with isocentric navigation in TPED on cadavers. Methods The surgical levels were L3/L4 and L4/L5 as well as L5/S1 of both sides of each cadaver specimen. First, the surgeon manually conducted the above procedures on the left side of every specimen without preoperative simulation and isocentric navigation (Group A). Then the same surgeon conducted the VR simulation for surgical planning of the right side (Group B). After VR simulation, the same surgeon made the percutaneous punctures and placed the working channel on the right side of the specimen at all levels. Results At the L3/L4 level, the puncture‐channel time was 11.36 ± 2.13 min in Group A and 11.29 ± 2.23 min in Group B (t = 0.097, P = 0.938). The exposure time was 17.21 ± 2.91 s in Group A and 14.64 ± 1.60 s in Group B (t = 2.534, P = 0.025). At the L4/L5 level, the puncture‐channel time was 13.86 ± 3.90 min in Group A and 11.93 ± 2.95 min in Group B (t = 2.291, P = 0.039). Exposure time was 20.64 ± 3.84 s in Group A and 16.43 ± 2.47 s in Group B (t = 6.118, P < 0.01). There were 7 patients undergoing foraminotomy in Group A and 3 patients undergoing foraminotomy in Group B (t = 2.280, P = 0.236). At the L5/S1 level, the puncture‐channel time was 18.21 ± 1.85 min in Group A and 15.71 ± 3.20 min in Group B (t = 2.476, P = 0.028). Exposure time was 26.07 ± 3.17 s in Group A and 22.50 ± 2.68 s in Group B (t = 2.980, P = 0.011). There were 14 patients receiving foraminotomy in Group A and 13 patients receiving foraminotomy in Group B (t = 1.000, P = 1.000). Conclusions Virtual reality combined with isocentric navigation is feasible in TPED. It enables precise surgical planning and improves intraoperative procedures, and has the potential for application in clinical practice.
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Affiliation(s)
- Zhi Zhou
- Orthopaedics Department, Shanghai Tenth People's Hospital, Shanghai, China.,Spinal Pain Research Institute, Tongji University School of Medicine, Shanghai, China
| | - Shuo Hu
- Orthopaedics Department, Shanghai Tenth People's Hospital, Shanghai, China
| | - Yong-Zhao Zhao
- Orthopaedics Department, Shanghai Tenth People's Hospital, Shanghai, China
| | - Yan-Jie Zhu
- Orthopaedics Department, Shanghai Tenth People's Hospital, Shanghai, China.,Spinal Pain Research Institute, Tongji University School of Medicine, Shanghai, China
| | - Chuan-Feng Wang
- Orthopaedics Department, Shanghai Tenth People's Hospital, Shanghai, China
| | - Xin Gu
- Orthopaedics Department, Shanghai Tenth People's Hospital, Shanghai, China
| | - Guo-Xin Fan
- Orthopaedics Department, Shanghai Tenth People's Hospital, Shanghai, China.,Spinal Pain Research Institute, Tongji University School of Medicine, Shanghai, China
| | - Shi-Sheng He
- Orthopaedics Department, Shanghai Tenth People's Hospital, Shanghai, China.,Spinal Pain Research Institute, Tongji University School of Medicine, Shanghai, China
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Martínez P, Rojas G, Martínez V, Marín R, Cornejo JP, Gómez V. Measuring Primary Health Care Clinicians' Skills for Depression Management. Front Psychiatry 2019; 10:570. [PMID: 31474886 PMCID: PMC6703131 DOI: 10.3389/fpsyt.2019.00570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/22/2019] [Indexed: 12/12/2022] Open
Abstract
Introduction: Primary health care clinicians play an important role in the management of depression. Thus, it is very important to have a valid and reliable assessment of the competences needed to manage depression in primary health care, with the use of clinical simulation providing such an opportunity. Objective: The present study describes the assessment of primary health care clinicians' depression-related skills through a series of objective structured clinical examination stations. Material and Methods: Clinicians from multi-professional teams for the management of depression at two primary health care clinics in Santiago, Chile, went through seven objective structured clinical examination stations, lasting 10 to 20 min each, to assess their depression-related skills. The clinical and communicative skills measured were in accordance with clinical guidelines. Standardized patients portrayed cases usually encountered in clinical practice, while expert raters evaluated clinicians' performance with standardized checklists. Results: Psychosocial clinicians performed better than biomedical clinicians in the assessed skills. The most notable results were as follows: a high level of accomplishment in the relationship with patient, medical anamnesis, health checkup, and lab test requests; heterogeneous performance in patient management according to screening results, feedback to the patient, and registration in clinical records; and major deficiencies in the differential diagnosis of bipolar disorder. Discussion: The objective structured clinical examinations administered provided an opportunity to perform an in-depth examination of the depression-related skills of primary health care clinicians, where flaws in the screening and diagnosis procedures used by biomedical clinicians were detected. Given the significant involvement of these types of clinicians in depression management, undergraduate-level and continuing health education opportunities are needed.
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Affiliation(s)
- Pablo Martínez
- Departamento de Psiquiatría y Salud Mental, Hospital Clínico Universidad de Chile, Santiago, Chile.,Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile.,Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile.,Escuela de Psicología, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Graciela Rojas
- Departamento de Psiquiatría y Salud Mental, Hospital Clínico Universidad de Chile, Santiago, Chile.,Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile.,Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
| | - Vania Martínez
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile.,Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile.,Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente (CEMERA), Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Rigoberto Marín
- Departamento de Educación en Ciencias de la Salud, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | | | - Víctor Gómez
- Departamento de Psiquiatría y Salud Mental, Hospital Clínico Universidad de Chile, Santiago, Chile.,Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
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Piot MA, Dechartres A, Guerrier G, Lemogne C, Layat-Burn C, Falissard B, Tesniere A. Effectiveness of simulation in psychiatry for initial and continuing training of healthcare professionals: protocol for a systematic review. BMJ Open 2018; 8:e021012. [PMID: 29997139 PMCID: PMC6089281 DOI: 10.1136/bmjopen-2017-021012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Although most healthcare professionals must deal with patients with mental illness, many are not prepared for the various situations that can ensue. Simulation may be a powerful pedagogical tool for simultaneously teaching knowledge, skills and attitudes. We aim to assess the effectiveness of simulation for initial and continuous training in psychiatry for healthcare professionals. METHODS AND ANALYSIS A comprehensive search for randomised and non-randomised controlled studies and single-group pretest/post-test reports will be conducted in electronic databases including MEDLINE, EMBASE, Scopus, CINAHL, PsychINFO, ERIC, the Cochrane Central Register of Controlled Trials (CENTRAL) and the Web of Science (Science and Social Sciences Citation Index), with a detailed query. The reference lists of selected studies, key journals and trial registers will also be searched for additional studies. Two independent reviewers, following predefined inclusion criteria, will screen titles and abstracts first and then the full texts of the remaining articles. A third author will evaluate discrepancies to reach a consensus. It will include randomised controlled trial (RCT), non-RCT, pre-test/post-test design studies, post-test design for satisfaction evaluation and qualitative studies. Risk of bias will be assessed by using the Cochrane Collaboration Tool for assessing risk of bias in RCTs. Meta-analyses will be performed if we find sufficient studies that assess predefined outcomes and if their characteristics are not too different. The quality of evidence will be assessed by the Grading of Recommendations Assessment, Development and Evaluation. A narrative synthesis will be performed for qualitative studies and when meta-analyses are deemed not possible. ETHICS AND DISSEMINATION Ethics permission is not required. Dissemination will be through publication in peer-reviewed journals, national and international conferences, and the lead author's doctoral dissertation. TRIAL REGISTRATION NUMBER CRD42017078779.
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Affiliation(s)
- Marie-Aude Piot
- Epidemiological and Public Health Research Center, INSERM U1178/CESP U1018, Villejuif, Ile-de-France, France
- School of Medecine, University Paris Descartes, Paris, France
- Health Care Simulation Center iLumens, University Paris Descartes, Sorbonne Paris Cité, Paris, France
- Psychiatry Department, University Hospital Institut Mutualiste Montsouris, Paris, France
| | - Agnès Dechartres
- Clinical Epidemiology Center, Hôtel-Dieu University Hospital, AP-HP, Paris, France
- Clinical Epidemiology Center, Cochrane France, Paris, France
- Epidemiological and Statistic Research Center of Sorbonne Paris City, INSERM U1153/CRESS, Paris, France
| | - Gilles Guerrier
- Health Care Simulation Center iLumens, University Paris Descartes, Sorbonne Paris Cité, Paris, France
- Anaesthetic Department, Cochin Hospital, AP-HP, Paris, France
| | - Cédric Lemogne
- Psychiatry and Neuroscience Center, INSERM U894, Paris, France
- Psychiatry Department, Georges Pompidou European Hospital, Western Paris University Hospital Group, AP-HP, Paris, France
| | | | - Bruno Falissard
- Epidemiological and Public Health Research Center, INSERM U1178/CESP U1018, Villejuif, Ile-de-France, France
- Public health department, School of Medecine, University Paris Saclay, Villejuif, Ile-de-France, France
| | - Antoine Tesniere
- School of Medecine, University Paris Descartes, Paris, France
- Health Care Simulation Center iLumens, University Paris Descartes, Sorbonne Paris Cité, Paris, France
- Epidemiological and Statistic Research Center of Sorbonne Paris City, INSERM U1153/CRESS, Paris, France
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Verkuyl M, Romaniuk D, Mastrilli P. Virtual gaming simulation of a mental health assessment: A usability study. Nurse Educ Pract 2018; 31:83-87. [DOI: 10.1016/j.nepr.2018.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 01/10/2018] [Accepted: 05/17/2018] [Indexed: 10/16/2022]
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Øgård-Repål A, De Presno ÅK, Fossum M. Simulation with standardized patients to prepare undergraduate nursing students for mental health clinical practice: An integrative literature review. NURSE EDUCATION TODAY 2018; 66:149-157. [PMID: 29704702 DOI: 10.1016/j.nedt.2018.04.018] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/23/2018] [Accepted: 04/13/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate the available evidence supporting the efficacy of using simulation with standardized patients to prepare nursing students for mental health clinical practice. DESIGN Integrative literature review. DATA SOURCES A systematic search of the electronic databases CINAHL (EBSCOhost), Embase, MEDLINE, PsycINFO, and SveMed+ was conducted to identify empirical studies published until November 2016. Multiple search terms were used. Original empirical studies published in English and exploring undergraduate nursing students' experiences of simulation with standardized patients as preparation for mental health nursing practice were included. A search of reference lists and gray literature was also conducted. In total, 1677 studies were retrieved; the full texts of 78 were screened by 2 of the authors, and 6 studies reminded in the review. REVIEW METHODS The authors independently reviewed the studies in three stages by screening the titles, abstracts, and full texts, and the quality of the included studies was assessed in the final stage. Design-specific checklists were used for quality appraisal. The thematic synthesizing method was used to summarize the findings of the included studies. RESULTS The studies used four different research designs, both qualitative and quantitative. All studies scored fairly low in the quality appraisal. The five themes identified were enhanced confidence, clinical skills, anxiety regarding the unknown, demystification, and self-awareness. CONCLUSIONS The findings of this study indicate that simulation with standardized patients could decrease students' anxiety level, shatter pre-assumptions, and increase self-confidence and self-awareness before entering clinical practice in mental health. More high-quality studies with larger sample sizes are required because of the limited evidence provided by the six studies in the present review.
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Affiliation(s)
- Anita Øgård-Repål
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, Centre for Caring Research, Southern Norway, University of Agder, P.O. Box 422, 4604 Kristiansand, Norway.
| | - Åsne Knutson De Presno
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, Centre for Caring Research, Southern Norway, University of Agder, Grimstad, Norway.
| | - Mariann Fossum
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, Centre for Caring Research, Southern Norway, University of Agder, Grimstad, Norway.
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