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Guidelines, Algorithms, and Evidence-Based Psychopharmacology Training for Psychiatric Residents

Drs. Osser and Levitt are with the Department of Psychiatry at the Brockton Veteran’s Administration Medical Center, Harvard Medical School, Brockton, Massachusetts. Dr. Patterson is with the Department of Psychiatry at the McLean Hospital, Harvard Medical School, Belmont, Massachusetts. Address correspondence to Dr. Osser, Brockton VAMC, 940 Belmont St., Brockton, MA 02301; david.osser{at}dmh.state.ma.us (E-mail). Copyright © 2005 Academic Psychiatry.

OBJECTIVE: The authors describe a course of instruction for psychiatry residents that attempts to provide the cognitive and informational tools necessary to make scientifically grounded decision making a routine part of clinical practice. METHODS: In weekly meetings over two academic years, the course covers the psychopharmacology of various psychiatric disorders in 32 3-hour modules. The first half of each module is a case conference, and the second is a literature review of papers related to the case. The case conference focuses on the extent to which past treatment has been consistent with evidence-supported guidelines and algorithms, and the discussants make recommendations that take the relevant scientific evidence into consideration. The second half of each module focuses on two papers: 1) a published guideline, algorithm, or review article and 2) a research study. RESULTS: Residents absorb a comprehensive overview of recommended clinical practices and acquire skills in assessing knowledge that affects decision making. Satisfaction with the course is rated highly. CONCLUSION: The course appears useful by its face validity, but research comparing the attitudes and practice outcomes of graduates of this course compared with recipients of other training methods is needed.

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