Kowalski Christopher, Sathanandan Shivanthi
Barnet, Enfield & Haringey Mental Health Trust, St Ann's Hospital, London, UK.
Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK.
BMJ Simul Technol Enhanc Learn. 2015 Apr 23;1(1):29-32. doi: 10.1136/bmjstel-2014-000006. eCollection 2015.
Using simulation, we developed an advanced communication skill training programme with the objective of improving core psychiatry trainees' confidence in managing difficult situations at work.
Two simulation courses, comprising six scenarios, were developed for psychiatry core trainees (CTs) on the University College London Partners (UCLP) training scheme. Trainees were divided into small groups. Each trainee undertook two scenarios each. Feedback was delivered by facilitators, peers and the simulated patients. Written feedback was also given.
The courses were delivered in a local postgraduate medical education centre.
Actors were used to simulate adult psychiatric patients and their relatives. Other scenarios involved actors portraying colleagues.
The simulations offered an opportunity for experiential learning while the debriefs allowed for focused feedback on trainees' communication styles.
Changes in trainees' perception of their ability to deal with difficult situations at work were measured. Semistructured interviews further explored trainees' experience of the course and its educational impact.
100% (n=39) of the trainees felt that their communication skills had improved after the training. 97% felt more able to defuse an angry/tense situation at work while 92% felt more able to deal with a difficult situation requiring sophisticated communication skills. 97% felt that regular simulation training would be valuable while 100% (n=24) of facilitators agreed that the experience was valuable to the trainees' professional development. Qualitative analysis showed that trainees found the scenarios realistic, that the experience had led to an increased awareness of their communication style and that original improvements in confidence had translated to their clinical work.
The programme demonstrates that it is possible to use simulation in a simple, inexpensive and time-effective manner to provide realistic, enjoyable and educationally beneficial advanced communication skill training relevant to psychiatric practice.
通过模拟，我们开发了一个高级沟通技能培训项目，旨在提高精神科核心住院医师应对工作中困难情况的信心。
为伦敦大学学院合作伙伴（UCLP）培训计划中的精神科核心住院医师（CT）开发了两个模拟课程，包括六个场景。学员被分成小组。每个学员参与两个场景。由主持人、同伴和模拟患者提供反馈。还提供书面反馈。
课程在当地的研究生医学教育中心进行。
使用演员模拟成年精神科患者及其亲属。其他场景涉及演员扮演同事。
模拟提供了体验式学习的机会，而汇报环节则允许对学员的沟通风格进行有针对性的反馈。
测量学员对其应对工作中困难情况能力的认知变化。半结构化访谈进一步探讨了学员对课程的体验及其教育影响。
100%（n = 39）的学员认为培训后他们的沟通技能有所提高。97%的学员觉得自己更有能力化解工作中的愤怒/紧张局面，92%的学员觉得自己更有能力应对需要复杂沟通技巧的困难情况。97%的学员认为定期模拟培训很有价值，100%（n = 24）的主持人认为该体验对学员的职业发展很有价值。定性分析表明，学员们认为场景逼真，该体验提高了他们对自身沟通风格的认识，并且最初的信心提升已转化到他们的临床工作中。
该项目表明，以简单、廉价且省时的方式使用模拟来提供与精神科实践相关的现实、有趣且具有教育意义的高级沟通技能培训是可行的。
