American Journal of Educational Research, 2017, Vol. 5, No. 6, 606-611 Available online at http://pubs.sciepub.com/education/5/6/2 ©Science and Education Publishing DOI:10.12691/education-5-6-2 Evaluation of a Visual Metaphor of Suicide Risk Factors: Results from a Pilot Randomized Controlled Trial in Psychology Students M Alyami 1,* , H Alyami 2 , F Sundram 3 , B A Haarhoff 4 1 School of Psychology, Massey University, Auckland, New Zealand 2 Consult Liaison Psychiatry, Starship Hospital, Auckland District Health Board, New Zealand and South Auckland Clinical Campus, The University of Auckland, New Zealand 3 Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand 4 Senior lecturer and Registered Clinical Psychologist, Massey University, Auckland, New Zealand *Corresponding author: mohsen.alyami.1@uni.massey.ac.nz Abstract Background: Although comprehensive knowledge of suicide risk assessment is fundamental, training programs for such an essential skill often include passive and didactic methods that may not facilitate recall. Objectives: To examine the efficacy of a recently published novel visual metaphor (VM) for teaching suicide risk factors as an adjunct to traditional teaching methods in a group of novice learners. Methods: A pilot non-blinded randomized controlled trial (RCT) was conducted. 22 first-year undergraduate psychology students were randomly assigned to either a control group, where they received traditional teaching (TT) or an intervention group, where they received traditional teaching and the visual metaphor (TT+VM). Participants then completed post-learning assessment including immediate free recall of suicide risk factors and knowledge application based on a clinical vignette. Cognitive load and participants’ satisfaction were also assessed. Descriptive statistics and the Mann- Whitney U test were used to analyse the data. Results: The TT+VM group demonstrated significantly better immediate free recall of suicide risk factors (mean= 14.56, SD= 3.2, p=.026), and superior application in the clinical vignette (mean= 14.33, SD= 1.00, p= .036). Furthermore, the TT+VM group also reported significantly less cognitive loading while learning suicide risk factors (mean= 3.44, SD= .88, p=.001) and significantly higher satisfaction levels (mean= 26.44, SD= 3.6, p=.001). The differences between the two groups on these domains ranged between medium and large effect sizes. Conclusions: Preliminary findings show that the use of TT+VM enhanced the learning of suicide risk factors. The VM could be a useful learning tool for novice learners but future large-scale studies are warranted to replicate this positive preliminary effect. Keywords: visual metaphor, suicide risk factors, learning, cognitive load theory Cite This Article: M Alyami, H Alyami, F Sundram, and B A Haarhoff, “Evaluation of a Visual Metaphor of Suicide Risk Factors: Results from a Pilot Randomized Controlled Trial in Psychology Students.” American Journal of Educational Research, vol. 5, no. 6 (2017): 606-611. doi: 10.12691/education-5-6-2. 1. Introduction There are gaps in suicide risk assessment training [1,2,3] and recently published work has suggested visual metaphor (VM) as a potential way of addressing these gaps [4]. For example, several studies have shown that only half of psychological trainees [5,6] and community nurses [7] received adequate risk assessment training. Similarly, a recent study indicates that 88% of surveyed health professionals reported having received no official training in suicide risk assessment or management [8]. Moreover, in non-mental health nurses dealing with high-risk groups such as oncology patients, only 1.1 % had very good knowledge about suicide and suicide assessment skills [9]. Available training programs rely heavily on didactic teaching methods which might not be the most effective way of converting knowledge about suicide risk factors into an applied clinical skill [3]. A review of the effects of didactic programs and interactive education on improving clinical practice concluded that didactic programs exhibited no-to-low effects; whereas, interactive programs demonstrated moderate-to-high effects [10]. VM has been proposed to help learn suicide risk factors (‘the what’), rather than how to conduct comprehensive suicide risk assessment (‘the how’) [4]. VM is proposed as a means to reduce cognitive load and optimize working memory (WM) utilization, which in turn will enhance long-term memory processing [11,12]. The purpose of this study was to assess the efficacy of VM as an adjunct to traditional methods in teaching suicide risk factors to first-year undergraduate psychology