Evaluation of a Gatekeeper Training Program

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.

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.

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.

A single question measured the level of knowledge about suicide that the individual believes they have. Response options were on a 4-point Likert scale from very to not at all.

A single question measured the level of ability that the individual believes they have in helping a suicidal person. Response options were on a 4-point Likert scale from very to not at all.

A single question measured the level of confidence that the individual believes they have in helping a suicidal person. Response options were on a 4-point Likert scale from very to not at all.

The Attitudes Towards Suicide Questionnaire (ATTS) was used to measure attitudes toward suicide. This scale is comprised of 37 items. Each item is rated on a 5-point Likert scale ranging from Strongly Disagree (1) to Strongly Agree (5). The total score of all 37 items was used for evaluation.

A single question measured the level of preparedness that the individual believes they have in dealing with a suicidal individual. Response options were on a 4-point Likert scale from very to not at all.

Interpersonal skills as rated by standardized patients in the OSCE setting according to the Interpersonal Skills Rating Scale. The IPS Rating Scale used 13 items to evaluate communication skills in the OSCE setting between patient and student from the patient's perspective, and included concepts such as empathy, respect, sensitivity, and listening skills. Each item was scored on a 7-point Likert scale from strongly agree to strongly disagree. The sum score of all 13 items was used for analysis.