Small-group online actors-as-instructors psychiatric clinical interview skill training: a single blind, randomised controlled study

Background:Leveraging the similarities between theatre training and psychiatric clinical interviews, our previous pilot study proved that incorporating actors as standardized patient-instructors (SPI) in communication skills training in the psychiatry module of the medical curriculum was feasible and welcomed by medical students and senior psychiatrists.Objectives:To evaluate the objective effectiveness of an online small group psychiatric clinical interview skill training program using the SPI approach in enhancing students’ clinical communication skills.Method:This is a single-blinded randomized controlled trial with two parallel arms: a control group receiving standard teaching, and an intervention group receiving a one-off intensive clinical skill training workshop instructed by trained actors, served as both simulated patients and tutors via an online platform. Students’ interview skill sub-score in the end-of-module Objective Structured Clinical Exam (OSCE) is the primary outcome measure. Results:112 Year 5 Medical students were recruited and randomly assigned into the intervention group (n=58) and the control group (n=54). The results show that there were no significant differences in their OSCE interview skill sub-score between the intervention group and the control group. Despite the non-significant examination results, participants expressed highly positive feedback towards the intervention training using the SPI approach: over 98% of students found the workshop positively impacted their clinical interview skills. Conclusion:The participants' positive subjective appraisal indicates that using a trained professional actor as the standardized patient-instructor in clinical interview skills training is feasible and welcomed by medical students. However, further improvements in the training design and objective measurement tools are needed to demonstrate the objective effectiveness of such an approach. Nevertheless, the SPI approach still holds considerable potential to enhance the acquisition of psychiatric interview skills education.