Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA.
School of Nursing, University of Rochester Medical Center, Rochester, New York, USA.
Suicide Life Threat Behav. 2022 Jun;52(3):373-382. doi: 10.1111/sltb.12827. Epub 2022 Jan 17.
Almost half of individuals who die by suicide have had contact with primary care (PC) services within 1 month of their death. PC providers must be able to assess and manage patients' suicidal ideation, intent, and behaviors. When didactic training is provided to providers, it is assumed that their requisite skills are well developed. The current study assessed observed skills following high-quality online didactics.
Medical residents and nurse practitioner (NP) trainees (n = 127) participated in online didactic training as part of their education program, followed by a standardized patient interaction conducted to assess demonstrated suicide prevention skills (i.e., assessment of risk factors, protective factors, suicidal ideation and behavior, safety planning).
Participants demonstrated only about 50% of the possible total skills in most domains and were least competent in assessing potential risk for suicide. Regression analyses showed that residents were rated significantly higher than NPs on observed skills. Personal experience with suicide was not associated with any observed skills. Baseline knowledge scores were positively associated with some skills while elapsed days since completion of didactics were negatively associated with skills.
Didactics were insufficient for building suicide-specific assessment skills among physicians and nurses in advanced training.
近半数自杀身亡者在死亡前 1 个月内曾与初级保健(PC)服务有过接触。PC 提供者必须能够评估和管理患者的自杀意念、意图和行为。当向提供者提供理论培训时,假设他们具备必要的技能。本研究评估了高质量在线教学后的观察技能。
作为其教育计划的一部分,住院医师和护士从业者(NP)受训者(n=127)参加了在线理论培训,随后进行了标准化患者互动,以评估展示的预防自杀技能(即评估风险因素、保护因素、自杀意念和行为、安全计划)。
参与者在大多数领域仅表现出约 50%的可能总技能,在评估自杀潜在风险方面的能力最差。回归分析显示,住院医师在观察技能方面的评分明显高于护士从业者。个人自杀经历与任何观察到的技能均无关联。基线知识得分与某些技能呈正相关,而完成教学后的天数与技能呈负相关。
在高级培训中,针对医生和护士开展的教学不足以建立特定于自杀的评估技能。