MaverickNH
NES Member
I’m reviewing a manuscript from UCLA where they split two incoming medical student classes in half, trained one half on screening for firearms and suicide and not training the other half. They then followed the students in clinical education 6mo later, where they interview a new mother with clinically significant postpartum depression - if asked, the script called for the new mother to say she kept a gun in her nightstand. Of the 300 students, only 3 actually did a firearms screening, with most later saying it didn’t come to mind or that had too little time. Actually, those that were trained said it didn’t cross their mind more often (62% vs 40%) and that they didn’t have enough time less often (25% vs 42%).
While authors suggested that role playing in firearms screening and repeated training might help increase the frequency of screening, I told the authors that I think the medical students were not being straightforward in their answers. How can those trained to council patients have a statistically significant ~50% reduction in “it crossing their mind”? I think they consciously avoided firearms screening, while the untrained group actually didn’t think about it.
Only 1 in 150 trained students did a firearms screening (0.7%) when they were trained to recognize suicide risks in postpartum depression. That’s not gonna get better with a few more training sessions. Only if institutions prompt such screening in records will that number increase. Most don’t/won’t go there.
Not that I think firearms screening is a good idea. But if a patient exhibits suicidal thoughts, they need some help. Guns, pills, asphyxiation - the focus should not be on the means, but on the suicidal intent.
While authors suggested that role playing in firearms screening and repeated training might help increase the frequency of screening, I told the authors that I think the medical students were not being straightforward in their answers. How can those trained to council patients have a statistically significant ~50% reduction in “it crossing their mind”? I think they consciously avoided firearms screening, while the untrained group actually didn’t think about it.
Only 1 in 150 trained students did a firearms screening (0.7%) when they were trained to recognize suicide risks in postpartum depression. That’s not gonna get better with a few more training sessions. Only if institutions prompt such screening in records will that number increase. Most don’t/won’t go there.
Not that I think firearms screening is a good idea. But if a patient exhibits suicidal thoughts, they need some help. Guns, pills, asphyxiation - the focus should not be on the means, but on the suicidal intent.