A randomized controlled trial of suicide prevention training for primary care providers: a study protocol

Wendi F Cross,Amanda H Kay,Jennifer C West,Jessica L Nielsen,Hugh F Crean,Eric D Caine,Anthony R Pisani

doi:10.1186/s12909-019-1482-5

Abstract

BackgroundSuicide is a national public health crisis and a critical patient safety issue. It is the 10th leading cause of death overall and the second leading cause of death among adolescents and young adults (15–34 years old). Research shows 80% of youth who died by suicide saw their primary care provider within the year of their death. It is imperative that primary care providers develop the knowledge and skills to talk with patients about distress and suicidal thoughts, and to assess and respond in the context of the ongoing patient - primary care provider relationship.MethodsThis study examines the effectiveness of simulation on suicide prevention training for providers-in-training by comparing two conditions: 1) a control group that receives online teaching on suicide prevention in primary care via brief online videos and 2) an experimental group that includes the same online teaching videos plus two standardized patient (SP) interactions (face-to-face and telehealth, presentation randomized). All SP interactions are video-recorded. The primary analysis is a comparison of the two groups’ suicide prevention skills using an SP “test case” at 6-month follow-up.DiscussionThe primary research question examines the impact of practice (through SP simulation) over and above online teaching alone on suicide prevention skills demonstrated at follow-up. We will assess moderators of outcomes, differences among SP simulations (i.e., face-to-face vs. telehealth modalities), and whether the experimental group’s suicide prevention skills improve over the three SP experiences.Trial registrationThe study was registered on Clinical Trials Registry (clinicaltrials.gov) on December 14, 2016. The Trial Registration Number is NCT02996344.

Highlights

Suicide is a national public health crisis and a critical patient safety issue
Aim This study aims to compare online teaching alone to online teaching plus practice through simulation on the suicide risk assessment and safety planning skills of primary care providers-in-training
There has been growing evidence suggesting that the Benjamin Hochberg (BH) method is the optimal solution to the multiple comparison problem in most practical situations. This RCT examines the benefit of practice via realistic standardized patient (SP) simulation interactions with feedback as part of training in suicide prevention skills

Summary

Introduction

Suicide is a national public health crisis and a critical patient safety issue It is the 10th leading cause of death overall and the second leading cause of death among adolescents and young adults (15–34 years old). Research shows 80% of youth who died by suicide saw their primary care provider within the year of their death. Another study found that 80% of youth who died by suicide saw their primary care provider within a year of their death [6]. Only 20% of individuals who died by suicide saw a mental health provider within a month of their death, compared to 45% of suicidal individuals who saw a primary care provider within a month of their death [5, 7]

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