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Simulation in Psychiatry

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The Comprehensive Textbook of Healthcare Simulation

Abstract

Simulation is used increasingly in psychiatry and mental health as a tool for clinician education, patient care, and research. Requiring realistic and evocative interpersonal interactions, as well as presentations of complex psychological symptom profiles for clinician training or emotionally salient stimuli for patient treatment, psychiatry pushes the boundaries of simulation design. Varying modalities, from simple audio tracks to immersive and interactive virtual environments, have been used to accomplish these goals. This chapter reviews current and future uses of simulation in psychiatry, focusing on the nuances of educational and therapeutic objectives as well as challenges inherent in using different simulation modalities.

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Notes

  1. 1.

    Before continuing, it is important to clarify terminology related to “SPs.” The “patients” used in high-fidelity simulation are variously referred to as “simulated” and “standardized.” As discussed by Brenner, these terms have different connotations, where simulated implies a step below the real patient experience and standardized suggests something superior to the inconsistencies of real patients [3]. In another commentary, McNaughton identifies simulated patients as healthy people who have been carefully coached, whereas standardized patients are individuals trained to portray their own problems (or individuals without a disease trained to portray a specific patient’s problems) in a consistent manner [21]. Both terms are used throughout the literature, sometimes referring to trained actors and other times to mental health experts who portray patients. We will use “SP” to refer to the full range of human standardized and simulated patients.

Abbreviations

CSAT:

Computer simulation assessment tool

DSM-IV:

Diagnostic and Statistical Manual of Mental Disorders IV

MSE:

Mental status examination

OSCE:

Objective Structured Clinical Examination

PTSD:

Posttraumatic stress disorder

SP:

Standardized or simulated patient

USMLE Step 2CS:

United States Medical Licensing Examination Step 2: Clinical Skills

VR:

Virtual reality

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Authors and Affiliations

  1. Department of Psychology, New York University, New York, NY, USA

    Elizabeth Goldfarb BA

  2. Division of Postgraduate Medical Education, Massachusetts General Hospital, Boston, MA, USA

    Tristan Gorrindo MD

  3. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Tristan Gorrindo MD

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  1. Elizabeth Goldfarb BA
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  2. Tristan Gorrindo MD
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Correspondence to Elizabeth Goldfarb BA .

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Editors and Affiliations

  1. Departments of Anesthesiology Otolaryngology, and Structural & Chemical Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Adam I. Levine MD

  2. Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Samuel DeMaria Jr. MD , Andrew D. Schwartz MD  & Alan J. Sim MD ,  & 

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Goldfarb, E., Gorrindo, T. (2013). Simulation in Psychiatry. In: Levine, A.I., DeMaria, S., Schwartz, A.D., Sim, A.J. (eds) The Comprehensive Textbook of Healthcare Simulation. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5993-4_36

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