title: Innovative training with virtual patients in transcultural psychiatry: the impact on resident psychiatrists' confidence.
abstract: BACKGROUND
  Virtual patients are now widely accepted as efficient and safe training tools in medical education, but very little is known about their implementation in psychiatry, especially in transcultural clinical care of traumatized refugee patients.
  
  
  OBJECTIVE
  This study aimed at assessing the impact of training with a virtual patient on confidence in providing clinical care for traumatized refugee patients.
  
  
  METHODS
  The authors developed an educational tool based on virtual patient methodology portraying the case of "Mrs. K", a traumatized refugee woman with symptoms of PTSD and depression. A group (N=32) of resident psychiatrists tested the system and their confidence in different aspects of providing clinical care for this patient group was evaluated pre- and post-test by using a validated confidence questionnaire. Cronbach's α was calculated for all clusters. Changes between pre- and post-test were compared by using the matched-pair t-test, binomial distribution for exact significance test and a calculation of effect sizes (Cohen's d).
  
  
  RESULTS
  A statistically significant improvement was exhibited in overall confidence (mean Δ: 0.34; p<0.0001; d: 0.89) as well as in four more specific domains of clinical care, with the area of identifying and evaluating trauma-related diagnoses and disability showing the most prominent improvement (mean Δ: 0.47; p<0.0001; d: 1.00).
  
  
  CONCLUSIONS
  This VP-system can lead to physicians' improvement of confidence in providing transcultural clinical care for traumatized refugee patients. Further research is required to investigate improvement in actual performance and cognitive outcomes with several VPs and in a long-term effect perspective.
authors: Cultural Medicine Unit, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.
authors: Ioannis
authors: I
authors: Pantziaras
authors: Department of Computer and Systems Sciences, Stockholm University, Stockholm, Sweden.
authors: Uno
authors: U
authors: Fors
authors: Cultural Medicine Unit, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.
authors: Solvig
authors: S
authors: Ekblad
mesh_terms: D000328:Adult; D004501:Education, Medical; D005008:Ethnopsychology / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016544:Patient Simulation; D010820:Physicians / Q000523:psychology*; D012036:Refugees; D013548:Sweden; D014947:Wounds and Injuries