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Learning Process of Medical Students During Simulation Training in Psychiatry (APSIMP)

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ClinicalTrials.gov Identifier: NCT03983798
Recruitment Status : Completed
First Posted : June 12, 2019
Last Update Posted : June 12, 2019
Sponsor:
Information provided by (Responsible Party):
Institut Mutualiste Montsouris

Brief Summary:

In french context, simulation training is not well implemented in medical school, mainly in psychiatry. To build a formative and summative assessment tool of competences specific to this pedagogic context, so as to support its development.

This studies aims to explore learning process and factors supporting or preventing from learning of medical students during simulation in psychiatry.

A convenient sample of 72 voluntary participants, allocated among 6 groups of 12 students, will be recruted at Paris Descartes and Paris Diderot Universities between september of 2018 and january of 2019. Each participant will complete 6 hours of psychiatric simulation training, dealing with mood disoerders, anxious disorders, eating disoerders, borderline disorders, substance abuse and shizophrénia.

Each particpant will have to complete a portfolio about learning process during the trimester they are involved, a concept gap before and after each training and the " Learning Effectiveness Inventory Scale "at the end of simulation. a random sample of students will have to complete a face-to-face semi-interview (until reaching data saturation).

Video record of simulation and audio-record of débriefing will be analysed.


Condition or disease Intervention/treatment
Role Playing Psychology Learning Other: Simulation training in psychiatry

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Detailed Description:

Since the end of the nineties, pedagogical transformations question traditional pedagogical system which favoured a passive learning from master to student, trying to overcome classical " teaching paradigm" to " learning paradigm ". Despite several critics, the notion of " professional competence " emerges as one of the essential purpose of learning. Competence might be defined as " complex ability that professional built, starting from a specialized knowledge base, developed and controlled by a collegial peer who constitute the profession ", implying " a reflexive practice inside and after action " which creates or increases new competence in return.

However in french context, this paradigmatic revolution didn't really happened yet, including in psychiatry. Moreover, there are no engineering didactic work on specific skills required by a physician (psychiatrist or not) should have in care of a patient with psychiatric disorders. For instance, skills required when a surgeon has to deliver a "clear, loyal and adjusted" information to a patient with a schizophrenia ; and try to get his or her agreement so as to operate a intestinal blockage? As a matter of facts, no integrated competence referential will be able to be a reference in this work.

In a report which is nowadays a reference for the faculties of medicine all over the world, the Royal College of Physicians and Surgeons of Canada (CRMCC) define a framework of essential skills that each physician have to control: medical expertise, erudition ; communicational and relational abilities; collaboration ; professionalism ; management; health promotion. In the French context, skills that each medical student have to provide fo the psychiatric speciality are defined by 33 questions of national classifying exam (ECN). The " Psychiatry and Addictology Referential " points to medical students the reference knowledge to provide to respond to these questions during the challenge of ECN. But this referential doesn't explain skills, abilities and attitudes required with a patient with psychiatric disorders.

The places of providing essential skills defined by CRMCC applied in French psychiatry (as relational and communicational skills for instance) are thus often situated in others spaces. Realization of well supervised clerkship in psychiatry constitutes for example one of the privilege way of skills acquisition. Nonetheless in French context, all the undergraduate students can benefit from psychiatry during their clerkship; especially because of the rarefaction of well supervised internship (decreasing demography of psychiatrist), associated with increase number of medical student over the past few years. Moreover, realisation of an only internship can not include all the diversity of main family situation that should be known by each physician; mainly because of dichotomy of internship between adult and child and adolescent psychiatry, specific populations specific who go to different service according to there trouble (emergencies, closed unit, expert diagnosis centers…). Providing pedagogical tools allowing acquisition of basic skills, abilities and attitudes (complementary to knowledge and know-repeat) to care patient with psychiatric disorders seems thus interesting, for improving medical training.

Besides, assessment modalities determine for students work methodology and time involved in each learning, following Hawthorne effect. Assessments support learning assessed, involving long term memory, following " testing effect " ; and hierarchize planning of ulterior learning activities. Trials of ECN in this current shape will probably value acquisition of declarative knowledge for students who would like to succeed in the competition; to the detriment of know-how and life skills. These skills to care patients who suffer from psychiatric disorders won't be neither provided during a specialty residency, unless it might be especially oriented to psychiatry. Thus, it seems important to wider summative assessment modalities in psychiatry during undergraduate medical studies, so as to value acquisition of the wall skills required for a physician in care of a patient with psychiatric disorders. Which implies precise explanation of skills, abilities and attitudes needed, to balance success of ECN with their acquisition. In that context, simulation can offer a good response to this double aim : formative et summative. However, if some theorical approach are references to understand learning process in simulation, very few learning tool are validated in simulation, and none, to our knowledge, did a modelisation on learning process in psychiatric simulation for medical students.

Objectives:

This study aims to explore learning process in a simulation training using simulated patients in psychiatry for 5th year medical students.

This study is one of the 3 studies included in a PhD on learning process during simulation training in psychiatry.

The results of this 3 studies will aim at building a formative and summative assessment tool of competences specific to this pedagogic context

Methodology:

A convenient sample of 72 voluntary medical students, allocated among 6 groups of 12 students, will be recruted at Paris Descartes and Paris Diderot Universities between september of 2018 and january of 2019. Each participant will complete 6 hours of psychiatric simulation training, dealing with mood disoerders, anxious disorders, eating disoerders, borderline disorders, substance abuse and shizophrénia.

Study design is a mixted method study, following grounded theory including:

  • Quantitative features:

    • Pre/post test concept map (for number of new thema, links and hierarchy)
    • Self-reported questionnairies : " Learning Effectiveness Inventory Scale "
    • Sociodémographical data and others questions
  • Qualitative : Grounded Theory

    • Portfolio completed during clinical clerkship, after simulation on each pathology studied
    • Pre/post test concept map (for clinical reasonning features)
    • Vidéo-record of simulation and audio-record
    • Audio-record of debriefing
    • Semi-structured interview of learners and teachers

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Study Type : Observational
Actual Enrollment : 72 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Learning Process of 5th Year Medical Students During Simulation Training in Psychiatry: a Multicentric Mixed Method Study
Actual Study Start Date : October 16, 2018
Actual Primary Completion Date : January 2, 2019
Actual Study Completion Date : April 2, 2019

Group/Cohort Intervention/treatment
Simulation training in psychiatry
Convenient sample of 72 voluntary medical students, allocated among 6 groups of 12 students, will be recruited at Paris Descartes and Paris Diderot Universities between september of 2018 and January of 2019.
Other: Simulation training in psychiatry

Each participant will complete 6 hours of psychiatric simulation training, dealing with mood disorders, anxious disorders, eating disorders, borderline disorders, substance abuse and schizophrenia. Simulation training will be supplemented by brief lecture on concept map and portfolio at the beginning of the first hour. For formative aim, a mind gap built by the principal investigator (and reviewed by other investigators) will be offered to students after completion of post-test concept map.

Curriculum integration of simulation training in psychiatric course assure that each pathology studied is supplemented by a one-hour lecture and 1 to 3 hours clinical cases and MCQ training. A part of the medical students are supplemented by clinical practice ; whereas the other won't benefit from clinical practice.





Primary Outcome Measures :
  1. Learning process assessed by qualitative : Grounded Theory [ Time Frame: 6 months ]
    Portfolio completed during clinical clerkship

  2. Learning process assessed quantitative features [ Time Frame: 6 months ]
    • Self-reported questionnairies : " Learning Effectiveness Inventory Scale"


Secondary Outcome Measures :
  1. Factors supporting or preventing learning of 5th year medical students during simulation training in psychiatry. [ Time Frame: 6 months ]
    Learning process assessed by semi-structured face-to-face interview from a random sample of participants, until reaching data saturation

  2. Grounded theory methodology [ Time Frame: 6 months ]
    • Learning process assessed of video and audio-record by quotation of interview.

  3. Post-test satisfaction [ Time Frame: 6 months ]
    self-questionnaire " Learning effectiveness inventory "



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Probability Sample
Study Population
Voluntary medical students recruited at Paris Descartes and Paris Diderot Universities
Criteria

Inclusion Criteria:

  • Age > to 18 years old
  • Undergraduate medical student of Paris Descartes or Paris Diderot University
  • During university year 2018-2019
  • French or English langage
  • Agreement

Exclusion Criteria:

•Refusal of agreement


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03983798


Locations
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France
Institut mutualiste montsouris
Paris, France, 75014
Sponsors and Collaborators
Institut Mutualiste Montsouris
Investigators
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Principal Investigator: Marie-Aude PIOT, MD, PhD Institut Mutualiste Montsouris

Publications:
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Responsible Party: Institut Mutualiste Montsouris
ClinicalTrials.gov Identifier: NCT03983798     History of Changes
Other Study ID Numbers: PSY-04-2018
First Posted: June 12, 2019    Key Record Dates
Last Update Posted: June 12, 2019
Last Verified: June 2019

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Institut Mutualiste Montsouris:
Simulation training
Patient simulation
Psychiatric
Students
medical
Educational