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Martin A, Weller I, Amsalem D, Adigun A, Jaarsma D, Duvivier R, de Carvalho-Filho MA. From Learning Psychiatry to Becoming Psychiatrists: A Qualitative Study of Co-constructive Patient Simulation. Front Psychiatry 2020; 11:616239. [PMID: 33488433 PMCID: PMC7820173 DOI: 10.3389/fpsyt.2020.616239] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 12/10/2020] [Indexed: 01/08/2023] Open
Abstract
Objectives: Co-constructive patient simulation (CCPS) is a novel medical education approach that provides a participatory and emotionally supportive alternative to traditional supervision and training. CCPS can adapt iteratively and in real time to emergent vicissitudes and challenges faced by clinicians. We describe the first implementation of CCPS in psychiatry. Methods: We co-developed clinical scripts together with child and adolescent psychiatry senior fellows and professional actors with experience performing as simulated patients (SPs). We conducted the simulation sessions with interviewers blind to the content of case scenarios enacted by the SPs. Each hour-long simulation was followed by an hour-long debriefing session with all participants. We recorded and transcribed case preparation, simulation interactions, and debriefing sessions, and analyzed anonymized transcripts through qualitative analysis within a constructivist framework, aided by NVivo software. Results: Each of six CCPS sessions was attended by a median of 13 participants (range, 11-14). The first three sessions were conducted in person; the last three, which took place during the COVID-19 pandemic, via synchronized videoconferencing. Each of the sessions centered on clinically challenging and affectively charged situations informed by trainees' prior experiences. Through iterative thematic analysis we derived an alliterating "9R" model centered on three types of Reflection: (a) in action/"while doing" (Regulate, Relate, and Reason); (b) on action/"having done" (Realities, Restraints, and Relationships); and (c) for action/"will be doing" (with opportunities for Repair and Reaffirmation). Conclusions: CCPS is an experiential approach that fosters autonomous, meaningful, and individually tailored learning opportunities. CCPS and the 9R model for reflective practice can be effectively applied to psychiatry and have the potential to contribute uniquely to the educational needs of its trainees and practitioners.
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Affiliation(s)
- Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, CT, United States
- Standardized Patient Program, Teaching and Learning Center, Yale School of Medicine, New Haven, CT, United States
- Center for Educational Development and Research in Health Sciences (CEDAR), LEARN, University Medical Center Groningen, Groningen, Netherlands
- *Correspondence: Andrés Martin
| | - Indigo Weller
- Bioethics Program, Harvard University, Cambridge, MA, United States
| | - Doron Amsalem
- Tel-Aviv University Faculty of Medicine, Ramat-Aviv, Israel
- Mental Health Services, Columbia University Irving Medical Center, New York, NY, United States
| | - Ayodola Adigun
- Child Study Center, Yale School of Medicine, New Haven, CT, United States
- Mental Health Services, Columbia University Irving Medical Center, New York, NY, United States
| | - Debbie Jaarsma
- Center for Educational Development and Research in Health Sciences (CEDAR), LEARN, University Medical Center Groningen, Groningen, Netherlands
| | - Robbert Duvivier
- Center for Educational Development and Research in Health Sciences (CEDAR), LEARN, University Medical Center Groningen, Groningen, Netherlands
- Parnassia Psychiatric Institute, The Hague, Netherlands
| | - Marco Antonio de Carvalho-Filho
- Center for Educational Development and Research in Health Sciences (CEDAR), LEARN, University Medical Center Groningen, Groningen, Netherlands
- School of Medical Sciences, University of Minho, Braga, Portugal
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Abstract
This article is one in a series on the roles of adjunct clinical faculty and preceptors, who teach nursing students and new graduates to apply knowledge in clinical settings. In this article, the author discusses how nursing instructors influence the ethical development of students in the clinical setting.
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Williams B, Reddy P, Marshall S, Beovich B, McKarney L. Simulation and mental health outcomes: a scoping review. Adv Simul (Lond) 2017; 2:2. [PMID: 29450003 PMCID: PMC5806484 DOI: 10.1186/s41077-016-0035-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 12/31/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND A scoping review was conducted in order to map and determine the gaps in literature on the impact of simulation as an educational approach to improve mental health care outcomes. As it became apparent that no literature existed on this topic, the study aimed to examine the educational impact of simulation on mental health education. METHODS An established five-stage scoping methodology was used: (1) identification of the research question, (2) identification of relevant studies, (3) study selection, (4) charting the data and (5) collation, summarising and reporting of results. CINAHL, ProQuest, PubMed, MEDLINE, EMBASE and PsychINFO databases were searched. These databases were deemed to represent a majority of the literature while accommodating for the particular search strategy used for this review. Websites that provide grey literature were also searched for articles of relevance. RESULTS A total of 48 articles were included in this review, with a considerable portion of studies conducted in the USA and UK. Others were conducted in an array of locations including Australia, Canada, Iran and Taiwan. Of the included articles, seven groups of simulation methods (including standardised patients, virtual reality and manikins as patients) were evident, with standardised patients being most prominent. CONCLUSIONS Literature is lacking to evidence the benefit of simulation on mental health patient outcomes. However, the available literature suggests a variety of simulation-based education, and training methods are currently being used within mental healthcare education. The findings do suggest some methods of simulation, such as the use of standardised patients, are more commonly used in education and have been deemed as effective to assist in mental health education. As no article specifically examining the mental health outcomes of patients treated by health professionals taught by simulation was identified, the educational outcomes outlined in this paper may be used to inform further research, incorporating mental health patient outcomes.
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Affiliation(s)
- Brett Williams
- Department of Community Emergency Health & Paramedic Practice, Monash University, Peninsula Campus, PO Box 527, McMahons Road, Frankston, 3199 Victoria Australia
| | - Priya Reddy
- Department of Community Emergency Health & Paramedic Practice, Monash University, Peninsula Campus, PO Box 527, McMahons Road, Frankston, 3199 Victoria Australia
| | - Stuart Marshall
- Monash University, HealthPEER, Claytoria, Victoria Australia
| | - Bronwyn Beovich
- Department of Community Emergency Health & Paramedic Practice, Monash University, Peninsula Campus, PO Box 527, McMahons Road, Frankston, 3199 Victoria Australia
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Goodman JH, Winter SG. Review of Use of Standardized Patients in Psychiatric Nursing Education. J Am Psychiatr Nurses Assoc 2017; 23:360-374. [PMID: 28569095 DOI: 10.1177/1078390317712697] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Simulations using standardized patients (SPs) are increasingly used to teach and assess competencies in psychiatric/mental health (PMH) nursing education. To advance the field, it is important to identify current knowledge, practice, and evidence. OBJECTIVE To determine the current knowledge, evidence, and practice of using SPs in PMH nursing education by conducting an integrative review of the empirical research on the use of SPs in PMH nursing education, and by providing a supplementary descriptive review of non-research articles on PMH simulations using SPs. DESIGN A comprehensive search using electronic databases was conducted to identify both research and simulation description papers meeting inclusion criteria. The research literature was reviewed using an integrative review approach and a simple descriptive review of the non-research simulation literature was also conducted. RESULTS Six research studies and 18 simulation description articles were included in the review. Although there are several PMH SP simulation descriptions in the literature, and anecdotal indications that they are a valuable educational tool, there is insufficient research evidence regarding their effectiveness as a method in psychiatric nursing education due to few published studies and methodological limitations of existing studies. CONCLUSIONS Well-designed research studies are needed to develop an evidence base for this promising and increasingly employed teaching method.
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Affiliation(s)
- Janice H Goodman
- 1 Janice H. Goodman, PhD, PMHCNS-BC, PMHNP-BC, MGH Institute of Health Professions, Boston, MA, USA
| | - Shira G Winter
- 2 Shira G. Winter, MSN, FNP-BC, MGH Institute of Health Professions, Boston, MA, USA
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Kirkbakk-Fjær K, Hedelin B, Moen ØL. Undergraduate Nursing Students' Evaluation of the Debriefing Phase in Mental Health Nursing Simulation. Issues Ment Health Nurs 2016; 37:360-6. [PMID: 27050663 DOI: 10.3109/01612840.2015.1136716] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The debriefing phase in mental health nursing simulation promotes a reflexive learning process with the opportunity to develop metacognitive and nontechnical skills. The aim of this quantitative study was to describe undergraduate nursing students' evaluation of their experience during the debriefing phase following high fidelity human simulation (HFHS). Data was collected using the "Debriefing Experience Scale" and analysed with descriptive and comparative tests. The debriefing phase was evaluated as very good. Background data and group size revealed few significant differences. Students with little clinical praxis evaluated having time to acknowledge feelings as important. Differences between groups revealed that groups should consist of up to eighteen students.
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Affiliation(s)
- Kari Kirkbakk-Fjær
- a Gjøvik University College , Department of Nursing , Gjøvik , Norway.,b Norwegian University of Science and Technology (NTNU) , Department of Nursing , Gjøvik , Norway
| | - Birgitta Hedelin
- a Gjøvik University College , Department of Nursing , Gjøvik , Norway.,b Norwegian University of Science and Technology (NTNU) , Department of Nursing , Gjøvik , Norway
| | - Øyfrid Larsen Moen
- a Gjøvik University College , Department of Nursing , Gjøvik , Norway.,b Norwegian University of Science and Technology (NTNU) , Department of Nursing , Gjøvik , Norway
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Akroyd M, Jordan G, Rowlands P. Interprofessional, simulation-based technology-enhanced learning to improve physical healthcare in psychiatry: The RAMPPS course. Health Informatics J 2015; 22:397-405. [PMID: 25552481 DOI: 10.1177/1460458214562287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
People with serious mental illness have reduced life expectancy compared with a control population, much of which is accounted for by significant physical comorbidity. Frontline clinical staff in mental health often lack confidence in recognition, assessment and management of such 'medical' problems. Simulation provides one way for staff to practise these skills in a safe setting. We produced a multidisciplinary simulation course around recognition and assessment of medical problems in psychiatric settings. We describe an audit of strategic and design aspects of the recognition and assessment of medical problems in psychiatric settings, using the Department of Health's 'Framework for Technology Enhanced Learning' as our audit standards. At the same time, as highlighting areas where recognition and assessment of medical problems in psychiatric settings adheres to these identified principles, such as the strategic underpinning of the approach, and the means by which information is collected, reviewed and shared, it also helps us to identify areas where we can improve.
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Affiliation(s)
- Mike Akroyd
- Derbyshire Healthcare NHS Foundation Trust, UK
| | - Gary Jordan
- Leeds Metropolitan University, UK; Leeds Beckett University, UK
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Akroyd M, Jordan G, Rowlands P. Interprofessional, simulation-based technology-enhanced learning to improve physical health care in psychiatry: The recognition and assessment of medical problems in psychiatric settings course. Health Informatics J 2014; 22:312-20. [PMID: 25425630 DOI: 10.1177/1460458214557098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
People with serious mental illness have reduced life expectancy compared with a control population, much of which is accounted for by significant physical comorbidity. Frontline clinical staff in mental health often lack confidence in recognition, assessment and management of such 'medical' problems. Simulation provides one way for staff to practise these skills in a safe setting. We produced a multidisciplinary simulation course around recognition and assessment of medical problems in psychiatric settings. We describe an audit of strategic and design aspects of the recognition and assessment of medical problems in psychiatric settings course, using the Department of Health's 'Framework for Technology Enhanced Learning' as our audit standards. At the same time as highlighting areas where recognition and assessment of medical problems in psychiatric settings adheres to these identified principles, such as the strategic underpinning of the approach, and the means by which information is collected, reviewed and shared, it also helps us to identify areas where we can improve.
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Affiliation(s)
- Mike Akroyd
- Derbyshire Healthcare NHS Foundation Trust, UK
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Webster D. Using Standardized Patients to Teach Therapeutic Communication in Psychiatric Nursing. Clin Simul Nurs 2014. [DOI: 10.1016/j.ecns.2013.08.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Webster D, Seldomridge L, Rockelli L. Making It Real: Using Standardized Patients to Bring Case Studies to Life. J Psychosoc Nurs Ment Health Serv 2012; 50:36-41. [DOI: 10.3928/02793695-20120410-06] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 03/14/2012] [Indexed: 11/20/2022]
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