Showing papers in "Academic Psychiatry in 1988"

Cultural Psychiatry Education during Psychiatric Residency

Abstract: At a time when more important information is known about cultural influences in psychiatry, a survey indicates that markedly less is being taught residents on this subject. Problems in defining what needs to be taught and how to do it are discussed. It seems than an emphasis during PGY1 and 2 on the cultural identity on the residents themselves will stimulate them to become more interested in the theoretical and practical issues which can be presented in the PGY 3 and/or 4 years.

Issues in Supervision of the Pregnant Psychiatric Resident

Abstract: The significant transference/countertransference and reality-based issues raised by the pregnancy of a psychiatry resident are rarely raised by the resident’s supervisors. A review of the literature and several case examples are given as background to recommendations to supervisors. These include: the development of reading materials and guidelines to actively encourage supervisors to discuss the potential impact of the pregnancy of their supervisees; supervisors should encourage pregnant residents to discuss their pregnancies early and realistically with their long-term patients; and the identification of one interested supervisor as a resource person for residents and faculty.

Alcoholism curriculum survey of psychiatric residency training programs

Abstract: A questionnaire was sent to accredited adult psychiatric residency training programs to investigate details of their alcoholism training. Three-quarters of the responding programs reported they had a formal training module for alcoholism. The educational sites were primarily acute inpatient settings using group therapy as the favored modality of treatment. A high proportion of programs included psychiatrists as educators. The importance of expanding alcoholism training to augment psychiatry’s expanding role in treating addictive behaviors is discussed.

Problem-Based Learning of Behavioral Science in a Traditional Medical School Curriculum

Abstract: A course in basic behavioral science is described in which problem-based learning is implemented in small groups within a traditional preclinical curriculum. Simulated patients are utilized to provide the problem data and to allow for practice in medical interviewing. Reception of the course, based on student and faculty evaluations, has been positive over the course of eight years, lending support to the conclusion that problem-based methods can be successfully integrated into a traditional lecture-based curriculum.

Stress Profiles and Their Implications for Intervention

Abstract: This study surveyed 222 medical students and found that financial difficulties, single marital status and being farther along in medical school were likely to be associated with increased dysphoria. The lack of available psychiatric faculty to meet all the student needs led to the development of two innovative programs. Psychiatrists recruited and prepared clinicians to serve as mentors for first year medical students. Psychiatric staff also trained and supervised associate deans to lead student support groups as a separate intervention. Program evaluations by both students and faculty have been encouraging.

Evaluation of Residents’ Dynamic Psychotherapy Skills

Abstract: The authors introduce a rating scale designed for use by supervisors evaluating residents doing psychotherapy. Factors assessed include: appropriateness of therapeutic arrangements, therapeutic alliance, self-observation, empathy, communication skills, detection of multiple meanings, quality of interpretations and psychodynamic formulation. The guiding principles behind the 18 items and sub-items are explicated and initial experience with the scale is discussed.

Psychiatric Residency Training in the Dynamics of Groups and Organizations

Abstract: The article describes and evaluates a core-curriculum course for first-year psychiatry residents on the dynamics of groups and organizations (“CDGO”). The “CDGO” utilizes experiential and didactic learning modes to teach concepts of authority, leadership, role, and task definition that relate to and are applicable in group work settings. The achievement of learning objectives is assessed, and the effectiveness of the “CDGO” is compared with that of an ongoing process-oriented group experience made available to the same cohorts of residents. The “CDGO” is shown to be effective in providing many critical components of the training in administration that is currently recommended for psychiatrists.

Psychiatric Recruitment: Suggestions to Departments of Psychiatry

Abstract: This study reports the suggestions made to Departments of Psychiatry in medical schools about ways they can exert a more positive influence on medical students’ choice of psychiatry as a specialty. The suggestions were made by 222 United States medical school graduates of 1982 who went directly into a first year postgraduate psychiatric training program. The 332 suggestions were directed toward admission to medical school, psychiatric curriculum, teaching approaches, psychiatric faculty, relations with non-psychiatric departments, and psychiatry as a specialty. Of the 332 suggestions, 177 (53%) dealt with psychiatric education.

An Organizing Model for Those Entering the Field of Psychiatry

Abstract: To enter the field of psychiatry is to encounter an overwhelming mass of clinical data, hypothetical notions, and theoretical constructs. Conceptual models are tools by which the trainee begins to master the field and these complexities. For psychiatry, the biopsychosocial model has become the prevailing conceptual model (and DSM III R its specific nosology). This paper will offer a method for the application of the biopsychosocial model in order to demonstrate its utility and diminish problems in its utilization.

Weaknesses in Emergency Psychiatric Education: A Solution

Abstract: Emergency psychiatry training is beset by various problems although it is recognized as essential for psychiatrists. Trainees often function under such adverse circumstances that constructive learning is impossible. An important case of these problems is the lack of integration of emergency room training with other departmental activities. In an attempt to address this difficulty an off-hours volunteer teaching program was developed. The author describes this aspect of a large training program in emergency psychiatry which has had numerous benefits, including the integration of the emergency service with the rest of the department, the education of the faculty about emergency psychiatry and the promotion of the feeling in trainees that their work is appreciated and important. Under such positive circumstances, effective learning can and does take place.

Variables Influencing the Choice of a Psychiatry Residency Program

Abstract: This survey of U.S. senior students evaluated the relative importance of a number of variables in influencing the choice of a particular psychiatry residency program. Three program aspects were endorsed by greater than 90% of respondents as vital or fairly important: 1) resident satisfaction, 2) eclecticism, and 3) geographic location. A “significant other” had some influence over the applicants choice in 71.1% of respondents. Students are also concerned with the quality of training offered in Internal Medicine and Neurology. Attention to these findings may improve the effectiveness of efforts to increase recruitment of students into psychiatry.

Resident competence, morale, and psychiatric training: I. The 'high risk' resident

Abstract: The authors surveyed 442 residents from a stratified random sample of 59 U.S. psychiatric training programs to determine the relationships between residents’ demographic characteristics and their perceptions of program supportiveness, self-confidence, competence, and training program satisfaction; one-third of residents surveyed responded. Results indicate that single, minority, female, older, and PGY II and III residents express more dissatisfaction with their training, report lower levels of self-confidence and competence, receive fewer program supports, and may experience more difficulties in professional identity development than other residents. Findings suggest the need to view residents’ program complaints as a partial function of their stage of professional development, demographic characteristics, and availability of similar role models.

Resident competence, morale, and psychiatric training: II. The 'high risk' training program

Abstract: The authors surveyed residents, faculty, and training directors from 59 training programs to determine the relationships between training program characteristics and residents’ self-reported confidence, competence and program satisfaction. Smaller training program size, non-university-based training, hours of supervision, number of weekly faculty-resident supportive contacts, and faculty competence were significantly associated with residents’ self-ratings of competence, confidence and program satisfaction. More modest (but significant) associations were found between the dependent variables and residents’salary, psychotherapy provisions, number of nights on call/month and days of vacation. Program factors reflecting the nature of resident-faculty relationships were more predictive of residents’ self-ratings than were their demographic characteristics. While it may not be feasible to develop a robust model of the “high risk resident” it maybe possible to develop a model of the “high risk training program.”

Psychiatric Residents Associations

Abstract: Peer interaction is a significant part of psychiatric residency training. Psychiatric Residents Associations (PRAs) are one of the potential formal structures in which peer interactions occur. In this report we present data on the current national state of PRAs and an in depth view of one particular PRA. The results indicate that PRAs play a significant albeit varigated role in psychiatric graduate education. Training directors believe PRAs to be useful and important, especially in regard to communication and resident support, and the relative value of these functions varies according to program size.

Resident Competence, Morale, and Psychiatric Training: III. Resident-Staff Agreement

Abstract: The authors surveyed faculty, residents, and training directors from 59 training programs in order to 1) determine which factors affect faculty members’ perceptions of program supportiveness to residents and 2) to compare faculty and resident perceptions of the training program milieu. Results indicate that faculty perceive their training programs as significantly more supportive than do residents. Faculty tenure, age, sex, rank, degree (MD vs. Ph.D.) and years of experience are positively related to perceptions of program supportiveness. Also, chairpersons and training directors describe their training programs as being significantly more supportive than do other faculty. Agree-ment between residents’ and staffs perceptions increases with residents’ advanced PGY status and recency of faculty’s completion of residency training. Results suggest that systematic measurements of both residents’ and staffs perceptions of the training program milieu might be used to better assess the value of program characteristics, enhance the quality of training environments, and eventually increase residents’ competence and program satisfaction.

Treatment of the Psychiatrically Ill Physician by the Psychiatric Resident

Abstract: Of 112 California psychiatric residents who responded to a questionnaire, 33 indicated that they had treated at least one physician. This occurred almost as frequently in inpatient as in outpatient settings. The residents found that treating the physicians was particularly difficult and anxiety-generating, because it challenged their own professional competence and professional identity formation. Yet few had received training in this area. Implications and recommendations derived from the survey are discussed, and two representative cases are briefly presented.