Department of Clinical Psychology and Psychotherapy, University of Trier, Trier, Germany.
PLoS One. 2024 Feb 22;19(2):e0294183. doi: 10.1371/journal.pone.0294183. eCollection 2024.
To train novice students adequately, it is crucial to understand where they start and how they develop their skills. This study examined the impact of novice students' characteristics on their initial clinical micro-skills when treating simulated patients with cognitive behavior therapy. The sample consisted of 44 graduate psychology students treating seven simulated patients. Clinical micro-skills were measured both using video-based ratings in reaction to short video clips of simulated patients (via the Facilitative Interpersonal Skills (FIS) performance task) and by using video-based ratings within a session with a simulated patient (using the Inventory of Therapeutic Interventions and Skills; ITIS). Two separate LASSO regressions were performed using machine learning to select potential predictors for both skills assessments. Subsequently, a bootstrapping algorithm with 10,000 iterations was used to examine the variability of regression coefficients. Using LASSO regression, we identified two predictors for clinical micro-skills in standardized scenarios: extraversion (b = 0.10) and resilience (b = 0.09), both were not significantly associated with clinical micro-skills. Together, they explained 15% of the skill variation. Bootstrapping confirmed the stability of these predictors. For clinical micro-skills in sessions, only competitiveness was excluded by LASSO regression, and all predictors showed significant instability. The results provide initial evidence that trainees' resilience and extraversion should be promoted in the clinical training of cognitive behavior therapy. More studies on clinical micro-skills and training with larger sample sizes are needed to fully understand clinical development.
为了充分培训新手学生，了解他们的起点以及他们如何发展技能至关重要。本研究考察了新手学生特征对他们在使用认知行为疗法治疗模拟患者时最初的临床微观技能的影响。该样本由 44 名研究生心理学学生组成，他们治疗了 7 名模拟患者。临床微观技能的测量既使用基于视频的评分来反应模拟患者的短视频剪辑（通过促进人际技能（FIS）表现任务），也使用基于视频的评分在与模拟患者的会话中进行（使用治疗干预和技能清单；ITIS）。使用机器学习进行了两次单独的 LASSO 回归，以选择两种技能评估的潜在预测因子。随后，使用 10,000 次迭代的自举算法来检查回归系数的可变性。使用 LASSO 回归，我们确定了标准化场景中临床微观技能的两个预测因子：外向性（b = 0.10）和韧性（b = 0.09），两者均与临床微观技能无显著相关。它们共同解释了 15%的技能变化。自举法证实了这些预测因子的稳定性。对于会话中的临床微观技能，只有竞争力被 LASSO 回归排除，所有预测因子均显示出显著的不稳定性。结果初步表明，在认知行为疗法的临床培训中，应该促进受训者的韧性和外向性。需要更多的关于临床微观技能和更大样本量的培训的研究来全面了解临床发展。
