Showing papers in "Academic Psychiatry in 2001"
TL;DR: The challenge of teaching good communication skills and psychotherapy to medical students was addressed through development of a clerkship seminar that stressed the practical application of psychotherapeutic techniques to the difficult and/or psychiatric patient.
Abstract: The challenge of teaching good communication skills and psychotherapy to medical students was addressed through development of a clerkship seminar that stressed the practical application of psychotherapeutic techniques to the difficult and/or psychiatric patient. Clinical vignettes from television programs such as "ER" were used to illustrate encounters with extremely emotional or personality-disordered patients. Students also examined the dynamic meaning of these encounters, their own countertransference, and their ability to tolerate emotional interchanges with such patients. In addition, the vignettes were used to examine and apply Buckman's model for breaking bad news to patients who have undergone a significant loss. Seventy-two third-year medical students participated and completed pre- and post-seminar questionnaires to assess their knowledge and attitudes toward psychotherapeutic techniques. Students significantly improved in knowledge of countertransference, boundary setting, and how to break bad news. Attitudes toward breaking bad news and recognizing strong countertransference also improved. Some differences in post-seminar knowledge and attitudes were found between male and female students.
45 citations
TL;DR: The authors discuss the deleterious consequences of the lack of both research and supervisory training requirements in psychiatry, and propose critical elements for supervision training and research.
Abstract: Supervisors and residents spend a significant amount of time and effort in psychotherapy supervision, yet receive little or no training in how to supervise. No specific requirements for supervision training exist in psychiatry or social work programs. Accredited graduate programs in professional psychology are required to expose students to supervision. The field of psychoanalysis has some requirements for being a supervisor, but not any specific training for supervisors. In contrast, the American Association of Marital and Family Therapy (AAMFT) requires extensive training for its supervisors, which is described. The authors explore the reasons for the absence of requirements in psychiatry. Regardless of the number of requirements, all disciplines show a striking paucity of empirically-based research in supervision training. Authors discuss the deleterious consequences of the lack of both research and supervisory training requirements and propose critical elements for supervision training and research.
24 citations
TL;DR: A Work Group on Training and Education of the American Academy of Child and Adolescent Psychiatry has developed sample core competencies for each area to serve as potential models for consideration by training programs as they develop criteria tailored to their program’s unique resources and needs.
Abstract: In an effort to improve the preparedness of residents to address health care needs, the Accreditation Council for Graduate Medical Education mandated that all Residency Review Committees (RRCs) incorporate the general competencies of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice into their requirements. In response, the Psychiatry RRC mandated that child and adolescent psychiatry programs develop one competency for each of the six areas, effective January 1, 2001. To assist in this effort, the Work Group on Training and Education of the American Academy of Child and Adolescent Psychiatry has developed sample core competencies for each area. These samples are meant to serve as potential models for consideration by training programs as they develop criteria tailored to their program’s unique resources and needs.
23 citations
TL;DR: A survey of research opportunities and training strategies in departments of psychiatry revealed a fairly low number of research training opportunities and the research didactics seem to be relatively short and lacking education in study design.
Abstract: A survey of research opportunities and training strategies in departments of psychiatry revealed a fairly low number of research training opportunities. Also, the research didactics seem to be relatively short and lacking education in study design. Trainees are rarely required to submit a research protocol and/or initiate their own research project. The authors discuss the implications of these findings and make recommendations for improvement of research training.
18 citations
TL;DR: The Summer Research Institute (SRI) as discussed by the authors is an annual week-long research training program followed by ongoing mentorship for about 25 selected fellows and junior faculty, which covers topics such as scientific integrity, recruitment of subjects, grant mechanisms, and balancing life and work.
Abstract: We currently need to train a sizeable group of researchers and academicians in geriatric psychiatry in order to prepare for the upcoming increase in the number of elderly mentally ill persons. The Summer Research Institute (SRI) is an annual week-long research training program followed by ongoing mentorship for about 25 selected fellows and junior faculty. Sessions cover topics such as scientific integrity, recruitment of subjects, grant mechanisms, and balancing life and work. About 90% of the 123 attendees have presented and written publishable papers within a year of attendance, and over 50% have received grant funding within 18 months of the SRI. The 3-year cumulative proportion remaining in full-time academics is 78%. The SRI offers a model for training junior investigators in a manner that is useful both to them and to the field as a whole.
18 citations
TL;DR: Faculty and residents showed no significant difference in their residency training in research offerings/requirements; however, current residents showed greater access to more programs offering research.
Abstract: The authors surveyed members of the American Association of Directors of Psychiatric Residency Training (AADPRT) and chief residents of training programs in 1999. (The Residency Review Committee [RRC] requires research training in psychiatry.) The survey gathered information on faculty and resident participation in research, attitudes, presentations and/or publications. The total response rate was 49%. Faculty and residents showed no significant difference in their residency training in research offerings/requirements; however, current residents showed greater access to more programs offering research. Ninety-eight percent of respondents indicated that research training should be offered to residents, but only 32% thought that research should be a requirement. Psychiatry residencies continue to require strong leadership in clearly defining acceptable components of strong research programs.
16 citations
TL;DR: The session helped trainees feel more comfortable and more open in supervision, and prompted them to try different supervision modalities, and it is recommended that this program be tried in other residency programs.
Abstract: Psychotherapy supervision is one of the most important avenues through which residents learn psychotherapy. However, instruction on how to effectively use supervision is minimal. Described here is a one-session introduction to supervision designed to help students prepare for their supervision experiences. A questionnaire revealed that residents had no previous education regarding supervision. Most helpful for trainees were the topics of characteristics of good supervisors, addressing problems in supervision, and the supervision contract/agreement. The session helped trainees feel more comfortable and more open in supervision, and prompted them to try different supervision modalities. It is recommended that this program be tried in other residency programs.
15 citations
TL;DR: Almost a decade of work is described on what may be the most comprehensive curriculum development process in academic psychiatry, with 43 model curricula in psychiatry that had been published or disseminated through organizations since 1985.
Abstract: Dr. Wulsin is at the Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio. Dr. Kramer is at the Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina. Address reprint requests to Dr. Wulsin, 231 Bethesda Ave., ML 559, Cincinnati, OH 45267. e-mail: lawson.wulsin@uc.edu Copyright 2001 Academic Psychiatry. The publication in this issue of the report by Glick and colleagues (1) on the revised version of the American College of Neuropsychopharmacology’s 1993 curriculum on psychopharmacology (2) describes almost a decade of work on what may be the most comprehensive curriculum development process in academic psychiatry. This publication raises the question “What is the state of the art of developing model curricula in academic psychiatry?” In 1998 (3), we found 43 model curricula in psychiatry that had been published or disseminated through organizations since 1985, covering roughly two dozen topic areas. At that time, only one of these curricula (2), had been used in more than two settings. Many had been created, but few had been borrowed. The model-curriculum tree clearly has borne fruit, most of it in various stages of near-ripeness, but where are the pickers?
10 citations
TL;DR: Although resident and faculty satisfaction with the examination was high, site-to-site variability in reliability and validity indicates the need to improve this ASO before using it for high-stakes evaluations.
Abstract: The authors examined the reliability and validity of American Board of Psychiatry and Neurology-style oral exams (ASOs) given jointly by two schools. ASOs were given to 80 psychiatry residents from all four postgraduate years during the study period. Interrater reliability was near perfect for two years at one university, but it was much weaker at the second site. Test-retest reliability could not be demonstrated at either institution. Concurrent validity was demonstrated one year but was inconsistently demonstrated the second year. Likewise, predictive and construct validity were variable. International medical graduates were more apt to fail than American medical graduates. Although resident and faculty satisfaction with the examination was high, site-to-site variability in reliability and validity indicates the need to improve this ASO before using it for high-stakes evaluations.
10 citations
TL;DR: A course focusing on the functional neuroanatomy of psychiatric disorders and the very favorable evaluations of the course by residents are summarized.
Abstract: The literature on the functional neuroanatomy of psychiatric disorders is growing and is certain to expand in the future. To prepare psychiatric residents for the inevitable transformation in how psychiatric disorders are conceptualized and treated, we have created a course focusing on the functional neuroanatomy of psychiatric disorders. The four sections of the course include neuroanatomy, functional neuroimaging techniques, cognitive neuroscience, and current evidence on the neuroanatomical basis of psychiatric disorders. This article summarizes the organization and content of the course and the very favorable evaluations of the course by residents.
8 citations
TL;DR: The authors present results of 10 years of experience in developing and teaching a seminar on how to think critically and do research and address the value and feasibility of adapting this course to other institutions and other medical specialties.
Abstract: The authors present results of 10 years of experience in developing and teaching a seminar on how to think critically and do research. This seminar has been taught at three different institutions by the authors and adapted at other institutions as well. Authors present and discuss short-term outcome measures based on an objective test and self-assessment survey as well as some more long-term findings. They also address the value and feasibility of adapting this course to other institutions and other medical specialties.
TL;DR: A 1-year follow-up evaluation of users’ experience found that 62% rated the curriculum, to varying degrees, as improving the teaching of psychopharmacology in their programs.
Abstract: There is now more information to assimilate in clinical psychopharmacology and newer ways to acquire this information. Educational materials should be designed for and targeted to meet the diverse needs of such groups as medical students, psychiatry residents, clinical practitioners, industry and federal scientists, and clinical research organizations. As a starting point, the authors developed, in 1997, a model curriculum for psychopharmacology residency programs. The curriculum consists of 1) overview, 2) learning and educational objectives, 3) what and how to teach, 4) how to evaluate, 5) how to organize a psychopharmacology program, and 6) an investigative psychiatry curriculum. There are 31 lecture outlines and hard copies of 1,500 slides, comprising basic and advanced courses. A 1-year follow-up evaluation of users’ experience found that 62% rated the curriculum, to varying degrees, as improving the teaching of psychopharmacology in their programs.
TL;DR: The author discusses how changes affect continuing psychiatric education, various ramifications of websites’ pre-publication posting, and controversies of posting “pseudoscientific,” non-reviewed papers, outlining advantages and disadvantages of print and electronic publishing.
Abstract: Because of a burgeoning Internet and increasing number of online electronic Journals, the way in which psychiatric practitioners are educated is changing. To better characterize these changes, the author conducted a survey of sources for obtaining medical information from the present and from 5 years ago among 55 academic psychiatrists and psychiatric residents. Comparisons show an average 14.0% ± 19.0% decrease in use of print media and a 16.2% ± 15.7% increase in the use of the Internet as a source of psychiatric information (P = 0.001). No significant change was found in use of live or videotaped lectures, classes, and conferences. The author discusses how these changes affect continuing psychiatric education, various ramifications of websites’ pre-publication posting, and controversies of posting “pseudoscientific,” non-reviewed papers, outlining advantages and disadvantages of print and electronic publishing.
TL;DR: In this paper, the authors address important gaps in theoretical and/or practical literature, are feasible to study, and are likely to have meaningful impact in psychiatric educational research, and those preparing to be educational researchers require proficiency in research design, writing and conducting protocols, and in acquiring necessary resources to carry out their studies successfully.
Abstract: Creative and curious psychiatric teachers who desire to improve the quality, effectiveness, and efficiency of educational and training experiences do psychiatric educational research. Researchable questions arise daily concerning students, teachers, instructional variables, the context of education, and outcomes. Worthwhile questions are stimulating, address important gaps in theoretical and/or practical literature, are feasible to study, and are likely to have meaningful impact. Those preparing to be educational researchers require proficiency in research design, writing, and conducting protocols, and in acquiring necessary resources to carry out their studies successfully. Professional development may take place via informal pathways as well as formal programs available locally, by means of distance-learning, and through nationally sponsored fellowships.
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TL;DR: In this paper, a cross-cultural study showed how personals are used in understanding the American value of individualism and the Chinese values of family and society, and that personals in an Indian newspaper and an Indian-American newspaper both demonstrate Indian values, yet the latter shows hints of American acculturation.
Abstract: Personal advertisements are powerful windows into understanding individuals, societal trends, and cultural values. “Personals” in the United States and elsewhere offer a unique opportunity to understand societal changes and cross-cultural issues. As one study demonstrates, personals reflect the societal importance placed on thinness in American women. A cross-cultural study shows how personals are used in understanding the American value of individualism and the Chinese values of family and society. Personals in an Indian newspaper and an Indian-American newspaper both demonstrate Indian values, yet the latter shows hints of American acculturation. For psychiatrists, the personals may be an important way to understand patients and their social and cultural contexts. Patients’ ads may help the psychiatrist and patient understand the patients’ values and fantasies, aid in treatment, and help form relationships.
TL;DR: A 7–10-week seminar was created in which residents design, perform, and interpret the results of a research project, which has been successful as measured by resident attendance, participation, and expressed interest.
Abstract: Understanding of research methodology is essential for the practice of modern medicine. Yet teaching research methodology to clinically-oriented physicians can be quite challenging. To maximize resident participation in the learning process, a 7–10-week seminar was created in which residents design, perform, and interpret the results of a research project. This approach has been successful as measured by resident attendance, participation, and expressed interest. Problems include a potentially inconsistent year-to-year experience and the requirement of an extensive commitment by the course coordinator. Nonetheless, this model may serve, with appropriate customization, as an example for other residency programs.
TL;DR: The authors report on 2 years of medical student evaluations of teaching and student performance outcomes from a psychiatric clerkship conducted in outpatient mental health clinics in a county jail system, where the jail sites were rated equivalently for teaching and patient variety.
Abstract: Some educators may view correctional settings as substandard sites for medical student clerkships in psychiatry. The authors report on 2 years of medical student evaluations of teaching and student performance outcomes from a psychiatric clerkship conducted in outpatient mental health clinics in a county jail system. When compared with other clerkship sites, the jail sites were rated equivalently for teaching and patient variety, and students at the jail sites performed comparably on exams and preceptor ratings.
TL;DR: A weekly, year-long research seminar, led by two clinical research faculty members, provides psychiatric residents with an opportunity to integrate clinical and research experience and “hands-on” familiarity with clinical research.
Abstract: A weekly, year-long research seminar, led by two clinical research faculty members, provides psychiatric residents with an opportunity to integrate clinical and research experience and “hands-on” familiarity with clinical research. The functional goal is production of an IRB-approved clinical research project design. The group approach is less intimidating for the residents, allows for individual flexibility while maintaining the project’s momentum, is congruent with other seminars and courses, and encourages a cooperative approach to research. Evaluations indicate that the residents value the experience and that they increase their knowledge of the requirements and techniques of clinical research.
TL;DR: In the entertainment industry, professional wrestling has gained a firm foothold in American culture and appears to be here to stay as mentioned in this paper and children comprise a large portion of its audience, much to the dismay of many parents and clinicians.
Abstract: Professional wrestling (PW) has gained a firm foothold in American culture and appears to be here to stay. Children comprise a large portion of its audience, much to the dismay of many parents and clinicians. Society has struggled with how to respond to their children’s fascination with PW, a novel hybrid between sports and entertainment. Parents expose children to sports, thinking they will learn healthy ways of managing conflict and aggression. However, PW is not a sport. Its values are the exact opposite of traditional sportsmanship; it demonstrates to children that cheating and verbal intimidation are effective problem-solving techniques. Because PW resembles sports, children risk applying its values to legitimate sports, as well as other realms of life. Parents can prevent this association by differentiating PW from sports, and the entertainment industry can prevent it by stopping their aggressive marketing of PW to children.