Showing papers in "Academic Psychiatry in 1990"
TL;DR: In this article, the authors administered the Opinion About Mental Illness (OMI) questionnaire and Derogatis' Symptom Checklist (SCL-90-R) before and after an eight-week academic and clinical course in psychiatry.
Abstract: Forty-six medical students were administered the Opinion About Mental Illness (OMI) questionnaire and Derogatis' Symptom Checklist (SCL-90-R) before and after an eight-week academic and clinical course in psychiatry. Significant changes were found after the course on dimensions of Benevolence and Interpersonal Etiology, and mean scores on the community portion of the OMI scale revealed movement in a positive direction. Using multiple regression analysis the pre-test attitude scores accounted for most of the variance on post-test attitudes. Stereotyping, a very important dimension of the OMI scale, was not rejected on either the pre-course or post-course measures. The students' own psychological distress did not have an effect on attitude change.
70 citations
TL;DR: Survey results suggest that religious ideation by resident candidates is a relatively unimportant variable in the programs’ selection; didactic instruction on any aspect of religion is infrequent; clinical supervision on religious dynamics is variable but more likely to occur thandidactic instruction; and academic progression is rarely impeded by behaviors emanating from residents’ religious values.
Abstract: Approximately 80% of the members of the American Association of Directors of Psychiatric Residency Training responded to a survey on the role of religion in psychiatric education. Survey results suggest that religious ideation by resident candidates is a relatively unimportant variable in the programs' selection; didactic instruction on any aspect of religion is infrequent; clinical supervision on religious dynamics is variable but more likely to occur than didactic instruction; and academic progression is rarely impeded by behaviors emanating from residents' religious values. Several implications of these findings are discussed.
57 citations
TL;DR: This method of teaching and evaluating biopsychosocial formulation of cases is well received, does not involve excessive reading or esoteric terminology, can be used within the time constraints of clinical practice, is flexible, and could be used for any psychiatric patient.
Abstract: Formulation is a poorly defined, core clinical skill in psychiatry. The authors present a method of teaching and evaluating biopsychosocial formulation of cases and introduce a reliable formulation marking scheme for scoring the comprehensiveness of a formulation. This method has been well received by four successive groups of residents, does not involve excessive reading or esoteric terminology, can be used within the time constraints of clinical practice, is flexible, and can be used for any psychiatric patient.
13 citations
TL;DR: The residents’ general attitudes regarding ECT as a therapeutic modality were consistent with those of previous surveys of practicing psychiatrists, and the level of knowledge was not related to reported didactic or practical experience.
Abstract: Graduating psychiatric residents in the Philadelphia area were surveyed about their attitudes, training experiences, and knowledge regarding electroconvulsive therapy (ECT). Twenty-nine residents were interviewed. Although the majority of respondents expressed positive attitudes about the use of ECT, only two (7%) expressed confidence in their own ability to perform the treatment without supervision. The residents’ general attitudes regarding ECT as a therapeutic modality were consistent with those of previous surveys of practicing psychiatrists. The level of knowledge of the residents interviewed was not related to reported didactic or practical experience. Significant gaps in training were noted. The need for more thorough, standardized training in ECT is discussed.
12 citations
12 citations
TL;DR: The attitudes of the PGY I–IV psychiatry residents in the Baylor College of Medicine residency toward psychotherapy supervision were surveyed and the results were compared to those of a previous nationwide survey of Canadian psychiatry residents.
Abstract: Psychotherapy supervision is an essential aspect of psychiatric residency training. The authors surveyed the attitudes of the PGY I–IV psychiatry residents in the Baylor College of Medicine residency toward psychotherapy supervision. The results were compared to those of a previous nationwide survey of Canadian psychiatry residents. The Baylor residents identified three factors as the most important elements of satisfactory supervision: the supervisor’s teaching ability, rapport between the supervisor and the trainee, and the supervisor’s fund of knowledge.
11 citations
TL;DR: The Psychiatry Resident In-Training Examination (PRTTE) has been produced annually since 1979 as mentioned in this paper and the Kuder-Richardson reliability coefficient for the global score in psychiatry was above.90.
Abstract: The Psychiatry Resident In-Training Examination (PRTTE) has been produced annually since 1979. On each test from 1980 through 1987, the Kuder-Richardson reliability coefficient for the global score in psychiatry was above .90. This is adequate reliability for making comparisons among individual examinees. The reliability coefficients for the neurology score and psychiatry subscores were lower and correlated with subtest length. Small differences in these scores may reflect measurement error. Mean raw scores showed statistically significant increases across groups of examinees with increasing levels of training completed. This supports the presence of construct validity.
10 citations
TL;DR: Residents in the department of psychiatry at the University of Toronto were surveyed in the spring of 1987 about their training in and attitudes about group psychotherapy and confidence in one’s ability as a group leader and knowledge about group therapy were correlated with the number of hours spent leading groups.
Abstract: Residents (n=114) in the department of psychiatry at the University of Toronto were surveyed in the spring of 1987 about their training in and attitudes about group psychotherapy. Significant interest in group psychotherapy was correlated positively with a perception that one’s group psychotherapy training was good, more hours of experience leading groups, a belief in the usefulness of group therapy in one’s future practice, and an appreciation of opportunities to refer patients to group therapy. Confidence in one’s ability as a group leader and knowledge about group therapy were correlated with the number of hours spent leading groups. The implications for planners of group psychotherapy training curricula and faculty are discussed and recommendations are made concerning the principles of group psychotherapy training programs.
8 citations
TL;DR: A description of the program demonstrates how such liaisons can promote improved access to high-quality services, while enriching the training of psychiatrists through outreach experiences.
Abstract: The Charleston Area Mental Health Center and the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina have collaborated to form a comprehensive emergency service with mobile capacity. The service is staffed by an interdisciplinary team of professionals from public and academic psychiatry. Psychiatric residents are fully integrated into the service. A description of the program demonstrates how such liaisons can promote improved access to high-quality services, while enriching the training of psychiatrists through outreach experiences.
8 citations
TL;DR: During a one-year experiment in postgraduate psychiatric education, residents participated in live debates instead of attending traditional lectures and seminars and rated the debate as a thought-provoking and highly effective teaching tool, and a fun one, to boot.
Abstract: During a one-year experiment in postgraduate psychiatric education, residents participated in live debates instead of attending traditional lectures and seminars. A variety of controversial topics in psychiatry were covered. Both residents and faculty rated the debate as a thought-provoking and highly effective teaching tool, and a fun one, to boot.
7 citations
TL;DR: This paper catalogues the inevitable problems that beset training directors and describes coping strategies designed to improve the likelihood of the training director’s survival and the quality of his or her life.
Abstract: This paper catalogues the inevitable problems that beset training directors and describes coping strategies designed to improve the likelihood of the training director’s survival and the quality of his or her life. The difficulties of the job include picking residents, struggling to assure that the faculty provides decent teaching programs, contending with repetitive bureaucratic details, being overloaded by numerous tasks, and warily watching as residents who somehow squeaked through the program are sent off on their own. Offsetting the hassles are the exciting jobs of picking residents, guiding the faculty in setting up teaching programs, keeping a complicated program running, mastering numerous challenges, and watching with satisfaction as new, competent psychiatrists graduate.
TL;DR: A significantly smaller proportion of the later cohort than the earlier group felt they had not learned as much psychiatry as they would need to practice medicine, although Psychiatry continued to be regarded as the most poorly taught and the least well learned subject in medical school.
Abstract: The results of a survey conducted in 1986 of the attitudes of nonpsychiatric house staff toward their psychiatric training in medical school were compared with the results of a similar survey conducted in 1966. Compared to the 1966 cohort, the 1986 cohort reported markedly reduced emphasis on the teaching of psychodynamics and an increased emphasis on neurobiology. Psychiatry continued to be regarded as the most poorly taught and the least well learned subject in medical school. However, a significantly smaller proportion of the later cohort than the earlier group felt they had not learned as much psychiatry as they would need to practice medicine. Areas of teaching singled out for criticism included the quality of instruction and its relevance to patient management.
TL;DR: Since 1985, approximately 75% of the psychiatry department faculty of a medical school have met every two weeks for a supervisors’ conference, which serves as a forum for supervisors to share their methods of supervision.
Abstract: Since 1985, approximately 75% of the psychiatry department faculty of a medical school have met every two weeks for a supervisors’ conference. The conference was conceived by members of the Residency Education Committee as a way to improve the supervision of psychiatry residents. It has evolved into a study group of supervision and serves as a forum for supervisors to share their methods of supervision. Conference formats range from literature reviews to videotaped observations of supervision. Future directions of the conference are reviewed regularly by conference attendees and by annual surveys of all departmental faculty members.
TL;DR: It is concluded that the use of structured MSE forms leads to a significant improvement in the comprehensiveness of MSE records and should be adopted for use on adult inpatient psychiatry units where residents are being trained.
Abstract: The quality of mental status examination (MSE) reports in consecutive admission notes by psychiatric residents was compared before and after the introduction of a structured, pre-printed MSE form that had been designed for teaching and quality of care purposes. We found the use of the form to be associated with a marked improvement in the quality of the reports; however, an important item not on the form was less likely to be recorded than with an unstructured record of the MSE. We conclude that the use of structured MSE forms leads to a significant improvement in the comprehensiveness of MSE records. We therefore recommend that some version of a comprehensive, structured MSE form be adopted for use on adult inpatient psychiatry units where residents are being trained.
TL;DR: Recent graduates of the University of South Carolina School of Medicine evaluated the clinical relevancy of their behavioral science curriculum and indicated that a body of behavioral science data are clinically relevant to physicians regardless of their specialty.
Abstract: Recent graduates of the University of South Carolina School of Medicine (n=108) evaluated the clinical relevancy of their behavioral science curriculum. The results indicate that a body of behavioral science data are clinically relevant to physicians regardless of their specialty. Additional behavioral science content areas are clinically relevant for practitioners in particular medical specialties. Suggestions are made for the role of behavioral science material in continuing medical education.
TL;DR: An inpatient database developed and used by the author as a clinical research tool to explore interesting questions about inpatient psychiatry and better integrate the academic and clinical service aspects of his junior faculty role is described.
Abstract: Junior faculty members beginning their careers in academic psychiatry are frequently assigned major clinical duties as directors of busy inpatient psychiatry units, leaving them little time or energy for research. The turnover in these positions is high and job dissatisfaction higher. This paper describes an inpatient database developed and used by the author as a clinical research tool to explore interesting questions about inpatient psychiatry and better integrate the academic and clinical service aspects of his junior faculty role.
TL;DR: Voluntary psychiatric patients on a teaching ward were asked to identify their medical personnel and rate their satisfaction with the care they received and were proficient in distinguishing between psychiatrists, psychiatric residents, and medical students.
Abstract: Voluntary psychiatric patients (N=118) on a teaching ward were asked to identify their medical personnel and rate their satisfaction with the care they received. The patients were proficient in distinguishing between psychiatrists, psychiatric residents, and medical students and were highly satisfied with the care they received. Patients over 35 were better at identifying residents than younger patients and also rated the quality of care pro-vided by psychiatrists more highly. Patients with adjustment reaction with depressed mood rated the quality of care provided by psychiatrists lower than did patients with major depression, bipolar affective disorder, or psychosis. Female patients rated their psychiatrists more highly than did male patients.
TL;DR: The use of blind role playing is described to introduce the theory and techniques of the short-term psychotherapies in a combined “laboratory” and lecture course.
Abstract: This report describes the use of blind role playing to introduce the theory and techniques of the short-term psychotherapies in a combined "laboratory" and lecture course. "Therapist" and "patient" (but not instructor) are blind to each other's governing assumptions about therapy, yet must respond creatively to each other based on the algorithms of the "script" and on real-life experience as both doctor and patient.
TL;DR: An integrated four-phase training model is presented that attempts to integrate the four main types of family therapy (process, form, historical, and evolutionary) into an eclectic but organized training format.
Abstract: A current dilemma facing teachers and supervisors of family therapy trainees concerns how to provide a broadly based, eclectic approach that integrates circular/systems thinking with linear/developmental thinking. This article presents an integrated four-phase training model that attempts to integrate the four main types of family therapy (process, form, historical, and evolutionary) into an eclectic but organized training format. A detailed case history illustrates the use of the training model in actual practice.
TL;DR: The experience suggests that preclinical psychiatry courses can play an important role in the medical educational response to AIDS, while, at the same time, achieving their traditional curricular goals.
Abstract: A new required psychiatry course for first-year medical students linked the urgent need for acquired immune deficiency syndrome (AIDS) education with the traditional goal of teaching the biopsychosocial model of illness. The course, “Human Behavior in Disease: AIDS as Paradigm,” used HIV/AIDS to demonstrate principles of all life-threatening diseases. Formal evaluations of the course’s impact indicated that it significantly reduced students’ prejudices and increased positive attitudes regarding AIDS patients. The students’ ratings of the course indicated that the AIDS paradigm was understood and valued. Our experience suggests that preclinical psychiatry courses can play an important role in the medical educational response to AIDS, while, at the same time, achieving their traditional curricular goals.
TL;DR: The various types of NIMH programs available and their goals, criteria, and time and budget limitations are described and the grant review process is summarized.
Abstract: Mental health professionals interested in clinical research careers need accurate, current information about research support mechanisms of the National Institute of Mental Health (NIMH). NIMH has recently expanded the research opportunities it offers in response to increased interest by the public and by Congress in schizophrenia, AIDS, and mental disorders of the elderly and children. This article describes the various types of NIMH programs available and their goals, criteria, and time and budget limitations. It also summarizes the grant review process and the role of NIMH program staff. Descriptions of new and revised grant mechanisms, including small grants, FIRST awards, Scientist Development Awards, and Academic Awards, and requirements for NIMH extramural and intramural fellowships and investigator-initiated training fellowships are also outlined.
TL;DR: Spontaneous declarations of field of interest by 150 applicants to the UCLA Neuropsychiatric Institute—West Los Angeles V.A. Medical Center psychiatric residency program in 1986 were examined.
Abstract: Spontaneous declarations of field of interest by 150 applicants to the UCLA Neuropsychiatric Institute—West Los Angeles V.A. Medical Center psychiatric residency program in 1986 were examined. In essays written as part of the National Resident Matching Program, many applicants expressed several areas of interest. About one-third of applicants expressed an interest in research, and about one-quarter expressed interests in teaching, psychotherapy, biological psychiatry, or child psychiatry. Between 5% and 9% expressed interest in community psychiatry, adolescent psychiatry, psychoanalysis, geriatric psychiatry, and chemical dependency, and <5% expressed interest in cross-cultural, emergency, legal, or administrative psychiatry.
TL;DR: Using correlation ratios and analysis of variance, several potential variability factors in student clerkship performance were examined, consistent with the idea that grades of clinical performance and performance on examinations measure different dimensions of student ability.
Abstract: Using correlation ratios and analysis of variance, several potential variability factors in student clerkship performance were examined. Comparisons are made between clerkship clinical sites for scores on written work, clinical work, and examination scores, and for factors such as the amount of patient and faculty contact. A small amount of grade variance is due to clerkship site. Correlations between scores on clinical skills and examination scores were low, consistent with the idea that grades of clinical performance and performance on examinations measure different dimensions of student ability. The relevance for clerkship planning and grading equity is discussed.
TL;DR: The reliability of the evaluative judgments by psychiatric faculty of physician-trainee interviewing skills was studied and some recommended modifications of observational systems are outlined that may help improve both the accuracy and reliability of ratings of trainee interviews skills.
Abstract: The reliability of the evaluative judgments by psychiatric faculty of physician-trainee interviewing skills was studied. Three methods were included: global rating scales, data checklists, and a time-allotment form. Data were obtained during a training workshop for psychiatric instructors in the U.S. The authors found low interrater reliability with all three methods. The study findings were replicated at a second workshop with Canadian faculty. The authors outline some recommended modifications of observational systems that may help improve both the accuracy and reliability of ratings of trainee interviewing skills. The use of more accurate quantitative techniques is briefly reviewed.
TL;DR: Of 203 psychiatry residency directors surveyed in 1988 about the career choices of graduates, 97 (48%) usable responses represented 1,403 residents and these findings reflect a departure from forecast expectations.
Abstract: Of 203 psychiatry residency directors surveyed in 1988 about the career choices of graduates, 97 (48%) usable responses represented 1,403 residents. Results were compared to previous surveys (1968–1972 and 1978–1979). The prior increase in post-residency fellowships (from 4% in 1968–1972 to 17% in 1978–1979) has leveled off (16.4% in 1988). Fewer residents chose academic psychiatry (9.7% in 1988 versus 26% in 1978–1979); more are entering hospital-based psychiatry (22.8% in 1988 versus 14% in 1978–1979). The proportions choosing private practice (28.7%) and community psychiatry (10%) are unchanged compared to 1978–1979. These findings reflect a departure from forecast expectations.
TL;DR: Graduation Questionnaire data collected by the Association of American Medical Colleges (AAMC) were used to identify student and medical school characteristics associated with future psychiatrists’ career plans.
Abstract: Graduation Questionnaire data collected by the Association of American Medical Colleges (AAMC) were used to identify student and medical school characteristics associated with future psychiatrists’ career plans. Subjects were senior medical students in the class of 1986 who definitely planned to specialize in psychiatry or child psychiatry. Medical school variables such as research experience, publication history, and exposure to a research-oriented environment were associated with plans for a career in academic medicine or research (versus clinical practice). Membership in a non-underrepresented minority group, having taken elective course work at a military or government agency, and having attended a private medical school all were associated with plans for a career in salaried clinical practice (versus private clinical practice).
TL;DR: The results emphasize the extent to which residents may receive inconsistent and contradictory advice from their clinical supervisors and raise important questions concerning the proper role and practice of psychotherapy supervision in residency training.
Abstract: The author, while in psychiatric residency training (PGY-3), presented an individual psychotherapy patient to two clinical supervisors, who acted formally as consultants, over a six-month course of treatment. There were fundamental differences of opinion between the supervisors concerning the psychotherapy. In addition, during a case conference, another senior psychiatrist acting as discussant offered a third and generally divergent view of the patient’s psychopathology and treatment. The results emphasize the extent to which residents may receive inconsistent and contradictory advice from their clinical supervisors and raise important questions concerning the proper role and practice of psychotherapy supervision in residency training.