LAUSR

The use of standardized patients in medical education is longstanding [1]. Training with standardized patients has been shown to be effective [2] and correlates with high learner satisfaction [3]. It has also been shown to prepare students for effectively communicating difficult topics such as delivering bad news [4]. The use of standardized patients is of particular interest in psychiatry given the nuanced interviews that are conducted, the importance of the mental status exam and the need to observe and interpret subtle facial expressions and body language cues. Educators have used standardized patients to train students in the evaluation of alcohol use disorder [5], suicide risk assessment [6], and end of life care [7]. A recent study demonstrated the utility of SPs in training students to manage difficult clinical situations including depression/ suicidal ideation, somatoform disorder, anxiety disorder, and borderline personality disorder [8]. High fidelity manikin–based simulation has become increasingly popular in medical education, particularly in anesthesia and emergency medicine [9–11]. Given the propensity to rely on the patient interview and mental status examination, psychiatry educators tend to prefer standardized patients over manikin-based simulation [12]. A 2016 systematic review of simulation activities in undergraduate psychiatry found 63 publications meeting inclusion criteria with 48 using standardized patients, 16 using online or virtual models, and only one using manikin-based simulation [12]. Unlike standardized patients, however, manikin-based simulation can represent the physiologic aspects of a patient’s illness and demonstrate real-time autonomous reactions to interventions and therapies [13]. There is a paucity of literature on the use of manikin-based simulation in psychiatry education. Two such studies looked at altered mental status and various scenarios involving drug and alcohol use. Both studies found significant changes in survey responses after the sessions [14, 15]. A detailed manikin-based simulation case involving alcohol withdrawal and lithium toxicity, demonstrating the utility of this technology for psychiatry clerkship education, has previously been published [16]. The primary aim of this study is to assess and compare the educational utility–particularly the acceptability to learners and the effectiveness at improving confidence in clinical skills–of two simulation modalities for teaching basic psychiatric concepts to clerkship medical students: traditional standardized patients vs manikin-based simulation.