We applaud the article by Neale,1 which highlights the importance of simulation training to teach communication skills in psychiatry. However, there was no reference to the role of simulation training in teaching medical students skills in addiction psychiatry.
Addiction psychiatry is a medical discipline that addresses the multiple comorbidities that are often associated with addiction such as mental illness, past-trauma, chronic pain and infectious diseases, such as human immune deficiency. There has been a call to reduce the stigma of addiction and raise the awareness of the impact of addiction.2 There have also been calls to improve addiction education through establishing partnerships between psychiatry and internal medicine3 to provide skills for physicians particularly those in primary care, to identify and to provide brief interventions for patients suffering from substance abuse. Brief interventions in the primary care population suffering from alcohol use disorder4 have demonstrated significant benefit in reducing the consumption of alcohol.
As noted by Neale,1 although simulation training in mental health is a heterogeneous term, there is a common goal of improving patient care. In addiction psychiatry, simulation provides an opportunity for medical training at all levels to learn clinical knowledge and skills in addressing substance abuse in the routine medical history including psychiatric comorbidity, a trauma history and a repertoire of the patient’s coping skills. The trainees are able to practise brief interventions for substance abuse based on evidence-based medicine.The simulation is carried out in small groups with constructive, structured feedback based on motivational interviewing by those trainees not actively involved in the process. It is hoped that in this way, physicians will be more motivated to overcome the traditional stigma regarding patients suffering from addiction and will be able to identify and treat substance abuse among their patients or refer more complex cases to specialised treatment programmes.
Using these principles, we were able to demonstrate a significant increase in knowledge about alcohol use disorder among fifth-year medical students: this group participated in a short-term intervention 12 months earlier, which included a simulation of an interview of an adolescent suffering from alcohol-related harm, compared with a control group of medical students who did not participate in the intervention.5
Footnotes
Contributors: All the authors contributed to the letter.
Funding: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests: None declared.
Patient consent for publication: Not required.
Provenance and peer review: Not commissioned; internally peer reviewed.
References
- 1. Neale J. What is the evidence for the use of simulation training to teach communication skills in psychiatry? Evid Based Ment Health 2019;22:23–5. 10.1136/ebmental-2018-300075 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. U.S. Department of Health and Human Services (HHS) . Office of the surgeon general, facing addiction in America: the surgeon General's report on alcohol, drugs and health. Washington DC: HHS, 2016. [PubMed] [Google Scholar]
- 3. Tetrault JM, Petrakis IL. Partnering with psychiatry to close the education gap: an approach to the addiction epidemic. J Gen Intern Med 2017;32:1387–9. 10.1007/s11606-017-4140-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4. Kaner EF, Beyer FR, Muirhead C, et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev 2018;2:CD004148. 10.1002/14651858.CD004148.pub4 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5. Jaworowski S, Raveh-Brawer D, Gropp C, et al. Preliminary results of a controlled educational intervention on alcohol related harm among medical students with a 12-month follow-up. Isr J Psychiatry Relat Sci 2018;55:37–9. [PubMed] [Google Scholar]