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Objective: ComPsych communication skills training is designed to teach psychiatry trainees effective skills and strategies for undertaking key communication tasks relating to mental illness, such as schizophrenia, with patients and their families/carers. This study examined the program’s feasibility, utility, and trainees’ self-efficacy. Methods: Trainee cohorts attending their first year formal education course were recruited annually over 4 years between 2015 and 2018. Each trainee attended at least one session of training in their cohort year. Trainees completed a questionnaire presenting questions about personal demographics, their perceived confidence in communication, and the effectiveness of elements of training delivery. A total of 41 trainee psychiatrists (15 male) completed the questionnaires presented at four time points (two pre-training and two post-training). Results: Participants reported a significant increase in confidence in their own communication skills post-training (d= 1.12) and rated elements of training delivery (video feedback, feedback from peers in small groups, small group facilitation, and use of simulated patients) as significantly more helpful or effective post-training (d= 0.42). Trainees also reported a significantly increased ability to critically evaluate their own communication skills post-training (d= 0.59), suggesting an increased ability to recognize their own communication skill competence. Conclusions: Following ComPsych training, trainees were more confident discussing information about schizophrenia with patients and their families/carers and were more able to critically evaluate their own communication skills: an important feature of good clinical acumen. These subjective ratings provide important self-efficacy information, including the benefits perceived and evidence of the program’s feasibility and utility.

Mental health clinicians can experience difficulties communicating diagnostic information to patients and their families/carers, especially about distressing psychiatric disorders such as schizophrenia. There is evidence for the effectiveness of communication skills training (CST) for improving diagnostic discussions, particularly in specialties such as oncology, but only limited evidence exists about CST for psychiatry. This study evaluated a CST program specifically developed for psychiatry residents called ComPsych that focuses on conveying diagnostic and prognostic information about schizophrenia. The ComPsych program consists of an introductory lecture, module booklets for trainees, and exemplary skills videos, followed by small group role-plays with simulated patients (SPs) led by a trained facilitator. A standardized patient assessment (SPA) was digitally recorded pre- and post-training with a SP using a standardized scenario in a time-limited (15 min) period. Recorded SPAs were independently rated using a validated coding system (ComSkil) to identify frequency of skills used in five skills categories (agenda setting, checking, questioning, information organization, and empathic communication). Thirty trainees (15 males and 15 females; median age = 32) undertaking their vocational specialty training in psychiatry participated in ComPsych training and pre- and post-ComPsych SPAs. Skills increased post-training for agenda setting (d= −0.82), while questioning skills (d= 0.56) decreased. There were no significant differences in any other skills grouping, although checking, information organization, and empathic communication skills tended to increase post-training. A dose effect was observed for agenda setting, with trainees who attended more CST sessions outperforming those attending fewer. Findings support the generalization and translation of ComPsych CST to psychiatry.

Important gaps are observed in clinicians’ communication with patients and families about psychiatric disorders such as schizophrenia. Communication skills can be taught, and models for education in these skills have been developed in other fields of medicine, such as oncology, providing a framework for training communication skills relevant to psychiatric practice. This study evaluated a pilot communication skills education program for psychiatry trainees, focusing on discussing schizophrenia diagnosis and prognosis. Communication skills training modules were developed based on an existing theoretical framework (ComSkil), adapted for discussing a schizophrenia diagnosis and prognosis. Pre-post training rating of self-reported confidence in a range of communication tasks was obtained, along with trainee views on the training methods. Thirty-eight participants completed the training. Significant improvements in confidence were reported post training for discussing schizophrenia prognosis, including an increased capacity to critically evaluate their own communication skills. Participants reported high levels of satisfaction with the program. This preliminary study provides support for the translation of a well-established educational model to psychiatric training addressing core clinical communication tasks and provides the foundation for the development of a more comprehensive evaluation and an extended curriculum regarding other aspects of care for patients with schizophrenia: ongoing management and recovery, dealing with conflict, and conducting a family interview.