|LETTER TO THE EDITOR
|Year : 2017 | Volume
| Issue : 2 | Page : 186-187
E-learning module on interpersonal dynamics: An evaluation
David Reiss1, Joanna Dow2, Gabriel Kirtchuk1
1 Three Bridges Medium Secure Unit, West London Mental Health NHS Trust, Imperial College London, London, England, UK
2 Orchard Unit, West London Mental Health NHS Trust, London, England, UK
|Date of Web Publication||19-Sep-2017|
Three Bridges MSU, West London Mental Health NHS Trust, Southall, Middlesex UB1 3EU
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Reiss D, Dow J, Kirtchuk G. E-learning module on interpersonal dynamics: An evaluation. Educ Health 2017;30:186-7
Most human beings are able to develop and maintain effective relationships, but many patients, especially psychiatric, get stuck in dysfunctional interaction patterns, leading to clinical challenges  and professional boundary breaches. Being able to recognize, analyze, and deal with these issues is an important skill for any clinician but is not explicitly within the vast majority of health professional curricula. Shortage of teaching time means that e-learning, if effective, would be an efficient vehicle for delivery of the relevant learning objectives.
Interpersonal Dynamics (ID) is an approach to integrating psychodynamic work into clinical assessments, thereby promoting effective care. A free e-module  was developed to teach health professionals the basic structure.,, It introduces the ID of interactions between patients and health professionals through two example scenarios: the first looks at the engagement of an isolative mental health patient; the second, a professional boundary breach in a general hospital. In each, the student interacts by responding to multiple-choice questions (MCQs) (one single correct answer out of four choices) with feedback given for each answer.
On completion, the student should be able to:
- Recognize the four interpersonal perspectives present in an interaction 
- Observe how events in a person's past interpersonal interactions may relate to the current interpersonal behavior
- Identify patterns of dysfunctional behavior which have an adverse impact on a patients' relationship with caring staff
- Formulate a coherent understanding of the patient's current dysfunctional relationship that underpins the creation of an effective intervention strategy.
Pilot evaluation for the module recruited 31 final-year medical student volunteers, who had finished their psychiatry attachment, to complete a pre- and post-module assessment; 19 students were also given a questionnaire about the e-learning experience. The assessment had six MCQs (one single correct answer out of five choices) related to a general practice scenario, assessing competence relevant to the learning objectives. The test score data were analyzed using a paired t-test. All participants provided oral informed consent.
The participant mean age was 23.5 years with a male: female ratio of 2:1. Students displayed an educationally and statistically significant improvement of 12.5% in their ability to demonstrate the learning objectives (from 4.0 to 4.5; n = 31, P < 0.01). Only one student scored lower posttest.
The module was reported to be appropriate, engaging, and relevant to both their current educational needs and their future clinical practice, raising awareness of other dimensions to patient management.
The pilot has significant limitations: one is the relatively small student sample, drawn from only one medical school. Another is that the volunteers may have had particular interest in e-learning technologies, leading to motivated learning and increased acceptance of the technology. Further research, with a larger, randomly chosen sample of students, would therefore be appropriate to provide more definitive evidence as to whether the module can be an effective educational tool.
Should it be found to be effective, subsequent development of this approach, in the context of a blended learning strategy, including practice under supervision, may help improve the skills of all staff, thereby enhancing their ability to implement and deliver effective care plans.
We would like to thank Dr. Maria Toro-Troconis and Mr. Ashish Hemani of the Faculty of Medicine, Imperial College London, who helped design and develop the e-learning module. We would also like to thank Dr. Nassim Parvizi who assisted with the evaluation.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Reiss D, Kirtchuk G. Interpersonal dynamics and multidisciplinary teamwork. Adv Psychiatr Treat2009;15:462-9.
Darnley B, Reiss D, Kirtchuk G. Boundary violations in medium security. In: Aiyegbusi A, Kelly G, editors. Forensic Focus 35: Professional and Therapeutic Boundaries in Forensic Mental Health Practice. London: Kingsley; 2012. p. 158-70.
Kirtchuk G, Gordon J, McAlister M, Reiss D. Interpersonal Dynamics Consultation: A Manual for Clinicians. London: Department of Forensic Education & Department of Forensic Psychotherapy, West London Mental Health NHS Trust; 2013.
OPD Task Force, editors. Operationalized Psychodynamic Diagnosis OPD-2. Oxford: Hogrefe; 2007.