title: Simulation in Undergraduate Psychiatry: Exploring the Depth of Learner Engagement.
abstract: OBJECTIVE
  Simulation-based methodologies are increasingly used in undergraduate medical education to expand students' exposure to complex clinical scenarios. Engagement of students in these simulation-based methodologies is a key determinant of their success in learning. Thus, the authors conducted a systematic review to (1) identify simulation methods in use within the undergraduate psychiatry curriculum and (2) assess learner engagement using these methods.
  
  
  METHODS
  Following a PRISMA methodology, the authors searched MEDLINE, ERIC, and PsychINFO databases from 1977 to 2015. Studies applying simulation in undergraduate psychiatric education were reviewed. The depth of learner engagement was assessed using Kolb's four-stage learning cycle.
  
  
  RESULTS
  Of 371 publications identified, 63 met all the inclusion criteria: 48 used standardized patients and 16 used online or virtual learning case modules. Only one study used high fidelity mannequins. Three studies satisfied multiple stages in Kolb's Learning Cycle, including a single study that addressed all four domains.
  
  
  CONCLUSIONS
  Despite the varied uses of simulation across other health disciplines, there were few novel or innovative uses of simulation in undergraduate psychiatric education since the last review in 2008. Expanding on the use of simulation to improve communication, build empathy, and decrease stigma in psychiatry is essential given the relevance to all facets of medical practice. Given the complexity of psychiatry, simulation interventions should extend beyond communication scenarios. Medical students need more opportunities to reflect and debrief on simulation experiences and integrate learning into new contexts. Faculty development should focus on these novel approaches to simulation to deeply engage learners and enhance outcomes.
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada. Petal.abdool@camh.ca.|University of Toronto, Toronto, Canada. Petal.abdool@camh.ca.
authors.forename: Petal S
authors.initials: PS
authors.lastname: Abdool
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|University of Toronto, Toronto, Canada.
authors.forename: Latika
authors.initials: L
authors.lastname: Nirula
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Bonato
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|University of Toronto, Toronto, Canada.
authors.forename: Tarek K
authors.initials: TK
authors.lastname: Rajji
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|University of Toronto, Toronto, Canada.
authors.forename: Ivan L
authors.initials: IL
authors.lastname: Silver
mesh_terms: D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D011570:Psychiatry / Q000193:education*; D000066908:Simulation Training / Q000379:methods*
keywords: Medical student; Psychiatry; Simulation; Undergraduate