Virtual patients as an innovative educational tool in transcultural psychiatry

Background: The dramatic increase in the number of patients with diverse ethnic backgrounds who have been exposed to severe mental trauma demonstrates that there is an urgent need for improvement in the quality of transcultural psychiatric health care through the development and evaluation of relevant and effective training tools.

Aim: This thesis describes the development and scientific study of a new medical educational tool based on Virtual Patient (VP) methodology and the evaluation of different aspects that highlight its educational potentials as a train environment for the clinical management of traumatised refugee patients.

Methods: We developed a dedicated VP system that portrayed a refugee with severe symptoms of post-traumatic stress disorder and depression. This was tested by a group of resident psychiatrists and evaluated in terms of user acceptance, expectations and attitudes as well as how it affected confidence levels in different aspects of providing clinical care for this patient group and core knowledge about related psychiatric conditions and communication skills.

Results: The participants responded in a positive way towards this new educational system. It was perceived as being highly realistic and there were high acceptance levels. A statistically significant improvement was exhibited in overall confidence in providing medical care for traumatized refugee patients as well as in four more specific domains of clinical care, with the area of identifying and evaluating trauma-related diagnoses and disability showing the most prominent improvement. A statistically significant improvement in core knowledge about trauma-related psychiatric diagnoses and basic communication skills was exhibited directly after the interaction with the VP.

Conclusions: Based on the results presented in this thesis it is concluded that the proposed VP-system demonstrated high acceptance among participants and good potential as a training tool for the clinical management of refugee patients. The results suggest that it can lead to resident psychiatrists’ improvement of confidence in providing transcultural clinical care for this vulnerable patient group. It can also successfully facilitate the acquisition of core knowledge in the field of psychiatry. Longitudinal studies with several VPs exhibiting different psychiatric disorders are needed in the future in order to scientifically study whether these impacts are sustainable.

List of scientific papers

I. Pantziaras, I., Courteille, O., Mollica, R., Fors, U., & Ekblad, S. (2012). A pilot study of user acceptance and educational potentials of virtual patients in transcultural psychiatry. Int J Med Educ, 3:132-140.
https://doi.org/10.5116/ijme.5004.7c78

II. Pantziaras, I., Fors, U. & Ekblad, S. (2014). Virtual Mrs K: The learners’ expectations and attitudes towards a virtual patient system in transcultural psychiatry. J Contemp Med Edu, 2(2):109-115.
https://doi.org/10.5455/jcme.20140627042240

III. Pantziaras, I., Fors, U. & Ekblad, S. (2015). Innovative Training with Virtual Patients in transcultural psychiatry: The impact on resident psychiatrists’ confidence. PLOS One. [Accepted]
https://doi.org/

10.1371/journal.pone.0119754

IV. Pantziaras, I., Fors, U. & Ekblad, S. (2015). Training with Virtual Patients in Transcultural Psychiatry: Do the learners actually learn? J Med Internet Res, 17(2):e46.
https://doi.org/10.2196/jmir.3497