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BACKGROUND: Recent changes in psychiatric care and teaching that limit patient contact for medical students can be overcome in part by simulation-based education. Understanding the learning processes of medical students involved in psychiatric simulation-based programmes could usefully inform efforts to improve this teaching. This study explored the learning processes of medical students the first time they role-play in psychiatry.METHODS: We used constructivist grounded theory to analyse semi-structured interviews of 13 purposively sampled medical students and the six psychiatrists who trained them. To improve the triangulation process, the results of this analysis were compared with those of the analyses of the role-play video and the debriefing audio-tapes.RESULTS: Five organising themes emerged: improving the students' immediate perception of patients with mental disorders; cultivating clinical reasoning; managing affect; enhancing skills and attitudes and fostering involvement in learning psychiatry.CONCLUSION: Results suggest that psychiatric role-playing can improve students' progressive understanding of psychiatry through the development of intuition and by allaying affects. Emotional elaboration and student involvement appear to be key features.

Resume La prevention des rechutes est devenue l’un des enjeux majeurs de toute prise en charge a long terme des patients schizophrenes. Les strategies psychosociales de detection des signes avant-coureurs de rechute s’averent pertinentes car elles permettent d’intervenir precocement sur le processus de rechute afin de le stopper ou d’en limiter les consequences. L’objectif de cette recherche etait d’etudier les contributions apportees par chacun des acteurs inclus dans ce type de strategie. Nous avons ainsi realise une etude qualitative et exploratoire aupres de dix parents de sujets schizophrenes, dix patients schizophrenes et dix soignants dans l’objectif de mieux comprendre la maniere dont ces trois groupes definissent les elements de la rechute. L’analyse de contenu realisee par le logiciel Alceste a degage differentes classes de discours mettant en exergue les conceptions variees d’une rechute, notamment la nature des signes precoces identifies. Nos resultats etayent l’importance d’une alliance therapeutique entre la triade patients/parents/soignants, en mettant en avant la complementarite de leur role et de leur expertise dans l’identification de la « signature de rechute » des patients. L’application de notre etude concerne la mise en place d’un dispositif de prevention des rechutes respectant les specificites de chacun.