Prabhakar Deepak, Balon Richard, Anzia Joan Meyer, Gabbard Glen O, Lomax James W, Bandstra Belinda ShenYu, Eisen Jane, Figueroa Sara, Theresa Garton, Ruble Matthew, Seritan Andreea L, Zisook Sidney
Henry Ford Health System, Detroit, MI, USA,
Acad Psychiatry. 2014 Oct;38(5):593-7. doi: 10.1007/s40596-014-0083-1. Epub 2014 Mar 25.
Every clinical specialty has its own high risk patient challenges that threaten to undermine their trainees' professional identity, evolving sense of competence. In psychiatric training, it is patient suicide, an all-too frequently encountered consequence of severe mental illness that may leave the treating resident perplexed, guilt-ridden, and uncertain of their suitability for the profession. This study evaluates a patient suicide training program aimed at educating residents about patient suicide, common reactions, and steps to attenuate emotional distress while facilitating learning.
The intervention was selected aspects of a patient suicide educational program, "Collateral Damages,"-video vignettes, focused discussions, and a patient-based learning exercise. Pre- and post-survey results were compared to assess both knowledge and attitudes resulting from this educational program. Eight psychiatry residency training programs participated in the study, and 167 of a possible 240 trainees (response rate = 69.58 %) completed pre- and post-surveys.
Knowledge of issues related to patient suicide increased after the program. Participants reported increased awareness of the common feelings physicians and trainees often experience after a patient suicide, of recommended "next" steps, available support systems, required documentation, and the role played by risk management.
This patient suicide educational program increased awareness of issues related to patient suicide and shows promise as a useful and long overdue educational program in residency training. It will be useful to learn whether this program enhances patient care or coping with actual patient suicide. Similar programs might be useful for other specialties.
每个临床专科都有其自身面临的高风险患者挑战,这些挑战有可能损害其学员的职业认同感以及逐渐形成的胜任感。在精神科培训中,患者自杀是一个严重精神疾病极为常见的后果,可能会让主治住院医师感到困惑、内疚,并对自己是否适合该职业产生怀疑。本研究评估了一个患者自杀培训项目,该项目旨在教育住院医师了解患者自杀、常见反应以及减轻情绪困扰并促进学习的步骤。
干预措施选取了患者自杀教育项目“附带损害”的一些方面——视频短片、重点讨论以及基于患者的学习练习。比较前后调查结果以评估该教育项目所产生的知识和态度。八个精神科住院医师培训项目参与了该研究,在可能的240名学员中,有167名(应答率 = 69.58%)完成了前后调查。
该项目结束后,与患者自杀相关问题的知识有所增加。参与者报告称,对医生和学员在患者自杀后常有的感受、推荐的“后续”步骤、可用的支持系统、所需文档记录以及风险管理所起的作用有了更高的认识。
这个患者自杀教育项目提高了对与患者自杀相关问题的认识,并且有望成为住院医师培训中一个有用且早就该有的教育项目。了解该项目是否能改善患者护理或应对实际的患者自杀情况将会很有帮助。类似的项目可能对其他专科也有用。