Abstract Background Simulation-based education has become an established component of medical training and is increasingly used in undergraduate psychiatry. While previous studies have primarily examined its effectiveness for developing clinical skills, less attention has been given to how different dimensions of psychiatric competence are represented within simulation-based educational and assessment frameworks. This review explores the representation of behavioural, relational and integrative competencies in simulation-based undergraduate psychiatric education. Methods A focused review was conducted following PRISMA principles. Electronic databases were searched to identify studies examining simulation-based education in undergraduate psychiatry. Eligible studies involved undergraduate medical students and the use of standardized or simulated patients in psychiatric teaching or assessment. Data were analysed using a narrative and interpretive synthesis informed by contemporary literature on professional competence, clinical reasoning and psychiatric practice. Results Four studies met the inclusion criteria. Across the reviewed literature, behavioural competencies, including interviewing skills, information gathering and psychopathological assessment, were consistently represented. Relational competencies, such as empathy, communication and therapeutic engagement, were also explicitly addressed. In contrast, integrative competencies involving formulation, contextual understanding, biopsychosocial synthesis and clinical judgement were rarely operationalised as explicit assessment constructs. Although integrative reasoning appeared to be implicitly required within complex clinical encounters, it remained comparatively less visible within published educational and assessment frameworks. Conclusions Simulation-based education contributes to the development of important clinical skills in undergraduate psychiatry. The findings suggest that behavioural and relational competencies are consistently represented within simulation-based educational and assessment approaches, whereas integrative competence is less frequently operationalised as an explicit construct. The concept of competence representation offers a useful perspective for understanding how psychiatric competence is conceptualised and assessed and may inform future developments in simulation-based psychiatric education.
Pulido et al. (Mon,) studied this question.