Embracing different languages and local differences:Coconstructive patient simulation strengthens host countries’clinical training in psychiatry

BACKGROUND Global education in psychiatry is heavily influenced by knowledge from Western,high-income countries,which obscures local voices and expertise.AIM To adapt a human simulation model to psychiatric education in a context that is specific to local languages and cultures.METHODS We conducted an observational study consisting of six human simulation sessions with standardized patients from two host countries,speaking their native languages,and following an adaptation of the co-constructive patient simulation(CCPS)model.As local faculty became increasingly familiar with the CCPS approach,they took on the role of facilitators—in their country’s native language.RESULTS Fifty-three learners participated:19 child and adolescent psychiatry trainees and 3 faculty members in Türkiye(as a group that met online during 3 consecutive months);and 24 trainees and 7 faculty in Israel(divided into 3 groups,in parallel in-person sessions during a single training day).Each of the six cases reflected local realities and clinical challenges,and was associated with specific learning goals identified by each case-writing trainee.CONCLUSION Human simulation has not been fully incorporated into psychiatric education:The creation of immersive clinical experiences and the strengthening of reflective practice are two areas ripe for development.Our adaptations of CCPS can also strengthen local and regional networks and psychiatric communities of practice.Finally,the model can help question and press against hegemonies in psychiatric training that overshadow local expertise.

Assessing Empathy in Anesthesia Residents with the Chinese Version of the Consultation and Relational Empathy: A Pilot Standardized Patient Program

Objectives To validate the reliability of the Chinese version of the Consultation and Relational Empathy(CARE)in physician-standardized patient(SP)encounter.We also tried to examine the agreement between video-based ratings and in-room ratings,as well as the agreement between the faculty ratings and SP ratings.Methods The CARE was translated into Chinese.Forty-eight anesthesia residents were recruited to make preoperative interview in SP-counter.Performance of each resident was graded by in-room raters,video raters and SP raters.Consistency between different raters was examined.Results The Chinese-CARE measure demonstrated high scale reliability with a Cronbach's alpha value of 0.95 and high consistency in the in-room ratings in intraclass correlation(coefficient=0.888,P<0.001).Despite a good consistency in intraclass correlation,video ratings were significantly higher than in-room ratings(39.6±7.1 vs.24.0±10.0,P<0.001),and Wilcoxon signed-rank test indicated that the pass/fail rate was significantly higher based on video ratings than based on in-room ratings(45/48 vs.22/48,P<0.001).SP ratings had a moderate consistency with in-room faculty ratings(coefficient=0..568,P<0.001),and there was no significant difference between the pass/fail rates based on the in-room ratings and SP ratings(22/48vs.28/48,P=0.12).Conclusions The Chinese-CARE measure is reliable in the assessment of empathy during preoperative anesthesia interview.In-room and video ratings are not equivalent,while SP may provide a feasible alternative for the faculty rater in the assessment of communication skills with an appropriate measure.

Application of Student Standardized Patient in the Clinical Teaching of Acute Abdomen

Background:In recent years,with the gradual expansion of the scale of medical education,the shortage of medical teaching resources and the reluctance of patients to cooperate with teaching have become increasingly prominent.Objective:To explore the application effect of student standardized patient(SSP)in the clinical teaching of acute abdomen.Methods:Fifty-four fifth-year general medical students from class 1826 of the general department of The First Affiliated Hospital of Xi’an Medical University were selected as the research subjects and randomly divided into two groups,with 27 students in the experimental teaching group,and the remaining 27 students in the conventional teaching group.The experimental teaching group adopted the SSP teaching approach.The SSPs were generated from the training students of the hospital through the recruitment and training process of SSP.In this study,seven qualified SSPs were selected for the clinical teaching of acute abdomen.At the end of the course,a periodic assessment was held.The rank sum test was used to compare the excellent and good rates between the two groups,while t-test was used to compare the difference between the two groups.Results:The results showed that the excellent and good rate of the experimental teaching group was significantly higher than that of the conventional group,in which the difference between the two groups was statistically significant(p<0.05).In terms of the assessment results,the theoretical scores and skills scores of the experimental teaching group were better than those of the conventional teaching group,in which the differences between the two groups were statistically significant(p<0.05).Conclusion:Through the training of SSP for acute abdomen and its application in surgical teaching and examination,the superiority of SSP is emphasized.Although there are still some shortcomings in the application of SSP in clinical teaching,it is a relatively new and effective teaching method,and it will play an increasingly critical role in clinical skills training pertaining to the medical specialty.

Progress in applying patient experience in nursing quality improvement

Background： Improving and sustaining the quality of nursing care is an intractable and persistent challenge. The patient experience of nursing care can give a different perspective on nursing quality and help clinical nursing staff to direct quality improvement. Attempts to identify what is patient experience,the relationship with nursing care, and the application of patient experience in nursing quality improvement practice, in order to provide advices for constructing the quality standards and quality improvement strategies of nursing care.Methods： We conducted a literature review of original research publications. The database platforms Pubmed, Web of Science, China National Knowledge Infrastructure（CNKI） and Wanfang were searched from inception until end of August 2015. After screening retrieved articles, 40 sources（articles and organizational websites） were selected for analysis for the connotation, development and application of patient experience in nursing quality researches.Results： Our study identified several concepts about patient experience, roughly sorted out the development path of patient experience in worldwide and the application of patient experience in nursing quality improvement. It points out four precautions when applying patient experience in nursing quality improvement, which are differentiating patient satisfaction and patient experience, choosing appropriate data collection method and appropriate feedback time, and the last but the most important, applying theories to actual clinical practice.Conclusions： Professional indexes are important to maintain the care quality, but it cannot fully reflect quality of nursing care, which needs patient experience as the supplement. Nursing staffs need to make more efforts to enhance patient＇s nursing care experience, and apply the research results to clinical practice, and finally make patient-centered care come true. For future study, the evaluation system and management strategies about patient experience need to be developed to guide nursing quality improvement.