Showing papers in "Academic Psychiatry in 1979"
TL;DR: It is revealed that entering medical students are more negative in their attitudes toward psychiatry than the general population and share fairly negative views of patients and psychiatrists with the Psychiatry Department faculty.
Abstract: The extent to which second year medical students increased their positivity to psychiatry and their orientation toward the patient as a person following a Behavioral Science course was measured in two successive years. Mastery of the cognitive aspects of the course were also assessed. While performance significantly improved on the Behavioral Science part of the National Boards, no change in attitudes was demonstrated. Both before and after the course medical students saw patients and psychiatrists as less desirable than and generally unlike themselves. Further study revealed that entering medical students are more negative in their attitudes toward psychiatry than the general population and share fairly negative views of patients and psychiatrists with the Psychiatry Department faculty. These attitudinal factors and several other barriers are cited as reducing the potential impact of pre-clinical teaching on medical students’ values.
24 citations
TL;DR: Psychiatrists who trained at the UCLA Neuropsychiatric Institute Residency program from 1956–1975 were surveyed about their current professional activities and factors contributing to changing practice patterns are discussed.
Abstract: Psychiatrists who trained at the UCLA Neuropsychiatric Institute Residency program from 1956–1975 were surveyed about their current professional activities. The large majority lead diversified careers. Less than half of responding graduates spend more than half of their professional time in office private practice and more than three-fourths have medical school appointments. Fewer recent graduates have engaged in psychoanalytic training and more have taken post-residency subspecialty fellowships. Recent graduates have been more involved with administrative, consultative, and hospital work than earlier graduates. Recent graduates also more frequently report marital/family problems, socio-economically disadvantaged patients, minority group patients, epilepsy, and group therapy methods to be very or moderately important in their work. Factors contributing to changing practice patterns are discussed.
19 citations
TL;DR: Attitudes toward mental illness were measured in 43, third year medical students on 3 different occasions and indicate that attitude change is a reasonable goal and that once achieved, changes are sustained.
Abstract: As psychiatry assumes a more prominent position in the medical school core curriculum, it should attempt to fulfill educational goals applicable to all physicians including the establishment of positive attitudes toward all patients including psychiatric patients. With the establishment of a required two month psychiatry clerkship, this became an educational goal. Attitudes toward mental illness were measured in 43, third year medical students on 3 different occasions: (a) before the clerkship, (b) immediately upon completion, and (c) in 32 of the original 43 after graduation from medical school. The results indicate that attitude change is a reasonable goal and that once achieved, changes are sustained.
19 citations
TL;DR: The results demonstrate that the Dispositional Unit students experienced a decrease in Benevolence and an increase in Social Restrictiveness, and the Treatment Unit students showed a increase in Mental Hygiene Ideology.
Abstract: This study explores the effects of the psychiatric clerkship on medical students’ attitudes toward mentally ill patients. Of 42 junior medical students in the study, 11 students were assigned to a primarily “Dispositional” unit and 11 to a “Treatment” unit. The control group consisted of 20 students with no psychiatric clerkship experience. All completed the Opinion about Mental Illness scale on the first and last days of the clerkship. The results demonstrate that the Dispositional Unit students experienced a decrease in Benevolence and an increase in Social Restrictiveness. The Treatment Unit students showed a decrease in Social Restrictiveness and an increase in Mental Hygiene Ideology.
17 citations
TL;DR: The clinical utility of the mental status examination and its teaching purposes are questioned after an overview of the literature and a survey of psychiatric training centers indicated lack of agreement regarding its purpose, content, and focus of measurement.
Abstract: There is a common assumption that psychiatrists mean the same thing when they speak of the mental status examination and use it for similar purposes. However, the clinical utility of the mental status examination and its teaching purposes are questioned after an overview of the literature and a survey of psychiatric training centers indicated lack of agreement regarding its purpose, content, and focus of measurement. It is suggested such lack of uniformity contributes to the lack of diagnostic consistency in psychiatry and that consensus on goals of the mental status examination is needed before a more standardized instrument can be implemented.
4 citations
TL;DR: In this paper, the authors present a prototype criterion-referenced mental status objective for evaluating resident competence in a residential program, and stimulate the exchange of ideas on evaluation resident competence.
Abstract: The field of educational evaluation provides a framework for developing objectives which are operational and useful for trainee evaluation and program decision making. Criterion-referenced objectives make possible a more holistic assessment of resident performance. The “mental status” objective from each of three residency programs is critiqued and a prototype criterion-referenced mental status objective is presented as an alternative. We hope this paper will stimulate the exchange of ideas on evaluating resident competence.
4 citations
TL;DR: A tape recording of a 17 minute fragment of a psychotherapy was rated by a panel of experienced psychoanalysts who identified twenty-two cues which they felt reflected the patient's concern with termination of treatment as mentioned in this paper.
Abstract: A tape recording of a 17 minute fragment of a psychotherapy was rated by a panel of experienced psychoanalysts who identified twenty-two cues which they felt reflected the patient’s concern with termination of treatment. The ability of 20 psychiatric residents to detect these cues was found to correlate with their overall performance in the residency program. A correlation was also found between the number of cues detected and individual differences in the residents’ listening style. Listening style was conceptualized as extending, at one extreme, from a critical, focused attention to, at another extreme, a holistic, free floating attitude. Two measures of listening style were used: eyeblink rate and memory for high imagery words. The clinical listening analogy may be useful in the training and evaluation of progress in the acquisition of clinical skills.
2 citations
TL;DR: During a required clinical clerkship in psychiatry, medical students participate in a self-paced Personalized Study Program consisting of structured reading assignments, private meetings with a tutor, and continuous monitoring by a faculty committee.
Abstract: During a required clinical clerkship in psychiatry, medical students participate in a self-paced Personalized Study Program consisting of: (1) structured reading assignments; (2) private meetings with a tutor; (3) standardized practice quizzes; (4) immediate remedial feedback; (5) optional use of audiovisual materials and attendance at lectures; (6) a written final examination; and (7) continuous monitoring by a faculty committee. National Board Examination scores in psychiatry have dramatically increased, and evaluations by students have been overwhelmingly favorable. An important factor in our success has been the enthusiasm of the tutors, who include full-time and volunteer faculty psychiatrists, residents, and selected medical students.
2 citations
TL;DR: In this paper, the transition from trainee to practitioner is a relatively neglected "normative crisis" which has been acutely exacerbated in recent years in the field of psychiatry, and a weekly seminar for third-year residents, begun as an exploratory venture, was designed to meet phase-specific needs at this crucial turning point.
Abstract: The transition from trainee to practitioner is a relatively neglected “normative crisis” which has been acutely exacerbated in recent years in the field of psychiatry. A weekly seminar for third-year residents, begun as an exploratory venture, was designed to meet phase-specific needs at this crucial turning point. The process that evolved seems best described as a “coping alliance.” A series of seven seminar “structures” is delineated as a way of organizing central issues and illustrating a variety of useful techniques for bringing them into focus. The response of successive groups of participants has thus far been so enthusiastically favorable as to lengthen and widen the scope of the experience. A core bibliography is appended in the hope of aiding others to shape still better instruments for ushering tomorrow’s psychiatrists into a field in crisis.
2 citations
TL;DR: Though these former residents of the State University of New York—Downstate Medical Center psychiatric training program rated the program well, in light of their current professional activities they felt that it was more deficient in clinical than in nonclinical areas, and especially in the area of family therapy.
Abstract: Two groups of former residents of the State University of New York—Downstate Medical Center psychiatric training program were surveyed by questionnaire. Though these former residents rated the program well, in light of their current professional activities they felt that it was more deficient in clinical than in nonclinical areas, and especially in the area of family therapy. Interestingly, the second group surveyed had had training in this area readily available to them. These findings are discussed. Input from practitioners in the field is noted as important in residency program planning and evaluation.
1 citations
TL;DR: This study adds a longer range evaluation that is useful to the curriculum committee and program director and shows that some of the most useful parts of the training program to some people were seen by some others as the least useful parts.
Abstract: Graduates of a psychiatric residency program replied anonymously to a questionnaire designed to ascertain the value and relevance of their training experiences to their current professional activities. The program was rated as having done well in providing a solid base of psychiatric expertise. The results also showed that some of the most useful parts of the training program to some people were seen by some others as the least useful parts of the program. Many of the least useful topics and rotations have been eliminated from the program. This study adds a longer range evaluation that is useful to the curriculum committee and program director.
TL;DR: In this paper, a video tape test of general psychiatry, previously reported to discriminate third year students finishing different programs (wards) was applied to a group of second year students following their courses in basic psychiatry.
Abstract: A video tape test of general psychiatry, previously reported1 to discriminate third year students finishing different programs (wards) was applied to a group of second year students following their courses in basic psychiatry. In contrast to earlier attempts in the literature this test could discriminate second year from post clerkship students (P <.0001). Discriminate function analysis yielded a subset of 10 questions which would select second from third year students with 96 percent accuracy, and seven video tape based items could predict 91 percent accurately. Thus the authors conclude that video tape test material can be used to assess clinical training and compare program (clerkship) efficacy.
TL;DR: Results support continuation of the summer preceptorship program as an effective technique for training prospective physicians to be more person-oriented, providing an experience from which students can increase their knowledge of psychiatry, and allowing for a unique experience fromwhich a more rational choice of medical specialty may be made.
Abstract: The authors surveyed the sixty-three preceptees who had completed a university psychiatry summer preceptorship in the past five years as to their perception of the preceptorship and its relation to their specialty choices. Fifty-four former preceptees responded (86%). Of the forty-three who indicated choice of specialty, twenty-six chose person-oriented (including fourteen who chose psychiatry) as opposed to technique-oriented specialties. Subsequent performance in the third year psychiatry clerkship of recent sophomore preceptees exceeds that of sophomores who did not participate in the preceptorship. Direct inferences of these findings cannot be made without more information about early socialization factors of the subjects. Nevertheless, results support continuation of the summer preceptorship program as an effective technique for training prospective physicians to be more person-oriented, providing an experience from which students can increase their knowledge of psychiatry, and allowing for a unique experience from which a more rational choice of medical specialty may be made.
TL;DR: The educational and training goals of the general medical experience in the first postgraduate year of the newly mandated, four year, psychiatric residency are discussed and possible concrete approaches to them are proposed.
Abstract: The educational and training goals of the general medical experience in the first postgraduate year of the newly mandated, four year, psychiatric residency are discussed. Important didactic and experiential aspects of such medical training are considered. Possible concrete approaches to them which are incorporated in a suggested medical curriculum for PGY-1 psychiatric residents are proposed. Evaluation methods and procedures to monitor the efficacy of such a curriculum and to provide a data base for ongoing modification of it are also suggested.
TL;DR: In this article, the authors describe a weekly experimental seminar for third-year residents which supplemented faculty with a large number of voluntary speakers from the community and supplemented the audience with other mental health personnel from the department.
Abstract: Small psychiatric training programs with few trainees, limited funds, and suboptimal numbers of faculty face problems in maintaining quality education. As a survival tip for such programs, the authors describe a weekly experimental seminar for third-year residents which supplemented faculty with a large number of voluntary speakers from the community and supplemented the audience with other mental health personnel from the department. The residents, guest speakers, and guest audience were exceedingly pleased with the results, indicating that small programs can find ways around their limitations without using extra funds.
TL;DR: A live simulation was incorporated into a presentation on the management of the suicidal patient, and an actress, carefully programmed to simulate details from an actual case, was interviewed both on videotape and live by a staff psychiatrist.
Abstract: As part of the Continuing Medical Education Program of Wayne State University, Department of Psychiatry, a live simulation was incorporated into a presentation on the management of the suicidal patient. An actress, carefully programmed to simulate details from an actual case, was interviewed both on videotape and live by a staff psychiatrist. The response of an audience composed of psychiatrists, physicians and medical students was exceptionally favorable. The respondents considered it an enjoyable and effective learning experience. The multimedia approach proved far more forceful and productive than a lecture alone. As a result of the overwhelming positive response, additional simulations are planned for future teaching in Psychiatry.
TL;DR: The authors surveyed third-year psychiatric residents in Southern California and found them generally satisfied with their education, in spite of some deficiencies, and thought psychiatric training was less stressful than their previous medical training.
Abstract: The authors surveyed third-year psychiatric residents in Southern California and found them generally satisfied with their education, in spite of some deficiencies. Program and age related to plans for additional supervision after graduation. Feeling competent correlated negatively with plans to join a psychoanalytic institute. Most residents thought psychiatric training was less stressful than their previous medical training. As might be expected, stress and satisfaction with their education correlated. Satisfaction with student status correlated with plans to continue formal education.
TL;DR: In this paper, a fourteen-day sample of psychiatric residents' activities, between the hours of midnight and 8:00 A.M. was taken to evaluate the "on call" requirement as a training experience.
Abstract: A fourteen-day sample of psychiatric residents’ “on call” activities, between the hours of midnight and 8:00 A.M. was taken to evaluate the “on call” requirement as a training experience. Data collected by residents revealed significant differences between calls for assistance originating from the evaluation services and calls from inpatient units. Differences are discussed in terms of training value and experience for the residents.