Current Educational Practices for Major Neurocognitive Disorders in Psychiatry: a Scoping Review.

OBJECTIVE: A scoping review of the literature was performed to examine the current state of education on major neurocognitive disorders within psychiatry, to review influential factors for pursuing a career working with these patients, and to review what has been done in education to address the shortage of providers to care for patients with major neurocognitive disorders. METHODS: Using the Arksey and O'Malley framework for conducting scoping reviews, twenty-eight studies on education in geriatric psychiatry, neuropsychiatry, and major neurocognitive disorders were selected. Learner groups included medical students, residents, and psychiatrists. The results from the studies were compared, and major themes were presented. RESULTS: Several studies found that positive clinical experiences with older adult patients and effective teachers in geriatric psychiatry play a role in influencing trainees to pursue a career in geriatric psychiatry. Topics pertaining to major neurocognitive disorders are taught by the majority of medical schools during the psychiatry rotation and are rated as the most important teaching topic in neurology among psychiatry residency program directors. Several interventions have resulted in increased comfort working with geriatric patients and patients who have major neurocognitive disorders among students, but fewer studies have resulted in an increase in interest seeing these patients in practice. There is a lack of research pertaining to psychiatry residents working with patients that have major neurocognitive disorders. CONCLUSIONS: While research on geriatric psychiatry and neuropsychiatry education exists, more research is needed that focuses specifically on how medical students and psychiatry residents are being taught major neurocognitive disorders.

Geriatric Psychiatry Inpatient Primer for Residents.

OBJECTIVE: The authors describe a novel curricular intervention that enhances first- and second-year psychiatry residents' geriatric psychiatry knowledge while preparing them for overnight call. METHODS: A brief, four-page document covering evaluation and management of common clinical scenarios in older adults, including agitation, falls, insomnia, chest pain, abnormal vital signs, and review of pharmacologic interventions, was presented to first- and second-year psychiatry residents. The residents completed an anonymous survey including their comfort level in answering pages and knowledge-based questions regarding evidence-based interventions both before and after the intervention. The pre-survey and post-survey were analyzed using the Wilcoxon-signed rank test, paired T test, and Mann-Whitney U test. RESULTS: The residents demonstrated statistically significant changes in first-line medication choices for common clinical scenarios such as non-aggressive agitation and insomnia. They were less likely to choose medications that should be avoided in elderly based on expert panel recommendations. CONCLUSIONS: Findings support the need for educational interventions designed to help residents taking call with geriatric patients. The results demonstrated an improvement in clinical knowledge following this brief intervention.