Showing papers in "Academic Psychiatry in 1981"
45 citations
TL;DR: A review of all data sources shows that the number and percent of American medical graduates entering psychiatry is decreasing and interest in psychiatric careers is declining among medical school applicants.
Abstract: A review of all data sources shows that the number and percent of American medical graduates entering psychiatry is decreasing. Interest in psychiatric careers is declining among medical school applicants. The number of foreign medical graduates in psychiatric training and the total number of psychiatric residents is also decreasing.
39 citations
TL;DR: This year-long study compared training experiences and outcome of consultation-liaison (CL) and traditional psychiatry clerkships and found greater improvement in their ability to employ psychiatry skills with general medical patients, and more favorable changes in their attitude towards psychiatry as a potential specialty.
Abstract: This year-long study compared training experiences and outcome of consultation-liaison (CL) and traditional psychiatry clerkships. CL students reported greater improvement in their ability to employ psychiatry skills with general medical patients, and more favorable changes in their attitude towards psychiatry as a potential specialty. Analyses of actual training experiences showed that these more positive CL outcomes were associated with greater experience in primary care settings and more positive senior staff relationships. The remainder of results agree with past findings showing no significant differences in knowledge, skill and attitude outcomes, and extend past findings by showing a parallel similarity in the content and methods of training across services. Directions for future research are suggested.
11 citations
9 citations
TL;DR: The paper concludes with several recommendations which will assist residency programs to increase skills and knowledge in alcoholism and drug abuse and change in a positive direction the attitudes of residents during their training.
Abstract: The authors review several significant events in alcohol and drug abuse training during psychiatric residency which have occurred over the past several years. They then report on the results of the alcoholism and drug abuse portion of the annual questionnaire sent to directors of residency training programs. The paper concludes with several recommendations which will assist residency programs to increase skills and knowledge in alcoholism and drug abuse and change in a positive direction the attitudes of residents during their training. At a recent working conference on medical education in alcoholism and drug abuse a set of curriculum objectives in these areas appropriate for residency training in psychiatry were developed. These curriculum objectives are included as an appendix.
9 citations
TL;DR: In response to a survey of medical school deans and chairmen of departments of psychiatry about factors contributing to reduced recruitment of medical students into psychiatry, opinions were obtained from 82 medical schools.
Abstract: In response to a survey of medical school deans and chairmen of departments of psychiatry about factors contributing to reduced recruitment of medical students into psychiatry, opinions were obtained from 82 American medical schools, with 50 deans’ and 59 chairmen’s responses returned. Factors most often cited include decreased federal support for psychiatric training, the push toward increasing the numbers of primary care physicians, role diffusion in mental health care, and poor teaching in some departments of psychiatry. Suggestions are offered for enhancing recruitment of students to psychiatry.
7 citations
TL;DR: The medical school curricula could reflect the nonpsychiatric physician's role in the treatment of psychiatric disorders, but could also provide the individual physician with the option to acquire a higher level of psychiatric skills if s/he desires.
Abstract: While the public and medical leaders generally view the nonpsychiatric physician as having a major responsibility for the treatment of psychiatric disorders, many of these physicians view their own preparation in the area as inadequate. The actual hours of training in psychiatry of most practicing physicians is very limited, although it has been increasing gradually and has increased substantially for those graduating since 1970. Only about ten percent in Chicago have taken postgraduate courses in psychiatry, and very few seek out psychiatric information through other sources such as journals, colleagues, etc. In view of this, plus the apparent lack of consensus among themselves with respect to their appropriate role in the treatment of psychiatric disorders, perhaps a more modest role could be envisaged for them. The medical school curricula could reflect this role, but could also provide the individual physician with the option to acquire a higher level of psychiatric skills if s/he desires.
6 citations
TL;DR: The data will reveal strategies of training which may prove to be effective in enhancing effective treatment of alcoholic persons by psychiatrists.
Abstract: Psychiatry residents, as part of their training, received experience in a hospital-based inpatient and outpatient program for the treatment of alcoholism. The intensity and variety of experience varied according to the calendar year in which the resident participated in the alcoholism program. A follow-up survey of the effect this training had on the residents current thinking, attitudes, and practice is presented. The data will reveal strategies of training which may prove to be effective in enhancing effective treatment of alcoholic persons by psychiatrists. In addition, the effect that training in alcoholism treatment may have in other areas of clinical practice is described.
6 citations
TL;DR: It is wondered what effect two conflicting theoretical orientations—psychoanalytic and community psychiatry—had on the type of practice chosen.
Abstract: Practicing psychiatrists who began the residency program at the Neuropsychiatric Institute at the University of Illinois over a fourteen year period (1959 through 1972) were surveyed. Demographic, economic and family background data were collected. Retrospective data about motivations for studying medicine and specialization in psychiatry were obtained. Questions were addressed such as did personal or family experience with psychiatric illness influence persons to enter this field; was there a need to solve personal problems; was there a profit or prestige motive? We wondered what effect two conflicting theoretical orientations—psychoanalytic and community psychiatry—had on the type of practice chosen.
5 citations
4 citations
TL;DR: A survey of the opinions of the psychiatric residents concerning the importance of certain factors, desirable features, and problems in postgraduate programs was conducted and it is suggested that these residents valued an apprenticeship type of experience.
Abstract: A survey of the opinions of the psychiatric residents concerning the importance of certain factors, desirable features, and problems in postgraduate programs was conducted. The findings suggest that these residents valued an apprenticeship type of experience. Adequate supervision and a wide variety of clinical experiences were most valued. These residents also felt the need to participate in their educational process. Some of the functional aspects of residents programs such as fringe benefits, printed catalogues of objectives and the on-call frequency were not viewed as very important. Learning in an atmosphere where service is not seen as a priority but in which supervision and education are, seemed to be ideal goals of these trainees.
TL;DR: This article used the semantic differential to survey the immediate impact on attitudes of 110 students enrolled in a human sexuality course before and after a four-hour audiovisual program, and found that significant changes occurred in the students' ratings of persons who are transsexual or homosexual.
Abstract: The semantic differential was used to survey the immediate impact on attitudes of 110 students enrolled in a human sexuality course before and after a four-hour audiovisual program. The audiovisual program contains patient interviews over a four-year time span, and documents the psychological, physical and relationship changes in a transsexual patient’s life. Students were asked to rate four types of persons (normal, diabetic, homosexual and transsexual) using the semantic differential. Significant changes occurred in the students’ ratings of persons who are transsexual or homosexual. Changes as a result of the educational session are in the direction of viewing transsexuality and homosexuality of a patient in a more positive manner and less judgmentally. Followup studies should be done to determine whether changes last.
TL;DR: Students interested in psychiatry as their future medical specialty were distinguished from those with other interests by a greater espousal of a Mental Hygiene Ideology and an expectation of personal benefit from psychiatric treatment.
Abstract: The attitudes of medical students to the field of psychiatry were assessed prior to their first formal curriculum exposure to the field. Students interested in psychiatry as their future medical specialty were distinguished from those with other interests by a greater espousal of a Mental Hygiene Ideology and an expectation of personal benefit from psychiatric treatment. Student future specialty preference was not correlated with machiavellianism nor acceptance of interpersonal etiologies in mental illness. Those students interested in family practice were attitudinally similar to students interested in specialties other than psychiatry.
TL;DR: In this article, the authors conducted a national survey to evaluate five types of information used in resident selection in six specialties: psychiatry, family practice, psychology, social work, and social work.
Abstract: In the nation-wide survey, directors of residency training in six specialties were asked to rank, in order of importance, five types of information used in selecting residents. Directors in psychiatry and family practice were similar to each other and different from the other specialties in that they ranked the personality of the applicant as the most important factor in resident selection. Directors in all the specialties indicated that letters from Deans and faculty should reflect students’ weaknesses as well as strengths and that more quantitative information should be provided. The author discusses the implications of these findings.
TL;DR: The legal, clinical and technical aspects of this approval as well as subjective aspects and the role of the countertransference are reviewed.
Abstract: Teaching conferences, like other aspects of hospital practice, may unnecessarily exclude patients from full participation. Including the patient throughout the conference has specific therapeutic benefits. This article reviews the legal, clinical and technical aspects of this approval as well as subjective aspects and the role of the countertransference.
TL;DR: Factors preceding and accompanying the career paths of 111 psychiatrists who graduated from the Stanford University residency program during the years 1965–1975, were studied through a survey, using multiple regression as main analytic technique.
Abstract: Factors preceding and accompanying the career paths of 111 psychiatrists who graduated from the Stanford University residency program during the years 1965–1975, were studied through a survey, using multiple regression as main analytic technique. Antecedent variables predicting the path of the full-time academic psychiatrist included having had a research residency, perceiving the residency program as relevant, being a foreign medical school graduate, and being male; while associated concomitant variables included number of journal articles and book chapters published, no formal continuing education reported, not living in California, and living in the South. The career paths of the clinical faculty psychiatrist, the non-academically affiliated clinician and the administratively oriented psychiatrist were similarly studied.
TL;DR: A new method for ranking educational objectives, the Priority Sort, is described, which allows many objectives to be handled and avoids the problems of ranking in order.
Abstract: A new method for ranking educational objectives, the Priority Sort, is described. Participants are asked to assign a rank (1 to 5) to educational objectives. This method allows many objectives to be handled and avoids the problems of ranking in order. Results for medical student teaching of psychiatry at Minnesota and Manitoba illustrate the method.
TL;DR: In the 10 years following graduation, about two-thirds of psychiatrists surveyed moved from a predominantly public to a predominantly private setting, and the authors suggest this shift to private practice derives from dissatisfactions with public jobs, rather than from financial or other incentives of private practice.
Abstract: 323 psychiatric residents and 883 graduated psychiatrists responded to a mail-return questionnaire which ascertained their anticipated or actual choice of jobs, their views on how training experiences affect initial job choice, and their views regarding quality of care provided by state mental hospitals. As expected, a psychiatrist typically works in more than one practice setting. A majority anticipated or took a first job which was primarily in a public setting. This is seen as consistent with a finding that clinical care experiences in public settings were rated as the most important training experiences affecting job choice. In the 10 years following graduation, about two-thirds of psychiatrists surveyed moved from a predominantly public to a predominantly private setting. The authors suggest this shift to private practice derives from dissatisfactions with public jobs, rather than from financial or other incentives of private practice.
TL;DR: In this paper, a questionnaire was designed to measure the process of education in teaching psychiatry to first year medical students in small groups and a set of goals were delineated by the course instructors and evaluated by student raters from each small group on a week by week basis.
Abstract: A questionnaire was designed to measure the process of education in teaching psychiatry to first year medical students in small groups. A set of goals was delineated by the course instructors and evaluated by student raters from each small group on a week by week basis. A pattern of linear increase in the ratings indicated that the course was definitely helping the students forge a professional identity in dealing with patients but was falling short in teaching students about establishing an alliance with patients and methods of communicating with patients. This assessment technique was not able to answer the larger question about the overall worth of the small group experience in teaching about the doctor-patient relationship, but it did yield information on areas where the course was succeeding and areas where more or different efforts were required.
TL;DR: In this paper, the authors describe the process of developing a continuing education program for psychiatric nurses, social workers and other health professionals and paraprofessionals in a state psychiatric hospital.
Abstract: The authors describe the process of developing a continuing education program for psychiatric nurses, social workers and other health professionals and paraprofessionals in a state psychiatric hospital. This process involved the formation of a Committee on Interdisciplinary Education, establishing educational alliances with key hospital personnel, assessing staff’s educational needs and developing seminars incorporating formative and summative evaluation methods that were responsive to these needs. The methods utilized for overcoming some of the institution-, participant-, and educator-related problems encountered in the course of developing these educational programs are also discussed.
TL;DR: The authors describe the use of operant methods to teach clinical operant conditioning to psychiatric residents in their second year of training, representing an example of experiential learning in psychiatry in terms of the learner actually experiencing the technique being taught as a subject.
Abstract: The authors describe the use of operant methods to teach clinical operant conditioning to psychiatric residents in their second year of training. In addition to the concepts of positive reinforcement, contingency management, shaping, social reinforcement, and the like being presented in a didactic fashion, at the same time, operant methods were employed by the instructors to increase attendance, attention, and the use of operant concepts in the care of patients. This represents an example of experiential learning in psychiatry in terms of the learner actually experiencing the technique being taught as a subject.
TL;DR: It is suggested that the recruitment value of the fellowships might be enhanced by extending them to undergraduate students interested in mental health, including those who are not “premedical.”
Abstract: One hundred twelve students who had participated in NIMH-supported fellowships in psychiatry were surveyed to determine the influence of the eight-week fellowship on specialty choice, and attitudes and opinions toward psychiatry. There were eight-two respondents of whom 15 or 19 percent were psychiatrists. The results clearly show the fellowships have a strongly positive impact on those students who subsequently enter nonpsychiatric specialties. Most of the students who subsequently became psychiatrists had either already decided their career plans or they indicated they were more influenced by the regular clinical clerkship than the fellowship. Both psychiatrists and nonpsychiatrists agreed that the money spent was worthwhile and, in general, they would take the fellowship again if they had the opportunity. It is suggested that the recruitment value of the fellowships might be enhanced by extending them to undergraduate students interested in mental health, including those who are not “premedical.”
TL;DR: Specific suggestions are made and furthermore, some of the steps taken so far toward this goal by the B’Department of Psychiatry and Neurology, University of Thessaloniki are described.
Abstract: Both psychiatric training and mental health care in Greece are reviewed and proven to be in need of change, which is long overdue. Because of the intimate relationship of training to delivery of care an improvement of psychiatric training will undoubtedly affect positively mental health services in Greece. Specific suggestions are made and furthermore, some of the steps taken so far toward this goal by the B’Department of Psychiatry and Neurology, University of Thessaloniki are described.
TL;DR: The more experienced clinicians were more interested in psychiatry and thought it more important than did the less experienced group and specific interests and self-assessed abilities are easily obtained from these instruments.
Abstract: More and less experienced aerospace medicine physicians were assessed on professional skills (diagnosis, management, administration, doctor-patient relationship) and conceptual skills (organism/biological system, personality system, sociocultural system) using a Psychiatric Knowledge Usefulness Questionnaire and a Psychiatric Knowledge Assessment Questionnaire. The more experienced clinicians were more interested in psychiatry and thought it more important than did the less experienced group. Specific interests and self-assessed abilities are easily obtained from these instruments.
TL;DR: The approach to effective teaching of communciation skills as described is applicable to all clinical areas and provides skill training in problem-solving counseling which is often demanded of most practicing physicians.
Abstract: This article describes experiences in designing and implementing an elective program to teach effective communication and counseling skills to medical students. Although studies have identified its importance, effective communication is rarely part of the closely supervised experience of students. Yet, most graduates enter a practice situation where effective patient-doctor communication must be established to ensure patient cooperation in diagnosis and treatment of disease. Physicians must also frequently assist patients in making decisions to which they become committed because they feel involved in the decision-making process. For these reasons, communication skills, presently one of the least developed aspects of training programs for students, must extend beyond interviewing techniques which result in simple information gathering and encompass the entire counseling approach. The approach to effective teaching of communciation skills as described is applicable to all clinical areas. In addition, it provides skill training in problem-solving counseling which is often demanded of most practicing physicians.
TL;DR: Issues described below were addressed in a monthly clinical psychopharmacology round during which a patient would be discussed both from a pharmacological as well as from a psychotherapeutic point of view.
Abstract: Traditional methods of teaching psychopharmacology often neglect to teach psychological implications and meanings, the doctor-patient relationship and interactional aspects of psychotherapeutic treatments with medication treatments. These issues have been taught over three weekly sessions as part of a four months weekly psychopharmacology course, conveyed in form of a dialogue between teacher and residents about pertinent case examples as well as by using assigned readings and applying it to patients. Some issues described below were addressed in a monthly clinical psychopharmacology round during which a patient would be discussed both from a pharmacological as well as from a psychotherapeutic point of view.