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
調査の概要
状態
条件
詳細な説明
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.
研究の種類
入学 (予想される)
段階
- 適用できない
連絡先と場所
研究場所
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-
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London、イギリス、SE5 9RJ
- Institute of Psychiatry, King's College London
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
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
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：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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実験的：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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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change in global clinical skills
時間枠：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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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in technical clinical skills
時間枠：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
|
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Change in attitudes towards teamworking
時間枠：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
時間枠：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
時間枠：4 weeks
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Post-course feedback questionnaire
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4 weeks
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Qualitative evaluation
時間枠：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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協力者と研究者
研究記録日
主要日程の研究
研究開始
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- 2011/051
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