National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Ireland.
School of Medicine, National University of Ireland Galway, University Road, Galway, Ireland.
BMJ Open Qual. 2021 Sep;10(3). doi: 10.1136/bmjoq-2021-001533.
Despite an evidence base demonstrating simulation to be an effective medical education tool, it is not commonly used in postgraduate psychiatry training as it is in other medical specialties.
This paper outlines the development and effectiveness of a hybrid-virtual simulation-based workshop designed to improve patient care by improving clinical skills of non-consultant hospital doctors (NCHDs) in detecting and managing rare and complex psychiatric emergencies.
Three clinical vignettes based on near-miss psychiatric cases were developed by a multidisciplinary team of physicians and nurses in psychiatry and experts in simulation-based medical education. The workshop, 'SafePsych' was delivered in a simulation laboratory while and broadcast via Zoom video-conferencing platform to observers. Debriefing followed each clinical scenario. Participants completed preworkshop and postworkshop questionnaires to evaluate clinical knowledge.
The workshop was attended by consultants (n=12) and NCHDs in psychiatry and emergency medicine (n=19), and psychiatric nurses (n=5). In the psychiatry NCHD group, test scores significantly improved following the workshop (p<0.001). There were significant improvements in the test scores with a mean difference of 2.56 (SD 1.58, p<0.001). Feedback from participants and observers was positive, with constructive appraisals to improve the virtual element of the workshop.
Simulation-based training is effective in teaching high risk, rare complex psychiatric cases to psychiatry NCHDs. Further exploration of the learning needs of nursing staff is required. Future workshop delivery is feasible in the COVID-19 environment and beyond, using a virtual element to meet social distancing requirements while enhancing the reach of the training.
尽管有证据表明模拟是一种有效的医学教育工具,但它在研究生精神病学培训中并不像其他医学专业那样普遍使用。
本文概述了一个混合虚拟基于模拟的工作坊的开发和有效性,旨在通过提高非顾问医院医生(NCHD)检测和管理罕见和复杂精神急症的临床技能来改善患者护理。
由精神病学医生和模拟医学教育专家组成的多学科团队开发了三个基于临床病例的临床情景。该工作坊“SafePsych”在模拟实验室进行,同时通过 Zoom 视频会议平台向观察员进行直播。每次临床情景后都进行了汇报。参与者完成了课前和课后问卷,以评估临床知识。
顾问(n=12)、精神病学和急诊医学 NCHD(n=19)以及精神科护士(n=5)参加了该工作坊。在精神病学 NCHD 组中,工作坊后测试成绩显著提高(p<0.001)。测试成绩有显著提高,平均差异为 2.56(SD 1.58,p<0.001)。参与者和观察员的反馈是积极的,提出了建设性的意见,以改进工作坊的虚拟部分。
基于模拟的培训在教授精神病学 NCHD 高风险、罕见复杂精神病例方面是有效的。需要进一步探索护理人员的学习需求。未来的工作坊在 COVID-19 环境中及以后可以通过虚拟元素来满足社交距离要求,同时扩大培训的覆盖面。