A Telepsychiatry Simulation for Suicide Assessment: Increasing Virtual Mental Health Competency in Health Professional Students

ABSTRACT

Objectives: Suicide is a global epidemic that claims up to 800,000 lives each year and is the second leading cause of death in young people aged 15-29 years. With the COVID-19 pandemic came increased rates of stress, helplessness, and suicide among adolescents. The increasing popularity of telemedicine opens new doors for identifying patients in distress, decreasing suicide rates, and increasing access to mental health services. Youth and adolescents grew up with electronics and will likely be open to the use of telemedicine in the future. However, it is unknown how prepared learners are for the unique challenges of these new modes of patient interaction. Method(s) We designed a telemedicine simulation for medical and physician assistant students to identify, assess, and appropriately escalate care for a standardized patient (SP) with suicidal ideation. We incorporated didactics on telepsychiatry, a motivational interviewing exercise, and a simulated telemedicine objective structured clinical exam (OSCE). Students completed a participant survey and were evaluated by SPs on their medical knowledge, interpersonal/communication skills, and 8 key telemedicine competencies. Result(s) Forty-four students completed the workshop, and 30 students completed the participant survey. Students were strongest in interpersonal/communication skills and weakest in telemedicine competencies. SPs evaluated telemedicine performance by deeming students "not yet entrustable," "approaching entrustment," or "entrustable" based on their ability to perform a described behavior or task unsupervised. Only 20% of students were entrustable to describe when patient safety was at risk, including when and how to escalate care. Fifty percent correctly interpreted the Patient Health Questionnaire, 59% completed the Columbia Suicide Risk Assessment, and 41% completed a suicide safety plan. Ninety-seven percent of students said that they expect to use telemedicine in their future practice. Conclusion(s) The telepsychiatry OSCE revealed gaps in students' telepsychiatry knowledge, particularly in telemedicine-specific competencies. Future studies are needed to assess the generalizability of our findings, including incorporating adolescent SPs to prepare students for the mental health needs of all ages given increasing rates of suicide in adolescent populations. TVM, S, AC Copyright © 2022