Intérêts d’un atelier de simulation avec des patients standardisés pour la formation à l’examen du risque suicidaire

Abstract

ObjectivesAssessment of suicidal risk is an essential step during the psychiatric interview. However, numerous doctors are uncomfortable or reluctant to question patients about their suicidal ideations. Thus, this study aimed to evaluate the interest of teaching medical students to assess suicide risk using a standardized patient module. MethodAll students from Paris Diderot University, in the 5th year of medical training and in psychiatric internship between March 2017 and June 2019, were invited to participate in a standardized patient module in the iLumens Paris 7 platform. During this module, students (divided into groups of 3 to 5) conducted three interviews with standardized patients presenting with typical psychiatric disorders (major depressive episode, Obsessive Compulsive Disorder, mania with psychotic features). All students conducted one interview and observed the others for two interviews behind a one-way window. Each interview (duration=15minutes) was followed by a debriefing (duration=15minutes) supervised by a trained psychiatrist in the presence of the standardized patient and all students of the group. Before and after the module, students completed a questionnaire assessing their perceived difficulty and ability to interview patients about their suicidal ideations (main question, objective of the training) and about their sexual dysfunctions (control question, which was not an objective of the training) (on a Likert scale ranging from 0 [no] to 10 [yes]). They also completed a questionnaire assessing their involvement, their satisfaction, and the theoretical and practical contribution of the module. ResultsOf the 323 students who were contacted, 281 participated to the module. The module significantly reduced the perceived difficulty to question patients about their suicidal ideations (Cohen's d=−0.54, P-value<0.001) and reduced to a lesser extent the perceived difficulty to question patients about sexual problems (Cohen's d=−0.32; P-value<0.001). The module did change the students’ ability towards asking questions about suicidal ideations but not sexual problems. The students were generally involved in the module and satisfied with the theoretical and practical contributions of the module as well as its organization. DiscussionThis study provides arguments for the educational value of a simulation module with standardized patients to change the perceived difficulty and ability of medical students towards asking questions about suicidal ideations.