Utilization of Moderate-Duration Summary Podcasts Compared to Long-Duration Podcasts for Psychiatry Education by Canadian Pre-clerkship Medical Students.

OBJECTIVE: The ideal length of podcasts for undergraduate medical education is unclear. Although many medical schools post full-lecture podcast recordings, there is increasing evidence that podcasts of shorter duration may be a more effective educational tool. Data on podcast utilization for psychiatry education in particular remain limited. This study aimed to compare traffic statistics (views and downloads) of both moderate- and long-duration podcasts. METHODS: Resident-driven, 5- to 15-min, moderate-duration audiovisual podcasts ("summary podcasts") were created to supplement the existing full-lecture podcast recordings ("long podcasts") during the 22-day University of Calgary medical school pre-clerkship psychiatry curriculum from November to December 2019. The authors compared traffic statistics including number of views and downloads of summary podcasts against long podcasts. RESULTS: Six lectures during the curriculum had both long podcasts and summary podcasts available to students. Overall, there was no statistically significant difference between the mean combined views and downloads of the summary podcasts compared to the long podcasts. When looking at views and downloads across the span of the curriculum, the long podcasts were predominantly accessed in the days following the lecture, with the summary podcasts being accessed more frequently in the days preceding the final examination. CONCLUSIONS: This study suggests that both long podcasts and summary podcasts were accessed by students. The differing patterns of when each type of podcast was accessed may indicate a preference for the summary podcasts being used as review tools, rather than as a primary means of learning the material.

Wellbeing and mental health amongst medical students in Canada.

RESEARCH: There is abundant data revealing that there is significant rate of rates of Psychiatric morbidity, psychological stress, and burnout in the medical student population. A core study group in the UK collaborated with 12 countries around the world to review medical student wellness. In this context we surveyed 101 medical students at the Cummings medical school, Calgary, Canada during the height of the COVID pandemic regarding their wellbeing and mental health. RESULTS/MAIN FINDINGS: Prior to medical school 27% reported a diagnosis with a mental disorder. Whilst at medical school 21% reported a mental health condition, most commonly an anxiety disorder and or depressive disorder. The most commonly reported source of stress was study at 81%, the second being relationships at 62%, money stress was a significant source of stress for 35%, and finally 10% reported accommodation or housing as stressful. Interestingly only 14% tested CAGE positive but 20% of students reported having taken a non-prescription substance to feel better or regulate their mood. Seventy-five percent of medical students met specific case criteria for exhaustion on the Oldenburg Burnout inventory 74% met criteria for the GHQ questionnaire. CONCLUSIONS: These findings confirm that medical students are facing significant stressors during their training. These stressors include, in order of frequency, study, relational, financial, and accommodation issues. Nonprescription Substance use was a common finding as well as exhaustion and psychiatric morbidity. Future interventions pursued will have to address cultural issues as well as the organizational and individual determinates of stress.

Wellbeing and mental health amongst medical students in Canada.

Across the world there is significant evidence that medical students have high levels of mental ill-health and psychological distress with subsequent concerning effects on personal and occupational functioning. In Canada, recent studies have demonstrated worrying levels of burnout and depressive symptoms among practising doctors. In common with other countries, Canadian medical students are also subject to a high-pressure environment - with long clinical weeks and significant stressors - and these soon-to-be doctors have been previously shown to already demonstrate high levels of burnout. We surveyed 69 medical students at the Cumming School of Medicine, Calgary regarding their wellbeing and mental health. 26% of the students had been diagnosed with a mental health condition prior to medical school, while 36% reported currently seeing a professional regarding their mental ill-health, with anxiety disorders forming the most commonly reported conditions. 83% reported their studies as a significant source of stress. 22% tested as CAGE positive and a number of students reported using other substances. 70% of medical students met specified case criteria for exhaustion on the Oldenburg Burnout Inventory. These findings speak to the need for access to mental health services, evidence-based individual counselling, and inclusive activities that fit within organisational frameworks to better improve the mental health and wellbeing of medical students in Canada.

Exploring Perceptions of Early-Career Psychiatrists About Their Relationships With the Pharmaceutical Industry.

OBJECTIVES: The pharmaceutical industry has engaged physicians through medical education, patient care, and medical research. New conflict of interest policy has highlighted the challenges to these relationships. The objective of this study was to explore the perceptions that early career psychiatrists (e.g. those within 5 years of entering practice) have regarding their relationship with the pharmaceutical industry. METHODS: Data were collected through semi-structured interviews and were analysed using a grounded theory methodology. Interviews were conducted and analyzed in an iterative way using a constant comparison approach in which data were collected and open coded for themes and subthemes. As new interviews were conducted, the themes were applied to data along with emergent themes and previous interviews recoded until additional interviews failed to provide new themes and thematic saturation was achieved. Through axial coding, a process of relating codes (categories and concepts) to each other, the theory was generated to explain the core variable mediating perceptions participants had about the relationship with industry. RESULTS: The participants described increasing frequency of experiences with industry throughout training into practice. Their perceptions developed through training, physician culture, industry promotion, and their own practices. In managing the relationship with industry, participants would either avoid interactions or engage in behaviors aimed to reduce the risk of influence. Maintaining one's professional integrity was the underlying driver used to manage the relationship with industry. CONCLUSIONS: Psychiatrists develop perceptions about industry through experience and observation leading them to develop their own strategies to manage these relationships while maintaining their professional integrity.

Factors affecting recruitment into psychiatry: a canadian experience.

OBJECTIVE: There is a projected shortage of psychiatrists in Canada in forthcoming years. This study assessed factors in medical school education that are associated with students selecting psychiatry first and matching as a discipline. METHOD: The Canadian Organization of Undergraduate Psychiatry Educators (COUPE) conducted telephone interviews and sent e-mail questionnaires to the 17 medical schools across Canada; all schools provided data for 2012. Relevant data were obtained from the Canadian Resident Matching Service. Statistics were performed using v12 STATA program, and significance was set at a p value of <0.05. RESULTS: Medical student enrollment ranged from 54 to 266 students (mean = 158 ± 16). Of these students, 4.9 ± 0.6 % ranked psychiatry as their first choice for residency. Final match results yielded similar numbers at 5.0 ± 0.6 %. Ten out of 17 programs filled all psychiatry residency positions, whereas the remaining 7 programs had vacancy rates from 5 to 100 % (mean = 43.4 ± 15.1 %). Medical students were exposed to an average of 2.8 ± 0.5 pre-clerkship psychiatry weeks and 6.2 ± 0.3 clerkship weeks. Linear regression analysis demonstrated that the percentage of graduating medical students entering a psychiatry residency program could be predicted from the number of weeks of pre-clerkship exposure (p = 0.01; R(2) = 0.36) but not from the number of clerkship weeks (p = 0.74). CONCLUSIONS: This study indicates that the duration of pre-clerkship exposure to psychiatry predicts the number of students selecting psychiatry as their first choice as a discipline. Thus, increasing the duration of pre-clerkship exposure may increase the enrollment of medical students into psychiatry.

Randomized trial of a decision aid for patients with cystic fibrosis considering lung transplantation.

RATIONALE: We developed an evidence-based decision aid for patients with advanced cystic fibrosis considering referral for lung transplantation. OBJECTIVES: To prospectively evaluate whether use of the decision aid increased knowledge about the options, improved realistic expectations, and decreased decisional conflict in adult patients. METHODS: We performed a single-blind randomized controlled trial involving 149 adult patients with cystic fibrosis with an FEV(1)

Applying new techniques to an old ally: a qualitative validation study of the Edinburgh Postnatal Depression Scale.

PURPOSE: To present the results of a study that used cognitive interviewing techniques to interview pregnant and postpartum women about their experience of completing the Edinburgh Postnatal Depression Scale. BACKGROUND: Most large-scale initiatives that screen women for depression during pregnancy and the first 3-6 months postpartum use the Edinburgh Postnatal Depression Scale. The scale is a 10-item instrument that is commonly self-administered and has been extensively validated using quantitative methods. However, the authors could find no published research that applied newer in-depth methods for assessing comprehension and interpretation to the scale. PARTICIPANTS AND METHODS: The design was an in-depth, qualitative instrument validation study. A total of nine pregnant and postpartum women who were referred for psychiatric care completed the Edinburgh Postnatal Depression Scale and then were interviewed about their experiences. Cognitive interviewing techniques were used to generate an in-depth examination of how women understood and interpreted the items, and to explore meaning, acceptability, and disclosure issues. RESULTS: Overall, participants felt that the instrument was straightforward, easy to read, and relatively simple to answer. It is important to note that eight of the nine participants had completed some post-secondary education and, thus, participant's average literacy level was relatively high. Women identified minor concerns or expressed interpretive differences on six of the ten Edinburgh Postnatal Depression Scale items. These six items are examined in detail. CONCLUSION: The results suggest that it may be useful for the Edinburgh Postnatal Depression Scale to be administered in the context of a discussion about a woman's mental health concerns, which could involve asking her for more details about her responses to particular items that have been identified in this study as potentially problematic. This will help ensure that practitioners are accurately interpreting a woman's answers to the items on the scale.