Comparing the Effectiveness of a Guide Booklet to Simulation-Based Training for Management of Acute Agitation

Simulation-based training may be an effective teaching modality for psychiatry residents; however, simulation-based training is an unstudied and underutilized aspect of psychiatry resident training. The objective of this study was to compare the teaching effectiveness of a simulation-based training to reading a resident on-call psychiatry guide booklet in improving the self-confidence and knowledge of residents that is necessary for managing acutely agitated patients. Pre-intervention self-confidence and knowledge were measured for all residents using a Likert scale questionnaire and a clinical vignette questionnaire, respectively. Residents (n = 23) were randomly assigned to either the simulation group (n = 12) or the guide booklet group (n = 11). Residents in the simulation group completed the simulation-based training, and residents in the guide booklet group were instructed to read the corresponding pages of the booklet regarding management of acute agitation. The comparative teaching effectiveness of the guide booklet and simulation-based training was measured with a post-intervention self-confidence questionnaire and a clinical vignette questionnaire. The study spanned approximately one academic year (July 2016- Sept 2017). Residents who participated in the simulation-based training showed significantly greater improvement in self-confidence (simulation median improvement = 1.458 vs. guide median improvement = 0.033, p = 0.002) and knowledge (simulation median improvement = 0.135 vs. guide median improvement = 0.021, p = 0.0124). Simulation-based training was more effective at improving residents' self-confidence and knowledge compared to the on-call psychiatry booklet for the management of acutely agitated patients. Though simulation is being used in other specialties, it is a very underutilized tool in the field of psychiatry. This finding underscores the potential for simulation-based training in residency programs to improve resident learning.