- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01416727
Simulation Training vs Workplace-Based Supervision in Psychiatry (EPIC-OSkER)
A Randomised Trial of Simulation Training vs Workplace-Based Supervision for Junior Doctors in Psychiatry
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Junior doctors starting work in psychiatry soon encounter a number of situations in the workplace for which they have had little or no preparation either at medical school or from work in other specialities. They will encounter clinically complex situations such as rapid tranquillisation, crisis presentations of self-harm, suicide risk assessment, overseeing supervised confinement and making decisions to admit or discharge mentally ill patients. Furthermore, many of these situations occur out of hours when there is little direct senior supervision available. The traditional induction programme is delivered in a didactic format, which does not encourage effective learning, nor does it allow any opportunity to practise or acquire hands-on skills or non-technical skills such as interprofessional communication, leadership and situational awareness. In the interests of patient safety and improving the quality of care and patient's experience, there is an urgent need to identify ways of improving induction and quickly equipping junior doctors with the clinical skills necessary to practise safely in psychiatry. We propose to evaluate and compare two approached to improved skills training in psychiatry: 1. workplace-based observation and feedback; 2. simulation training.
All new junior doctors starting work in the South London and Maudsley NHS Foundation Trust, London, UK, in August 2011 will be invited to take part in a randomised controlled trial of training in addition to the standard induction. Following a day of lectures on relevant clinical topics, participants will be randomly allocated to receive either observed workplace-based training by a more senior doctor during their on-call duties, or a two-day simulation-based training course. Before and after the training, assessments of participants' clinical skills and attitudes will be carried out by questionnaires and by observations of simulated clinical encounters. Changes in performance will be compared between the two groups. Longer term evaluation will be carried out by means of qualitative interviews and simulated clinical encounters once participants have been working for several months.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
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London, United Kingdom, SE5 9RJ
- Institute of Psychiatry, King's College London
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Junior doctors starting work at the South London and Maudsley NHS Foundation Trust in August 2011 in any of the following grades: 1. Core Psychiatric Training; 2. Foundation Training; 3. General Practice Vocational Training; 4. Core Trainee 1-3 equivalent posts, e.g. long-term locums
Exclusion Criteria:
- Unwillingness to participate in the study
- Inability to attend the training programme or participate in the evaluation
Study Plan
How is the study designed?
Design Details
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: OSkER
"Observed SKills in the Emergency Room" - workplace-based supervision.
|
For four weeks, participants will be accompanied by a senior psychiatric registrar or consultant psychiatrist, who has received training in giving feedback, during their on-call duties.
Each participant will receive between 8-12 hours of 1:1 training.
|
Experimental: EPIC
"Emergency Psychiatry Immersion Course" - simulation-based training.
|
A two-day simulation-based training course covering assessment of self-harm, capacity, managing aggression, working with the emergency team and medical emergencies in the psychiatric hospital
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in global clinical skills
Time Frame: Baseline; 4 weeks; 16 weeks
|
Participants will participate in a single simulated clinical encounter.
Encounters will be video-recorded and then rated by observers, who are blind to the allocation status and time point of each video, using a global rating scale.
|
Baseline; 4 weeks; 16 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in technical clinical skills
Time Frame: Baseline; 4 weeks; 16 weeks
|
Participants will participate in a single simulated clinical encounter.
Encounters will be video-recorded and then rated by observers, who are blind to the allocation status and time point of each video, using a checklist-based rating scale.
|
Baseline; 4 weeks; 16 weeks
|
Change in attitudes towards teamworking
Time Frame: Baseline; 4 weeks; 16 weeks
|
The Operating Room Management Attitudes Questionnaire will be modified to be appropriate for working in psychiatry.
|
Baseline; 4 weeks; 16 weeks
|
Change in attitudes towards self-harm
Time Frame: Baseline; 4 weeks; 16 weeks
|
The Attitudes to Deliberate Self-Harm Questionnaire
|
Baseline; 4 weeks; 16 weeks
|
Self-reported views on usefulness and acceptability of the training programmes
Time Frame: 4 weeks
|
Post-course feedback questionnaire
|
4 weeks
|
Qualitative evaluation
Time Frame: 8 - 12 weeks
|
Focus groups will be conducted to evaluate how participants have learned to manage psychiatric emergencies, and the contribution of the courses to their learning.
|
8 - 12 weeks
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 2011/051
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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