Quantifying efficacy of investigation during a simulated psychiatric interview

Simulation is a very promising educational tool. It provides medical students with clinical experience without jeopardizing patients' health. This tool can be implemented in psychiatry training in order to develop interview and specific assessment skills which is why the Université de Lorraine relies increasingly on simulation in teaching psychiatry to its residents. However, there are few objective indicators in that field that make it possible to assess learners. This study aims to assess the relevance of a quantitative measure for objectivising the investigation efficiency by psychiatry residents of a suicidal risk during a simulated psychiatric interview.

A simulation exercise was offered to 20 psychiatric trainees from the Université de Lorraine. Their mission was to identify relevant information for assessing and guiding a standardized patient with suicidal risk during a psychiatric interview. The key judgemental criterion was the I²/Q ratio which corresponds to the squared number of relevant items collected by the interviewer divided by the number of questions. When dealing with emergency cases it is indeed important to collect as many key items in as little time as possible. This score was assessed by two examiners based on the analysis of filmed interviews.

The mean I²/Q ratio was 1.13 (SEM±0.2) and ranged between 0.25 and 2.86. Statistical analysis showed a positive correlation between I²/Q ratio and students' clinical experience (R=0.46, P=0.04). The interclass correlation coefficient (ICC) of the I²/Q ratio between the two examiners was 0.94.

I²/Q ratio may provide a consistent quantitative measure of a student's efficiency in assessing suicidal risk. Further research is now needed to evaluate its consistency in other clinical cases.