LAUSR

To the Editor: In 2014, the mandatory clinical attachment for fifth-year medical students at Copenhagen University (UCPH) Medical School was reduced from 4 to 3 weeks. As the performance of the mental status examination (MSE) is considered a difficult part of the course objectives, the time reduction spurred the development of a collection of short video recordings of authentic patients, interviewed only for educational purposes and only for the training of MSE. Video demonstrations of patients or simulated patients are regularly used in psychiatry lectures [1], but we deemed it important that the students had access to the video vignettes whenever they had time to spare at the wards. Consequently, we set out to make a video library as a supplementary educational resource accessible across the 12 general psychiatric hospitals that are part of UCPH Medical School. The use of authentic patients was deemed relevant, as the video vignettes were to be used to describe varieties of real phenomena [2]. The project was approved by the Ethics Board of Faculty of Health, CopenhagenUniversity after thorough consideration of the ethical aspects of using authentic patient videos for the described educational and research purpose. Patients were recruited at a general psychiatric hospital with four integrated wards and an emergency unit, with a total of 80 beds and several outpatient clinics. We passed information leaflets about the project around the wards with a call for all clinicians to recruit patients for the project. A senior resident worked full time on the project and went on recruitment rounds 2–3 times a week, where she talked to patients who showed an initial interest in the project. One in five patients agreed to participate in the project, and the number of recruitments per week varied from 0 to 4. If a patient agreed to participate, their decision was immediate. No patient who initially hesitated ended up agreeing to participate. The resident informed the patients about the project and secured signed consent, which was always confirmed a week after the video was recorded. One patient withdrew consent at the confirmation request. The videos were recorded at the wards or in the adjacent Research Unit. Two video cameras were used at every recording; the camera with highest resolution (Sony PXW-X70) and audio input (Sony Microports, URX P03, and UTX B03) was focused on the patient with medium close-up, and the smaller camera (Sony Handycam HDR-CX740) recorded the total interview situation, including the whole-body patient and interviewer. The interview started out with questions about recent or present mental problems and continued with screening for affective disorder and psychosis symptoms and risk of self-harm. Recordings lasted between 8 and 20min. The raw recordings were imported into a clipboard (Adobe Premiere Pro, version 2015), where they were compiled into one multi-camera sequence from which it was possible to switch between camera views and cut out sequences irrelevant to MSE. However, we avoided extensive cutting and extensive switching between camera views in order to maintain phenomena continuity. The final video vignettes were 8–12 min long, as recommended by Dong and Goh [3] and were downsized from full HD 1080 25p, H264 to HD 720 25p, H264, as size became an issue for the video library server placement. Apart from the vignettes, the library also entailed an expert MSE upshot of each video. First, a professor in psychiatry (RH) undertook the task of writing the MSE upshot of all * Sidse Marie Arnfred [email protected]