Simulation in psychiatry for medical doctors: A systematic review and meta‐analysis

Context Most medical doctors are likely to work with patients experiencing mental health conditions. However, educational opportunities for medical doctors to achieve professional development in the field of psychiatry are often limited. Simulation training in psychiatry may be a useful tool to fost...

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Published in:Medical education 2020-08, Vol.54 (8), p.696-708
Main Authors: Piot, Marie‐Aude, Dechartres, Agnès, Attoe, Chris, Jollant, Fabrice, Lemogne, Cédric, Layat Burn, Carine, Rethans, Jan‐Joost, Michelet, Daphne, Cross, Sean, Billon, Gregoire, Guerrier, Gilles, Tesniere, Antoine, Falissard, Bruno
Format: Article
Language:English
Subjects:
Medical education
Medical students
Meta-analysis
Psychiatry
Simulation
Systematic review
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Summary:Context Most medical doctors are likely to work with patients experiencing mental health conditions. However, educational opportunities for medical doctors to achieve professional development in the field of psychiatry are often limited. Simulation training in psychiatry may be a useful tool to foster this development. Objectives The purpose of this study was to assess the effectiveness of simulation training in psychiatry for medical students, postgraduate trainees and medical doctors. Methods For this systematic review and meta‐analysis, we searched eight electronic databases and trial registries up to 31 August 2018. We manually searched key journals and the reference lists of selected studies. We included randomised and non‐randomised controlled studies and single group pre‐ and post‐test studies. Our main outcomes were based on Kirkpatrick levels. We included data only from randomised controlled trials (RCTs) using random‐effects models. Results From 46 571 studies identified, we selected 163 studies and combined 27 RCTs. Interventions included simulation by role‐play (n = 69), simulated patients (n = 72), virtual reality (n = 22), manikin (n = 5) and voice simulation (n = 2). Meta‐analysis found significant differences at immediate post‐tests for simulation compared with active and inactive control groups for attitudes (standardised mean difference [SMD] = 0.52, 95% confidence interval [CI] 0.31‐0.73 [I2 = 0.0%] and SMD = 0.28, 95% CI 0.04‐0.53 [I2 = 52.0%], respectively), skills (SMD = 1.37, 95% CI 0.56‐2.18 [I2 = 93.0%] and SMD = 1.49, 95% CI 0.39‐2.58 [I2 = 93.0%], respectively), knowledge (SMD = 1.22, 95% CI 0.57‐1.88 [I2 = 0.0%] and SMD = 0.72, 95% CI 0.14‐1.30 [I2 = 80.0%], respectively), and behaviours (SMD = 1.07, 95% CI 0.49‐1.65 [I2 = 68.0%] and SMD = 0.45, 95% CI 0.11‐0.79 [I2 = 41.0%], respectively). Significant differences in terms of patient benefit and doctors’ behaviours and skills were found at the 3‐month follow‐up. Conclusions Despite heterogeneity in methods and simulation interventions, our findings demonstrate the effectiveness of simulation training in psychiatry training. By synthesizing the literature on simulation in psychiatry, Piot et al reveal the impacts it can have on both learner behaviour and patient care.
ISSN:0308-0110
1365-2923
DOI:10.1111/medu.14166