To The Editor: Recent efforts by the Accreditation Council for Medical Education (ACGME) to expose psychiatry residents to a research experience during their 4 years of training has been problematic for many predominately clinical programs. A debate about how to effectively engage psychiatric residents in research is ongoing throughout academic institutions. In the Department of Psychiatry and Human Behavior at Thomas Jefferson University, we developed a required 7-week, 1-day per week research rotation during which PGY-3 residents are asked to write a proposal. From our experience, we found that residents have many questions emanating from their clinical experiences. Our approach is threefold: First, residents develop and refine a clinical question of interest to them and, with our supportive guidance, formulate a hypothesis. Second, they are asked to perform a limited literature search and this material is discussed with a member of the faculty. Third, they complete our Institutional Review Board Forms and a brief proposal to answer their query. The proposal includes sections on background and significance, specific aims, population characteristics, and subject consent procedures, all of which help the residents to focus and express their ideas in a practical format. Throughout the preparation and completion of their research rotation, we meet with the residents to discuss the write-up and feasibility of their proposal (about 45 minutes per week). The required rotation contains aspects of the ACGME guidelines in that the rotation helps to foster the development of skills required to conduct research. Our goal is to foster the development of some research skills by having the residents answer a clinical question of interest to them.
Competency rating for the activity was problematic. Initially, we tried to use Thomas Jefferson’s standard Clinical Rotation Form, but it did not capture the research activity residents experienced on the rotation. To address this problem, we generated a list of research performance items categorized according to the ACGME General Competencies:
• Does the resident understand how to generate a research question?
• Does the resident demonstrate knowledge of research methods?
• Does the resident understand how to focus a research question?
B. Evidence-base learning and improvement
• Can the resident utilize research staff to improve knowledge and skill?
• Can the resident search literature and use the information to guide their project development?
• Can the resident recognize and learn from his/her own efforts?
• Has the resident demonstrated interest and involvement in scholarly activities such as presentations and publications?
• Can the resident negotiate mutually agreeable goals with the research supervisor?
• Can the resident work effectively with other professionals to conduct research in outpatient settings?
• Can the resident present the research proposal and results in a well-organized, clear, and appropriate manner?
• Does the resident recognize ethical issues in research?
• Does the resident maintain adequate documentation and results, including adverse events, for clinical research?
• Is the resident reliable, responsible, and considerate in carrying out research responsibilities?
E. System-based paractice
• Is the resident aware of the social and financial resources necessary to conduct research?
• Can the resident work effectively in a multidisciplinary team?
• Has the resident prepared documentation suitable for review by the Institutional Review Board?
We find this approach to be a rewarding experience for the residents. Of the five residents who have completed this rotation, four residents plan to complete their research proposals during an elective in their fourth year of training.