Medical students' experiences in learning the Mental State Examination with standardized patients.

Abstract

Standardized patients are widely used in psychiatry teaching and examinations, but their effectiveness in teaching psychopathology and the Mental State Examination in particular has not been established. A mixed-methods study was undertaken amongst fourth year medical students during a psychiatry rotation to explore the usefulness of learning the Mental State Examination with standardized patients compared with real patients. Qualitative semistructured interviews (N=10) were done to explore learning experiences with standardized patients. The Experience with Standardized Patients Scale was used (N=200) for the quantitative assessment in relation to examination performance and learning experience. In qualitative interviews, the common themes were that the experience with standardized patients was not natural and made it difficult to suspend disbelief, but students recognized the usefulness of standardized patients for practicing their skills. While there was no significant relationship between overall student experiences with standardized patients and their examination performance in the end-of-rotation Observed Standardized Clinical Examination (P=.40), the exception was with those who perceived they learnt more communication skills with standardized patients (P=.002). Students' experience with standardized patients role-playing psychotic disorders was poorest compared with standardized patients role-playing depressive and neurotic disorders. There were statistically significant differences in experiences between the three diagnostic groups. Standardized patients are useful in psychiatry for students to practice and improve their skills in eliciting psychopathology. However, attention to the training and selection of these individuals for psychiatric roles are crucial.