A Verbal De-escalation Standardized Patient Workshop for Third- and Fourth-Year Medical Students

• Main Authors: Neeta Shenai (Author), Valerie Fulmer (Author), Catherine Gowl (Author), Jordan See (Author), Ryan Peterson (Author), Reed Van Deusen (Author)
• Format: Book
• Published: Association of American Medical Colleges, 2024-07-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.15766/mep_2374-8265.11417; 2374-8265
• Keywords: Patient Agitation; Verbal De-escalation; Internal Medicine; Physician-Patient Relationship; Psychiatry; Standardized Patient; Medicine (General); R5-920; Education; L
• Source: MedEdPORTAL, Vol 20 (2024)

Introduction Verbal de-escalation is an essential skill for physicians across specialties and is the first-line intervention for patients who present with agitation. Training in verbal de-escalation for medical students is less robust compared to other health care disciplines. We describe the creation and evaluation of a novel verbal de-escalation curriculum for third- and fourth-year medical students on their psychiatry clerkship rotation. Method We developed a simulation using standardized patient (SP) methodology and a dedicated reflection session, implementing it in the third-year psychiatry clerkship. Participants in the scenario received targeted feedback from their peers and SPs. The sessions were video recorded, and a random sample was selected and reviewed to identify key observations and themes from student performance. Results A total of 139 students participated in the encounter. One hundred twenty-two of 125 students (82%) stated the activity met the learning objectives, with 108 (86%) assigning the letter grade A to the activity. Written feedback indicated that the majority of students believed the activity to be realistic, instructive, and helpful but felt the SPs de-escalated too quickly. Video review of the encounters found that while the students effectively used the skills, many jumped to a quick fix, and some offered inappropriate choices to end the encounter. Discussion This SP activity was effective in allowing students to practice skills in a safe setting and was valued by students. In the future, adding another workshop in the fourth year could facilitate higher retention and practice of skills.