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Simulation in psychiatric teaching

  • Subodh Dave


The use of simulated patients in medicine offers students a standardised learning experience and a reproducible way of exploring attitudes and teaching communication skills. This would seem to be particularly relevant to psychiatry with its focus on attitudes and interpersonal skills, but doubts have been raised about the utility of simulated patients in teaching skills such as empathy and the generalisability of this learning to the real world. This, tempered with cost implications, may have limited the use of simulated patients to assessment through objective structured clinical examinations rather than to teaching and to learning. This article examines the educational advantages and disadvantages of the use of simulated patients in psychiatric teaching and argues that their judicious use complements undergraduate and postgraduate training in psychiatry. The article offers practical tips on writing simulated patient scenarios to deliver specific learning objectives and discusses the potential use of novel simulation techniques in psychiatric education.

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Corresponding author

Dr Subodh Dave, Derbyshire Mental Health Services NHS Trust, Royal Derby Hospital, Uttoxeter Road, Derby DE22 3NE, UK. Email:


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Barrows, H (1993) An overview of the uses of standardized patients for teaching and evaluating clinical skills. Academic Medicine 68: 443–51.
Bennett, A, Arnold, L, Welge, J (2006) Use of standardized patients during a psychiatry clerkship. Academic Psychiatry 30: 185–90.
Birndorf, C, Kaye, M (2002) Teaching the mental status examination to medical students by using a standardised patient in a large group setting. Academic Psychiatry 26: 180–3.
Bokken, L, van Dalen, J, Rethans, JJ (2004) Performance-related stress symptoms in simulated patients. Medical Education 38: 1089–94.
Brenner, A (2009) Uses and limitations of simulated patients in psychiatric education. Academic Psychiatry 33: 112–9.
Chur-Hansen, A, Koopowitz, L (2002) Introducing psychosocial and psychiatric concepts to first year medical students using an integrated biopsychosocial framework. Education for Health 15: 305–14.
Clay, M, Lane, H, Willis, S et al (2000) Using a standardised family to teach clinical skills to medical students. Teaching and Learning in Medicine 12: 145–9.
Cleland, J, Abe, K, Rethans, J (2010) The use of simulated patients in medical education: AMEE Guide No 42. Medical Teacher 31: 477–86.
Collins, J, Harden, R (1998) AMEE Medical Education Guide No. 13: real patients, simulated patients and simulators in clinical examinations. Medical Teacher 20: 508–21.
Dave, S, Dogra, N, Leask, SJ (2010) Current role of service increment for teaching funding in psychiatry. The Psychiatrist 34: 31–5.
Dave, S, Tandon, K (2011a) Cinemeducation in psychiatry. Advances in Psychiatric Treatment 17: 301–8.
Dave, S, Morrison, A (2011b) Funding of the teaching of medical undergraduates. In Teaching Psychiatry to Undergraduates (eds Brown, T, Eagles, J) 264–77. Royal College of Psychiatrists.
Du Boulay, C, Medway, C (1999) The clinical skills resource: a review of current practice. Medical Education 33: 185–91.
Eagles, J, Calder, S (2011) Teaching with simulated patients and role-play. In Teaching Psychiatry to Undergraduates (eds Brown, T, Eagles, J) 230–44. Royal College of Psychiatrists.
Eagles, JM, Calder, SA, Nicoll, KS et al (2001) A comparison of real patients, simulated patients and videotaped interview in teaching medical students about alcohol misuse. Medical Teacher 23: 490–3.
Eagles, JM, Calder, SA, Wilson, S et al (2007) Simulated patients in undergraduate education in psychiatry. Psychiatric Bulletin 31: 187–90.
Edinger, W, Robertson, J, Skeel, J et al (1999) Using standardized patients to teach clinical ethics. Journal of Medical Education Online 4: 6.
Ekblad, S, Manicavasagar, V, Silove, D et al (2004) The use of international videoconferencing as a strategy for teaching medical students about transcultural psychiatry. Transcultural Psychiatry 41: 120–9.
Gay, T, Himle, J, Riba, M (2002) Enhanced ambulatory experience for the clerkship: Curriculum innovation at the University of Michigan. Academic Psychiatry 26: 90–5.
General Medical Council (2009) Tomorrow's Doctors. GMC.
Good, M, Gravenstein, J (2003) Patient simulation for training basic and advanced clinical skills. Medical Education 37: 1421.
Haist, S, Wilson, J, Pursley, H (2003) Domestic violence: increasing knowledge and improving skills with a four-hour workshop using standardised patients. Academic Medicine 78: S246.
Haist, S, Lineberry, M, Griffith, C et al (2004) Improving students' sexual history inquiry and HIV counseling with an interactive workshop using standardized patients. Journal of General Internal Medicine 19: 549–53.
Halbach, J, Sullivan, L (2005) Teaching medical students about medical errors and patient safety: Evaluation of a required curriculum. Academic Medicine 80: 600–6.
Hall, M, Adamo, G, McCurry, L et al (2004) Use of standardized patients to enhance a psychiatry clerkship. Academic Medicine 79: 2831.
Hanson, MD, Johnson, S, Niec, A et al (2008) Does mental illness stigma contribute to adolescent standardized patients' discomfort with simulations of mental illness and adverse psychosocial experiences? Academic Psychiatry 32: 98103.
Hodges, B, Hanson, M, McNaughton, N et al (2002) Creating, monitoring, and improving a psychiatry OSCE: a guide for faculty. Canadian Journal of Psychiatry 26: 134–61.
Hoppe, R, Farquhar, L, Henry, R et al (1990) Residents' attitudes towards and skills in counseling: Using undetected standardized patients. Journal of General Internal Medicine 5: 415–20.
Issenberg, S, Gordon, M, Greber, A (2003) Bedside cardiology skills training for the osteopathic internist using simulation technology. Journal of American Osteopathic Association 103: 603–7.
Issenberg, SB, McGaghie, WC, Petrusa, ER et al (2005) Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Medical Teacher 27: 1028.
Jotkowitz, A, Glick, S, Porath, A (2004) A physician charter on medical professionalism: a challenge for medical education. European Journal of Internal Medicine 15: 59.
Kennedy, C, Yellowlees, P (2003) The effectiveness of telepsychiatry measured using the Health of the Nation Outcome Scale and the Mental Health Inventory. Journal of Telemedecine and Telecare 9: 12–6.
Ker, J, Dowie, A, Dowell, J et al (2005) Twelve tips for developing and maintaining a simulated patient bank. Medical Teacher 27: 49.
Ker, J, Bradley, P (2007) Simulation in Medical Education: Understanding Medical Education. Association for the Study of Medical Education.
Klamen, D, Yudkowski, R (2002) Using standardized patients for formative feedback in an introduction to psychotherapy course. Academic Psychiatry 26: 168–72.
Kneebone, RL, Scott, W, Darzi, A et al (2004) Simulation and clinical practice: strengthening the relationship. Medical Education 38: 1095–102.
Krahn, L, Bostwick, J, Sutor, B et al (2002) The challenge of empathy: a pilot study of the use of standardized patients to teach introductory psychopathology to medical students. Academic Psychiatry 26: 2630.
Lane, C, Rollnick, S (2007) The use of simulated patients and role play in communication skills training: a review of the literature to August 2005. Patient Education and Counselling 67: 1320.
McNaughton, N, Ravitz, P, Wadell, A et al (2008) Psychiatric education and simulation: a review of the literature. Canadian Journal of Psychiatry 53: 8593.
Medical Professionalism Project (2002) Medical professionalism in the new millennium: a physicians' charter. Lancet 359: 520–2.
Mohammed, M, Cheng, K, Rouse, A et al (2001) Bristol, Shipman, and clinical governance: Shewhart's forgotten lessons. Lancet 357: 463–7.
Quest, T, Otsuki, J, Banja, J et al (2002) The use of standardized patients within a procedural competency model to teach death disclosure. Academic Emergency Medicine 9: 1326–33.
Scally, G, Donaldson, LJ (1998) Clinical governance and the drive for quality improvement in the new NHS in England. BMJ 317: 61–5.
Shah, P, Mountain, D (2007) The medical model is dead – long live the medical model. British Journal of Psychiatry 191: 375–7.
Srinivasan, M, Hwang, J, West, D et al (2006) Assessment of clinical skills using simulator technologies. Academic Psychiatry 30: 505–15.
Talente, G, Haist, S, Wilson, J (2007) The relationship between experience with standardized patient examinations and subsequent standardized patient examination performance. Evaluation and the Health Professions 30: 6474.
Taverner, D, Dodding, C, White, J (2000) Comparison of methods for teaching clinical skills in assessing and managing drug-seeking patients. Medical Education 34: 285–91.
Thomson, L, Dave, S (2011) The organisation of undergraduate teaching. In Teaching Psychiatry to Undergraduates (eds Brown, T, Eagles, J) 3851. Royal College of Psychiatrists.
Trudel, J (1996) Simulated patients for the teaching of basic psychotherapeutic techniques: a practical guide. Annals de Psychiatrie 11: 14–8.
Tysinger, J, Klonis, L, Sadler, J et al (1997) Teaching ethics using small-group, problem-based learning. Journal of Medical Ethics 23: 315–8.
Wallace, J, Rao, R, Haslam, R (2002) Simulated patients and objective structured clinical examinations: review of their use in medical education. Advances in Psychiatric Treatment 8: 342–8.
Wass, V, Van Der Vleuten, C, Schatzer, J et al (2001) Assessment of clinical competence. Lancet 357: 945–9.
Wilkes, M, Milgrom, E, Hoffman, J (2002) Towards more empathic medical students: a medical student hospitalisation experience. Medical Education 36: 528–33.

Simulation in psychiatric teaching

  • Subodh Dave


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Simulation in psychiatric teaching

  • Subodh Dave
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