Article summary of The Mental Status Exam Through Video Clips of Simulated Psychiatric Patients: an Online Educational Resource by Martin et al. - Chapter

What is the Mental status exam (MSE)? 

The Mental status exam (MSE) is used for symptom recognition of various mental illnesses during a psychiatric interview with a patient. The MSE utilizes the ABC-STAMPS approach, which stands for: Appearance, Behavior, Cooperation, Speech, Thought (this includes both thought process and thought content), Affect, Mood, Perceptions, and Suicidality. These nine facets of the patient are all assessed by the psychiatrist during the MSE. 

What were the methods used in the MSE study by Martin et al. (2019)?

Martin et al. investigated the effects of showing several video clips, which featured actors playing psychiatric patients, to both medical and nursing students. Multiple approaches have been used in the past in regards to teaching the MSE, including psychiatric interviews with actual patients, psychiatric interviews with simulated psychiatric patients (SPPs), documentaries and movies about mental illnesses, and online videos from university-level sources. The study by Martin et al. opted for showing clips of psychiatric interviews with SPPs as they found it to be the most accessible and ethically sound option. 

The researchers compiled 16 clips consisting of actors simulating 10 different common mental illnesses: depression, bipolar disorder, generalized and social anxiety, obsessive-compulsive disorder, borderline personality disorder, anorexia nervosa, schizophrenia, dementia, delirium, and opiate dependence/withdrawal. The 16 clips were shown during an hour-long lecture which also included information about the ABC-STAMPS approach. Afterward, students in the intervention group completed an online MSE assessment tool to evaluate their abilities to identify psychiatric symptoms seen in clinical interviews. Students in the control group completed the online MSE assessment without having previously attended the lecture containing the video clips. Additionally, all students were asked to answer questions about their knowledge of the MSE, ranking their perceived skills on a scale of 1-5. 

Martin et al. used the students’ scores on the MSE assessment tool as a dependent variable and didactic (whether students are in the intervention vs. control group) and discipline (medical degree vs. nursing degree) as two independent variables. They carried out a multiple linear regression, and using analysis of variance (ANOVA) they compared the MSE assessment scores between the intervention and control groups. 

What were the findings of the MSE study? 

The researchers found that the intervention group attained significantly higher scores on the MSE assessment than the control group. The effect of discipline on assessment score was not significant. Further, students’ subjective measurements of their MSE knowledge was not shown to be correlated with their score on the objective MSE assessment tool. 

The video clips showing psychiatric interviews featuring SPPs were therefore found to be an effective way to improve students’ knowledge of the MSE and their abilities to recognize psychopathological symptoms. One limitation of the study is that the students researched were all in preclinical university programs, so it is not possible to infer what the effects of the educational clips would be in the rest of the population.