The use of simulation to develop advanced communication skills relevant to psychiatry

Abstract

Objective: Using simulation, we developed an advanced communication skill training programme with the objective of improving core psychiatry trainees' confidence in managing difficult situations at work.

Design: Two simulation courses, comprising six scenarios, were developed for psychiatry core trainees (CTs) on the University College London Partners (UCLP) training scheme. Trainees were divided into small groups. Each trainee undertook two scenarios each. Feedback was delivered by facilitators, peers and the simulated patients. Written feedback was also given.

Setting: The courses were delivered in a local postgraduate medical education centre.

Patients: Actors were used to simulate adult psychiatric patients and their relatives. Other scenarios involved actors portraying colleagues.

Interventions: The simulations offered an opportunity for experiential learning while the debriefs allowed for focused feedback on trainees' communication styles.

Main outcome measures: Changes in trainees' perception of their ability to deal with difficult situations at work were measured. Semistructured interviews further explored trainees' experience of the course and its educational impact.

Results: 100% (n=39) of the trainees felt that their communication skills had improved after the training. 97% felt more able to defuse an angry/tense situation at work while 92% felt more able to deal with a difficult situation requiring sophisticated communication skills. 97% felt that regular simulation training would be valuable while 100% (n=24) of facilitators agreed that the experience was valuable to the trainees' professional development. Qualitative analysis showed that trainees found the scenarios realistic, that the experience had led to an increased awareness of their communication style and that original improvements in confidence had translated to their clinical work.

Conclusions: The programme demonstrates that it is possible to use simulation in a simple, inexpensive and time-effective manner to provide realistic, enjoyable and educationally beneficial advanced communication skill training relevant to psychiatric practice.

Keywords: communication skills; postgraduate training; psychiatry; simulation.