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. 2022 Feb;46(1):95-105.
doi: 10.1007/s40596-021-01524-w. Epub 2021 Oct 6.

A Mixed-Methods Realist Analysis of an Interdisciplinary Simulation Intervention for Psychiatry Residents

Paige Durling  1 , Jihane Henni  2 , Dean Mrozowich  2 , Joanna Rankin  2 , Amber Barlow  2 , Rachel Grimminck  2
Affiliations

A Mixed-Methods Realist Analysis of an Interdisciplinary Simulation Intervention for Psychiatry Residents

Paige Durling et al. Acad Psychiatry. 2022 Feb.

Abstract

Objectives: Simulation research in postgraduate psychiatry remains limited, with minimal studies on interdisciplinary involvement and mechanisms of change. To address these gaps, the authors implemented a mixed-methods realist analysis of an interdisciplinary simulation intervention administered to psychiatry residents.

Methods: The University of Calgary implemented a simulation intervention for psychiatry residents. Eight junior residents participated in or observed 4 scenarios and eighteen senior residents participated in or observed 8 scenarios. Scenarios lasted 15 minutes with a pre-simulation orientation and post-scenario debrief. Most scenarios involved interdisciplinary staff. Scenarios included agitated and suicidal patients; treatment-related emergencies; and challenging conversations. All residents completed pre- and post-simulation surveys reporting confidence levels. Changes in confidence were analyzed using paired t tests and differences between junior and senior residents' confidence using ANOVA. Eleven residents participated in 2 focus groups. Transcripts were analyzed using a constant comparative model to identify contexts, mechanisms, outcomes, and the relationship between these realist categories. Key themes were extracted using generic theme analysis.

Results: Aggregated survey data demonstrated statistically significant improvements in self-reported confidence for 7 of 8 proposed scenarios, with variations in confidence outcomes between junior and senior residents. Four themes emerged: (1) How Simulations Facilitate Learning, (2) The Role of Pre-simulation Instructions, (3) Factors Facilitating Confidence, (4) Positive Effects of Interdisciplinary Involvement.

Conclusions: This study identifies possible mechanisms for residents' self-reported improvements in learning and confidence, which may help programs tailor interventions. Furthermore, this study suggests there may be benefits to interdisciplinary simulations, with self-reported outcomes of improved collaboration and safety planning.

Keywords: Education; Interdisciplinary; Psychiatry; Realist; Simulation.

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Conflict of interest statement

Two grants were received by Dr. Rachel Grimminck to support the cost of developing and running the simulation intervention. The organizations providing the grants were not involved in the development of the simulations, the research process, the creation of the manuscript, nor the dissemination of any research findings. There are no other conflicts of interest reported for Dr. Rachel Grimminck. On behalf of all authors, the corresponding author states that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Relationships between the contexts, mechanisms, and outcomes found to be associated with improved learning in focus group data
See this image and copyright information in PMC

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