Academic journal article Indian Journal of Psychiatry

Postgraduate Trainees as Simulated Patients in Psychiatric Training: Role Players and Interviewers Perceptions

Academic journal article Indian Journal of Psychiatry

Postgraduate Trainees as Simulated Patients in Psychiatric Training: Role Players and Interviewers Perceptions

Article excerpt

Byline: Santosh. Chaturvedi, Prabha. Chandra

Background : Teaching skills to enhance competence in clinical settings need to have a focus on learning "how to do." This paper describes the subjective experiences and feedback of trainees who participated in a teaching technique using postgraduate trainees as simulated patients. Materials and Methods : The Objective Structured Clinical Assessment and Feedback was employed for training using trainees as simulated patients and interviewers. This exercise is performed in front of consultants and peers who subsequently provide feedback about the content and process using a structured format. In order to assess the subjective experience of the interviewer and the role players they were requested to provide structured feedback on several aspects. The trainee role player provided feedback on comfort in playing the role, need for further inputs, satisfaction regarding role play, satisfaction with the interview, and the overall effect of the activity. The trainee interviewer gave feedback on his/her level of comfort performing in front of a peer group, being watched, and evaluated in a group. Results : The feedback forms from 15 sessions were analyzed. Only two of the role players indicated that they felt very uncomfortable while the rest reported comfort. Twelve of the 15 trainees who simulated patients felt they needed more inputs to improve the clarity of the role play; however they all reported feeling satisfied with the role play or interview. The feedback from the interviewers indicated that most were comfortable in all aspects, i.e. conducting the interview, performing in front of a group, being evaluated, and given feedback in front of a group. Conclusion: The trainees report indicates that those simulating patients need more clarity on their roles and majority had no discomfort performing in front of a group. Interviewers were satisfied and comfortable with all aspects. On the whole, simulated interviews and role plays were found to be an acceptable teaching method by postgraduate psychiatry trainees.

Introduction

It is known that "What you hear you forget, what you see you remember, and what you do, you understand" [Chinese Proverb]. On similar principles, the Millers's triangle of learning principles has four stages of development-"knows, knows how, shows how and does" indicating steps from acquiring knowledge to performing a task in practice [sup][1] and focus on competence-based learning and medical training. [sup][2] Teaching skills to enhance competence in clinical settings need to have a focus on learning "how to do." This paper describes the use of certain techniques to increase skill-based competence and also describes findings of a brief study on the perception of trainees involved in this activity. The paper concludes with a description of the advantages and disadvantages of such methods.

OSCE as a training method

Assessment of competence can be done by objective structured clinical examination (OSCE), which has been used for examination of undergraduates and postgraduate medical students. The nature of conducting OSCE is such that it has a potential for use also as a teaching method to enhance competence-based training. [sup][2] The OSCE format can be used in the training of communication skills, which are an essential element to the doctor patient relationship. The interaction can provide feedback on key interviewing skills such as paraphrasing, summarizing, and empathy. OSCE can also be used to teach history taking or for eliciting specific signs and symptoms. [sup][2] While much of the literature has focused on the use of OSCE as a formative examination for students' clinical skills, [sup][3] not much has been discussed about its role in training.

Simulated clinical interviews and role plays

Role plays and simulated interviews are also used for teaching clinical skills. Simulated and/or standardized patients have been used in medical education both in undergraduate and postgraduate settings. …

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