Acad Psychiatry recent issues

Education on Genetics for Psychiatric Residents [EDITORIALS]

Layde, J. B., Roberts, L. W. — Thu, 11 Mar 2010 11:21:16 PST

Psychiatric Education in the Genomic Era [COMMENTARIES]

Lehner, T., Insel, T. — Thu, 11 Mar 2010 11:21:16 PST

Remembered [COMMENTARIES]

Doyle, M. — Thu, 11 Mar 2010 11:21:16 PST

Educational Aspects of Interactions With the Pharmaceutical Industry [EDITORIALS]

Balon, R. — Thu, 11 Mar 2010 11:21:16 PST

Medical Education Meets Pharma: Moving Ahead [COMMENTARIES]

Yager, J., Feinstein, R. E. — Thu, 11 Mar 2010 11:21:16 PST

Real Doctors [COMMENTARIES]

Caplan, J. P. — Thu, 11 Mar 2010 11:21:16 PST

Key Aspects of Physician and Pharmaceutical Industry Relationships for Trainees [COMMENTARIES]

Jain, S. — Thu, 11 Mar 2010 11:21:16 PST

Delta [COMMENTARIES]

Parker, A. T. — Thu, 11 Mar 2010 11:21:16 PST

Psychiatric Resident and Faculty Views on and Interactions With the Pharmaceutical Industry [RESEARCH ARTICLES]

Misra, S., Ganzini, L., Keepers, G. — Thu, 11 Mar 2010 11:21:16 PST

OBJECTIVE: Sales visits, or detailing, by pharmaceutical industry representatives at academic institutions has been increasingly criticized. The authors surveyed psychiatric residents and faculty members on their views and interactions with representatives of the pharmaceutical industry. METHODS: In 2007, a 46-item online survey measuring attitudes toward and interactions with pharmaceutical industry representatives was sent to 49 faculty psychiatrists and 40 psychiatric trainees (residents and fellows) at a Northwest academic medical center. RESULTS: Sixty-five percent (N=58) of surveys were completed. Two-thirds of respondents did not agree that pharmaceutical representatives have an important teaching role. Only 24% of faculty and 18% of trainees agreed that pharmaceutical representatives provide useful and accurate information on new drugs. Forty-one percent of faculty and 53% of trainees agreed that pharmaceutical representatives should be restricted from making presentations on campus. Trainees were less likely than faculty to agree that they would maintain contact with representatives if no gifts or food were distributed. Nevertheless, most respondents endorsed that pharmaceutical companies supported important conferences, and more than 90% had attended an industry-sponsored event in the previous year. In open-ended questioning, respondents revealed worries that bans would undermine the ability to secure national speakers and to support other activities that residents valued. CONCLUSION: Faculty and psychiatric residents and fellows do not view pharmaceutical representatives as having an important teaching role and mistrust the information they offer but believe that loss of industry financial support does adversely affect educational and other highly valued activities. They favor greater policy restrictions but do not support an outright ban on pharmaceutical support.

Reflections of an Outpatient Medical Director [RESEARCH ARTICLES]

Huh, J. — Thu, 11 Mar 2010 11:21:16 PST

The Current State of Genetics Training in Psychiatric Residency: Views of 235 U.S. Educators and Trainees [RESEARCH ARTICLES]

Hoop, J. G., Savla, G., Roberts, L. W., Zisook, S., Dunn, L. B. — Thu, 11 Mar 2010 11:21:16 PST

OBJECTIVE: As researchers make progress in understanding genetic aspects of mental illness and its treatment, psychiatrists will increasingly need to understand and interpret genetic information specific to psychiatric disorders. Little is known about the extent to which residency programs are preparing psychiatrists for this new role. This study was designed to explore the current state of genetics education in psychiatric residency. METHODS: U.S. psychiatric residency educators and residents were invited to participate in an Internet-based survey. RESULTS: Out of 509 educators and at least 207 residents contacted, 100 educators and 135 residents from 55 geographically dispersed U.S. psychiatry training programs in diverse settings responded to the survey. Participants rated genetics as somewhat important as a curricular topic but less important than other subjects. Nearly half of the educators reported that their program had few or no faculty with adequate expertise in teaching this subject. Most residents routinely obtained family psychiatric histories when evaluating patients, but most did not feel competent to order and interpret genetic tests or to interpret papers on psychiatric genetics. CONCLUSION: This study presents a sobering picture of the state of genetics education in psychiatric residency training. Potential obstacles to improving genetics education include perceptions of the relative importance of genetics in comparison with other topics and a lack of faculty with appropriate expertise.

Training in Psychiatric Genomics During Residency: A New Challenge [RESEARCH ARTICLES]

Winner, J. G., Goebert, D., Matsu, C., Mrazek, D. A. — Thu, 11 Mar 2010 11:21:16 PST

OBJECTIVE: The authors ascertained the amount of training in psychiatric genomics that is provided in North American psychiatric residency programs. METHODS: A sample of 217 chief residents in psychiatric residency programs in the United States and Canada were identified by e-mail and surveyed to assess their training in psychiatric genetics and genomics. RESULTS: Eighty chief residents completed the survey for a response rate of 37%. Forty-five respondents (56%) reported that during their residency training they received 3 or fewer hours of training in genomics. Of these, 13 reported that they had received no training in genomics. Chief residents who received 3 or fewer hours of training were more likely to indicate that they had not actively participated in a multidisciplinary team which utilized genetic/genomic specialists than residents who had received more didactic training in genomics (p<0.001). Although 67% of 77 respondents indicated that they understood the concept of genetic predisposition to psychiatric disease, only 14% of 80 respondents indicated that they understood the role a genetic counselor could play on a clinical team. CONCLUSION: Training in the clinical applications of genomic testing has not been thoroughly implemented in some residency programs.

Neuroimaging Week: A Novel, Engaging, and Effective Curriculum for Teaching Neuroimaging to Junior Psychiatric Residents [RESEARCH ARTICLES]

Downar, J., Krizova, A., Ghaffar, O., Zaretsky, A. — Thu, 11 Mar 2010 11:21:16 PST

OBJECTIVE: Neuroimaging techniques are increasingly important in psychiatric research and clinical practice, but few postgraduate psychiatry programs offer formal training in neuroimaging. To address this need, the authors developed a course to prepare psychiatric residents to use neuroimaging techniques effectively in independent practice. METHODS: The authors present the format and curriculum of a highly interactive, 5-day intensive neuroimaging course, taught by psychiatry, neurology, radiology, nuclear medicine, and sleep medicine staff, covering psychiatrically oriented neuroanatomy; neuroimaging techniques and principles; clinical skills, including interpretation of computed tomography and MRI in neuropsychiatric cases; and formal approaches to critiquing neuroimaging research and applying its findings to clinical practice. Detailed questionnaires assessed the subjective and objective impact of the course on residents’ knowledge of, and attitudes toward, neuroimaging in psychiatry before and after the course. RESULTS: Twenty-five first-year residents completed the questionnaires. Participants were enthusiastic about the content and interested in improving their skills in interpreting clinical neuroimaging studies. By the end of the course, residents also reported large gains in subjective comfort level with neuroimaging literature appraisal and functional neuroanatomy and believed that the course was effective in meeting their own specific learning objectives. Objective measures showed significant gains in most areas of the curriculum. CONCLUSION: This short, intensive course effectively teaches clinically oriented neuroimaging principles to psychiatric residents and can be readily adapted to other postgraduate programs or continuing medical education.

State Hospital-University Collaborations: A 25-Year Follow-Up [BRIEF REPORTS]

Talbott, J. A., Faulkner, L. R., Buckley, P. F. — Thu, 11 Mar 2010 11:21:16 PST

OBJECTIVE: A formative survey of psychiatry departments 25 years ago showed strong and valued relationships between these departments and state hospitals. The authors sought to evaluate the extent of present-day collaborative relationships. METHODS: A repeat of a similar survey was sent in 2005 to 119 chairs of departments of psychiatry. RESULTS: Fifty-eight of 119 chairs (49% response rate) participated. A sustained high level of programmatic partnership was still observed, with 75% of respondents reporting ongoing administrative relationships. Seventy-four percent of respondents reported ongoing residency training relationships. CONCLUSION: These findings suggest that strong state-university collaborations have prevailed over the past 25 years despite major changes for academic health care and psychiatry residency training during this period.

Selection Factors Among International Medical Graduates and Psychiatric Residency Performance [BRIEF REPORTS]

Shiroma, P. R., Alarcon, R. D. — Thu, 11 Mar 2010 11:21:16 PST

OBJECTIVE: The authors examine the association between the selection factors used in a psychiatric residency program and subsequent clinical and academic performance among international medical graduate (IMG) candidates. METHODS: The authors completed a retrospective review of application files and residency evaluations of 50 IMG residents who completed the 4-year psychiatry training in a university-affiliated program from July 1994 through June 2004. RESULTS: United States Medical Licensing Examination (USMLE) Step 1 and personal interview appear associated with residents’ performance determined by the program director’s ranking. Standardized examinations before (USMLE Step 1 and 2) and during the residency (PRITE) were significantly correlated (USMLE 1, r=0.37; USMLE 2, r=0.40, p<0.003). Personal interview scores and psychotherapy treatment session evaluations were also significantly associated (r=0.38, p<0.003). CONCLUSION: Further research is necessary to determine predictive factors related to psychiatric residents’ performance, especially among IMGs. Adjusting current selection criteria may result in better outcomes for training programs and future psychiatrists.

A Pilot Study in Suicide Intervention Training Using a Group Intervention for Patients With Recurrent Suicide Attempts [BRIEF REPORTS]

Sockalingam, S., Flett, H., Bergmans, Y. — Thu, 11 Mar 2010 11:21:16 PST

OBJECTIVE: This article describes psychiatric trainees’ reflections regarding their participation in a psychosocial/psychoeducational group intervention for individuals with recurrent suicide attempts. METHODS: Fourteen psychiatric residents who completed at least one 20-week intervention cycle were given a 15-item questionnaire which consisted of 12 reflective statements rated on a 5-point Likert scale. The questionnaire assessed their perceptions of the training experience and subsequent comfort in managing recurrently suicidal patients. RESULTS: Thirteen residents (93%) completed the survey. Following the training experience, nearly all residents (85%) endorsed feeling more comfortable managing patients with recurrent suicide attempts. Training was perceived as having clinical and educational value and an impact on general practice. CONCLUSION: Although the intervention was associated with changes in psychiatric residents’ perceived comfort in managing patients with recurrent suicide attempts, more rigorous research examining the effects of the intervention on suicidology training is needed.

Facing Our Frustration [BRIEF REPORTS]

Krakower, S. — Thu, 11 Mar 2010 11:21:16 PST

Gender Differences in Faculty Development: A Faculty Needs Survey [BRIEF REPORTS]

Seritan, A. L., Iosif, A.-M., Hyvonen, S., Lan, M.-F., Boyum, K., Hilty, D. — Thu, 11 Mar 2010 11:21:16 PST

OBJECTIVE: The authors investigated professional development needs of faculty in the Department of Psychiatry and Behavioral Sciences at the University of California (UC) Davis, while also exploring any existing differences according to gender and academic rank. METHODS: An online survey was sent to 75 faculty members, and 41 responses (17 women, 24 men) were collected. Respondents rated 29 items on a Likert scale, from "very important" to "not important" and ranked the top three items in order of importance. RESULTS: Very important items included finding meaning in one’s work, maintaining integrity and ethics, maintaining one’s values and academic vitality, balancing personal and professional demands, a flexible work environment, and preventing and handling burnout. Results were similar across gender and rank. CONCLUSION: UC Davis men and women academic psychiatrists in different career development stages have similar needs, although paths leading to personal and professional fulfillment may vary according to gender.

CORRECTION [CORRECTION]

Thu, 11 Mar 2010 11:21:16 PST

Psychiatric OSCE Performance of Students With and Without a Previous Core Psychiatry Clerkship [BRIEF REPORTS]

Goisman, R. M., Levin, R. M., Krupat, E., Pelletier, S. R., Alpert, J. E. — Thu, 11 Mar 2010 11:21:16 PST

OBJECTIVE: The OSCE has been demonstrated to be a reliable and valid method by which to assess students’ clinical skills. An OSCE station was used to determine whether or not students who had completed a core psychiatry clerkship demonstrated skills that were superior to those who had not taken the clerkship and which areas discriminated between clerkship completers and noncompleters. METHODS: One hundred thirty-six students took a 48-item, fourth-year OSCE with one psychiatry station. Sixty-three (46%) had already completed psychiatry, and 70 (51%) had not, with three unknown. Students were to take histories, perform mental status examinations, assess dangerousness, and propose the differential diagnosis and treatment plans. RESULTS: Nine items differed significantly between completers and noncompleters, six concerning phenomenology and mental status and three concerning differential diagnosis. There were no differences regarding history, communication skills, or recommended interventions. CONCLUSION: Students may learn history taking, communication, and treatment planning in many settings. However, for the mental status examination, phenomenology, and differential diagnosis, completing a psychiatry clerkship was associated with better OSCE performance.

The Joker: A Dark Night for Depictions of Mental Illness [MEDIA COLUMN]

Camp, M. E., Webster, C. R., Coverdale, T. R., Coverdale, J. H., Nairn, R. — Thu, 11 Mar 2010 11:21:16 PST

The Psychiatry Institute for Medical Students: A Decade of Success [RESOURCE]

Andermann, L. F., De Souza, C., Lofchy, J. — Thu, 11 Mar 2010 11:21:16 PST

Evaluation of Reliability and Validity of the Psychiatry OSCE in Iran [INTERNATIONAL EDUCATION REPORT]

Thu, 11 Mar 2010 11:21:17 PST

Documentation of Program Evaluation and Written Improvement Plan [LETTERS]

Richards, M., Magen, J. G., Giuliano, C. — Thu, 11 Mar 2010 11:21:17 PST

Refining the Human Behavior Small Group Experience [LETTERS]

Averbuch, R. N., Wadsworth, C. S., Hobbs, J. A. — Thu, 11 Mar 2010 11:21:17 PST

Call for Papers [SPECIAL ARTICLES]

Thu, 11 Mar 2010 11:21:17 PST

Stigma, Hope, and Challenge in Psychiatry: Trainee Perspectives From Five Countries on Four Continents [EDITORIALS]

Roberts, L. W. — Wed, 13 Jan 2010 17:26:45 PST

Psychotherapy Training for Residents: Reconciling Requirements With Evidence-Based, Competency-Focused Practice [RESEARCH ARTICLES]

Weerasekera, P., Manring, J., Lynn, D. J. — Wed, 13 Jan 2010 17:26:45 PST

OBJECTIVE: The Accreditation Council for Graduate Medical Education (ACGME) and the Royal College of Physicians and Surgeons of Canada (RCPSC) changed the training requirements in psychotherapy, moving toward evidence-based therapies and emphasizing competence and proficiency as outcomes of training. This article examines whether the therapies selected for training are evidence based and the authors review research concerning methods for training and assessment that effectively lead to competence in these psychotherapies. METHODS: The authors searched PsycINFO and PubMed for studies from 2000 to 2009 using the terms meta-analysis, meta-analyses, and psychotherapy combined with specific psychotherapies listed in the ACGME and RCPSC requirements to determine if high-level evidence supported the use of these therapies in patients with psychiatric disorders. A similar systematic search was carried out using the same search engines for all years with the terms psychotherapy, competence, training, evaluation, and therapist rating scales for the specific therapies selected by the ACGME and the RCPSC to determine if empirically validated therapist competency scales and specific teaching methods that enhance competence could be identified. RESULTS: Meta-analyses support the use of several psychotherapies in the treatment of patients with psychiatric disorders and specifically those selected for training. Empirically validated rating scales assess therapist competence in several therapies, and specific teaching methods enhance therapist skill. CONCLUSION: The Accreditation Council for Graduate Medical Education and the Royal College of Physicians and Surgeons of Canada have incorporated evidence-based psychotherapies in their new guidelines. Evidence-based methods for assessing competence and for teaching psychotherapy are available and could be encouraged or required in the future.

Psychiatric Residents' Views of Quality of Psychotherapy Training and Psychotherapy Competencies: A Multisite Survey [RESEARCH ARTICLES]

Calabrese, C., Sciolla, A., Zisook, S., Bitner, R., Tuttle, J., Dunn, L. B. — Wed, 13 Jan 2010 17:26:45 PST

OBJECTIVE: Few studies of residents’ attitudes toward psychotherapy training exist. The authors examined residents’ perceptions of the quality of their training, support for training, their own competence levels, and associations between self-perceived competence and perceptions of the training environment. METHODS: An anonymous, web-based questionnaire was distributed to residents at 15 U.S. training programs in 2006–2007. Likert-scaled items were used to evaluate attitudes regarding psychotherapy training and self-perceived competence in five modes of psychotherapy: brief, cognitive-behavioral, combined psychotherapy and psychopharmacology, psychodynamic, and supportive. RESULTS: Surveys were completed by 249 of 567 residents (43.9%). Over one-half agreed that their program provided high-quality psychotherapy training. Concerns about the adequacy of the time and resources provided by their programs were expressed by 28%. Although residents generally believed that their training directors supported psychotherapy training, approximately one-third did not believe that other key department leaders were supportive. Across years of training and modes of therapy, residents perceived their own competence in neutral to slightly positive terms, with self-perceived competence increasing with years of training. CONCLUSION: Given the current residency training requirements, these data provide a mixed picture about how residents experience psychotherapy training. Residency programs may need to reassess the quality and quantity of resources dedicated to psychotherapy training. Critical appraisal of support provided by key departmental leadership is also warranted.

The Role of Personal Therapy in Psychiatric Residency Training: A Survey of Psychiatry Training Directors [RESEARCH ARTICLES]

Habl, S., Mintz, D. L., Bailey, A. — Wed, 13 Jan 2010 17:26:45 PST

OBJECTIVE: The authors examine the current place of personal therapy for residents in U.S. training programs. METHODS: All U.S. training directors were provided an anonymous survey assessing current attitudes and practices with regard to personal therapy and training director perception of their residents’ use of therapy. RESULTS: Training directors generally believed that personal therapy is useful during training, but fewer than one-third of residents seek therapy during residency. Program characteristics associated with the use of personal therapy by residents included training director beliefs in the value of therapy to mitigate personal problems, active encouragement by the training director to seek therapy, programmatic supports to reduce the cost of therapy to residents, and geographic location. CONCLUSION: The proportion of residents seeking personal therapy is falling, despite training directors’ perceptions of the benefit of therapy to residents. This study identified practices promoting a culture in which residents seek therapy.

Using Media to Teach How Not to Do Psychotherapy [RESEARCH ARTICLES]

Gabbard, G., Horowitz, M. — Wed, 13 Jan 2010 17:26:45 PST

OBJECTIVE: This article describes how using media depictions of psychotherapy may help in teaching psychiatric residents. METHODS: Using the HBO series In Treatment as a model, the authors suggest how boundary transgressions and technical errors may inform residents about optimal psychotherapeutic approaches.RESULTS: The psychotherapy vignettes depicted in In Treatment show how errors in judgment may grow out of therapists’ good intentions. These errors can be understood and used constructively for teaching. CONCLUSION: With the growing interest in depicting psychotherapy on popular TV series, the use of these sessions avoids confidentiality problems and may be a useful adjunct for teaching psychotherapy.

A Neurosciences-in-Psychiatry Curriculum Project for Residents in Psychiatry [RESEARCH ARTICLES]

Dunstone, D. C. — Wed, 13 Jan 2010 17:26:45 PST

OBJECTIVE: The author describes a 20-session, student-centered course relating contemporary neuroscience to psychiatry for second-year psychiatric residents. METHODS: Twenty residents who took the course (2003–2007) completed pre- and postcourse surveys and were contacted for more remote follow-up regarding the course. RESULTS: Survey results are predominantly qualitative and positive. CONCLUSION: This course is intended to be an active, student-centered learning experience as one exploration of practice-based learning, and it also explores the use of various applications of emerging telecommunications and information technology as a further learning goal. The course may have particular relevance for training programs with a dearth of local expertise in neuroscience relevant to psychiatry.

Kubler-Ross [RESEARCH ARTICLES]

Tsao, C. — Wed, 13 Jan 2010 17:26:45 PST

Geriatrics Education in Psychiatric Residencies: A National Survey of Program Directors [RESEARCH ARTICLES]

Warshaw, G. A., Bragg, E. J., Layde, J. B., Meganathan, K., Brewer, D. E. — Wed, 13 Jan 2010 17:26:45 PST

OBJECTIVE: The authors describe the current characteristics of geriatrics training within general psychiatry training programs. METHODS: In the fall of 2006, a survey was mailed and made available online to all U.S. psychiatric residency program directors (N=181). RESULTS: The response rate was 54% (n=97). Of the responding psychiatry programs, 96% (n=93) required a clinical experience in geriatrics, with a mean of 54.9 half days of required clinical training. The predominant training sites were inpatient geriatric psychiatry acute care units, ambulatory care experiences precepted by one or more geriatric psychiatrists, and outpatient geriatric psychiatry assessment centers. The mean number of physician faculty per residency program available to teach geriatrics was 2.8 full-time equivalents, and the mean number of physicians certified in geriatric psychiatry was 3.2 per program. Conflicting time demands with other curricula was ranked as the most significant barrier to expanding geriatrics training. CONCLUSION: Variability in the amount of time devoted to geriatrics training exists across general psychiatric residency programs. Some residents spend very little time in specific required geriatric psychiatry clinical experiences and have limited exposure to well-trained geriatric psychiatrists. Therefore, some psychiatrists who will take care of older patients in the future may be ill prepared to do so.

Terminating the Frame [RESEARCH ARTICLES]

Taskiran, S. — Wed, 13 Jan 2010 17:26:45 PST

Don't Leave Teaching to Chance: Learning Objectives for Psychodynamic Psychotherapy Supervision [BRIEF REPORTS]

Rojas, A., Arbuckle, M., Cabaniss, D. — Wed, 13 Jan 2010 17:26:45 PST

OBJECTIVE: The way in which the competencies for psychodynamic psychotherapy specified by the Psychiatry Residency Review Committee of the Accreditation Council for Graduate Medical Education translate into the day-to-day work of individual supervision remains unstudied and unspecified. The authors hypothesized that despite the existence of competencies in psychodynamic psychotherapy, residents did not know what they should be learning in psychodynamic psychotherapy supervision. METHODS: Twenty-four psychiatric residents in PGYs 3 and 4 at Columbia University were asked to complete an anonymous course evaluation about their learning experience in psychodynamic psychotherapy supervision. The evaluation had eight items: seven yes/no questions and one open-ended question. RESULTS: Sixteen of 24 surveys were returned, a response rate of 66.6%. Of the residents who responded, eight said they did not know what they were supposed to be learning in psychodynamic psychotherapy supervision, nine had not discussed this with their supervisor, and six did not believe that their discussions in psychodynamic psychotherapy supervision correlated with didactic courses. CONCLUSION: These results support the need for specific learning objectives for psychodynamic psychotherapy supervision that can be communicated to both supervisors and supervisees to facilitate the process of learning and assessment.

Excuses [BRIEF REPORTS]

Buckler, M. — Wed, 13 Jan 2010 17:26:45 PST

Adequacy of Psychiatric Training: A Singaporean Perspective [BRIEF REPORTS]

Tor, P.-C., Ng, T.-P., Kua, E.-H. — Wed, 13 Jan 2010 17:26:45 PST

OBJECTIVE: The specialty training program for psychiatry in Singapore is transitioning to a seamless 5-year training program. It is timely to assess the perceived adequacy of current psychiatric specialty training. METHODS: An anonymous survey was sent to all psychiatry trainees and psychiatrists in the public sector to assess the current adequacy and perceived importance of 11 aspects of psychiatric specialist training. RESULTS: Forty-nine percent of those surveyed (54 of 110) replied. The current adequacy of training was rated lower than the perceived importance of training for all 11 aspects of training. Those aspects of training rated most important were disorder and diagnosis, pharmacological treatment, clinical interview, and treatment skills. Psychiatrists rated most aspects of training as being more important than did trainees except for cultural aspects, research, and basic neuroscience. Psychiatrists rated adequacy of training better than did trainees, except in the aspect of research. The difference between psychiatrists’ and trainees’ ratings for adequacy of psychotherapy treatment knowledge was significant (p<0.05). CONCLUSION: There were perceived deficiencies in all 11 aspects of training. Psychiatrists and trainees have different perceptions of adequacy and importance of training.

The Beautician [BRIEF REPORTS]

Shakespear, J. — Wed, 13 Jan 2010 17:26:45 PST

An Anonymous Survey of Psychosomatic Medicine Fellowship Directors Regarding Breaches of Contracts and a Proposal for Prevention [BRIEF REPORTS]

Levenson, J. L., Bialer, P. — Wed, 13 Jan 2010 17:26:45 PST

OBJECTIVE: The authors studied how often applicants accept positions at more than one program, or programs offer positions to applicants who have already signed contracts with other programs. METHODS: An anonymous survey was distributed to all psychosomatic medicine fellowship program directors. RESULTS: It is fairly common for applicants to sign contracts for fellowship positions and then back out of the contracts. Only one program reported ever knowingly offering a contract to an applicant who had accepted a position elsewhere. Programs are divided over whether there are extenuating circumstances under which it would be acceptable to offer a position to an applicant who has already signed a contract with another program. CONCLUSION: Guidelines for fellowship programs that do not use the National Resident Match Program can improve the recruitment process.

Supportive Psychotherapy: A Crash Course for Medical Students [RESOURCE]

Philip, N. S., Rost-Banik, D., Shaffer, S., Johnson, B., Boland, R. — Wed, 13 Jan 2010 17:26:45 PST

Passing of the Renaissance Man and Woman [RESOURCE]

Bauer, A. — Wed, 13 Jan 2010 17:26:45 PST

Views of Psychiatry: A Comparison Between Medical Students From Barcelona and Medellin [INTERNATIONAL EDUCATION REPORT]

Pailhez, G., Bulbena, A., Lopez, C., Balon, R. — Wed, 13 Jan 2010 17:26:45 PST

The Unit [INTERNATIONAL EDUCATION REPORT]

Shakespear, J. — Wed, 13 Jan 2010 17:26:45 PST

Medical Students' Beliefs and Attitudes Toward Mental Illness: Effects of a Psychiatric Education [INTERNATIONAL EDUCATION REPORT]

Aghukwa, C. N. — Wed, 13 Jan 2010 17:26:45 PST

Splitting [INTERNATIONAL EDUCATION REPORT]

Ley, R. — Wed, 13 Jan 2010 17:26:45 PST

Students' Attitudes Toward Psychiatry at Al-Hassa Medical College, Saudi Arabia [INTERNATIONAL EDUCATION REPORT]

El-Gilany, A.-H., Amr, M., Iqbal, R. — Wed, 13 Jan 2010 17:26:45 PST

Attitudes Towards Psychiatry: A Survey of Romanian Medical Residents [INTERNATIONAL EDUCATION REPORT]

Voinescu, B. I., Szentagotai, A., Coogan, A. — Wed, 13 Jan 2010 17:26:45 PST

Safety and Respectful Treatment of Medical Students and Residents [LETTERS]

Ellwood, A. — Wed, 13 Jan 2010 17:26:45 PST

Comparing Psychiatrists' and Primary Care Physicians' Knowledge of Nonpsychiatric Medicine [LETTERS]

Grace, G. D., Christensen, R. C. — Wed, 13 Jan 2010 17:26:45 PST

Disclosure of Competing Interests [ANNOUNCEMENT]

Wed, 13 Jan 2010 17:26:45 PST

Professionalism in Psychiatry: A Very Special Collection [EDITORIALS]

Weiss Roberts, L. — Mon, 23 Nov 2009 11:26:06 PST

When Residents Need Health Care: Stigma of the Patient Role [RESEARCH ARTICLES]

Mon, 23 Nov 2009 11:26:06 PST

OBJECTIVE: Whether and under what circumstances medical residents seek personal health care is a growing concern that has important implications for medical education and patient welfare, but has not been thoroughly investigated. Barriers to obtaining care have been previously documented, but very little empirical work has focused on trainees who seek health care at their home institution. METHODS: A self-report survey on special issues in personal health care of residents was created and distributed at the University of New Mexico School of Medicine in 2001. The authors report findings regarding stigma, fear of jeopardy to training status, and attitudes toward seeking self-care for residents in dual roles as patients and trainees. RESULTS: Residents (N=155) rated their concerns regarding stigma and jeopardy to training status and the likelihood of seeking care at their training institution for six vignettes. The vignettes were paired to make comparisons between attending or supervisor as treating physician and between clinical scenarios. Alcohol abuse, nausea and diarrhea, panic attacks, and pregnancy were the most highly stigmatizing to residents; diabetes and hypertension were the least. Differences were also found for gender and specialty. CONCLUSION: Residents’ perceived stigma for clinical situations was an influential factor, strongly affecting concern about jeopardizing training status and likelihood of avoiding care at their home institution.

Developing a Modern Standard to Define and Assess Professionalism in Trainees [RESEARCH ARTICLES]

Schwartz, A. C., Kotwicki, R. J., McDonald, W. M. — Mon, 23 Nov 2009 11:26:06 PST

OBJECTIVE: Assessing professionalism in medical education poses many challenges. The authors discuss common themes and principles in managing professionalism in medical education. METHODS: The authors review the development of standards of professionalism in medical education. They define educational goals for professionalism and also discuss the practical problems with assessing professionalism and addressing it with the trainees. Strategies for remediation of unprofessional conduct are outlined. RESULTS: Given the importance of role models in the development of professional behavior, maintaining an environment that fosters professionalism is an implicit feature of teaching professionalism. Professionalism should be a part of the objectives for each course and clinical rotation, using clearly defined goals and objectives. Assessment of professionalism should begin early and be conducted frequently, giving trainees the opportunity to change. A formal mentoring system can be an effective mechanism to develop role models and teach professionalism. CONCLUSION: Teaching professionalism through formal curricula is paramount in helping develop new generations of compassionate and responsible physicians. Additional strategies such as consistent role modeling of professional behaviors are also needed to encourage the development of professional physicians.

Mind-Brain Dualism [RESEARCH ARTICLES]

Debbink, N. L., Ping Tsao, C. I. — Mon, 23 Nov 2009 11:26:06 PST

End-of-Life Care Education forPsychiatric Residents:Attitudes, Preparedness, andConceptualizations of Dignity [RESEARCH ARTICLES]

Tait, G. R., Hodges, B. D. — Mon, 23 Nov 2009 11:26:06 PST

OBJECTIVE: The authors examined psychiatric residents’ attitudes, perceived preparedness, experiences, and needs in end-of-life care education. They also examined how residents conceptualized good end-of-life care and dignity. METHODS: The authors conducted an electronic survey of 116 psychiatric residents at the University of Toronto. The survey had a mix of qualitative and quantitative questions. RESULTS: Eighty-two of 116 invited psychiatric residents participated for a response rate of 71%. With favorable attitudes, residents felt least prepared in existential, spiritual, cultural, and some psychological aspects of caring for dying patients. Trainees conceptualized dignity at the end of life in a way very similar to that of patients, including concerns of the mind, body, soul, relationships, and autonomy. Residents desired more longitudinal, contextualized training, particularly in the psychosocial, existential, and spiritual aspects of care. CONCLUSION: This is the first study to examine the end-of-life educational experience of psychiatric residents. Despite conceptualizing quality care and the construct of dignity similarly to dying patients, psychiatric residents feel poorly prepared to deliver such care, particularly the nonphysical aspects of caring for the dying. These results will inform curriculum development in end-of-life care for psychiatric residents, a complex area now considered a core competency.

Confession [RESEARCH ARTICLES]

Buckler, M. — Mon, 23 Nov 2009 11:26:06 PST

Cultivating Empathy for the Mentally Ill Using Simulated Auditory Hallucinations [RESEARCH ARTICLES]

Bunn, W., Terpstra, J. — Mon, 23 Nov 2009 11:26:06 PST

OBJECTIVE: The authors address the issue of cultivating medical students’ empathy for the mentally ill by examining medical student empathy pre- and postsimulated auditory hallucination experience. METHODS: At the University of Utah, 150 medical students participated in this study during their 6-week psychiatry rotation. The Jefferson Scale of Physician Empathy, Student Version, was used before and after the experience. The auditory hallucinations were provided as part of the "Hearing Voices That Are Distressing" curriculum created by the National Empowerment Center, which attempted to simulate the experience of hearing auditory hallucinations. While the students were listening to the auditory hallucinations, they underwent a psychiatric interview and simplified cognitive testing and were asked to socially interact in the community. We conducted a paired sample t-test of significance to identify pre- and postsimulated auditory hallucination changes in medical student empathy. Fifty students were randomly selected to serve as a comparison group. RESULTS: The paired sample t-test revealed that after listening to the simulated auditory hallucinations and participating in the simplified neurocognitive testing, the students’ empathy score increased. Students in the comparison group had no significant difference in their empathy scores. CONCLUSION: These results suggest that empathy may increase when students are given a brief glimpse into the mind of a mentally ill patient by listening to simulated auditory hallucinations. Specific interventions to increase empathy for the mentally ill can lead to a better understanding of how empathy can improve patient care, enhance the doctor-patient relationship, and direct future educational strategies.

Professionalism and Ethics Education on Relationships and Boundaries: Psychiatric Residents' Training Preferences [RESEARCH ARTICLES]

Lapid, M., Moutier, C., Dunn, L., Hammond, K. G., Roberts, L. W. — Mon, 23 Nov 2009 11:26:06 PST

OBJECTIVE: Awareness of the privileges and limits of one’s role as physician, as well as recognition and respect for the patient as a human being, are central to ethical medical practice. The authors were particularly interested in examining the attitudes and perceived needs of psychiatric residents toward education on professional boundaries and relationships given the heightened current focus on professionalism and ethics.METHODS: Residents from six psychiatric residencies provided views on professionalism and ethics education on a survey encompassing 10 domains of professionalism. The authors focus on residents’ perceived need for education on boundaries in the psychiatrist-patient relationship and in peer-peer and supervisor-trainee interactions.RESULTS: Respondents (N=134) felt that nine relationship and boundary issues arising during training should receive more education: being asked to work with inadequate supervision, resolving conflicts between attendings and trainees, resident health care, adequately caring for patients while adhering to work-hour guidelines, performing work beyond one’s competence, mistreatment of residents, sexual/romantic relationships between faculty and trainees, mistreatment of medical students, and sexual/romantic relationships between residents and medical students (p<0.05 in all cases). In addition, 15 relationship and boundary issues arising during clinical practice were felt to warrant more education: responding to impaired colleagues, coping with mistakes in clinical care, reporting mistakes, balancing personal and professional life, resolving conflicts, writing prescriptions for friends or family, allocation of health care resources, providing medical advice to friends and family, physicians’ social responsibilities, interacting with families, medicine as a profession, gender bias, being asked to falsify clinical information, accepting gifts from patients, and personal relationships with patients (p<0.05 in all cases).CONCLUSION: The authors found a perceived need for more education for psychiatric residents for the majority of topics pertaining to boundaries and relationships. Residents who reported encountering ethical dilemmas more frequently wanted more education on these topics.

Door [RESEARCH ARTICLES]

Koh, S. — Mon, 23 Nov 2009 11:26:06 PST

Medical Students' Affirmation of Ethics Education [RESEARCH ARTICLES]

Lehrmann, J. A., Hoop, J., Hammond, K. G., Roberts, L. W. — Mon, 23 Nov 2009 11:26:06 PST

OBJECTIVE: Despite the acknowledged importance of ethics education in medical school, little empirical work has been done to assess the needs and preferences of medical students regarding ethics curricula. METHODS: Eighty-three medical students at the University of New Mexico participated in a self-administered written survey including 41 scaled questions regarding attitudes, needs, and preferences toward medical ethics and ethics education. RESULTS: Students reported strong personal interest in learning more about ethics in clinical medicine and research. They most strongly endorsed as valid objectives of ethics education the goals of helping professionals "better recognize ethical issues and clarify values-laden choices," "improve patient care and clinical decision-making," and "improve ethical practices in clinical research." Participants strongly agreed that "professional attitudes and values are an appropriate focus for medical education" and also expressed strong interest in learning more about specific ethical topics and learning methods. Women more strongly endorsed interest in additional ethics education and a preference for increased ethics education than men. Preclinical participants expressed a greater desire for additional training on all ethics topics than clinical students. CONCLUSION: The medical students surveyed strongly affirmed ethics education in medical school and expressed clear preferences for curricular topics and teaching methods.

Learning the Ropes [RESEARCH ARTICLES]

Gilgenbach Bosler, J. — Mon, 23 Nov 2009 11:26:06 PST

Relationships Between Drug Company Representatives and Medical Students:Medical School Policies and Attitudes of Student Affairs Deans and Third-Year Medical Students [RESEARCH ARTICLES]

Mon, 23 Nov 2009 11:26:06 PST

OBJECTIVES: The authors sought to ascertain the details of medical school policies about relationships between drug companies and medical students as well as student affairs deans’ attitudes about these interactions. METHODS: In 2005, the authors surveyed deans and student affairs deans at all U.S. medical schools and asked whether their schools had a policy about relationships between drug companies and medical students. They asked deans at schools with policies to summarize them, queried student affairs deans regarding their attitudes about gifts, and compared their attitudes with those of students who were studied previously. RESULTS: Independently of each other, 114 out of 126 deans (90.5%) and 114 out of 126 student affairs deans (90.5%) responded (identical numbers are not misprints). Ten schools had a policy regarding relationships between medical students and drug company representatives. Student affairs deans were much more likely than students to perceive that gifts were inappropriate. CONCLUSION: These 2005 policies show trends meriting review by current medical schools in considering how to comply with the 2008 Association of American Medical Colleges recommendations about relationships between drug companies and medical students or physicians.

Students' Views on Factors Affecting Empathy in Medical Education [RESEARCH ARTICLES]

Winseman, J., Malik, A., Morison, J., Balkoski, V. — Mon, 23 Nov 2009 11:26:06 PST

OBJECTIVE: Empathy is a prominent goal of medical education that is too often underachieved. Using concept mapping, the authors constructed a student-generated conceptual model of factors viewed as affecting empathy during medical education. METHODS: During the 2005–2006 academic year, 293 medical students and interns answered a brainstorming survey asking respondents to list factors affecting empathy, and 34 participants then sorted the factors into categories and rated each factor’s relative importance. Factors and ratings were examined using multidimensional scaling and cluster analyses, Pearson’s r, and Student’s t test. This process, known as "concept mapping," was conducted using Concept Systems. RESULTS: One hundred sixty perceived empathy factors were identified and sorted into four clusters: personal experiences, connections and beliefs; negative feelings and attitudes toward patients; mentoring and clinical experiences that promote professional growth (rated most important); and school and work experiences that undermine development of empathy (rated least important). All students rated factors in a similar hierarchical fashion across all four clusters with no differences among groups. Listening was the most highly rated factor. CONCLUSION: Students consider experiences that promote personal and professional growth to be the most important factors affecting empathy in medical education. Though less important to students, negative feelings and attitudes toward patients, as well as negative school and work experiences, affect empathy at all stages of education.

Steinbeck: A Teaching Resource for Medical Educators [MEDIA COLUMN]

Greiner, C. B. — Mon, 23 Nov 2009 11:26:06 PST

The Tower [MEDIA COLUMN]

Fisher, T. J. — Mon, 23 Nov 2009 11:26:06 PST

Editorial Leadership of Academic Psychiatry [EDITORIALS]

Wed, 14 Oct 2009 12:14:50 PDT

Academic Psychiatry, twenty years ago. . . [EDITORIALS]

Wed, 14 Oct 2009 12:14:50 PDT

Psychopharmacology Curriculum Field Test [RESEARCH ARTICLES]

Wed, 14 Oct 2009 12:14:50 PDT

OBJECTIVE: As part of an effort to improve psychopharmacology training in psychiatric residency programs, a committee of residency training directors and associate directors adapted an introductory schizophrenia presentation from the American Society of Clinical Psychopharmacology’s Model Psychopharmacology Curriculum to develop a multimodal, interactive training module. This article describes the module, its development, and the results of a field trial to test its feasibility and usefulness. METHODS: Nineteen residency programs volunteered to use the module during the first half of the 2007–2008 academic year. Evaluation consisted of a structured phone interview with the training director or teaching faculty of participating programs during February and early March 2008, asking whether and how they used the curriculum, which components they found most useful, and how it was received by faculty and residents. RESULTS: Of the 19 programs, 14 used the module and 13 participated in the evaluation. The most commonly used components were the pre- and postmodule questions, video-enhanced presentation, standard presentation, problem- or team-based teaching module, and other problem-based teaching modules. No two programs used the module in the same fashion, but it was well received by instructors and residents regardless of use. CONCLUSION: The results of this field trial suggest that a dynamic, adult-centered curriculum that is exciting, innovative, and informative enough for a wide variety of programs can be developed; however, the development and programmatic barriers require considerable time and effort to overcome.

The Research Innovation and Scholarship in Education Program: An Innovative Way to Nurture Education [RESEARCH ARTICLES]

Wed, 14 Oct 2009 12:14:50 PDT

OBJECTIVE: Education is becoming a recognized career path in psychiatry. Yet, there are few published accounts of how to create sustainable structures within departments to support this academic focus. The authors document the creation and 5-year progress of the Research Innovation and Scholarship in Education (RISE) program at the largest psychiatry department in Canada. METHODS: The authors analyzed the RISE archive of early proposals for enhancing scholarship in the department, the 5-year plan, annual reports, and curricular vitae of members and also gathered testimonials from inaugural residents and fellows of the program. Materials were analyzed using Boyer’s framework of scholarship. RESULTS: Organizationally, RISE has embodied all four tenets of Boyer’s model of scholarship. The program has allowed education research, teaching, and creative professional development to flourish in the department, and there are considerably fewer barriers to pursuing an education career path. However, as the program expands, more work needs to be done to increase funding and protected time so that even more residents, fellows, and faculty can engage in educational scholarship. CONCLUSION: Enhancing medical education scholarship through a model that actively integrates research with teaching, creative professional development, and mentorship can help the trajectories of faculty and students wishing to make education a priority in their careers.

Psychiatrists' Perceptions and Practices in Treating Patients' Obesity [RESEARCH ARTICLES]

Lichwala-Zyla, C., Price, J. H., Dake, J. A., Jordan, T., Price, J. A. — Wed, 14 Oct 2009 12:14:50 PDT

OBJECTIVE: This study identified psychiatrists’ perceptions and practices regarding advising and treating obese patients. METHODS: Questionnaires were mailed to a national random sample of 500 members of APA. A three-wave mailing was used to maximize the return rate. The questionnaire contained items on weight control based on the Stages of Change and Health Belief models, Self-Efficacy theory, and the 5As strategy. RESULTS: A total of 236 psychiatrists responded to the survey. Most did not have any formal training during medical school on treating obese patients and three-quarters evaluated their training in psychiatric residency programs on weight loss/control issues as "not adequate at all" or "not very adequate." The majority regularly assisted their obese patients with weight management. Most psychiatrists felt confident to ask, advise, assess, assist, and arrange (5As) regarding weight loss issues and believed that doing so would result in significant weight loss. The majority were more likely to advise obese patients to lose weight when comorbid conditions were present. The most common barriers to aiding obese patients were time constraints, poor patient compliance, lack of clear guidelines and practice tools, limited medical training on the issue, and fear of offending patients. CONCLUSION: Patients can no longer afford to have their psychiatrists provide cursory assistance with obesity. Weight management training should be incorporated into psychiatric residency training and continuing education programs.

Ex-Con [RESEARCH ARTICLES]

Langheim, F. J. P. — Wed, 14 Oct 2009 12:14:50 PDT

Mentors' Perspectives on Group Mentorship: A Descriptive Study of Two Programs in Child and Adolescent Psychiatry [RESEARCH ARTICLES]

Wed, 14 Oct 2009 12:14:50 PDT

OBJECTIVE: The authors assess mentors’ perceptions of mentoring and experiences participating in an intensive, small-group mentorship program, with particular attention to potential challenges in their retention and the recruitment of new mentors to similar, future programs. METHODS: Similar group mentorship programs were implemented at two child and adolescent psychiatry conferences, one national and the other international. The program included three daily small group meetings, one closing meeting for all participants, and administration of a web-based survey. RESULTS: Of the 43 mentors, 42 (98%) completed the survey, and results were comparable across both programs. Among respondents, 93% found the group experience personally fulfilling and an equally valuable teaching and learning opportunity. Mentors unanimously agreed that co-mentoring enhanced the group mentoring experience. Group diversity enhanced the mentorship process, although differences in trainees’ interests and levels of experience as posed concrete challenges. Sixty-two percent of the mentors thought that they would be able to adapt lessons and experiences from the mentorship program in their home institutions, and 95% agreed to participate if invited to mentor in future programs. CONCLUSION: Mentors found the intensive, brief group mentorship model to be a powerful, time-efficient, and enjoyable approach to mentoring, increasing trainees’ exposure to child and adolescent psychiatry. Although group composition, schedule coordination, and logistics warrant closer scrutiny, these positive perceptions bode well for mentor recruitment and retention and for using a similar program in other settings.

Psychiatry Morbidity and Mortality Rounds: Implementation and Impact [RESEARCH ARTICLES]

Goldman, S., Demaso, D. R., Kemler, B. — Wed, 14 Oct 2009 12:14:50 PDT

OBJECTIVE: This study assessed the implementation of psychiatry morbidity and mortality rounds (M&Ms) on the clinical and educational practice in a children’s hospital. METHODS: Attendees to monthly M&Ms between July 2005 and May 2007 included staff and trainees from psychiatry, psychology, nursing, and social work. Cases were selected based on a priori risk criteria and each rated on the hospital’s four-level risk management scale. M&Ms were reviewed for recurrent patterns that contributed to adverse patient care. Attendees completed a survey at the end of each year, evaluating the educational value of the rounds. RESULTS: Possible opportunities for patient care improvement were found in 80% of the cases and fell into four overlapping areas: diagnostic/formulation errors, communication problems, system-based problems, and class/culture misunderstandings. Identifying these problems led to corrective actions and positive changes in patient care. CONCLUSION: M&Ms appear to be a potentially productive venue for self-appraisal and case review to aid psychiatry programs in patient safety efforts and clinician education.

Adolescent Depression: Evaluating Pediatric Residents' Knowledge, Confidence, and Interpersonal Skills Using Standardized Patients [RESEARCH ARTICLES]

Lewy, C., Sells, C. W., Gilhooly, J., McKelvey, R. — Wed, 14 Oct 2009 12:14:50 PDT

OBJECTIVE: The authors aim to determine whether pediatric residents used DSM-IV criteria to diagnose major depressive disorder and how this related to residents’ confidence in diagnosis and treatment skills before and after clinical training with depressed adolescents. METHODS: Pediatric residents evaluated two different standardized patients portraying major depressive disorder before and after learning about adolescent depression. Residents’ interactions with standardized patients were observed, and checklists containing DSM-IV criteria for major depressive disorder and other pertinent information, such as comorbidities, were completed for each interaction. After the encounter, residents completed a survey asking about the "patient’s" diagnosis and the residents’ confidence in their clinical skills. RESULTS: Residents assessed significantly more checklist items in the second encounter with a standardized patient. Residents’ confidence in treatment was significantly higher after the rotation, while confidence in diagnostic skills was unchanged, remaining high. Even after the rotation, residents did not use all DSM-IV criteria for major depressive disorder in their diagnoses. CONCLUSION: Major depressive disorder is a common adolescent psychiatric disorder. Pediatricians must be equipped with appropriate interpersonal and diagnostic skills to detect this and other psychiatric disorders. Standardized patients represent one useful way to teach and assess these skills. This study suggests that residents’ interpersonal and diagnostic skills can improve with practice. Although resident scores improved, post-encounter checklists showed that residents were still not asking all the necessary questions for a DSM-IV diagnosis, concluding prematurely that the standardized patients had major depressive disorder before satisfying all diagnostic criteria. The majority did not consider other depressive conditions or comorbid disorders.

Psychiatrist-In-Training [RESEARCH ARTICLES]

Tsao, C. — Wed, 14 Oct 2009 12:14:50 PDT

An Innovative Child CBT Training Model for Community Mental Health Practitioners in Ontario [RESEARCH ARTICLES]

Wed, 14 Oct 2009 12:14:50 PDT

OBJECTIVE: Cognitive behavior therapy (CBT) for children has been shown efficacious, but community access to it is often limited by the lack of trained therapists. This study evaluated a child, CBT-focused, 20-session weekly group supervision seminar with a didactic component which was provided to community mental health practitioners by experienced CBT therapists from an academic center. METHODS: Twenty-two practitioners from four community mental health agencies completed the training in four groups (one for each agency); one group was trained by videoconference. The authors assessed outcomes immediately after the training and at 6-month follow-up using a mixed-method design including quantitative and qualitative methods to ensure a comprehensive evaluation. RESULTS: Participants’ knowledge on a multiple-choice test of child CBT increased with training, as did their self-reported confidence using CBT and desire to do further child CBT. Therapist age and use of an intake diagnostic screen related to positive outcomes, and participants advocated for more structured training. CONCLUSION: Child CBT can be successfully taught to community practitioners using this training model, but refinement based on participant feedback and further studies that include direct observation of CBT skills are needed.

Behind the Scenes [RESEARCH ARTICLES]

Campbell, B. — Wed, 14 Oct 2009 12:14:50 PDT

Introducing Evidence-Based Practice to an Inpatient Child and Adolescent Psychiatry Unit [BRIEF REPORTS]

Kurth, J. — Wed, 14 Oct 2009 12:14:50 PDT

OBJECTIVE: An evidence-based practice (EBP) course was presented to the nonphysician clinical staff of an inpatient child psychiatry unit to assess change in attitude and knowledge. METHODS: Staff members were surveyed to determine change in attitudes and knowledge. RESULTS: The staff gained knowledge about EBP and attitudes were positive overall, indicating that the staff was much more likely to use EBP after the course. CONCLUSION: This study demonstrates the feasibility of teaching EBP to inpatient child psychiatry staff, although the small sample size was a significant limitation and further studies are indicated.

Writing Clearly but With Confusion [BRIEF REPORTS]

Bernstein, M. — Wed, 14 Oct 2009 12:14:50 PDT

Relationship Between Resident-In-Training Examination in Psychiatry and Subsequent Certification Examination Performances [BRIEF REPORTS]

Wed, 14 Oct 2009 12:14:50 PDT

OBJECTIVE: This study analyzed the relationship between performance on The American College of Psychiatrists’ Psychiatry Resident-In-Training Examination (PRITE) and the ABPN Part 1 examination. METHODS: Pearson correlation coefficients were used to examine the relationship between performance on the 2002 PRITE and the 2003 Part 1 examination for 297 examinees. RESULTS: The correlation between the PRITE global psychiatry and the Part 1 psychiatry scores was 0.59, and the correlation between the PRITE global neurology and the Part 1 neurology scores was 0.39. CONCLUSION: Although the PRITE and the Part 1 examination have different purposes and are developed independently, the significant correlations between scores on the two tests support the use of PRITE results to guide preparation for the Part 1 examination. Guidelines for PRITE scores associated with poor performance on the Part 1 examination are provided.

Journal Club Experience in a Postgraduate Psychiatry Program in Chile [BRIEF REPORTS]

Wed, 14 Oct 2009 12:14:50 PDT

OBJECTIVE: Literature about journal clubs in postgraduate psychiatry programs is scarce, and there is no reference to residents' preferences. METHODS: Residents were asked to respond to a survey about their general satisfaction with the current journal club format and paper preferences, according to subject, scope, and type. RESULTS: Residents' general satisfaction was high. Residents preferred clinically relevant meta-analyses and randomized controlled trials about mood and psychotic disorders, neuroscience, and biological therapies. CONCLUSION: There is a trend to prefer articles related to biological aspects of psychiatry, centered in evidence-based medicine methodology. An effort should be made to broaden the scope of selection of papers, incorporating, for instance, humanistic views, psychotherapy, and other methodologies.

A Residency Training in Rural Psychiatry [BRIEF REPORTS]

Gillig, P. M., Comer, E. A. — Wed, 14 Oct 2009 12:14:50 PDT

OBJECTIVE: This article describes a residency training program that incorporates a rural didactic curriculum and rural clinical training. METHODS: Residents participate in didactic seminars and a rural clinical rotation. RESULTS: In this jointly funded (academic-state-agency) model, faculty members from a community-based medical school train psychiatric residents at a rural clinic. This model differs from a primary care model because it is a direct care model and not a consultation model. CONCLUSION: Locations near medical schools that are within driving distance of a rural or rural/manufacturing community could use this model. It would require modification (including telemedicine) where greater distances are involved or where faculty clinical work must be done at the medical school site to support a university-based hospital or clinic.

Computer Simulation and Virtual Reality in the Diagnosis and Treatment of Psychiatric Disorders [MEDIA COLUMN]

Gorrindo, T., Groves, J. E. — Wed, 14 Oct 2009 12:14:50 PDT

A Perfect Answer [MEDIA COLUMN]

Arnold, R., Back, A. — Wed, 14 Oct 2009 12:14:50 PDT

Post-Katrina Stabilization of the LSU/Ochsner Psychiatry Residency Program: Caveats for Disaster Preparedness [RESOURCE]

Griffies, W. S. — Wed, 14 Oct 2009 12:14:50 PDT

OBJECTIVE: The Louisiana Health Science Center/Ochsner Hospital psychiatric residency was displaced in August 2005 by Hurricane Katrina to multiple state hospitals and clinics throughout Louisiana. The program encountered many difficulties and learned many lessons about disaster preparedness. METHODS: The LSU/Ochsner Residency Director at the time of Hurricane Katrina chronicles challenges in reestablishing educational program infrastructure in the face of a disaster. RESULTS: Seven caveats of disaster preparedness and program reestablishment are outlined. CONCLUSION: No program can be completely prepared for the unpredictable nature of a sudden disaster, which disrupts an entire residency program years in the making. However, an analysis of the LSU Health Science Center psychiatric residency reveals seven caveats which may help other residency programs in case of a future disaster.

White Coats [RESOURCE]

Cohen, M. — Wed, 14 Oct 2009 12:14:50 PDT

A Survey of British Senior Psychiatry Trainees' Ethnocultural Personal Values [INTERNATIONAL EDUCATION REPORT]

Neelam, K., Duddu, V., Chaudhry, I. B., Antonysamy, A.S., Husain, N. — Wed, 14 Oct 2009 12:14:51 PDT

OBJECTIVE: The authors explored the ethnocultural values of a group of senior psychiatry trainees in the northwest region of England. METHODS: The authors surveyed senior psychiatry trainees using the Personal Values Questionnaire and analyzed responses under the headings of ethnic stereotypes, ethnocultural service issues, and perceptions of racism. They also explored training requirements on cultural issues in a subsample of trainees. RESULTS: The majority of the trainees disagreed with certain commonly held ethnic stereotypes and acknowledged the role of culture in mental health. However, they had contrasting views on the need for culture-specific services and on perceptions of racism. They expressed interest in training programs on cultural issues in psychiatric practice. CONCLUSION: In multicultural settings, personal beliefs, perceptions, and values are likely to influence psychiatric practice. A training program on cultural aspects of mental health could help improve awareness and sensitivity of these issues and the quality of care.

Geriatric Triple Board Residency or Post-Geriatrics Portal Project [LETTERS]

Kalapatapu, R. K. — Wed, 14 Oct 2009 12:14:51 PDT