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Encephale. 2017 Dec 21. pii: S0013-7006(17)30202-6. doi: 10.1016/j.encep.2017.09.009. [Epub ahead of print]

Evaluation by undergraduate medical students of a role-playing training program on the management of acute states of agitation.

Author information

1
CHU Lille, pôle de psychiatrie, université de Lille, 59000 Lille, France; Centre de simulation PRESAGE, faculté de médecine de Lille, université de Lille, 59000 Lille, France.
2
Centre de simulation PRESAGE, faculté de médecine de Lille, université de Lille, 59000 Lille, France; Service de réanimation médicale, université de Lille, CHU de Lille, 59000 Lille, France.
3
CHU Lille, pôle de psychiatrie, université de Lille, 59000 Lille, France.
4
Centre de simulation PRESAGE, faculté de médecine de Lille, université de Lille, 59000 Lille, France; Service de réanimation médicale, université de Lille, CHU de Lille, 59000 Lille, France. Electronic address: mercedes.jourdain@univ-lille2.fr.

Abstract

OBJECTIVES:

Acute states of agitation (ASAs) are frequent in daily medical practice. However, training on real ASAs raises technical and ethical issues, whereas lecture-based teaching hardly addresses some educational objectives, e.g., improving relational skills and team-based coordination. Simulation-based medical education (SBME) is a promising medium to train students on managing ASAs. We have recently implemented a role-playing training module on ASAs. In this scenario, four to five students play the role of the staff, while a trained professional actor plays the agitated patient. A subsequent standardized debriefing is conducted by a senior psychiatrist. A first wave of 219 students participated in a one-session training of this ASA module in June 2015. They completed pre-session and post-session questionnaires aiming to collect "proof-of-concept" data.

METHODS:

The pre-session questionnaire investigated: previous experience of ASA among students during their clinical training; previous participation in a role-playing SBME; and perceived knowledge of the good practice rules for managing ASAs. The post-session questionnaire investigated among the students if: they thought having been able to appropriately manage the simulated ASA; they found the SBME medium more fitted for training than real situations; they found that the SBME session faithfully reproduced a real ASA; and the session was found useful for transmitting the skills on correct management of ASA. The average level of stress induced by the training was assessed using a numerical rating scale (0-10).

RESULTS:

Two hundred and six of the 219 students completed the pre-session questionnaire (63% females; response rate 96.7%). A hundred and thirty four students played the scenario and completed the post-session questionnaire (65.7% females; response rate 100%). 38.3% of the responders reported having previously experienced a situation of ASA in their practice, and 31.1% deemed to know the good practices rules for managing an ASA. In post-session, 29.9% of the participants considered that they appropriately managed the ASA, 79.9% deemed that the role-playing session faithfully reproduced a real ASA, and 97% deemed that this SBME was more fitted and useful than a real clinical situation to improve their medical skills. Bivariate analyses revealed that the post-session responses and level of stress were not influenced by previous experience on ASA, previous participation in a SBME role-playing session, or thinking to know the rules for managing ASAs.

CONCLUSION:

SBME role-playing training appears a promising, realistic, and well-accepted method for teaching the management of ASA.

KEYWORDS:

Acteur; Actor; Acute state of agitation; Enseignement; Jeu de rôle; Medical education; Psychiatrie; Psychiatry; Role-playing training; Simulation; État d’agitation aigu

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