The Ohio State University College of Medicine, Columbus, OH, USA.
Acad Psychiatry. 2021 Jun;45(3):288-291. doi: 10.1007/s40596-021-01425-y. Epub 2021 Mar 2.
Patient suicide is a common experience in psychiatry residency, and its effects on trainees can be profound. There are currently no ACGME Common Program Requirements for education about patient suicide, and a need exists for evidence-based curricula to prepare residents for this difficult outcome.
A comprehensive patient suicide curriculum was developed utilizing multiple modes of delivering content, including a training designed to foster built-in support among peers in the healthcare workplace. The content was delivered at intervals over the course of the 2019-2020 academic year for 43 psychiatry residents at The Ohio State University Wexner Medical Center. Pre- and post-curriculum surveys were obtained to assess the resident experience of the new curriculum.
Twenty-seven residents completed the pre-curriculum survey and 25 completed the post-curriculum survey. Results demonstrated statistically significant improvements in ratings of preparedness to deal with the loss of a patient by suicide, preparedness to support a co-resident who has experienced the death of a patient by suicide, program-level support for residents, understanding systems-level and quality processes, and knowledge of what steps to take if finding out a patient has completed suicide.
A multimodal approach incorporating understanding emotional reactions, provision of support, delineation of procedural issues, and education regarding quality and risk management considerations was effective at improving resident preparedness to cope following a patient suicide.
在精神科住院医师培训中，患者自杀是一种常见现象，其对受训者的影响可能是深远的。目前，ACGME 普通项目要求中并没有关于患者自杀教育的规定，因此需要制定基于证据的课程，使住院医师为应对这一困难的结果做好准备。
利用多种方式传递内容，包括旨在培养医疗工作场所中同行之间内在支持的培训，开发了全面的患者自杀课程。该内容在 2019-2020 学年期间分阶段提供给俄亥俄州立大学韦克斯纳医学中心的 43 名精神科住院医师。在课程前后进行了调查，以评估住院医师对新课程的体验。
27 名住院医师完成了课前调查，25 名住院医师完成了课后调查。结果表明，在应对患者自杀导致的损失的准备程度、应对共同住院医师经历患者死亡的准备程度、对住院医师的计划支持、对系统级和质量流程的理解以及如果发现患者自杀该采取哪些措施的知识方面，评分均有统计学意义上的显著提高。
一种多模式方法，包括理解情绪反应、提供支持、阐明程序问题，以及关于质量管理和风险管理注意事项的教育，在提高住院医师应对患者自杀后的准备方面是有效的。
