Assessing Depression in the Mental State Examination: OSCE Scores and Student Satisfaction with Simulated Versus Real Patients.

Abstract

Objective: To compare the Objective Structured Clinical Examination (OSCE) performance and learner satisfaction among undergraduate medical students trained in depression assessment during the Mental State Examination (MSE), using simulated patients (SPs) versus real patients (RPs).

Study design: A quasi-experimental study. Place and Duration of the Study: Department of Psychiatry, Civil Hospital, Karachi, Pakistan, from June to November 2023.

Methodology: Fourth-year medical students on psychiatry clinical postings were divided into two groups: Control group and Intervention group. A demonstration session on assessing depression, led by the facilitator, was followed by a practice session. The Control group practised on real patients, while the Intervention group practised on simulated patients. Students' satisfaction with learning experience was recorded using a validated, self-rated scale, Escala de Satisfacao com as Experiencias Clinicas Simuladas (ESECS). Clinical skills were assessed during the OSCE at the end of the clinical posting using a rating scale. Data were analysed using SPSS, Chi-square test, independent sample t-test, and Pearson correlation for descriptive statistics.

Results: A total of 80 students participated in this study. The two groups demonstrated comparable performance on the OSCE station (p = 0.43) and almost similar levels of learner satisfaction (p = 0.06), indicating no statistically significant differences.

Conclusion: Both real and simulated patients contributed equally to the acquisition of clinical skills for assessing depression by medical students. The selection of teaching resources, therefore, depends on patient availability and specific clinical needs of the students.

Key words: Simulated Patients, Mental state examination, Depression, Medical students, Objective structured clinical examination, Learner satisfaction.