Insights about psychotherapy training and curricular sequencing: portal of discovery

The authors discuss the curricular implications of a research project originally designed to evaluate the instructional strategy of using standardized patients in a psychotherapy training seminar.

The original project included second-year residents enrolled in an introductory psychotherapy seminar that employed sequential meetings with standardized patients. Residents were videotaped at baseline and at 6 week intervals; these sessions were rated by outside raters, standardized patients, and the residents themselves using two rating scales designed to assess psychotherapy skill. Results of the ratings were used to assess whether the instructional strategy was effective in teaching psychotherapy.

Data were analyzed for group and individual effects. Results of unpaired t tests revealed that as a group resident performance did not improve. Individual effects were examined using regression analysis of individual learning plots. This analysis revealed that residents differed widely in their individual responses to this instructional technique.

These results precipitated a realization about the curriculum. Despite initial disappointment about the apparent limitations of the technique, thoughtful analysis prompted a reinterpretation that led to residency curriculum modification.