International Journal of Healthcare Simulation

Background:

COVID-19 required many simulation faculties to provide online alternatives to in-person training. Over this period, our organization pivoted fully to online delivery of mental health simulation-based education (SBE), defined as delivery entirely via a videoconferencing platform to participants remote from one another and the simulation team. SBE can help early-stage psychiatric doctors to bridge educational and clinical practice by providing exposure to a variety of presentations and a safe space to hone communication and de-escalation techniques while encouraging reflective practice ^[1,2]. There is, however, limited research comparing the efficacy of in-person and online mental health SBE.

Aim:

We assessed for any significant differences across several course evaluation measures in a comparison between groups attending in-person and online versions of a simulation course for early-stage psychiatric doctors.

Method:

An existing full-day course was adapted for online delivery over a half-day period. It focuses on developing confidence and skills in psychiatric history-taking, mental state examination, risk assessment and formulation, meeting the relevant learning outcomes set by the Royal College of Psychiatrists. It encourages participants to explore consultation dynamics with a key emphasis on communication and human factors skills. Participants for in-person (n = 228) and online deliveries (n = 90) comprised of early-stage psychiatric doctors (core psychiatric trainee, or GP trainee level) based in mental health trusts in South London. Pre- and post-course quantitative data (assessing learners’ confidence, situational awareness, and course satisfaction) using the Human Factors Skills for Healthcare Instrument (HuFSHI) and Course-specific Questions (CSQ) measures were collected and compared across the two delivery formats, that is, in-person and online. Data previously collected from participants attending in-person deliveries were used in the comparison.

Results:

Paired-samples t-tests were conducted to determine whether there were any changes in HuFSHI and CSQ scores pre- and post-course. Results indicated that there were significant improvements in HuFSHI scores as well as CSQ scores for both digital delivery and in-person delivery. Large and very large effect sizes were also observed for HuFSHI and CSQ scores, respectively, in both delivery formats. Our data suggest that participants benefited more from in-person delivery across CSQ measures and from digital delivery across HuFSHI measures.

Implications for practice:

Our understanding of the educational differences between in-person and online mental health SBE is at an early stage. Our data suggest that online mental health SBE potentially represents an effective alternative to in-person delivery. Further research is required to better understand these differences.