Aggarwal Neil Krishan, Lam Peter, Castillo Enrico G, Weiss Mitchell G, Diaz Esperanza, Alarcón Renato D, van Dijk Rob, Rohlof Hans, Ndetei David M, Scalco Monica, Aguilar-Gaxiola Sergio, Bassiri Kavoos, Deshpande Smita, Groen Simon, Jadhav Sushrut, Kirmayer Laurence J, Paralikar Vasudeo, Westermeyer Joseph, Santos Filipa, Vega-Dienstmaier Johann, Anez Luis, Boiler Marit, Nicasio Andel V, Lewis-Fernández Roberto
Columbia University, New York, NY, USA.
New York State Psychiatric Institute, New York, NY, USA.
Acad Psychiatry. 2016 Aug;40(4):584-91. doi: 10.1007/s40596-015-0429-3. Epub 2015 Oct 8.
This study's objective is to analyze training methods clinicians reported as most and least helpful during the DSM-5 Cultural Formulation Interview field trial, reasons why, and associations between demographic characteristics and method preferences.
The authors used mixed methods to analyze interviews from 75 clinicians in five continents on their training preferences after a standardized training session and clinicians' first administration of the Cultural Formulation Interview. Content analysis identified most and least helpful educational methods by reason. Bivariate and logistic regression analysis compared clinician characteristics to method preferences.
Most frequently, clinicians named case-based behavioral simulations as "most helpful" and video as "least helpful" training methods. Bivariate and logistic regression models, first unadjusted and then clustered by country, found that each additional year of a clinician's age was associated with a preference for behavioral simulations: OR = 1.05 (95 % CI: 1.01-1.10; p = 0.025).
Most clinicians preferred active behavioral simulations in cultural competence training, and this effect was most pronounced among older clinicians. Effective training may be best accomplished through a combination of reviewing written guidelines, video demonstration, and behavioral simulations. Future work can examine the impact of clinician training satisfaction on patient symptoms and quality of life.
本研究的目的是分析临床医生在《精神疾病诊断与统计手册》第5版文化定式访谈现场试验期间报告的最有帮助和最无帮助的培训方法、原因，以及人口统计学特征与方法偏好之间的关联。
作者采用混合方法，分析了来自五大洲的75名临床医生在标准化培训课程及首次进行文化定式访谈后关于其培训偏好的访谈内容。内容分析按原因确定了最有帮助和最无帮助的教育方法。双变量和逻辑回归分析将临床医生的特征与方法偏好进行了比较。
临床医生最常将基于案例的行为模拟列为“最有帮助”的培训方法，而将视频列为“最无帮助”的培训方法。双变量和逻辑回归模型，先未进行调整，然后按国家进行聚类分析，发现临床医生的年龄每增加一岁，就与对行为模拟的偏好相关：比值比=1.05（95%置信区间：1.01-1.10；p=0.025）。
大多数临床医生在文化能力培训中更喜欢积极的行为模拟，这种影响在年长的临床医生中最为明显。有效的培训可能最好通过结合审查书面指南、视频演示和行为模拟来完成。未来的工作可以研究临床医生培训满意度对患者症状和生活质量的影响。
