Abstract
Introduction With the number of people presenting to services, being diagnosed with, and requiring support for mental health problems continuing to increase, more and more decisions are being made by more and more mental health clinicians about the treatment and futures of their patients. This is in the context of reductions to inpatient psychiatric beds, and increasing numbers of people attending Emergency Departments with mental health concerns. However, decision-making can be an ambiguous process, with clinicians having varied opinions, and guidelines not always being clear. Aims To outline briefly the design of a simulation course for decision-making in mental health, before presenting the findings of a mixed methods evaluation. Method Simulation training used 6 scenarios involving every participant and trained actors, followed by a structured and reflective debrief on the decisions made in assessment and treatment. Pre- and post-questionnaires ( n =82) were employed to collect quantitative and qualitative data regarding participants' skills and knowledge of decision-making, which was further bolstered by qualitative follow-up surveys. Results Analyses found statistically significant increases in participants' knowledge and awareness of the decision-making process and personal biases, while qualitative responses showed significant changes pre- and post-course. Themes from qualitative feedback also identified self-reported changes to the clinical practice of participants, from awareness of biases, to reflecting on decisions. Conclusion Decision-making processes require explicit acknowledgement and exploration in psychiatry, with such training have a potential impact on the care and decision delivered by participants, a significant step in patient experience and outcomes.
Published Version
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