The Children's Hospital of Philadelphia, Department of Child & Adolescent Psychiatry and Behavioral Sciences, Philadelphia, PA, USA.
Department of Psychiatry, Yale-New Haven Hospital, New Haven, CT, USA.
Psychiatr Q. 2019 Dec;90(4):861-869. doi: 10.1007/s11126-019-09670-z.
Simulation-based training may be an effective teaching modality for psychiatry residents; however, simulation-based training is an unstudied and underutilized aspect of psychiatry resident training. The objective of this study was to compare the teaching effectiveness of a simulation-based training to reading a resident on-call psychiatry guide booklet in improving the self-confidence and knowledge of residents that is necessary for managing acutely agitated patients. Pre-intervention self-confidence and knowledge were measured for all residents using a Likert scale questionnaire and a clinical vignette questionnaire, respectively. Residents (n = 23) were randomly assigned to either the simulation group (n = 12) or the guide booklet group (n = 11). Residents in the simulation group completed the simulation-based training, and residents in the guide booklet group were instructed to read the corresponding pages of the booklet regarding management of acute agitation. The comparative teaching effectiveness of the guide booklet and simulation-based training was measured with a post-intervention self-confidence questionnaire and a clinical vignette questionnaire. The study spanned approximately one academic year (July 2016- Sept 2017). Residents who participated in the simulation-based training showed significantly greater improvement in self-confidence (simulation median improvement = 1.458 vs. guide median improvement = 0.033, p = 0.002) and knowledge (simulation median improvement = 0.135 vs. guide median improvement = 0.021, p = 0.0124). Simulation-based training was more effective at improving residents' self-confidence and knowledge compared to the on-call psychiatry booklet for the management of acutely agitated patients. Though simulation is being used in other specialties, it is a very underutilized tool in the field of psychiatry. This finding underscores the potential for simulation-based training in residency programs to improve resident learning.
基于模拟的培训可能是精神病学住院医师的有效教学模式；然而，基于模拟的培训是精神病学住院医师培训中一个未经研究且未得到充分利用的方面。本研究的目的是比较基于模拟的培训与阅读住院医师值班精神病学指南手册在提高管理急性激越患者所需的住院医师自信心和知识方面的教学效果。使用李克特量表问卷和临床病例问卷分别测量所有住院医师的干预前自信心和知识。将 23 名住院医师随机分配到模拟组（n=12）或指南手册组（n=11）。模拟组的住院医师完成基于模拟的培训，指南手册组的住院医师被指示阅读手册中关于急性激越管理的相应页面。通过干预后自信心问卷和临床病例问卷来衡量指南手册和基于模拟的培训的相对教学效果。该研究大约持续了一个学年（2016 年 7 月至 2017 年 9 月）。参加基于模拟的培训的住院医师在自信心（模拟中位数改善=1.458 与指南中位数改善=0.033，p=0.002）和知识（模拟中位数改善=0.135 与指南中位数改善=0.021，p=0.0124）方面的改善明显更大。与管理急性激越患者的值班精神病学手册相比，基于模拟的培训在提高住院医师的自信心和知识方面更有效。尽管模拟在其他专业中得到了应用，但它在精神病学领域的应用非常有限。这一发现强调了基于模拟的培训在住院医师培训项目中提高住院医师学习效果的潜力。
