Evaluation of a Gatekeeper Training Program

NCT01252927 | Completed

• 1 other identifier: H2009:073
• Study Type: interventional
• Target: 112
• Locations: 1 country
• Sites: 1

Brief Summary

The main objective of the proposed study is to evaluate the efficacy of a gatekeeper training suicide intervention program, Applied Suicide Intervention Skills Training (ASIST), in improving medical students' knowledge about suicide intervention, impact of attitudes on someone at risk for suicide and competent use of intervention skills to recognize risk and intervene effectively compared to medical education as usual. This research project will be undertaken using a randomized-controlled trial design. Questionnaires and objective structured clinical examinations using simulated patients will be completed at three time points: 1) before training, 2) after training, and 3) at one year following the training. Medical students' clinical skills in recognizing risk and intervening with simulated patients, as well as knowledge about suicide intervention and the impact of attitudes on someone at risk for suicide will be evaluated.

Conditions

Suicide

Outcome Measures

Primary Outcomes (3)

• OSCE checklist total score

  Four Objective Structured Clinical Examinations (OSCEs) stations were developed for each time point in the study. All student-patient interactions were videotaped. Raters blind to the student's group assignment rated the videos according to a checklist of desired gatekeeper behaviors based on the key components of the ASIST program. A total score was the sum of all behaviours performed.

  1 week before training, 1 week following training, and 4 years following training

• SIRI-2 score

  The Suicide Intervention Response Inventory (SIRI-2) is a self-administered questionnaire designed to measure competence in choosing appropriate responses to a series of clinical scenarios with suicidal individuals. It contains 25 items, each of which consists of a "client" remark and two "helper" responses. Respondents were instructed to evaluate the appropriateness of each of the two helper responses on a 7-point Likert scale, ranging from +3 (highly appropriate response) through 0 (neither appropriate nor inappropriate response) to -3 (highly inappropriate response). Ratings by a group of expert suicidologists and crisis interventionists provided a mean expert response criterion against which individual respondents are compared. The sum of the absolute value of the differences between the students' rating and the mean response from experts was calculated to obtain an overall score of how well the student performed with respect to expert responses.

  1 week before training, 1 week following training, and 4 years following training

• OSCE global rating total score

  Four Objective Structured Clinical Examinations (OSCEs) stations were developed for each time point in the study. All student-patient interactions were videotaped. Raters blind to the student's group assignment rated the videos. Raters were asked to give a global rating score according to the performance of each student in each of the 3 key areas trained by the ASIST program, and a global rating of the student's performance on the station in general. The sum of all global ratings was used to determine a total score.

  1 week before training, 1 week following training, and 4 years following training

Secondary Outcomes (6)

• self-perceived knowledge about suicide

  1 week before training, 1 week following training, and 4 years following training

• self-perceived skill in helping a suicidal individual

  1 week before training, 1 week following training, and 4 years following training

• self-perceived confidence in helping a suicidal individual

  1 week before training, 1 week following training, and 4 years following training

• Attitudes towards suicide total score

  1 week before training, 1 week following training, and 4 years following training

• self-perceived preparedness

  1 week before training, 1 week following training, and 4 years following training

Study Arms (2)

ASIST intervention

EXPERIMENTAL

The gatekeeper training intervention group received the Applied Suicide Intervention Skills Training (ASIST) 10.0 in addition to TAU. ASIST is a two-day (fourteen hour), intensive, interactive and practice-dominated course aimed at enabling people to recognize risk and learn how to intervene immediately to prevent suicide. The intervention was offered to students on a weekend and was conducted by three senior ASIST trainers and one junior trainer, with two trainers assigned to each training group.

Other: ASIST

Control group: training as usual

NO INTERVENTION

Training as usual consisted of didactic teaching and a tutorial with case-based examples around suicide risk factors in their first year of medical school. Third- and fourth-year students may also have the opportunity to practice their skills with real patients during their clerkship rotations or in the emergency department.

Interventions

ASIST OTHER

The gatekeeper training intervention group will receive the Applied Suicide Intervention Skills Training (ASIST) workshop in addition to training as usual. ASIST is a 2-day intensive, interactive and practice-dominated course aimed at enabling people to recognize risk and learn how to intervene immediately to prevent suicide.

ASIST intervention

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• all medical students at University of Manitoba

You may not qualify if:

• those who choose not to participate
• those who have already taken ASIST training or related SafeTALK training

Sponsors & Collaborators

• University of Manitoba: lead
• American Foundation for Suicide Prevention: collaborator

Study Sites (1)

University of Manitoba

Winnipeg, Manitoba, R3E 3N4, Canada

Location

MeSH Terms

Conditions

Suicide

Condition Hierarchy (Ancestors)

Self-Injurious Behavior; Behavioral Symptoms; Behavior

Study Officials

• Shay-Lee Bolton, PhD

  University of Manitoba

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD

Study Record Dates

• First Submitted: August 18, 2010
• First Posted: December 3, 2010
• Study Start: March 27, 2011
• Primary Completion: May 1, 2015
• Study Completion: August 1, 2015
• Last Updated: September 17, 2021

Record last verified: 2021-09

Locations

CA (1)