Plenary
Friday, June 13
8:00 – 9:00 a.m.
Explorers’ Room
SPECIAL ADDRESS
Laura
Weiss Roberts, M.D.
University
of New Mexico
Editor-in-Chief
of Academic Psychiatry
Educational goals: This plenary presentation will provide
an introduction to the process of getting published in the psychiatric
education literature, giving guidance on how to approach the writing process,
on what makes a good paper, and on emerging ethical standards in the medical
education literature
Method: Participants will
be introduced to the process of getting a paper published in the psychiatric
education literature, including manuscript preparation, submission, editorial
review, peer-review, revision and resubmission, editorial decision-making, and
publication production. Information
will be provided on specialized format papers, such as annotated
bibliographies, review papers, brief reports.
Specific strategies for assessing one’s strengths and motivations as a
writer and collaborator, for choosing the “right“ target journal for a paper,
for selecting the “right” presentation of the content, for responding to
reviewers’ concerns, and for working with editors will be addressed. We will also cover important but seldom
discussed considerations related to collaboration with co-authors, authorship
“ethics”, and scientific integrity issues. Essential skills for medical
educators regarding ethical and regulatory issues in educational research will
be outlined. Relevant federal
regulations for educational research will be outlined.
Results: This presentation
is aimed at enhancing the understanding and skills of early and middle career
academic psychiatrists with an interest in writing manuscripts for publication
in the field of psychiatric education.
It will also be valuable for more senior faculty who serve as mentors,
senior authors, and guest editors.
Conclusions:
This plenary session will help enhance confidence and competence of
members of the audience in approaching the process of getting published in the
psychiatric education literature.
Workshop
Friday, June 13
9:00 – 10:15 a.m.
Wapiti 1
Aurora J. Bennett, M.D.
Lowell Tong, M.D.
University of California, San Francisco
Kemal Sagduyu, M.D.
University of Missouri, Kansas City
On-line schedules and evaluations were introduced into the clerkships
at our various institutions during the past two years. The on-line programs utilized by our
departments range from large commercial programs to small clerkship-specific
designs. Students and faculty complete
evaluations on-line and the data are organized in a manner that facilitates the
tracking of various sites and preceptors.
Reports are readily generated that provide faculty with their individual
scores and comments, from students, along with the numerical averages at
comparable sites. The development and
implementation of these programs has been challenging, but the rewards far
exceed the difficulties. Examples of
the various systems will be viewed as a means of promoting discussion about the
pros and cons of the varying designs.
Workshop
Friday, June 13
9:00 – 10:15 a.m.
Moose 2
Using
Guided Role-plays to Prepare
Students
for Standardized Patient Experiences
Julia
Frank, M.D.
George
Washington University
Educational goals: Participants
in this workshop will learn how to
use semistructured role playing exercises to teach interviewing skills
and the skills of psychiatric assessment in primary care settings.
Description: For the last five
years, clerks at the George Washington University
School of Medicine have learned outpatient psychiatric assessment skills
in part through participating in a series of semistructured role plays.
These exercises, which build on the problem based methods used in
preclinical courses, may be self or faculty led in groups ranging from
four to thirty people. Students are assigned in advance to be a primary
care doctor, an unfamiliar patient or a psychiatric consultant. The
latter two receive specific information and research their tasks ahead
of time. During the exercise, the naive primary care doctor interviews
the patient, observers join in, and finally the consultant reviews the
diagnosis and treatment options for the group as a whole.
This method, which has generally been well received by
students,
resembles the standardized patient experiences that will soon be part of
national boards. The interviews are longer than typical SP experiences,
but the format allows for direct observation of interviewing technique
and feedback, with particular emphasis on simultaneous
behavioral-psychiatric and medical assessment.
Workshop participants will be invited to participate in a sample
exercise and to review the available feedback. They will then have time
to offer their reactions and suggestions for improving this experience.
A complete copy of the current curriculum will be available for
participants to take and adapt to their own institutions.
Workshop
Friday, June 13
9:00 – 10:15 a.m.
Wapiti 2
(Down-to-earth)
Writers’ Workshop:
Writing
Manuscripts for Publication
Laura
Weiss Roberts, M.D
University
of New Mexico
John Coverdale, M.D.
Alan Louie, M.D.
University
of California, San Francisco
Academic Psychiatry
Educational goals: This workshop is a down-to-earth,
hands-on introduction to the essential skills of writing manuscripts for
publication in peer-reviewed academic medical journals.
Method: In helping
participants to build their writing skills, the course will involve
presentation of valuable and detailed information on the framework of empirical
and conceptual manuscripts and of specialized format papers, such as annotated
bibliographies, review papers, brief reports.
Participants will be introduced to the process of getting a paper
published, including manuscript preparation, submission, editorial review, peer-review,
revision and resubmission, editorial decision-making, and publication
production. This process will be
discussed in a step-by-step fashion, giving insights from the perspective of
writers, reviewers, and editors.
Specific strategies for assessing one’s strengths and motivations as a
writer and collaborator, for choosing the “right“ target journal for a paper,
for selecting the “right” presentation of the content, for responding to
reviewers’ concerns, and for working with editors will be addressed. We will also cover important but seldom
discussed considerations related to collaboration with co-authors, authorship
“ethics”, and scientific integrity issues. This workshop will involve
interactive learning and Q and A formats, and it will have a tone of warmth and
collegiality. Up-to-date resource
materials will be provided to all participants.
Results: This workshop is
aimed at enhancing the skills of early and middle career academic psychiatrists
with respect to writing manuscripts for publication in peer-reviewed
journals. It will also be valuable for
more senior faculty who serve as mentors, senior authors, and guest editors.
Conclusions:
Psychiatric educators may receive benefit from activities which enhance
and expand their skill set and prepare them for the tasks of careers in
academic psychiatry.
Poster
Friday, June 13
10:15 – 10:45 a.m.
Explorers’ Room
Psychiatrists
Compared to Other Specialists on Performance Before, During and After Medical
School: Over Three Decades of Data from the Jefferson Longitudinal Study
Frederick S. Sierles, M.D.
Finch
University of Health Sciences/The Chicago Medical School
Michael J. Vergare, M.D.
Mohammadreza Hojat, Ph.D.
Joseph
S. Gonnella, M.D.
Thomas
Jefferson University
Educational goals:
Participants will compare longitudinal academic performance of
psychiatrists compared to other specialists, and discuss the implications of
this for career counseling and curriculum development for third and early
fourth year
medical students and first year psychiatry residents, and
for recruitment of medical students into psychiatry.
Objectives:
This study was designed to compare psychiatrists with other physicians
on measures of academic performance before, during and after medical school.
Method: More than three
decades of data for graduates of Jefferson Medical College (n=5,701) were analyzed. Those who pursued psychiatry were compared
to physicians in seven other specialties on 21 performance measures. Using analysis of covariance controlled
gender effect.
Results: Psychiatrists
performed better on measures of verbal ability and general information before
medical school, and in evaluations of knowledge and skills in behavioral
sciences during medical school, but not on the examinations of general medical
sciences. Also, in their first year of
residency training, psychiatrists were rated high on the clinical competence
area of socioeconomic aspects of patient care, but not in the areas of
knowledge and data gathering, interpersonal skills and attitudes. The latter finding is counterintuitive but
readily explainable.
Conclusions: The results have implications for
career counseling of third year and early-fourth-year medical students, for
program planning and career counseling for first year psychiatry residents, and
for recruitment of medical students into psychiatry. More attention should be paid to the general medical education of
psychiatrists and other non-generalist specialists.
Poster
Friday, June 13
10:15 – 10:45 a.m.
Explorers’ Room
Julia Frank, M.D.
George Washington University
Educational goals:
1.
Increase students’
self-awareness in their interactions with psychiatric patients.
2.
Increase students’
tolerance for patients’ distress.
3.
Improve residents’
ability to use non-directive teaching methods with medical students.
Description: Since July, 2002,
students on their third year psychiatry
clerkship at George Washington University School of Medicine have
participated in a modified group exercise based on the work of Michael
and Enid Balint. This method, used extensively with primary care
practitioners in England and in some US residency programs, involves
small group sessions in which one member is instructed to present a
patient from the point of view of the doctor patient relationship. The
presenter is encouraged to reflect on his/her reactions to the
patient, for the purpose of understanding more about the patient, based upon
the countertransference he/she elicits. Others in the group then comment
on the dyad presented.
Groups of 8 students meet three times during the clerkship for an hour
fifteen minutes. Advanced residents lead the groups, under the
supervision of a resident who has received special training in
Balint’s methods.
Conclusions: Based on anonymous feedback, students have
found these
groups helpful in buffering the emotional stress of dealing with very
ill psychiatric patients, especially children. The residents leading
the groups have also expressed high levels of satisfaction with the
experience, which leads to an open discussion of issues rarely
addressed during formal clerkship didactics. By June, there will be
enough feedback available to comment on whether this experience
increases or stifles students’ self declared interest in working with
the mentally ill.
Poster
Friday, June 13
10:15 – 10:45 a.m.
Ruth
M. Lamdan, M.D.
Temple
University
Educational goals: At the conclusion of
this poster, participants will gain an understanding of the group process as a
tool for faculty development and assurance of uniformity amongst clerkship
training sites as mandated by the LCME.
Introduction: Temple
University School of Medicine Department of Psychiatry faculty has more than
doubled in size over the past year with the hiring of our new graduates. This paucity of teaching experience in our
new faculty and the “end of school” medical student survey from the AAMC
alerted us to educational needs of our students.
Method: At the
recommendation of our Chair and Chief of Service we created a “Supervising the
Supervisors” group to address these training goals. This forum has been used for the purpose of improving resident
supervision in psychiatry residency training programs. Our review of the
literature failed to uncover its utility or description. Our monthly group for all faculty and our
chief residents is ongoing. We are
addressing both the content and process of the clinical clerkship curriculum,
the evaluation process and the critical clinical skills which we require to
pass the rotation.
Findings/Results:
We will report on the beginning development of this group: the growth of our faculty identity and
cohesiveness, specific training directives, evaluation standards, specific
curriculum and course content: to establish our unique educational
culture. Future goals include the
development of qualitative measures of our faculty process. We will also disseminate the new standards
and techniques for improving the supervision of medical students to our
off-site faculty to assure uniformity amongst training sites and enhance their
supervisory skills.
Poster
Friday, June 13
10:15 – 10:45 a.m.
Simon Kung, M.D.
Maria I. Lapid, M.D.
Lois E. Krahn, M.D.
Mayo Clinic
We designed a simple and
user-friendly computer program to allow students to self-test their knowledge
of Psychiatry. The program presents a
series of multiple-choice questions drawn from a databank of questions geared
towards content found on standardized, national Psychiatry examinations. Students are familiar with this method of
testing because of the computerized USMLE examinations. The program runs on any Microsoft Windows
computer that has Microsoft Access, a widely-available database program.
In the spirit of academic
collaboration and to decrease barriers to access, we plan to share this
program, free of charge, with anyone who is interested. Because we are writing these assessment
questions ourselves, we also welcome contributions to our databank of
questions. Future plans include
producing a similar program for the wildly popular Palm-style computers.
Poster
Friday, June 13
10:15 – 10:45 a.m.
Dimensions
of First Year Medical Student
Religiosity
and Correlation with Attitude
Towards
Psychiatry and the Behavioral Sciences
Mercer University School of Medicine
Macon, Georgia
Introduction:
Despite a growing interest in addressing religious and spiritual issues
in the undergraduate medical curriculum relatively little is known about
medical student religiosity, how it is affected by medical education, and how
it correlates with medical students’ attitudes towards psychiatry and the
behavioral sciences. This poster
presents initial, pilot data from a longitudinal project, which will follow
medical students over the course of their medical education and assess these
things.
1.
To quantify key
dimensions of medical student religiosity, specifically organizational
religious practice, non-organizational religious practice, intrinsic
religiosity, and religious coping.
2.
To assess medical
students’ views of the role of religion
and spirituality in the medical school curriculum
3.
To assess medical
students’ views of the role of religion
and spirituality in the practice of medicine
4.
To assess first year medical
students’ attitudes towards psychiatry and the behavioral sciences
5.
To see if key
dimensions of medical student religiosity correlate with students’ views of the
role of religion and spirituality in
the medical school curriculum
6.
To see if key dimensions
of medical student religiosity correlate with attitudes towards psychiatry and
the behavioral sciences.
Description:
First year medical students at Mercer University School of Medicine were
surveyed using the Duke University Religion Index, R-COPE (religious coping),
Intrinsic Religious Motivation Scale, Attitudes Towards Religion in Medicine
Scale, ATP-30 (attitudes towards psychiatry), and Behavioral Medicine
Questionnaire (attitudes towards behavioral science.) The results of each survey will be quantified and the data will
be analyzed for correlation between the various instruments. Associations with age, sex, and choice of
medical specialty will also be analyzed.
This group of medical students will be re-surveyed at the end of their
second and fourth years of medical school to assess for change over the course
of medical education.
Conclusion:
Relatively little is known about medical student religiosity and
attitudes towards addressing religion and spirituality in the medical school
curriculum. This poster will present
pilot results of an assessment of several dimensions of medical student
religiosity and associations with attitudes towards psychiatry and the
behavioral sciences.
Poster
Friday, June 13
10:15 – 10:45 a.m.
Pre-Clinical
Medical School Education:
The Patient
Perspective
Lois E. Krahn, M.D.
Mayo Clinic
Educational
goals:
1.
Participants will be
aware of the degree of satisfaction and willingness to return that patients
interviewed in a pre-clinical medical student course expressed.
2.
Participants will be
aware of the multiple reasons that patients provided for participating in the
medical student course, many of which revealed an altruistic desire to help
students and health care institutions.
3.
Participants will be
able to consider identifying a group of psychiatric outpatients willing to be
involved with small group sessions in pre-clinical courses.
Purpose: The purpose of
this project is to understand why patients are willing to come in for
appointments arranged purely for the sake of medical education. By
understanding the patient perspective, we hope to better understand the nature
of the experience for our students as well as develop means to recruit more
patients as participants.
Introduction: For over eight
years Mayo Medical School has had a patient-oriented preclinical course called
"Introduction to Psychopathology." The course includes 18 hours of
lectures. The course was designed to incorporate active adult learning
techniques and use a case method teaching style. Each day after an introductory
lecture, the students break up into groups of 6-7 students where they interview
patients. Each small group has the opportunity to interview 15 patients. The
patients are recruited from the inpatient units as well as outpatient practice.
In the past we have tried using standardized patients. However we found that
when available, actual patients had several advantages over standardized patients'. Recruiting appropriate patients is a
potential challenge. Outpatient participants are suggested to the education
secretary by their psychiatrist or psychologist. The secretary contacts them
and asks them if they would be willing to participate. The patients participate
in two interviews an afternoon. The interviews are 30 minutes in length and
followed by a 30-minute break during which time the small groups discuss the
patient's interview. The patient is not present for the students' discussion.
Patients are paid for their participation.
Method: A six-question
survey was mailed to all participating outpatients after the course. This study
was approved by the Mayo IRB.
Results: Surveys were sent
to the 15 patients who participated in the 2002 course. The mean age was 50 years (range 27-70) and
73% were women. Eleven patients responded (73%). The mean duration of
participation was 3.5 years (range 1-8 years). Patients were highly satisfied
with their experience (mean 4.7 on a 5-point scale with 5 highly satisfied,
range 3-5). Their reasons for participating are listed in Table I. All would be
willing to participate again.
TABLE I
|
MOTIVATION FOR
PARTICIPATING |
|
|
Desire
to help students |
100% |
|
Opportunity
to teach about their illness |
91% |
|
Wish
to satisfy their psychiatrist |
18% |
|
Opportunity
to meet students/teachers |
73% |
|
Enjoyable |
64% |
|
Financial
Compensation |
65% |
|
Desire
to support the institution |
91% |
Conclusions: Patients who
returned the survey expressed a high degree of satisfaction and a willingness
to return next year. They provided multiple reasons for participating, many of
which revealed an altruistic desire to help students and health care
institutions. More medical schools could consider identifying a group of
psychiatric outpatients willing to be involved with small group sessions in
pre-clinical courses.
Reference: Krahn LE, Bostwick JM, Sutor, B, Olsen MW.
"The Challenge of Empathy: A Pilot Study Using Standardized Patients to
Teach Introductory Psychopathology to Medical Students." Academic
Psychiatry. 2002,26:26-30.
Poster
Friday, June 13
10:15 – 10:45 a.m.
Patient
Acceptance and Comfort Level Regarding
Medical
Students in Psychiatric Outpatient Clinic
University of Alabama
Educational goals:
To help participants to better prepare medical students for patient
interaction by being aware of patient comfort and confidence about seeing
medical students in an academic psychiatric outpatient clinic.
Method: The authors
developed a self-administered questionnaire that was distributed to patients
waiting for an office visit with the psychiatrists who served as faculty for
third year medical students in an academic institution. The questionnaire asked patients about their
comfort levels with having medical students present during their visits and
their confidence in the abilities of medical students.
Results: Ninety-nine
patients completed the survey. The
majority was female (76%) and Caucasian (84%).
Twelve respondents were excluded due to missing data. A majority of patients accepted students as
student doctors in training; 36% of patients preferred to see physician only;
and 41% preferred to see the physician only during first visit. Patients were uncomfortable discussing
sexual issues (49%), marital problems (30%), substance abuse issues (27%), and
financial and legal issues (28%) with medical students. Some patients felt that they had to repeat
their stories. Greater than 95% of
patients rated students favorably in their skills and professionalism.
Conclusions:
Although generalizations to all patients are limited by the sampling
design of the study, the majority of patients are accepting of medical students
in the academic psychiatry clinic.
Despite patient confidence in medical students’ abilities, a sizeable
minority prefers to see the physician only.
This may be due in part to having to repeat their histories to multiple
professionals. Academic psychiatric
physicians should prepare medical students for some patient discomfort in
talking with them and particularly as regards more sensitive issues.
Plenary
Friday, June 13
10:45 a.m. – 12:00 p.m.
Explorers’ Room
ASSESSMENT, PART I: MEASURING
ATTITUDES AND PERFORMANCE
Amy
Brodkey, M.D., Chair
University
of Pennsylvania
School-by-School
Trends in Medical Student
Career
Choice of Psychiatry, 1999-2001
Frederick S. Sierles, M.D.
Stephen H. Dinwiddie, M.D.
Delia Patroi, M.D.
Nutan Atre-Vaidya, M.D.
Michael J. Schrift, D.O.
John Woodard, M.D.
Finch University of Health Sciences/The Chicago Medical
School
Educational goals:
Participants will be able to summarize the factors that influence
school-by-school trends in medical student career choice of psychiatry.
Introduction: The proportion of students matching
into psychiatry (PMP) at each medical school results from a complex interplay
between national and regional trends (extrinsic variables) and characteristics
of each school, including the quality of its psychiatric education
(intrinsic). The authors ascertained
which extrinsic factors are associated with school-by-school differences in PMP
from 1999-01.
Methods: The authors obtained the PMP for each U.S. school (data
for individual schools is confidential and will not be mentioned) from student
affairs deans and the National Residency Matching Program (NRMP). They obtained data about the independent
variables from the AMA, the AAMC, the APA and Harvard’s HealthSystem
Consortium. Data were analyzed using
SPSS 11.
Results: The best
predictor of a school’s PMP is its PMP from the prior year. There were no significant associations
between PMP and the school’s funding, tuition, clerkship length, having a
psychiatrist dean, ethnic composition of the student body, admissions
preference for students from rural areas or underserved minority populations or
preferring primary care. Findings about
the association between PMP and local managed care penetration were surprising
and initially counterintuitive. There
was a significant, low-magnitude inverse correlation between PMP and
proportions of IMGs in the psychiatry residency. PMP for geographic region has changed notably since 1991-92.
Conclusions:
Though national trends are currently conducive to medical students
choosing psychiatry, individual departments cannot expect to be beneficiaries
of good fortune in their students choosing psychiatry based on regional or
school related “extrinsic” factors such as Southern location or public
funding. It is reasonable to infer,
therefore, that departments wishing to improve their PMP must provide the resources
in personnel and time to produce the best possible education programs.
Ple