Effects of Interview Training with Simulated Patients on Suicide, Threat, and Abuse Assessment

Mental health practitioners as often not provided sufficiently effective interview training to assess for suicidality (Schmitz et al. 2012), to evaluate for abuse (Young et al. 2001), or to respond effectively to suicidal risk (Mackelprang et al. 2014). The current study examined the efficacy of general interview training using simulated patients to increase clinician competency in assessing for threats to self or others and abuse. Data were collected from doctoral clinical psychology students, who received weekly instruction for a number of interview-relevant topics. Each participant completed pre- and post-test videotaped interviews with simulated patients. The interviews evaluated using the Skills in Psychological Interviewing: Clinical Evaluation Scales. In addition, all participants completed the Suicidal Ideation Response Inventory, Second Edition at pre- and post-test to assess their skill in responding to suicidal clients. Paired samples t-tests were used to determine differences in trainees’ skills before and after the training. The tests revealed significant increases in competence for all assessment skills (p<.001) as well as for response to suicidal verbalizations (p<.001). Present findings suggest broad spectrum training with simulated patients has significant implications for the efficacy of future clinicians. The implications of using simulated patients is also discussed. Keywords: Training, Suicide, Abuse, Assessment, Competency

Machine Learning in Clinical Psychology and Psychotherapy Education: A Mixed Methods Pilot Survey of Postgraduate Students at a Swiss University

Background: There is increasing use of psychotherapy apps in mental health care.Objective: This mixed methods pilot study aimed to explore postgraduate clinical psychology students' familiarity and formal exposure to topics related to artificial intelligence and machine learning (AI/ML) during their studies.Methods: In April-June 2020, we conducted a mixed-methods online survey using a convenience sample of 120 clinical psychology students enrolled in a two-year Masters' program at a Swiss University.Results: In total 37 students responded (response rate: 37/120, 31%). Among respondents, 73% (n = 27) intended to enter a mental health profession, and 97% reported that they had heard of the term “machine learning.” Students estimated 0.52% of their program would be spent on AI/ML education. Around half (46%) reported that they intended to learn about AI/ML as it pertained to mental health care. On 5-point Likert scale, students “moderately agreed” (median = 4) that AI/M should be part of clinical psychology/psychotherapy education. Qualitative analysis of students' comments resulted in four major themes on the impact of AI/ML on mental healthcare: (1) Changes in the quality and understanding of psychotherapy care; (2) Impact on patient-therapist interactions; (3) Impact on the psychotherapy profession; (4) Data management and ethical issues.Conclusions: This pilot study found that postgraduate clinical psychology students held a wide range of opinions but had limited formal education on how AI/ML-enabled tools might impact psychotherapy. The survey raises questions about how curricula could be enhanced to educate clinical psychology/psychotherapy trainees about the scope of AI/ML in mental healthcare.

Psychological characteristics of students in learning clinical interview skills with the use of virtual patient

Background The goal of this exploratory study is to analyse which psychological characteristics of students are related to the effectiveness of learning clinical interview skills with the use of a virtual patient (VP). Methods The sample consisted of 29 final-year clinical psychology students. The authors’ VP tool was used for measuring and teaching clinical interview skills: building contact with the patient, gathering important information, and identifying the students’ mistakes. Psychological questionnaires were used to measure the students’ psychological features: need for cognitive closure, ability to achieve cognitive structure, beliefs in the changeability of human traits, level of hope, intelligence, positive vs negative affect, and academic knowledge. Results The most important aspect of the diagnostician’s psychological features which substantially influence effectiveness of learning interview skills is belief in the stability or changeability of human traits and the need to achieve cognitive closure. Participants who have a belief in human changeability are able to perform the task correctly even without training, while those who believe in human stability improve only slightly with training. Students with lower need of cognitive closure successfully learned to build a good relation with the patient. Conclusions The study allows a better understanding of the phenomena occurring during the learning of clinical interview skills with the use of a VP.

Virtual patients and clinical decision-making skills: How students learn to diagnose depending on their psychological characteristics (Preprint)

BACKGROUND The process of conducting a clinical assessment is a highly complex task. Virtual Patient (VP) technology may be a useful tool to complement educational activities based on real patients and it is widely used in medical education. OBJECTIVE The goal of this exploratory study is to analyse which psychological characteristics of clinical psychology students are related to the effectiveness of learning clinical decision-making skills with the use of VP. METHODS Authors’ VP was used for measuring the ability to learn the decision-making in 29 last-year clinical psychology students by: negative vs positive aspects of a patient’s functioning, reactance, coping, stage of change, cognitive errors, adequacy of assessment data, and the quality of assessment. Psychological questionnaires were used for measuring student’s: need for cognitive closure; ability to achieve closure; beliefs of changeability on human traits; the level of hope, intelligence, positive vs negative affect, and academic knowledge. RESULTS Developing clinical decision-making with the use of VP is effective for students who have a higher ability to tolerate ambiguity and complexity of data. Students convinced of the changeability of human traits take into consideration more diverse data and the process of diagnosis requires the analysis of complex phenomena. Students with dominant negative affect seem to build diagnoses more carefully and make fewer cognitive errors than those with positive affect. CONCLUSIONS Our study indicates which properties of students support and which weaken the acquisition of the ability to make a diagnosis.

The History of the Early Controlled Trial: Lessons for Contemporary Clinical Psychologists and Students

In this review, we traverse the long and fascinating journey of the clinical trial, which started with a variety of attempts to examine the effectiveness of psychological and medical interventions, and only later incorporated randomization, blinding, and use of placebos. We also briefly explore why many of these early discoveries were resisted or outright ignored, and how the counterintuitive nature of the clinical trial may help to explain the ongoing criticism and resistance to randomized controlled trials in contemporary clinical psychology. We hope that today’s clinical psychologists, clinical psychology students, and clinical psychology instructors will find much of this material not merely interesting in its own right but informative in affording a broader historical perspective on modern views of evidence-based practice and resistances to it.

Virtual Patients and Clinical Decision-making Skills: How Students Learn to Diagnose Depending on Their Psychological Characteristics

Background:The goal of this exploratory study is to analyse which psychological characteristics of clinical psychology students are related to the effectiveness of learning clinical decision-making skills with the use of virtual patient (VP).Methods: Authors’ VP was used for measuring the ability to learn the decision-making: negative vs positive aspects of a patient’s functioning, reactance, coping, stage of change, cognitive errors, adequacy of assessment data, and the quality of assessment. Psychological questionnaires were used for measuring student’s: need for cognitive closure; ability to achieve closure; beliefs of changeability on human traits; the level of hope, intelligence, positive vs negative affect, and academic knowledge. Results: Developing clinical decision-making with the use of VP is effective for students who have a higher ability to tolerate ambiguity and complexity of data. Students convinced of the changeability of human traits take into consideration more diverse data and the process of diagnosis requires the analysis of complex phenomena. Students with dominant negative affect seem to build diagnoses more carefully and make fewer cognitive errors than those with positive affect.Conclusions:Our study indicates which properties of participants support and which weaken the acquisition of the ability to make a diagnosis.