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Evaluation by undergraduate medical students of a role-playing training program on the management of acute states of agitation

Abstract : OBJECTIVE: Acute states of agitation (ASAs) are frequent in daily medical practice. However, training on real ASAs raises technical and ethical issues, whereas lecture-based teaching hardly addresses some educational objectives, e.g., improving relational skills and team-based coordination. Simulation-based medical education (SBME) is a promising medium to train students on managing ASAs. We have recently implemented a role-playing training module on ASAs. In this scenario, four to five students play the role of the staff, while a trained professional actor plays the agitated patient. A subsequent standardized debriefing is conducted by a senior psychiatrist. A first wave of 219 students participated in a one-session training of this ASA module in June 2015. They completed pre-session and post-session questionnaires aiming to collect "proof-of-concept" data. METHODS: The pre-session questionnaire investigated: previous experience of ASA among students during their clinical training; previous participation in a role-playing SBME; and perceived knowledge of the good practice rules for managing ASAs. The post-session questionnaire investigated among the students if: they thought having been able to appropriately manage the simulated ASA; they found the SBME medium more fitted for training than real situations; they found that the SBME session faithfully reproduced a real ASA; and the session was found useful for transmitting the skills on correct management of ASA. The average level of stress induced by the training was assessed using a numerical rating scale (0-10). RESULTS: Two hundred and six of the 219 students completed the pre-session questionnaire (63% females; response rate 96.7%). A hundred and thirty four students played the scenario and completed the post-session questionnaire (65.7% females; response rate 100%). 38.3% of the responders reported having previously experienced a situation of ASA in their practice, and 31.1% deemed to know the good practices rules for managing an ASA. In post-session, 29.9% of the participants considered that they appropriately managed the ASA, 79.9% deemed that the role-playing session faithfully reproduced a real ASA, and 97% deemed that this SBME was more fitted and useful than a real clinical situation to improve their medical skills. Bivariate analyses revealed that the post-session responses and level of stress were not influenced by previous experience on ASA, previous participation in a SBME role-playing session, or thinking to know the rules for managing ASAs. CONCLUSIONS: SBME role-playing training appears a promising, realistic, and well-accepted method for teaching the management of ASA.
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https://hal.univ-lille.fr/hal-02457848
Contributeur : Lilloa Université de Lille <>
Soumis le : mardi 28 janvier 2020 - 12:50:15
Dernière modification le : mercredi 18 mars 2020 - 11:21:06

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Benjamin Rolland, Thomas Fovet, J. Poissy, C. Eichholtzer, M. Lesage, et al.. Evaluation by undergraduate medical students of a role-playing training program on the management of acute states of agitation. L'Encéphale, Elsevier Masson, 2017, L'Encephale, 44 (2), pp.101-105. ⟨10.1016/j.encep.2017.09.009⟩. ⟨hal-02457848⟩

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