Post Traumatic Stress Disorder: A Self-Directed Learning Module

Publication ID Published Volume
9325 January 28, 2013 9

Abstract

Medical schools, many of which operate at geographically distant campuses, must provide opportunities for students to encounter patients with similar clinical conditions across all instructional sites within a given discipline. Various medical disciplines offer databases of simulated cases to cover the curriculum (for example, the pediatric CLIPP and the surgery WISE MD cases). Such learning resources have several advantages: 1) portability (can be viewed anywhere where a computer is available), 2) availability of repetitive viewing, 3) standardized content built into the script, 4) can be updated according to advances in medical knowledge and users’ feedback. 

The Clinical Simulation Initiative (CSI) taskforce was developed in 2010 by the Association of Directors of Medical Student Education in Psychiatry (ADMSEP) to create a free national database of online psychiatry self-directed learning modules. Faculty from 8 medical schools are collaborating to create learning modules and so far, four modules have been published on MedEdPortal, 3 others have been reviewed by an internal ADMSEP Editorial Board, 4 others are awaiting review or are in preparation. The taskforce developed anonymous student and faculty surveys, to ensure that periodic updates and improvements are based on consistent user feedback about the modules’ content. Pilot data from IRB-approved studies at Georgia Regents University, University of Central Florida and University of California Davis in 2011-12, shows a mean faculty satisfaction with the modules of 5.43-6.50, and a mean student satisfaction of 4.40-5.92 on a 7-point scale. 

We used Articulate® software to develop a self-directed learning module which includes video clips of an interview with an actor representing a patient with post- traumatic stress disorder (PTSD), an outline of key aspects of the etiology, diagnosis and treatment and self-assessment quizzes related to the module’s learning objectives. 

Anxiety disorders, including PTSD are listed in the ADMSEP Clinical Learning Objective Guide for Psychiatry Education of Medical Students (2007) and lead to significant morbidity, mortality and illness burden. This module presents a video of a patient coming in for his first visit with a psychiatrist, prompted by his wife. The interviewer acquires basic information needed to complete the history and mental status exam, addresses possible comorbidity and covers basic suicide risk assessment. The physician refers the patient for alcohol rehabilitation treatment and suggests that the patient consider psychotherapy for PTSD. Two other video clips present the initial psychotherapy evaluation and the 1st session of prolonged exposure therapy for PTSD. Given the short duration of the psychiatry clerkships and the difficulty of introducing medical students into ongoing psychotherapy cases, this module offers a glimpse into a psychotherapy session. Existing practice guidelines for treatment of PTSD, data from clinical trials of PTSD treatment, Kaplan and Sadock Synopsis of Psychiatry and information from the American Society of Clinical Psychopharmacology (ASCP) Model Psychopharmacology Curriculum, 6th Edition are incorporated in the module. 

This module is not intended to replace the exposure to real patients with PTSD but it can be used to augment clinical exposure and help acquire basic knowledge of the illness. 

The resource became available in 2012 for the use by 3rd year medical students at Georgia Regents University in Augusta. The module is available on the 3rd year clerkship’s password-protected website along with the other modules created by CSI taskforce (Adolescent Depression, Somatization, Bipolar Disorder, A Case Study of Dementia, Personality Disorders and Psychiatric Interview). The students are encouraged to view the module to supplement their real-patient exposure or when the mid-rotation feedback uncovers gaps in patient exposure. 

Other potential uses: 

  • Small group teaching setting; to illustrate concepts about PTSD and its treatment, particularly its psychotherapy treatment. 
  • Clinical correlation; to supplement 1st or 2nd year medical school neuroscience modules. 

Other learners who may benefit of the self-learning module: 

  • Nursing students - behavioral science curriculum. 
  • Family medicine and neurology residents on core or elective psychiatry rotations 

Citation

Foster A, Hines C, Davidson B, Johnson T. Post traumatic stress disorder: a self-directed learning module. MedEdPORTAL Publications. 2013;9:9325. http://doi.org/10.15766/mep_2374-8265.9325

Contains time-sensitive information that will likely be inaccurate, obsolete, or irrelevant by November 29, 2015

Educational Objectives

  1. To list diagnostic criteria for PTSD
  2. To list factors that can affect management of a patient with PTSD
  3. To develop a treatment plan for a patient with PTSD

Keywords

  • PTSD, Psychotherapy, Prolonged Exposure Therapy, ADMSEP Clinical Simulation

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