[Specialist Training in Psychiatry and Psychotherapy : Evaluation of the East Westphalia-Lippe Academy curriculum]. / Facharztweiterbildung Psychiatrie und Psychotherapie : Evaluation des Curriculums eines Weiterbildungsverbunds in Ostwestfalen-Lippe.

BACKGROUND: Despite of the undisputed impact of education quality on becoming a specialist in psychiatry and psychotherapist, systematic studies in this field do not exist in Germany, apart from the evaluation of practical education by the medical councils. MATERIALS AND METHODS: The Akademie-OWL, an education union of psychiatric clinics in the East Westphalia region of Germany, has provided 12-item questionnaire-based routine evaluations of theoretical education seminars since 2009. Seminars are held by consultants of psychiatry and psychotherapy within six separate weeks over a period of four years. All lecturers receive feedback from the evaluation. The results of this ongoing evaluation are presented using a typical example and in an aggregated format as a time series on the basis of one global item. RESULTS: The data show that (1) the full range of a five-point Likert scale is used by the candidates, (2) psychiatric competences of the lecturers are more positively evaluated than their didactic competences, (3) neither within the four-years period of psychiatric education nor between different generations of candidates are systematic changes of evaluation results observed, and (4) minor to moderate differences of evaluation were observed between the different thematic fields of psychiatry and psychotherapy. DISCUSSION: These results indicate the need of more systematic education research on establishing valid and reliable specific instruments as well as the need of systematic training of didactic competences of teaching consultants.

Generating visual images: units and relations.

Three major conclusions were drawn from the results of the experiments reported in this article: First, mental images may be constructed by amalgamating images of individual parts, and an increment of time is required to add each additional part to an image. This was true when "parts" were defined by the Gestalt laws of proximity, continuity, or similarity, when parts of objects were presented on separate pages initially and the subject mentally "glued" them together into a single image, and when the number of parts was varied by altering the way an ambiguous geometric form was described. Second, descriptive information can be used in constructing images. Subjects were able to image scenes in accordance with descriptions that specified the relative distances between component objects of the scene. More time was required to form images of scenes containing more objects, and more time was later required to scan between two imaged objects if they were mentally pictured at greater distances. Third, the ease of imaging a unit depends on how much material is included in each unit and on how difficult it is to locate where the unit should be placed relative to the existing portions of an image. This conclusion was supported by the finding that subjects require less time to image arrays composed of units containing fewer letters and require less time if arrays are composed of relatively discriminable letters than if arrays are composed of relatively indiscriminable letters. Finally, in two of the experiments nonimagery control groups were tested to demonstrate that generating an image is not the same as simply retrieving memorized verbal information or reviewing information in some more abstract format.

Long-term selenium exposure.

Metabolic pathways and toxic effects of long-term selenium exposure in animal models and humans have both similarities and significant differences. In animal models the target organ is the liver, in which chronic cirrhosis develops. In man the target organ appears to be the lung, which manifests acute "rose cold," or, as in our patient, a chronic granulomatous hypersensitivity. Our data indicate not only a different target organ than would have been predicted from animal models, but also a difference in the distribution of selenium in human tissues. Long-term use of selenium favors production of dimethylselenide, which is excreted by the lungs and should be considered a pulmonary toxin. The ramifications of these findings may require a change in the monitoring techniques of long-term industrial exposure and mandate a close follow-up of selenium as a health fad.