gms | German Medical Science

Question: The aim of the skills training was to help students develop communication skills applicable in difficult psychiatric situations which are also relevant to other specialties.

The aim of the study was to examine the quality of standardized patients (SPs) portraying mental-health disorders compared to real patients in a controlled study design.

Methods: For the skills training six roles were developed for SPs: suicidal patient, sexual problems in depression, incompliant patient, patient with acute panic attack, borderline-patient with self-injury, aggressive manic patient. The course was split into two parts and took part during the two weeks which third-year students spent in the psychiatric hospital. In groups of 3 or 4 they rotate through the stations. Each time one of them interviews the SP. After talking for about five minutes the student gets feedback and is then given the opportunity to repeat the interview so that he can try to improve his communication techniques immediately. In the first course there is one station where basic communication skills are repeated.

For the study 6 videos were taped of SPs and 6 of real patients (depression, schizophrenia, obsessive-compulsive disorder, borderline personality disorder). SPs and real patients were matched as closely as possible. The interview was standardized and each video took between 10 and 12 minutes. In March they will be shown to 20 blinded psychiatrists who will answer a questionnaire regarding the quality of the presentation and the suitability of these videos for teaching medical students about mental-health disorders.

Results: The evaluation by the students showed the skills training to be generally highly accepted (1,4, range 1 to 6). Very good marks were given for the authenticity of the SPs and the quality of their feedback. The repetition of the interview immediately after feedback sometimes lead to controversial discussions. If a student was able to improve his skills and see the positive influence of the feedback on the following interview the acceptance was very high. Students who had already done very well or whose skills had worsened in quality didn’t see the point of this concept. In the first case some SPs started to make the interview more difficult, for example by being more aggressive as a manic patient. In the second case a good feedback and assistance by the teacher was necessary.

The results of the study are being awaited and will be presented at the congress.

Conclusion: Communication skills training in Psychiatry should be an inherent part of the curriculum. The immediate repetition of the interview can be very useful but should be examined in further studies.

The results of the video study could be of consequence regarding the acceptance of SPs in psychiatry. They may have influence on examinations such as OSCEs [1], [2], [3], [4], [5].