A Randomized Controlled Trial Assessing the Feasibility of Examination Room Versus Conference Room Teaching in a Psychiatric Setting

摘要

Background: Teaching in the presence of the patient is an acceptable model in medical settings. Questions have been raised about the appropriateness of this type of teaching (exam room teaching) with patients with mental health issues. Purposes: This prospective randomized controlled study examined outpatient exam room teaching in a psychiatric setting. Methods: In 2011-2012, patients in the adult outpatient psychiatry clinic at the University of Iowa were randomized to have faculty-learner presentations either in the presence of the patient or in the conference room. Teaching encounters were timed and faculty, learners, and patients completed post encounter surveys. Results: Participation included 126 patients, nine faculty, and 16 residents. Comparison of patient encounters randomized to exam room (n = 58) or conference room (n = 64) demonstrated that exam room teaching was roughly twice as time efficient as conference room teaching (p ≤.0001). Patients expressed a preference for exam room teaching during future visits (p ≤.003) for those patients who experienced exam room teaching during the study. Faculty were generally comfortable with exam room teaching and felt it had some advantages for patient decision making. Learners felt they had to choose their words more carefully in exam room teaching and expressed some concerns about depth of teaching. Conclusions: Once exposed to exam room teaching, this model is acceptable and feasible to faculty, learners, and patients in a psychiatry clinic setting.