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使用模拟进行精神科风险评估的教育方法:范围综述。

Educational Approaches Using Simulation for Psychiatric Risk Assessment: a Scoping Review.

机构信息

University of Toronto, Toronto, ON, Canada.

Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.

出版信息

Acad Psychiatry. 2024 Feb;48(1):61-70. doi: 10.1007/s40596-023-01836-z. Epub 2023 Aug 16.

Abstract

OBJECTIVE

The ability to assess a patient's risk of harm to self or others is a core competency for mental health clinicians which can have significant patient outcomes. With the growth of simulation in medical education, there is an opportunity to enhance education outcomes for psychiatric risk assessment. The purpose of this study was to determine how simulation is used to build competency in risk assessment and map its educational outcomes.

METHODS

The authors conducted a systematic scoping review using the Arksey and O'Malley framework. Electronic database searches were conducted by an academic librarian. Studies published before August 2022 which described simulation activities aimed at training clinicians in suicide, self-harm, and/or violence risk assessment were screened for eligibility.

RESULTS

Of the 21,814 articles identified, 58 studies were selected for inclusion. The majority described simulations teaching suicide risk assessment, and there was a notable gap for building competency in violence risk assessment. Simulation utility was demonstrated across emergency, inpatient, and outpatient settings involving adult and pediatric care. The most common simulation modality was patient actors. A smaller subset implemented technological approaches, such as automated virtual patient avatars. Outcomes included high learner satisfaction, and increases in psychiatric risk assessment knowledge, competency, and performance.

CONCLUSION

Simulation as an adjuvant to existing medical curricula can be used to teach risk assessment in mental health. Based on the results of our review, the authors provide recommendations for medical educators looking to design and implement simulation in mental health education.

摘要

目的

评估患者对自身或他人造成伤害的风险的能力是心理健康临床医生的核心能力,这对患者的预后有重要影响。随着模拟技术在医学教育中的发展,为精神病学风险评估提供教育成果的机会也随之增加。本研究旨在确定模拟技术如何用于建立风险评估能力,并对其教育成果进行映射。

方法

作者使用 Arksey 和 O'Malley 框架进行了系统的范围界定审查。学术图书馆员进行了电子数据库搜索。筛选了描述旨在培训临床医生进行自杀、自残和/或暴力风险评估的模拟活动的研究,这些研究发表于 2022 年 8 月之前,符合入选标准。

结果

在确定的 21814 篇文章中,有 58 项研究被纳入。其中大部分描述了模拟教学自杀风险评估,而在暴力风险评估能力建设方面存在明显差距。模拟在涉及成人和儿科护理的急诊、住院和门诊环境中具有广泛的应用。最常见的模拟模式是患者扮演者。一小部分研究采用了技术方法,如自动化虚拟患者头像。研究结果包括学习者满意度高,以及精神病学风险评估知识、能力和表现的提高。

结论

作为现有医学课程的辅助手段,模拟技术可用于教授心理健康领域的风险评估。基于我们的审查结果,作者为希望在心理健康教育中设计和实施模拟的医学教育工作者提供了建议。

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