Late-life Suicide Risk-assessment Training
Late-life Suicide Risk-assessment Training
Sixty-seven participants (51% of attendees) provided pre- and posttest responses to the self-report attitude and knowledge questions. As indicated in Table 2, participants from primarily mental health backgrounds reported greater confidence in assessing and managing suicide risk at both assessment time points. Confidence and knowledge increased significantly during the training; no difference in improvement between groups was indicated (Table 2). Ninety-three percent of respondents indicated that they were highly or definitely likely to apply the information from the workshop to their clinical practice (Figure 1).
(Enlarge Image)
Figure 1.
Workshop effect on intent for practice change and long-term effect on awareness, interest, and perceived utility. Figure 1 presents the percentage of participants who believed that they were likely or highly likely to apply knowledge and skills from the workshop to their clinical practice and agreed or highly agreed that the workshop increased their awareness about late-life suicide, who continued to be interested in learning more about late-life suicide, and who thought the workshop was useful. Ranges for the use in clinical practice scale: 1 = not at all, 2 = unlikely, 3 = somewhat likely, 4 = highly likely, 5 = definitely. Ranges for workshop increased awareness and continued interest: 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree. Use in clinical practice = Percentage of respondents indicating highly likely or definitely that they "would apply changes in knowledge, attitude, or skills obtained in this learning activity to their clinical practice." Increased awareness = Percentage of respondents who agreed or strongly agreed with the statement "The workshop increased my awareness about late life suicide." Continued interest = Percentage of respondents who agreed or strongly agreed with the statement "I would like to learn more about late-life suicide." Workshop helped = Percentage of respondents who agreed or strongly agreed with the statement "I believe I gained a better understanding of how to conduct suicide risk assessment in older populations as a result of the Late-Life Suicide Prevention Workshop."
At 3-month follow-up, 90% (49/53) of respondents agreed or strongly agreed that the workshop increased their awareness of late-life suicide risk and management, 86% (n = 44) indicated continued interest in learning more about the topic, and 84% (n = 43) agreed or strongly agreed that the workshop helped them in their ability to conduct a suicide risk assessment in older adults (Figure 1).
At the 3-month postworkshop evaluation, participants reported making several changes to their clinical practice with regard to suicide risk assessment and management. Qualitative statements from participants included:
For the detailed analysis of the pre- and posttest vignette notes, 71 (53%) participants returned pre and posttest notes; 14 (25%) of those showed considerably poorer motivation on completing postworkshop evaluations than that demonstrated on their own pretest (scored > 1 standard deviation worse). These 14 were interpreted as providing invalid, essentially missing, posttest data and were removed from further analyses. These exclusions represent radically different pre- and posttests (e.g., a thorough 1-page note at pretest and a 2-sentence response on posttest). Two participants did not indicate their training background, leaving a remaining sample size of 55 (77% of the original 71). Comparisons between those retained and those removed were conducted using chi-square (χ) or t-test as appropriate. Results indicated no differences between groups with regard to proportion of those with mental health and non-mental health background (χ (1) = 0.119, P = .73), years of experience (t (64) = 0.412, P = .68), baseline self-ratings (P = .62 to .92), or likelihood of employing the training information in their work (t (48) = 1.48, P = .15), although the removed group scored significantly better on pretest note ratings (t (69) = 3.18, P = .002), suggesting that novelty of training content was positively associated with cooperation with the posttest evaluation.
The results of the clinical behavioral outcomes closely paralleled those of the self-report ratings above (Table 2). The 38 participants (69%) from primarily mental health backgrounds scored significantly higher on the overall quality of their note and on the ratings specific to static versus dynamic risk. Participants also demonstrated significant improvement in total quality and static versus dynamic content from pre- to posttest but not for content related to management or specific to older adults. Again, these effects applied across training background.
Results
Attitudes and Knowledge Outcomes
Sixty-seven participants (51% of attendees) provided pre- and posttest responses to the self-report attitude and knowledge questions. As indicated in Table 2, participants from primarily mental health backgrounds reported greater confidence in assessing and managing suicide risk at both assessment time points. Confidence and knowledge increased significantly during the training; no difference in improvement between groups was indicated (Table 2). Ninety-three percent of respondents indicated that they were highly or definitely likely to apply the information from the workshop to their clinical practice (Figure 1).
(Enlarge Image)
Figure 1.
Workshop effect on intent for practice change and long-term effect on awareness, interest, and perceived utility. Figure 1 presents the percentage of participants who believed that they were likely or highly likely to apply knowledge and skills from the workshop to their clinical practice and agreed or highly agreed that the workshop increased their awareness about late-life suicide, who continued to be interested in learning more about late-life suicide, and who thought the workshop was useful. Ranges for the use in clinical practice scale: 1 = not at all, 2 = unlikely, 3 = somewhat likely, 4 = highly likely, 5 = definitely. Ranges for workshop increased awareness and continued interest: 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree. Use in clinical practice = Percentage of respondents indicating highly likely or definitely that they "would apply changes in knowledge, attitude, or skills obtained in this learning activity to their clinical practice." Increased awareness = Percentage of respondents who agreed or strongly agreed with the statement "The workshop increased my awareness about late life suicide." Continued interest = Percentage of respondents who agreed or strongly agreed with the statement "I would like to learn more about late-life suicide." Workshop helped = Percentage of respondents who agreed or strongly agreed with the statement "I believe I gained a better understanding of how to conduct suicide risk assessment in older populations as a result of the Late-Life Suicide Prevention Workshop."
At 3-month follow-up, 90% (49/53) of respondents agreed or strongly agreed that the workshop increased their awareness of late-life suicide risk and management, 86% (n = 44) indicated continued interest in learning more about the topic, and 84% (n = 43) agreed or strongly agreed that the workshop helped them in their ability to conduct a suicide risk assessment in older adults (Figure 1).
Qualitative Comments on Practice Change
At the 3-month postworkshop evaluation, participants reported making several changes to their clinical practice with regard to suicide risk assessment and management. Qualitative statements from participants included:
"Have asked more in-depth questions about depression during my assessments."
"Monitor closely if change in living arrangements; passing away of loved one/friend; complain of chronic pain. Make appropriate referrals for further assessment."
"Use the risk factors checklist when I see a potentially suicidal veteran to make sure I don't miss anything. It helps to guide my decisions as to what to do next."
"Helped teach medical students about risk assessment."
Clinical Behavior Outcomes
For the detailed analysis of the pre- and posttest vignette notes, 71 (53%) participants returned pre and posttest notes; 14 (25%) of those showed considerably poorer motivation on completing postworkshop evaluations than that demonstrated on their own pretest (scored > 1 standard deviation worse). These 14 were interpreted as providing invalid, essentially missing, posttest data and were removed from further analyses. These exclusions represent radically different pre- and posttests (e.g., a thorough 1-page note at pretest and a 2-sentence response on posttest). Two participants did not indicate their training background, leaving a remaining sample size of 55 (77% of the original 71). Comparisons between those retained and those removed were conducted using chi-square (χ) or t-test as appropriate. Results indicated no differences between groups with regard to proportion of those with mental health and non-mental health background (χ (1) = 0.119, P = .73), years of experience (t (64) = 0.412, P = .68), baseline self-ratings (P = .62 to .92), or likelihood of employing the training information in their work (t (48) = 1.48, P = .15), although the removed group scored significantly better on pretest note ratings (t (69) = 3.18, P = .002), suggesting that novelty of training content was positively associated with cooperation with the posttest evaluation.
The results of the clinical behavioral outcomes closely paralleled those of the self-report ratings above (Table 2). The 38 participants (69%) from primarily mental health backgrounds scored significantly higher on the overall quality of their note and on the ratings specific to static versus dynamic risk. Participants also demonstrated significant improvement in total quality and static versus dynamic content from pre- to posttest but not for content related to management or specific to older adults. Again, these effects applied across training background.
Source...