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1.
J Nutr ; 154(8): 2431-2436, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38825041

ABSTRACT

The burden of disease attributable to mental health is expected to rise in the coming decades. Poor nutritional status is considered a modifiable risk factor for general mental health. In fact, nutrition interventions are now accepted as a core strategy in mental healthcare to combat physical health inequalities and life-expectancy gap in people with certain psychiatric disorders. However, most psychiatrists are not familiar with evidence for the potential therapeutic benefits of diet in psychiatric illness, and this may be related to sparse nutrition education for physicians. Thus, there is a need to integrate nutritional management in psychiatric practice, but there is a gap in medical education that would support this practice. Here, we discuss evidence for and challenges in 1) assessing diet quality in psychiatric illness, 2) recommending improvements in diet quality and specific dietary patterns in psychiatric illness, and 3) recommending dietary supplements in psychiatric illness. This discussion serves as a call to develop nutrition curricula within psychiatry residency programs.


Subject(s)
Internship and Residency , Nutritional Sciences , Psychiatry , Humans , Psychiatry/education , Nutritional Sciences/education , Mental Disorders/therapy , Diet , Curriculum , Nutritional Status , Dietary Supplements
2.
Curr Psychiatry Rep ; 26(3): 60-72, 2024 03.
Article in English | MEDLINE | ID: mdl-38329570

ABSTRACT

PURPOSE OF REVIEW: Palliative care (PC) psychiatry is a growing subspecialty focusing on improving the mental health of those with serious medical conditions and their caregivers. This review elucidates the current practice and ongoing evolution of PC psychiatry. RECENT FINDINGS: PC psychiatry leverages training and clinical practices from both PC and psychiatry, addressing a wide range of needs, including enhanced psychiatric care for patients with serious medical illness, PC access for patients with medical needs in psychiatric settings, and PC-informed psychiatric approaches for individuals with treatment-refractory serious mental illness. PC psychiatry is practiced by a diverse workforce comprising hospice and palliative medicine-trained psychiatrists, psycho-oncologists, geriatric psychiatrists, other mental health professionals, and non-psychiatrist PC clinicians. As a result, PC psychiatry faces challenges in defining its operational scope. The manuscript outlines the growth, current state, and prospects of PC psychiatry. It examines its roles across various healthcare settings, including medical, integrated care, and psychiatric environments, highlighting the unique challenges and opportunities in each. PC psychiatry is a vibrant and growing subspecialty of psychiatry that must be operationalized to continue its developmental trajectory. There is a need for a distinct professional identity for PC psychiatry, strategies to navigate administrative and regulatory hurdles, and greater support for novel clinical, educational, and research initiatives.


Subject(s)
Palliative Care , Psychiatry , Humans , Aged , Psychiatry/education , Delivery of Health Care
3.
BMC Psychiatry ; 24(1): 97, 2024 Feb 05.
Article in English | MEDLINE | ID: mdl-38317097

ABSTRACT

BACKGROUND: This study aimed to survey the prevalence of depression and its associated factors among psychiatrists and psychiatry trainees (physicians in psychiatric residency training). METHODS: This cross-sectional study surveyed Thai psychiatrists and psychiatry trainees from January to February 2023 using an online questionnaire. The questionnaires consisted of (1) the demographic and work-related information; (2) perceptions towards social support and work; (3) the Patient Health Questionnaire-9 (PHQ-9) Thai version; and (4) the 6-item Revised UCLA Loneliness Scale Thai version. All data were analyzed using descriptive statistics, and the associated factors concerning depression were analyzed via multiple linear regression analyses. RESULTS: Of the 225 total participants, 52(23.1%) and 173 (76.9%) were psychiatry trainees and psychiatrists, respectively. Most of them were female (64.9%) with overall median age (interquatile) was 34 (30, 42) years. Regarding the PHQ-9 findings, the prevalence of depression among all participants was 12.4% (psychiatrists 13.9% and psychiatry trainees 7.7%). From regression analyses, depression was associated with loneliness and perceived levels of work satisfaction and work stress in psychiatrists, while in psychiatry trainees, depression was associated with loneliness and perceived level of ability to control work schedule. CONCLUSIONS: One-tenth of psychiatrists and psychiatry trainees had depression. Although the prevalence of depression in this study was not extremely high, key contributing factors related to depression, such as loneliness, work satisfaction, work stress, and ability to control the work schedule should be required to action to reduce the depression rate among mental health personnel.


Subject(s)
Occupational Stress , Psychiatry , Humans , Female , Male , Psychiatrists , Depression/epidemiology , Cross-Sectional Studies , Loneliness , Psychiatry/education , Surveys and Questionnaires , Social Support
4.
Med Teach ; 46(6): 776-781, 2024 06.
Article in English | MEDLINE | ID: mdl-38113876

ABSTRACT

PURPOSE: We have evaluated the final-year Psychiatry and Addiction Medicine (PAM) summative Objective Structured Clinical Examination (OSCE) examinations in a four-year graduate medical degree program, for the previous three years as a baseline comparator, and during three years of the COVID-19 pandemic (2020-2022). METHODS: A de-identified analysis of medical student summative OSCE examination performance, and comparative review for the 3 years before, and for each year of the pandemic. RESULTS: Internal reliability in test scores as measured by R-squared remained the same or increased following the start of the pandemic. There was a significant increase in mean test scores after the start of the pandemic compared to pre-pandemic for combined OSCE scores for all final-year disciplines, as well as for the PAM role-play OSCEs, but not for the PAM mental state examination OSCEs. CONCLUSIONS: Changing to online OSCEs during the pandemic was related to an increase in scores for some but not all domains of the tests. This is in line with a nascent body of literature on medical teaching and examination following the start of the pandemic. Further research is needed to optimise teaching and examination in a post-pandemic medical school environment.


Subject(s)
Addiction Medicine , COVID-19 , Educational Measurement , Psychiatry , Students, Medical , COVID-19/epidemiology , Humans , Psychiatry/education , Educational Measurement/methods , Addiction Medicine/education , Australia/epidemiology , Students, Medical/psychology , Clinical Competence , SARS-CoV-2 , Pandemics , Reproducibility of Results , Education, Distance
5.
BMC Med Educ ; 24(1): 192, 2024 Feb 25.
Article in English | MEDLINE | ID: mdl-38403589

ABSTRACT

BACKGROUND: Distributed Medical Education (DME), a decentralized model focused on smaller cities and communities, has been implemented worldwide to bridge the gap in psychiatric education. Faculty engagement in teaching activities such as clinical teaching, supervision, and examinations is a crucial aspect of DME sites. Implementing or expanding DME sites requires careful consideration to identify enablers that contribute to success and barriers that need to be addressed. This study aims to examine enablers, barriers, and factors influencing psychiatrists' willingness to start or continue participating in teaching activities within Dalhousie University's Faculty of Medicine DME sites in two provinces in Atlantic Canada. METHODOLOGY: This cross-sectional study was conducted as part of an environmental scan of Dalhousie Faculty of Medicine's DME programs in Nova Scotia (NS) and New Brunswick (NB), Canada. In February 2023, psychiatrists from seven administrative health zones in these provinces anonymously participated in an online survey. The survey, created with OPINIO, collected data on sociodemographic factors, practice-related characteristics, medical education, and barriers to teaching activities. Five key outcomes were assessed, which included psychiatrists' willingness to engage in (i) clinical training and supervision, (ii) lectures or skills-based teaching, (iii) skills-based examinations, (iv) training and supervision of Canadian-trained psychiatrists, and (v) training and supervision of internationally trained psychiatrists. The study employed various statistical analyses, including descriptive analysis, chi-square tests, and logistic regression, to identify potential predictors associated with each outcome variable. RESULTS: The study involved 60 psychiatrists, primarily male (69%), practicing in NS (53.3%), with international medical education (69%), mainly working in outpatient services (41%). Notably, 60.3% lacked formal medical education training, yet they did not perceive the lack of training as a significant barrier, but lack of protected time as the main one. Despite this, there was a strong willingness to engage in teaching activities, with an average positive response rate of 81.98%. The lack of protected time for teaching/training was a major barrier reported by study participants. Availability to take the Royal College of Physicians and Surgeons of Canada Competency by Design training was the main factor associated with psychiatrists' willingness to participate in the five teaching activities investigated in this study: willingness to participate in clinical training and supervision of psychiatry residents (p = .01); provision of lectures or skills-based teaching for psychiatry residents (p < .01); skills-based examinations of psychiatry residents (p < .001); training/supervision of Canadian-trained psychiatrists (p < .01); and training and supervision of internationally trained psychiatrists (p < .01). CONCLUSION: The study reveals a nuanced picture regarding psychiatrists' engagement in teaching activities at DME sites. Despite a significant association between interest in formal medical education training and willingness to participate in teaching activities, clinicians do not consider the lack of formal training as a barrier. Addressing this complexity requires thoughtful strategies, potentially involving resource allocation, policy modifications, and adjustments to incentive structures by relevant institutions.


Subject(s)
Education, Medical , Psychiatry , Humans , Male , Psychiatrists , Cross-Sectional Studies , Canada , Psychiatry/education , Surveys and Questionnaires , Faculty, Medical
6.
BMC Med Educ ; 24(1): 669, 2024 Jun 17.
Article in English | MEDLINE | ID: mdl-38886678

ABSTRACT

BACKGROUND: Clinical associates are a health professional cadre that could be utilised in mental health task sharing in South Africa but this is training dependent. The objectives of the study were to identify the potential curricula content, training sites, and teaching modalities for undergraduate and potential postgraduate clinical associate mental health training and to identify the tasks that they should perform based on these curricula. METHODS: We utilised the Delphi method to reach consensus on items with the panel comprising psychiatrists and family physicians. The first round questionnaire of the Delphi survey was developed based on a literature review and the results from earlier phases of the overall study. The survey was administered electronically and consisted of three rounds. Following both the first and second rounds, an updated questionnaire was constructed omitting the items on which consensus was reached. The questionnaire consisted primarily of nine-point scales with consensus based on 70% of participants rating 1,2,3 or 7,8,9. RESULTS: There were 26 participants in the first round with this number falling to 23 in later rounds. There was strong consensus on a training attachment to a mental health clinic at a community health centre (CHC) at undergraduate (96.2%) and postgraduate level (100%). Consensus was reached on the importance of training on the management of six categories of disorders at the undergraduate level and nine categories of disorders at the postgraduate level. Clerking patients as a teaching modality reached 100% consensus at both undergraduate and postgraduate levels. PHC clinics, CHCs and district hospitals reached consensus as appropriate settings for clinical associates to provide mental health services. In addition, GP practices and secondary hospitals reached consensus for those with postgraduate training. Consensus was reached on ten of the 21 listed tasks that could be performed based on undergraduate training and 20 of the 21 tasks based on a postgraduate qualification in mental health. CONCLUSIONS: The Delphi panel's recommendations provide a clear roadmap for enhancing mental health curricula for clinical associates, enabling their utilisation in mental health service provision. A future postgraduate mental health qualification for clinical associates would allow for expanded task sharing.


Subject(s)
Curriculum , Delphi Technique , Psychiatry , Female , Humans , Male , Consensus , Education, Medical, Graduate , Education, Medical, Undergraduate , Mental Health , Mental Health Services , Physicians, Family/education , Psychiatrists/education , Psychiatry/education , South Africa , Surveys and Questionnaires
7.
Nord J Psychiatry ; 78(5): 440-447, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38669224

ABSTRACT

BACKGROUND: Collegial conversations are important for sustainable learning to last beyond a course. Research on collegial conversations and peer learning in the workplace during psychiatric residency courses remains sparse, however. In this study, the aim was to explore residents' opportunities for collegial conversations during and after national courses in psychiatry. METHODS: Residents in psychiatry completed an online survey including questions on opportunities for collegial conversations in their workplaces. Logistic regression was used for multivariate analysis and thematic content analysis was used for the open-ended answers where a theoretical framework of communities of practice was employed for the interpretation of the findings. RESULTS: The survey was completed by 112 residents out of 725 (15,4%). The participants reported few structured forums for collegial discussion. The results of multivariate analysis suggest that more women than men feel it is advantageous to attend courses with others from the same workplace or from the same group of residents, described here as a team. The analysis of qualitative data identified how opportunities for collegial conversations differ across contexts and the type of values that are attached to team participation in residency courses. CONCLUSIONS: This study highlights the importance of collegial conversations as a way to sustain the learning from residency courses into the workplace. By learning about residents' perceptions of collegial conversations during and after courses, teachers and directors may be more able to support residents' lifelong learning and professional development.


Subject(s)
Internship and Residency , Psychiatry , Workplace , Humans , Female , Male , Psychiatry/education , Adult , Workplace/psychology , Sweden , Communication , Surveys and Questionnaires , Learning
8.
Community Ment Health J ; 60(4): 813-825, 2024 05.
Article in English | MEDLINE | ID: mdl-38319528

ABSTRACT

The conceptualization of mental disorders varies among professionals, impacting diagnosis, treatment, and research. This cross-disciplinary study aimed to understand how various professionals, including psychiatrists, psychologists, medical students, philosophers, and social sciences experts, perceive mental disorders, their attitudes towards the disease status of certain mental states, and their emphasis on biological versus social explanatory attributions. A survey of 371 participants assessed their agreement on a variety of conceptual statements and the relative influence of biological or social explanatory attribution for different mental states. Our findings revealed a consensus on the need for multiple explanatory perspectives in understanding psychiatric conditions and the influence of social, cultural, moral, and political values on diagnosis and classification. Psychiatrists demonstrated balanced bio-social explanatory attributions for various mental conditions, indicating a potential shift from the biological attribution predominantly observed among medical students and residents in psychiatry. Further research into factors influencing these differing perspectives is necessary.


Subject(s)
Mental Disorders , Psychiatry , Psychotic Disorders , Students, Medical , Humans , Concept Formation , Mental Disorders/diagnosis , Mental Disorders/therapy , Mental Disorders/psychology , Psychiatry/education
9.
Psychiatr Q ; 95(2): 271-285, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38880831

ABSTRACT

Transcranial magnetic stimulation (TMS) is a non-invasive method of neuromodulation with heterogeneous usage between countries, which may be potentially influenced by healthcare professionals' opinions. This study aimed to assess the knowledge, acceptability, and attitudes of mental health professionals in Spain towards TMS. A cross-sectional multicentric study was conducted using an online survey, with 219 participants including psychiatrists, psychologists, and residents. Nearly 100% of participants correctly answered theoretical aspects related to the rationale and indications of TMS. Although only 55% considered TMS effective, 80% would refer patients if TMS were available at their workplace, and 74% would undergo TMS if experiencing depression. 85% believed neuromodulation training should be increased in residency, and 73% demanded TMS inclusion in public hospitals. Teaching staff and psychologists defined TMS as a last resort (p = 0.03 and 0.045). Both disagreed on its ease of use (p < 0.001) and patient referral (p = 0.01), considering an impact on the therapeutic bond (p = 0.029). Previous TMS training, clinical experience, or availability of TMS at the workplace, were associated with better knowledge, a higher perception of efficacy and utility in treating resistant patients (all p < 0.05). In conclusion, surveyed mental health professionals in Spain demonstrated good knowledge of the technique and positive opinions regarding its utility. Findings emphasized limited clinical experience of the sample, a call for training programs, and the demand for the inclusion of TMS in the portfolio of Spanish public hospitals.


Subject(s)
Attitude of Health Personnel , Health Knowledge, Attitudes, Practice , Health Personnel , Transcranial Magnetic Stimulation , Humans , Spain , Cross-Sectional Studies , Female , Male , Adult , Health Personnel/statistics & numerical data , Health Personnel/education , Middle Aged , Psychiatry/education , Surveys and Questionnaires , Psychology
10.
Australas Psychiatry ; 32(4): 365-369, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38597339

ABSTRACT

OBJECTIVE: To reflect on the importance of teaching formulation skills in psychiatry training and explore how creative writing, particularly writing poetry, can help achieve this goal. CONCLUSIONS: It is vital that formulation skills are embedded throughout psychiatry training. Formulations have an artistic element, and writing poetry can help foster a capacity for curiosity that can assist trainees in developing these skills.


Subject(s)
Creativity , Poetry as Topic , Psychiatry , Writing , Humans , Psychiatry/education , Education, Medical/methods
11.
Acad Psychiatry ; 48(2): 163-167, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38279072

ABSTRACT

OBJECTIVES: The current study investigated the gap between actual and expected work responsibilities of psychiatry vice chairs of education (VCEs), their work satisfaction, and perceived work barriers. METHODS: Psychiatry VCEs were identified through professional memberships and school websites within the USA. In 2021, identified VCEs were emailed an anonymous survey that was based on past research on roles and responsibilities of VCEs. Through qualitative and quantitative questions, the survey assessed demographic characteristics, actual and expected work responsibilities, work satisfaction, and work barriers during time spent in the VCE role. RESULTS: Of 57 identified psychiatry VCEs, 32 (56.1%) completed the survey. Most respondents (59.4%) said their department/institution did not have a written VCE job description. There were gaps between actual and expected VCE responsibilities, especially with the performance review of education leaders (Δ - 11; actual n = 20 vs. expected n = 31). The greatest satisfaction came from mentoring trainees/faculty (respectively 4.88 ± 0.33 and 4.85 ± 0.37 on a 5-point scale) and overseeing/supporting educational programs (4.66 ± 0.48). Comments on work barriers included limited protected time (n = 11), education budget constraints (n = 6), and having multiple leadership roles (n = 5). The actual full-time equivalent in the VCE role was significantly lower than expected (p < .001). CONCLUSION: Considering the role of psychiatry VCEs remains relatively new and is evolving, adequate allocation of resources and improved job descriptions may help close the gap between expected and actual responsibilities. The current findings can assist in developing such job descriptions to attract and define the work of a VCE based on specific responsibilities and associated work satisfaction.


Subject(s)
Faculty , Psychiatry , Humans , Leadership , Surveys and Questionnaires , Psychiatry/education , Job Satisfaction , Faculty, Medical
12.
Acad Psychiatry ; 48(3): 227-232, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38478200

ABSTRACT

OBJECTIVE: The goal of this study was to assess an online collection of brief educational resources (videos, case studies, articles) for teaching a broad range of concepts relating to neuroscience in psychiatry. METHODS: A national sample of 52 psychiatrists enrolled in the study. Forty (77%) completed an assessment before and after having access to the educational resources for 4 weeks. Pre- and post-assessments were compared using paired t-tests. Fifteen participants were randomly selected to participate in a semi-structured interview. RESULTS: The mean knowledge score increased on a multiple-choice quiz from 46.9 to 86.4% (p < .01). Based on a 5-point Likert rating, participants reported significant gains in self-confidence in their ability to integrate a neuroscience perspective into their clinical work (p = .03) and to discuss neuroscience with their patients (p = .008). Participants rated the extent that they applied neuroscience concepts (such as neurotransmitters, genetics, epigenetics, synaptic plasticity, and neural circuitry) to their overall case formulation and treatment plan over the past typical work week and how often they discussed these elements with patients. Significant gains were noted across all elements (p ≤ .001). Overall satisfaction with the resources were high: participants agreed that the content was useful and relevant (100%) and the teaching resources were engaging (95%). On semi-structured interviews, participants appreciated the mixed teaching approaches and the brief format. Many commented on how the resources impacted their clinical practice. CONCLUSIONS: Brief online teaching resources may be an effective approach for enhancing neuroscience education among psychiatrists and may help facilitate the integration of neuroscience into clinical practice.


Subject(s)
Neurosciences , Psychiatry , Humans , Neurosciences/education , Psychiatry/education , Adult , Female , Internet , Male , Curriculum , Internship and Residency , Education, Distance
13.
Australas Psychiatry ; 32(3): 242-246, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38351657

ABSTRACT

OBJECTIVE: Trainees and Fellows of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) work in complex interpersonal and organisational environments. Engagement in supervision can be a helpful way for trainees and Fellows to achieve interpersonal, professional, and organisational success. Supervision comes in many forms depending on the stage and state of one's career. An awareness of different supervision models is relevant to trainees' understanding of what is expected of them and their supervisors in their work and educational contexts. This paper explores the taxonomy of supervision models available to RANZCP trainees and Fellows in Australia and New Zealand. CONCLUSION: Supervision is a heterogeneous concept with multiple aims, outcomes, and processes that change with ones' stage of career.


Subject(s)
Fellowships and Scholarships , Psychiatry , Humans , New Zealand , Psychiatry/education , Australia , Fellowships and Scholarships/organization & administration , Societies, Medical/organization & administration
14.
Acad Psychiatry ; 48(4): 351-356, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38844654

ABSTRACT

OBJECTIVE: Increasing evidence demonstrates that climate change has effects on mental health. Given the magnitude of climate change's health consequences, mitigation and adaptation will require massive societal changes and the involvement of individuals and professional organizations. The aim of this research was to assess the views of psychiatrists and psychiatrists-in-training about climate change and its effects on health, perceived barriers to discussing climate change in their clinical, teaching, research, and advocacy work, personal preparedness for climate action, and expected roles of their professional organizations. METHODS: The authors administered an online anonymous survey to members of two mid-Atlantic professional psychiatric organizations. Measures included an adaptation of The International Climate and Health Survey and demographic and career characteristics. Descriptive statistics for categorical variables were conducted. RESULTS: The majority of the 67 participants who completed the survey were White and senior in their career, and almost all were clinicians. Most were concerned about climate change and its mental health effects on patients and supported their organizations' engagement in activities related to this topic. Barriers to engagement in climate change action included lack of time and believing it would not make a difference. CONCLUSIONS: These findings demonstrate a desire of psychiatrists involved in teaching, research, and clinical work to address climate change and a need for training. These findings highlight the need for preparedness as newer generations face more disasters related to climate change, and experience psychological distress related to climate change.


Subject(s)
Attitude of Health Personnel , Climate Change , Psychiatry , Humans , Psychiatry/education , Female , Male , Adult , Surveys and Questionnaires , Middle Aged , Psychiatrists
15.
Acad Psychiatry ; 48(3): 254-257, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38321353

ABSTRACT

OBJECTIVES: This study aimed to identify factors affecting current general psychiatry residents' interest in child and adolescent psychiatry (CAP) at Lehigh Valley Health Network (LVHN). Furthermore, it aimed to identify areas for improvement in clinical education to address the shortage of child psychiatrists at the institution at the time of this study. METHODS: An electronic anonymous pre-implementation survey was sent to all the current general psychiatry residents at LVHN. It assessed the most important factors for trainees in deciding their career paths into CAP, their comfort level with children and families, and overall CAP and related systems-based knowledge. Interventions based on the survey results were implemented in the LVHN psychiatry residency program. The residents then completed a post-intervention survey to assess the impact of these interventions on their perspectives toward CAP. RESULTS: CAP rotation experience and work with families were strong influencers for general psychiatry residents at LVHN in pursing CAP. Systems-based knowledge was particularly lacking compared to overall CAP knowledge. Educational interventions that were implemented at LVHN led to improvements in residents' sense of competence working with children and families with no net loss of interest in CAP. CONCLUSIONS: Educational modifications enhanced attitudes toward CAP among LVHN general psychiatry residents. Implementing such modifications at other residency programs may be likewise effective in retaining interest in CAP among their general psychiatry residents.


Subject(s)
Adolescent Psychiatry , Career Choice , Child Psychiatry , Internship and Residency , Humans , Child Psychiatry/education , Adolescent Psychiatry/education , Female , Surveys and Questionnaires , Male , Adult , Attitude of Health Personnel , Psychiatry/education
16.
Australas Psychiatry ; 32(4): 375-382, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38705873

ABSTRACT

OBJECTIVE: To evaluate New South Wales (NSW) psychiatrists' and psychiatry trainees' knowledge and attitudes towards eating disorders (EDs). METHOD: A total of 1781 psychiatrists and trainees in NSW were invited to complete an anonymous questionnaire assessing ED confidence, knowledge and attitudes. RESULTS: A total of 51 doctors responded to the survey, with 38 completing all items. Significant knowledge gaps were revealed. Respondents expressed a desire for more ED training. CONCLUSION: Enhanced ED training in psychiatry education and incorporating the lived experience voice to improve attitudes appear necessary.


Subject(s)
Attitude of Health Personnel , Feeding and Eating Disorders , Health Knowledge, Attitudes, Practice , Psychiatry , Humans , Psychiatry/education , Feeding and Eating Disorders/therapy , New South Wales , Surveys and Questionnaires , Male , Female , Adult , Psychiatrists
17.
Australas Psychiatry ; 32(4): 359-364, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38739630

ABSTRACT

OBJECTIVE: The Objective Structured Clinical Examination (OSCE) has been used for clinical assessment of a broad range of medical student competencies in Psychiatry and Addiction Medicine. However, there has been little research into online assessments. We investigated the virtual OSCE (v-OSCE) from the user perspective to better understand its acceptability, usefulness, benefits, challenges and potential improvements. METHODS: At the conclusion of the v-OSCE, all participants (medical students, examiners and simulated patients) were invited to participate in a brief online survey, based on the Technology and Acceptance Model. Freeform qualitative feedback was also obtained to explore participants' experiences and attitudes. RESULTS: Participants reported the v-OSCE was acceptable, efficient, convenient and easy to use. It was perceived as useful for demonstrating students' interviewing skills and interacting with the simulated patient. Benefits included greater convenience, reduced stress and travel time. Challenges were similar to those experienced in 'real world' telepsychiatry, primarily related to assessment of non-verbal cues and emotional prosody. CONCLUSIONS: Our findings inform recommendations for improving online examinations. These include increased preparation, practice and professionalism, to better simulate the in-person experience. Study credibility was strengthened by the triangulation of qualitative, quantitative and psychometric data.


Subject(s)
Addiction Medicine , Clinical Competence , Educational Measurement , Psychiatry , Students, Medical , Humans , Psychiatry/education , Addiction Medicine/education , Educational Measurement/methods , Educational Measurement/standards , Adult , Patient Simulation , Male , Female
18.
Australas Psychiatry ; 32(1): 89-94, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38151322

ABSTRACT

OBJECTIVES: Eating disorders are serious psychiatric conditions that affect people of all ages. Many psychiatry trainees' first and only experience with eating disorders during training is their Child and Adolescent Psychiatry (CAP) rotation. This study aimed to explore the learning experience of psychiatry trainees working within an Eating Disorder Program (EDP) during their CAP rotation. METHODS: Fifteen trainees who participated in the EDP were recruited to complete an online survey and focus groups; a thematic analysis design was used to identify themes emerging from their responses. RESULTS: Themes emerged from the trainee learning experience of working in the EDP around what they found they learnt, what aided that process, what was difficult, and recommendations for future improvement. CONCLUSIONS: This study provided insight into the trainee experience in an EDP as one example of how trainees can learn about eating disorders and one way that could inform future workforce and training initiatives.


Subject(s)
Child Psychiatry , Feeding and Eating Disorders , Internship and Residency , Psychiatry , Child , Humans , Adolescent , Psychiatry/education , Surveys and Questionnaires , Curriculum , Adolescent Psychiatry/education , Child Psychiatry/education
19.
Acad Psychiatry ; 48(4): 329-333, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38740718

ABSTRACT

OBJECTIVE: Feedback is a critically important tool in medical education. This pilot program applies and evaluates a competency-based approach to develop residents' skills in providing feedback to medical students. METHODS: In 2018-2019, a competency-based resident feedback skills program incorporating videorecording of skills, multi-source feedback using assessment tools with validity evidence, and sequential deliberate practice was piloted in a single-center, prospective study at the University of Rochester. Study participants included eight second-year psychiatry residents and 23 third-year clerkship students. After an introduction to foundational feedback concepts in didactic sessions, residents were videorecorded providing feedback to medical students. Recordings were reviewed with a faculty member for feedback. Skills were assessed by students who had received resident feedback, residents, and faculty utilizing a tool with validity evidence. Observations were repeated a total of three times. RESULTS: Mean feedback scores increased from 2.70 at the first feedback observation, to 2.77 at the second feedback observation, to 2.89 at the third feedback observation (maximum 3.00 points). The differences between the first and third sessions (0.19) and second and third sessions (0.12) were statistically significant (p values were < .001 and .007, with SE of 0.4 and 0.4, respectively). CONCLUSIONS: The observed competency-based feedback skills training program for residents using sequential, multi-source review and feedback was feasible and effective. Direct observation is a key component of high-quality feedback, and videorecording is an efficient methodology for observations, enabling both direct observation by the assessor and opportunity for enhanced self-assessment by residents viewing themselves in the feedback encounter.


Subject(s)
Clinical Competence , Competency-Based Education , Internship and Residency , Psychiatry , Humans , Competency-Based Education/methods , Psychiatry/education , Pilot Projects , Formative Feedback , Prospective Studies , Students, Medical , Feedback , Educational Measurement , Clinical Clerkship , Adult , Female , Male
20.
Acad Psychiatry ; 48(3): 244-248, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38570407

ABSTRACT

OBJECTIVE: Mental health treatment is often initiated in primary care settings, but many primary care providers (PCPs), residents, and medical students report discomfort in managing psychiatric conditions. This study evaluated the effect of an educational workshop that featured an evidence-based psychopharmacology clinical decision support tool (CDST) on trainee confidence and willingness to treat psychiatric conditions. METHODS: Participants completed pre- and post-workshop surveys. Nine months after the workshop, a subset of trainees participated in a focus group. RESULTS: Of the participants, 62.5% of the obstetrics-gynecology (OB-GYN) resident physicians (10/16) and 100% of the medical students (18/18) completed both pre- and post-surveys. Following the workshop, OB-GYN resident physicians reported significantly improved confidence in treating psychiatric disorders (p < 0.001), sense of having psychiatric support tools (p < 0.001), and knowledge of treating psychiatric disorders (p = 0.021). Medical students reported significantly improved confidence in treating psychiatric disorders (p < 0.001), willingness to devise treatment plans for psychiatric disorders (p = 0.024), sense of having psychiatric support tools (p < 0.001), knowledge of treating psychiatric disorders (p < 0.001), and comfort in presenting a psychiatric treatment plan to an attending (p = 0.003). Most focus group participants (93.75%; 15/16) reported that they continued to use the CDST, and it increased their confidence in formulating psychiatric treatment plans. CONCLUSIONS: These findings suggest that educational workshops that introduce high-quality psychopharmacology CDSTs may be an effective method for improving provider comfort in treating psychiatric disorders.


Subject(s)
Internship and Residency , Students, Medical , Humans , Students, Medical/psychology , Female , Primary Health Care , Male , Adult , Clinical Competence , Psychiatry/education , Obstetrics/education , Focus Groups , Gynecology/education , Attitude of Health Personnel , Psychopharmacology/education , Mental Disorders/therapy , Surveys and Questionnaires , Decision Support Systems, Clinical , Education
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