Emergency Department, Westmead Hospital, Australia; and Simulated Learning Environment for Clinical Training (SiLECT), Australia.
Department of Psychiatry, Westmead Hospital, Australia.
Australas Psychiatry. 2020 Jun;28(3):354-358. doi: 10.1177/1039856220901480. Epub 2020 Feb 24.
We explored the feasibility of developing, running and evaluating a simulation-based medical education (SBME) workshop to improve the knowledge, skills and attitudes of emergency department (ED) doctors when called on to assess patients in psychiatric crisis.
We designed a four-hour workshop incorporating SBME and a blend of pre-reading, short didactic elements and multiple-choice questions (MCQs). Emergency department nurses (operating as SBME faculty) used prepared scripts to portray patients presenting in psychiatric crisis. They were interviewed in front of, and by, ED doctors. We collected structured course evaluations, Debriefing Assessment for Simulation in Healthcare (DASH) scores, and pre- and post-course MCQs.
The pilot workshop was delivered to 12 ED registrars using only existing resources of the Psychiatry and Emergency Departments. Participants highly valued both 'level of appropriateness' (Likert rating = 4.8/5.0) and 'overall usefulness' ( = 4.7/5.0) of the programme. They reported an improved understanding of the mental state and of relevant legal issues and rated the debriefings highly (participant DASH rating: = 193; score = 6.3/7.0). Median MCQ scores improved non-significantly pre- and post-course (7.5/12 vs 10/12, = 0.261).
An SBME workshop with these aims could be delivered and evaluated using the existing resources of the Psychiatry and Emergency Departments.
探索开发、运行和评估基于模拟的医学教育（SBME）研讨会的可行性，以提高急诊科（ED）医生在评估处于精神危机的患者时的知识、技能和态度。
我们设计了一个四小时的研讨会，包括 SBME 以及预读、简短教学元素和多项选择题（MCQ）的混合。急诊科护士（作为 SBME 教师）使用准备好的剧本来描绘呈现精神危机的患者。他们在 ED 医生面前和 ED 医生面前接受采访。我们收集了结构化的课程评估、模拟医疗保健中的反思评估（DASH）评分以及课前和课后 MCQ。
仅使用精神病学和急诊科的现有资源，该试点研讨会已向 12 名 ED 住院医师提供。参与者高度重视该计划的“适当程度”（Likert 评分=4.8/5.0）和“整体有用性”（=4.7/5.0）。他们报告说，对精神状态和相关法律问题的理解有所提高，并对辅导评价很高（参与者 DASH 评分=193；得分=6.3/7.0）。课前和课后 MCQ 分数均略有提高（7.5/12 与 10/12，=0.261）。
使用精神病学和急诊科的现有资源，可以提供和评估具有这些目标的 SBME 研讨会。
