MedEdPORTAL (Nov 2011)
Standardized Patient Case: John/Joan Marriot, Acute Mania
Abstract
Abstract Introduction Mood disorders are common and can lead to substantial morbidity and even mortality. Bipolar disorder is a severe form of mood disorder characterized by dramatic shifts in mood states including periods of mania and depression. This standardized patient case was designed as a formative educational experience to enhance medical trainees' skills in psychiatric interviewing and case formulation. Conducting a clinical evaluation of a patient with acute emotional and/or behavioral concerns is an essential task of medical personnel in a variety of disciplines including not only psychiatry, but also primary care, emergency medicine, and even medical and surgical specialties. Designed for use with third-year medical students, the case can be used for a variety of learning levels. Methods This case provides an opportunity for trainees to interview a patient with common psychiatric symptoms. The encounter allows students to gain familiarity with symptoms of mania including elevated mood, grandiosity, and psychomotor agitation. The trainees have an opportunity to experience a “challenging” interview in that the patient speaks fast, can be difficult to redirect, and has poor insight into his/her illness. Students have an opportunity to hone their skills in handling “difficult” situations, including having to interrupt a patient and specify professional boundaries. Results Student feedback has generally been positive—students have found the case realistic, and the experience fair and reasonable for their level of training. Discussion The case has thus far been used in a psychiatry clerkship but may have particular relevance for students or residents training in emergency medicine, internal medicine, or family medicine. Our department has found this case to be an excellent tool for developing students' abilities to conduct a psychiatric interview and discuss diagnostic and management decisions.
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