Clinical Skills Training Clinical Trial
Official title:
A Randomised Trial of Simulation Training vs Workplace-Based Supervision for Junior Doctors in Psychiatry
The purpose of this study is to evaluate and compare the effectiveness of two forms of clinical skills training for teaching emergency psychiatry skills to doctors who have just started to work in psychiatry
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.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor)