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Use of high-fidelity multi-professional simulation to upskill foundation trainees on the management of mental health patients with concurrent physical conditions

10 May 2024

People with severe mental illness face health inequalities and have much shorter lifespans. The EoE Multiprofessional Foundation School Team explored the use of actor-led high-fidelity simulation to upskill foundation level trainee pharmacists and doctors on how to jointly manage mental health patients presenting in hospital with acute physical conditions.
We developed a clinical scenario around a psychotic patient admitted with severe stomach pain. Trainees were expected to communicate with the patient and other healthcare staff, make an accurate diagnosis based on acute symptoms and drug history, and create a comprehensive treatment plan.
The mental health scenario was delivered at 10 simulation centres to 98 trainees (46 foundation doctors and 52 trainee pharmacists) using an actor. Trainees were able to practise their communication skills under ‘difficult circumstances’ and learn together about the complexities of managing clozapine-induced bowel obstruction3. Structured debriefs were provided by a consultant psychiatrist and multiprofessional faculty.
After the course, 72% of trainee pharmacists stated that they felt confident to deal with mental health patients, compared to 26% pre-course. All trainees stated that the structured debrief widened their learning and would welcome more mental health-focused scenarios.
Evaluations to-date, indicate that an actor-led mental health simulation, improves the ability of foundation trainees to communicate effectively with both patients and the wider team. It also emphasises the need to prioritise management of physical conditions, despite manifestation of concurrent mental health issues. Ongoing work focuses on development of more mental health patient scenarios in different healthcare settings.

Charleen Liu, Multiprofessional Foundation School Simulation Lead - East of England, Emergency Medicine Consultant
Thirza Pieters, Educational delivery and Evaluation Lead - NHSE WT&E EoE Multiprofessional Foundation School
Maria Christou, Pharmacy Education Lead, Multiprofessional Foundation School - NHS England East of England WT&E Directorate

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