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
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
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.
Type d'étude
Inscription (Anticipé)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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London, Royaume-Uni, SE5 9RJ
- Institute of Psychiatry, King's College London
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La 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
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: OSkER
"Observed SKills in the Emergency Room" - workplace-based supervision.
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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.
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Expérimental: EPIC
"Emergency Psychiatry Immersion Course" - simulation-based training.
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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
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change in global clinical skills
Délai: Baseline; 4 weeks; 16 weeks
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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.
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Baseline; 4 weeks; 16 weeks
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change in technical clinical skills
Délai: Baseline; 4 weeks; 16 weeks
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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.
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Baseline; 4 weeks; 16 weeks
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Change in attitudes towards teamworking
Délai: Baseline; 4 weeks; 16 weeks
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The Operating Room Management Attitudes Questionnaire will be modified to be appropriate for working in psychiatry.
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Baseline; 4 weeks; 16 weeks
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Change in attitudes towards self-harm
Délai: Baseline; 4 weeks; 16 weeks
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The Attitudes to Deliberate Self-Harm Questionnaire
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Baseline; 4 weeks; 16 weeks
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Self-reported views on usefulness and acceptability of the training programmes
Délai: 4 weeks
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Post-course feedback questionnaire
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4 weeks
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Qualitative evaluation
Délai: 8 - 12 weeks
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Focus groups will be conducted to evaluate how participants have learned to manage psychiatric emergencies, and the contribution of the courses to their learning.
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8 - 12 weeks
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Collaborateurs et enquêteurs
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Anticipé)
Achèvement de l'étude (Anticipé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Autres numéros d'identification d'étude
- 2011/051
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