1
|
Molina-Ruiz R, Nakagami Y, Mörkl S, Vargas M, Shalbafan M, Chang JPC, Rai Y, Seun-Fadipe CT, Erzin G, Kazhungil F, Vidal P, Brihastami S, Yıldızhan E, Maiti T, Fedotov I, Rojnic-Palavra I, Horinouchi T, Renganathan V, Pinto da Costa M. Training in neuropsychiatry: views of early career psychiatrists from across the world. BJPsych Bull 2024; 48:78-84. [PMID: 37395121 PMCID: PMC10985715 DOI: 10.1192/bjb.2023.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 02/01/2023] [Accepted: 04/16/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Training and practice in neuropsychiatry varies across the world. However, little is known about the experiences and opinions of early career psychiatrists (ECPs) across different countries regarding neuropsychiatry. AIMS AND METHOD To investigate neuropsychiatry training experiences, practices and opinions among ECPs across different countries. An online survey was distributed to ECPs in 35 countries across the world. RESULTS A total of 522 participants took part in this study. Responses show that neuropsychiatry is integrated to a variable extent in psychiatric training curricula across the world. Most respondents were not aware of the existence of neuropsychiatric training or of neuropsychiatric units. Most agreed that training in neuropsychiatry should be done during or after the psychiatry training period. Lack of interest among specialty societies, lack of time during training, and political and economic reasons are regarded as the main barriers. CLINICAL IMPLICATIONS These findings call for an improvement in the extent and in the quality of neuropsychiatry training across the world.
Collapse
Affiliation(s)
| | | | | | | | - Mohammadreza Shalbafan
- Iran University of Medical Sciences, Tehran, Iran
- Institute for Cognitive Sciences Studies, Tehran, Iran
| | | | - Yugesh Rai
- Essex Partnership University NHS Foundation Trust, Colchester, UK
| | | | - Gamze Erzin
- Diskapi Training and Research Hospital, Ankara, Turkey
| | | | - Pablo Vidal
- Hospitalario Universitario A Coruña, A Coruña, Spain
| | | | - Eren Yıldızhan
- Bakirkoy Mazhar Osman Research and Training Hospital for Psychiatry, Istanbul, Turkey
| | - Tanay Maiti
- South Yorkshire NHS Foundation Trust, Dewsbury, UK
| | | | | | - Toru Horinouchi
- Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Mariana Pinto da Costa
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| |
Collapse
|
2
|
Schildkrout B, Niu K, Cooper JJ. Clinical Neuroscience Continuing Education for Psychiatrists. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023:10.1007/s40596-023-01776-8. [PMID: 37106262 DOI: 10.1007/s40596-023-01776-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Affiliation(s)
| | - Kathy Niu
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | |
Collapse
|
3
|
Boland RJ, Dingle AD, Travis MJ, Osborne LM, Shapiro MA, Madaan V, Ahmed I. Using the Psychiatry Resident-In-Training Examination (PRITE) to Assess the Psychiatry Medical Knowledge Milestones in Psychiatry. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:331-337. [PMID: 34623622 DOI: 10.1007/s40596-021-01537-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 09/09/2021] [Indexed: 05/13/2023]
Abstract
OBJECTIVE The introduction of the Milestone Project underscored the need for objective assessments of resident progress across the competencies. Therefore, the authors examined the Psychiatry Resident-In-Training Examination (PRITE) utility for measuring improvements in medical knowledge (MK). METHODS The authors compared the mean performance for each MK subcompetency by resident year for all residents taking the PRITE from 2015 to 2017 (18,175 examination administrations). In addition, they surveyed psychiatry residency program directors regarding how well they thought they teach these subcompetencies. RESULTS Increases in MK subcompetencies by resident year were significant for Psychopathology (p < 0.003), Psychotherapy (p < 0.002), and Somatic Therapies (p < 0.000). Development, Clinical Neuroscience, and Practice of Psychiatry did not show statistically significant differences between postgraduate years. Eighty psychiatry program directors responded to the survey and felt optimistic about their ability to teach the Psychopathology, Psychotherapy, Somatic Therapies, and Practice of Psychiatry subcompetencies. CONCLUSIONS The PRITE measured significant improvements in medical knowledge for several of the core subcompetencies. The program director's responses would suggest that the lack of statistically significant differences found for Development and Clinical Neuroscience reflects areas in need of curricular development. The disparity between PRITE performance and program director perception of the Practice of Psychiatry subcompetency may reflect difficulties in defining the scope of this subcompetency. Overall, this suggests that structured examinations help measure improvements in certain subcompetencies and may also help identify curricular needs. However, there may be potential problems with the definition of some subcompetencies.
Collapse
Affiliation(s)
- Robert J Boland
- Baylor College of Medicine and the Menninger Clinic, Houston, TX, USA.
| | - Arden D Dingle
- University of Nevada, Reno School of Medicine, Reno, NV, USA
| | - Michael J Travis
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | | | - Vishal Madaan
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Iqbal Ahmed
- Tripler Army Medical Center Psychiatry Residency Program, Honolulu, HI, USA
| |
Collapse
|
4
|
Hernandez CR, Camp MME. Current Educational Practices for Major Neurocognitive Disorders in Psychiatry: a Scoping Review. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:451-459. [PMID: 33686538 DOI: 10.1007/s40596-021-01424-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE A scoping review of the literature was performed to examine the current state of education on major neurocognitive disorders within psychiatry, to review influential factors for pursuing a career working with these patients, and to review what has been done in education to address the shortage of providers to care for patients with major neurocognitive disorders. METHODS Using the Arksey and O'Malley framework for conducting scoping reviews, twenty-eight studies on education in geriatric psychiatry, neuropsychiatry, and major neurocognitive disorders were selected. Learner groups included medical students, residents, and psychiatrists. The results from the studies were compared, and major themes were presented. RESULTS Several studies found that positive clinical experiences with older adult patients and effective teachers in geriatric psychiatry play a role in influencing trainees to pursue a career in geriatric psychiatry. Topics pertaining to major neurocognitive disorders are taught by the majority of medical schools during the psychiatry rotation and are rated as the most important teaching topic in neurology among psychiatry residency program directors. Several interventions have resulted in increased comfort working with geriatric patients and patients who have major neurocognitive disorders among students, but fewer studies have resulted in an increase in interest seeing these patients in practice. There is a lack of research pertaining to psychiatry residents working with patients that have major neurocognitive disorders. CONCLUSIONS While research on geriatric psychiatry and neuropsychiatry education exists, more research is needed that focuses specifically on how medical students and psychiatry residents are being taught major neurocognitive disorders.
Collapse
|
5
|
Neuroscience Education: Making It Relevant to Psychiatric Training. Psychiatr Clin North Am 2021; 44:295-307. [PMID: 34049650 DOI: 10.1016/j.psc.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Psychiatric education has struggled to move past dualistic notions separating mind from brain, and embrace the field's identity as a clinical neuroscience discipline. To modernize our educational systems, we must integrate neuroscience perspectives into every facet of our clinical work. To do this effectively, neuroscience education should be clinically relevant, informed by adult learning theory, and tailored to the individualized needs of learners. Classic neuropsychiatry skills can help us better understand our patients' brain function at the bedside. Integrating neuroscience perspectives alongside the other rich perspectives in psychiatry will help trainees appreciate the relevance of neuroscience to modern medical practice.
Collapse
|
6
|
Lee J, Galli J, Siemon J, Huang M, Schlumbrecht M. Assessment of Cancer Survivorship Training and Knowledge Among Resident Physicians in Obstetrics and Gynecology. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:491-496. [PMID: 31734870 DOI: 10.1007/s13187-019-01652-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The number of gynecologic cancer survivors in the USA is expected to grow to nearly 2 million by 2029. Gynecologic oncologists alone will not be able to care for all of these women. Thus, preparation of general obstetrician/gynecologists (OBGYNs) to deliver this care is crucial. Our objective was to assess cancer survivorship training (CST) among OB/GYN residents and to evaluate knowledge in basic gynecologic cancer survivorship. OB/GYN residents were recruited nationally to complete a de novo questionnaire, querying demographics, hours of CST received, teaching methods used, and efficacy of those methods. Survivorship knowledge was assessed by ten questions based on the 2017 Society of Gynecologic Oncology recommendations on post-treatment surveillance, which includes topics appropriate for generalists. Analyses were done using t tests and ANOVA, with significance set at p = 0.05. In total, 128 residents responded to the survey. Observation was the most common method of CST (53%), with patient contact reported as the most effective method (42.6%). The mean score of correct responses (MSCRs) among all respondents was 61.5%. MSCR significantly improved with increasing post-graduate year (PGY) (p = 0.003). Survivorship training method was not associated with improved MSCR. Improvements in MSCR were observed with an increasing number of CST hours (p = 0.011). A total of 13.9% of residents reported feeling "very comfortable" with survivorship care, yet 88.5% of respondents indicated they did not want additional CST. More hours of CST are associated with improved resident in knowledge in cancer survivorship care, though deficits still remain. Further investigation into optimizing CST is warranted.
Collapse
Affiliation(s)
- Jared Lee
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Johnny Galli
- Department of Obstetrics, Gynecology, and Reproductive Science, University of Miami Miller School of Medicine, Miami, FL, USA
| | - John Siemon
- Department of Obstetrics, Gynecology, and Reproductive Science, University of Miami Miller School of Medicine, Miami, FL, USA
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center, The University of Miami Miller School of Medicine, 1121 NW 14th St, Suite 345C, Miami, FL, 33136, USA
| | - Marilyn Huang
- Department of Obstetrics, Gynecology, and Reproductive Science, University of Miami Miller School of Medicine, Miami, FL, USA
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center, The University of Miami Miller School of Medicine, 1121 NW 14th St, Suite 345C, Miami, FL, 33136, USA
| | - Matthew Schlumbrecht
- Department of Obstetrics, Gynecology, and Reproductive Science, University of Miami Miller School of Medicine, Miami, FL, USA.
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center, The University of Miami Miller School of Medicine, 1121 NW 14th St, Suite 345C, Miami, FL, 33136, USA.
| |
Collapse
|
7
|
Manning KJ, Gunning FM, Aizenstein HJ, Steffens DC. Training the Next Generation of Geriatric-Focused Clinical Neuroscientists. Am J Geriatr Psychiatry 2019; 27:720-727. [PMID: 30928155 DOI: 10.1016/j.jagp.2019.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/26/2019] [Accepted: 03/07/2019] [Indexed: 01/21/2023]
Abstract
It remains challenging to integrate clinical neuroscience into clinical practice. Hindrances at the training level (e.g., lack of qualified faculty and curriculum) contribute to this impasse. To help address this, we present a model of training in clinical neuroscience. We expand on a growing literature on incorporating neuroscience into psychiatry training by emphasizing two points. That is, 1) we propose a training model designed for the geriatric-minded clinician; and 2) that extends across several phases of education and career development. Considering the relevance of dementia to our population of interest, and the potential impact expertise in clinical neuroscience can have in elders with cognitive impairment, we provide relevant curriculum examples at various training stages. Clinical research, both as a practitioner and consumer, figures prominently into our training model. We discuss two mentoring programs, T32 fellowships and Research Career Institute in the Mental Health of Aging, as ways to engage geriatric psychiatrists early in their training and transition them successfully to post-residency clinical investigator positions. Although there is increasing opportunity for geriatric psychiatrists and other clinicians to become leaders in the field of neuroscience, this remains a work in progress; ours and others' training programs continue to evolve based on input from trainers and trainees alike, as well as from the increasing literature on this important topic.
Collapse
Affiliation(s)
- Kevin J Manning
- Department of Psychiatry (KJM, DCS), University of Connecticut Health Center, Farmington, CT.
| | - Faith M Gunning
- Department of Psychiatry (FMG), Weill Cornell Medical College, White Plains, NY
| | | | - David C Steffens
- Department of Psychiatry (KJM, DCS), University of Connecticut Health Center, Farmington, CT
| |
Collapse
|
8
|
Juul D, Lyness JM, Thomas CR, Faulkner LR. Primary Care and Neurology in Psychiatry Residency Training: a Survey of Early Career Psychiatrists. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2019; 43:51-55. [PMID: 29943277 DOI: 10.1007/s40596-018-0922-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 04/09/2018] [Indexed: 05/23/2023]
Abstract
OBJECTIVE A survey of recently certified psychiatrists was conducted to obtain their feedback about the contribution of the primary care and neurology components of residency training to their professional development and to their current needs as practitioners. METHODS A 22-item survey was developed based on issues discussed at a forum on residency competence requirements and administered electronically to four cohorts of recently certified psychiatrists. RESULTS The response rate was 17% (1049/6083). Overall, the respondents described both their primary care and neurology experiences as helping them accomplish several goals for their professional development. The majority were satisfied with their primary care training and felt well-prepared to enter practice. The most common suggestions for improving the primary care component were better integration with psychiatry and providing longitudinal experiences and more outpatient experience. They were somewhat less satisfied with their neurology training, and only about half felt well-prepared for the neurologic aspects of psychiatry practice. The most common suggestions for improving neurology training were to provide more time in neurology with experiences that were more relevant to psychiatry such as outpatient and consultation experiences. Some also thought longitudinal experiences would be useful. CONCLUSIONS These psychiatrists were generally satisfied with the primary care and neurology components of residency training and felt that they had contributed to their professional development. Their suggestions for improvement contribute to the rich discussion among training directors and other psychiatry educators about these components of residency training.
Collapse
Affiliation(s)
- Dorthea Juul
- American Board of Psychiatry and Neurology Inc., Deerfield, IL, USA.
| | - Jeffrey M Lyness
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | | | - Larry R Faulkner
- American Board of Psychiatry and Neurology Inc., Deerfield, IL, USA
| |
Collapse
|
9
|
Cooper JJ, Korb AS, Akil M. Bringing Neuroscience to the Bedside. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2019; 17:2-7. [PMID: 31975952 PMCID: PMC6493145 DOI: 10.1176/appi.focus.20180033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Clinical psychiatry has not historically expected practitioners to learn the basic science of psychiatric illness. Despite wide recognition that all effective psychiatric treatments have neurophysiological mechanisms, the field has struggled to integrate concepts of the mind and brain. Because of historical separations of clinical psychiatry and evolving neuroscience research, many psychiatric residency programs feel underresourced to teach clinically relevant neuroscience, and current residency graduates are not being prepared to integrate neuroscience findings into their practice. Significant strides have been made in the understanding of the neurobiology of psychiatric disorders. Similarly, the neurobiological mechanisms of a wide variety of treatments have been elucidated, spanning interventions from psychotherapy to physical exercise, electroconvulsive therapy, and modern neuromodulation techniques. The authors discuss strategies for integrating the language of clinical neuroscience into everyday psychiatric practice and review resources available to clinicians and trainees to help them acquire and practice these skills.
Collapse
Affiliation(s)
- Joseph J Cooper
- Department of Psychiatry, University of Illinois at Chicago (Cooper); Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (Korb); Department of Psychiatry, MedStar Georgetown University Hospital, Washington, D.C. (Akil)
| | - Alexander S Korb
- Department of Psychiatry, University of Illinois at Chicago (Cooper); Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (Korb); Department of Psychiatry, MedStar Georgetown University Hospital, Washington, D.C. (Akil)
| | - Mayada Akil
- Department of Psychiatry, University of Illinois at Chicago (Cooper); Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (Korb); Department of Psychiatry, MedStar Georgetown University Hospital, Washington, D.C. (Akil)
| |
Collapse
|
10
|
Holmes EA, Ghaderi A, Harmer CJ, Ramchandani PG, Cuijpers P, Morrison AP, Roiser JP, Bockting CLH, O'Connor RC, Shafran R, Moulds ML, Craske MG. The Lancet Psychiatry Commission on psychological treatments research in tomorrow's science. Lancet Psychiatry 2018; 5:237-286. [PMID: 29482764 DOI: 10.1016/s2215-0366(17)30513-8] [Citation(s) in RCA: 323] [Impact Index Per Article: 53.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 11/10/2017] [Accepted: 11/24/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Emily A Holmes
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Ata Ghaderi
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Catherine J Harmer
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Trust Foundation, Warneford Hospital, Oxford, UK
| | | | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Anthony P Morrison
- Psychosis Research Unit, Greater Manchester Mental Heath Trust, Manchester, UK; School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Claudi L H Bockting
- Academic Medical Center, Department of Psychiatry, University of Amsterdam, Amsterdam, Netherlands
| | - Rory C O'Connor
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Roz Shafran
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - Michelle L Moulds
- School of Psychology, The University of New South Wales, UNSW, Sydney, NSW, Australia
| | - Michelle G Craske
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| |
Collapse
|
11
|
Roberts LW, Kim JP. Receptiveness to participation in genetic research: A pilot study comparing views of people with depression, diabetes, or no illness. J Psychiatr Res 2017; 94:156-162. [PMID: 28719815 PMCID: PMC5621512 DOI: 10.1016/j.jpsychires.2017.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/28/2017] [Accepted: 07/02/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND Genetic research in human health relies on the participation of individuals with or at-risk for different types of diseases, including health conditions that may be stigmatized, such as mental illnesses. This preliminary study examines the differences in attitudes toward participation in genetic research among individuals with a psychiatric disorder, individuals with a physical disorder, and individuals with no known illness. METHODS Seventy-nine individuals with a history of diabetes or depression, or no known illness, underwent a simulated consent process for a hypothetical genetic research study. They were then surveyed about their willingness to participate in the hypothetical study and their attitudes about future and family participation in genetic research. RESULTS Participants with and without a history of depression ranked participating in genetic and medical research as very important and indicated that they were likely to participate in the hypothetical genetics study. Expressed willingness to participate was generally stable and consistent with future willingness. Individuals less strongly endorsed willingness to ask family members to participate in genetic research. CONCLUSION Individuals with and without a history of mental illness viewed genetic and medical research favorably and expressed willingness to participate in real-time and in the future. Informed consent processes ideally include an exploration of influences upon volunteers' enrollment decisions. Additional empirical study of influences upon genetic research participation is important to ensure that volunteers' rights are respected and that conditions that greatly affect the health of the public are not neglected scientifically.
Collapse
Affiliation(s)
- Laura Weiss Roberts
- Stanford University, School of Medicine, Department of Psychiatry and Behavioral Sciences, 401 Quarry Rd., Stanford, CA 94304, United States.
| | - Jane Paik Kim
- Stanford University, School of Medicine, Department of Psychiatry and Behavioral Sciences, 401 Quarry Rd., Stanford, CA 94304
| |
Collapse
|
12
|
Arantes M, Barbosa JM, Ferreira MA. Neuroanatomy education: The impact on perceptions, attitudes, and knowledge of an intensive course on general practice residents. ANATOMICAL SCIENCES EDUCATION 2017; 10:465-474. [PMID: 28264141 DOI: 10.1002/ase.1686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 01/28/2017] [Accepted: 02/04/2017] [Indexed: 06/06/2023]
Abstract
General practitioners are responsible for the management of an increasing number of patients with neurological illness, and thus a solid education in neurosciences is a necessary component of their training. This study examines the effects of an intensive clinical neuroanatomy course on twenty general practice residents' perceptions, attitudes, and knowledge. A knowledge test was completed by the participants and by a control group at four different time points. The participants were asked to answer a questionnaire about their reasons for signing up for the course and their attitudes and perceptions toward the course experience. Experimental and control groups demonstrated identical mean baseline test scores. The experimental group significantly increased its test scores (plus 49.0% correct answers, a mean improvement of 120%) relative to controls after the educational intervention. There were no differences among scores from the evaluated time points after the educational intervention in the experimental group. In the control group, there were likewise no significant differences between the four evaluated time points. Most participants indicated that they signed up for the course to update/acquire knowledge and skills in the field of neurosciences, and also because they had difficulty in diagnosing and managing patients with neurological diseases. Participants' attitudes and perceptions toward the course experience were very positive. Most of the participants (n = 17; 85%) rated the course as "extremely useful," and 3 (15%) rated it as "very useful." This study provides evidence demonstrating the potential positive effect of neurosciences education to general practice residents. Anat Sci Educ 10: 465-474. © 2017 American Association of Anatomists.
Collapse
Affiliation(s)
- Mavilde Arantes
- Department of Anatomy, Faculty of Medicine of the University of Porto, Porto, Portugal
- Division of Neuroradiology, Department of Radiology, Portuguese Institute of Oncology, Porto, Portugal
| | - Joselina Maria Barbosa
- Department of Medical Education and Simulation, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Maria Amélia Ferreira
- Department of Medical Education and Simulation, Faculty of Medicine, University of Porto, Porto, Portugal
| |
Collapse
|
13
|
Muzyk AJ, Gagliardi JP, Rakesh G, Jiroutek MR, Radhakrishnan R, Pae CU, Masand PS, Szabo ST. Development of a Diverse Learning Experience for Diverse Psychiatry Resident Needs: A Four-Year Biological Psychiatry Curriculum Incorporating Principles of Neurobiology, Psychopharmacology, and Evidence-Based Practice. Psychiatry Investig 2017; 14:289-297. [PMID: 28539947 PMCID: PMC5440431 DOI: 10.4306/pi.2017.14.3.289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 03/15/2016] [Accepted: 06/03/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE A clinically relevant approach to patient care grounded in neurobiological constructs and evidence based practice which emphasizes a relevant psychopharmacology is needed to optimally train psychiatry residents. METHODS We implemented a biological psychiatry course that now incorporates neurobiology, psychopharmacology, and evidence-based practice in conjunction with a Research Domain Criteria (RDoC) perspective. A survey launched prior to course implementation and following each class session, served as the outcome metric of residents' attitudes toward the new curriculum and followed a baseline attitudinal survey designed to evaluate the program. RESULTS Greater than 90% of the psychiatry residents at Duke University who took the attitudinal survey agreed or strongly agreed with needing a course that helped them develop an understanding of neurobiology, psychopharmacology, and evidence-based practice concepts. Most residents also indicated a less than adequate understanding of the neurobiology and psychopharmacology of psychiatric disorders prior to sessions. CONCLUSION Our biological psychiatry curriculum was associated with enthusiasm among residents regarding the incorporation of neurobiology, psychopharmacology, and evidence-based practice into course topics and discussions. A biological psychiatry curriculum with integrated neurobiology and psychopharmacology built on an evidence base approach is possible, well-received, and needed in training of future psychiatrists.
Collapse
Affiliation(s)
- Andrew J Muzyk
- Department of Pharmacy Practice, Campbell University School of Pharmacy and Health Sciences, Buies Creek, NC, USA
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
| | - Jane P Gagliardi
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
- Department of Medicine, Duke University, Durham, NC, USA
| | - Gopalkumar Rakesh
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
| | - Michael R Jiroutek
- Department of Clinical Research, Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC, USA
| | | | - Chi-Un Pae
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
- Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Prakash S Masand
- Academic Medicine Education Institute, Duke-NUS Medical School, Singapore
- Global Medical Education, New York, NY, USA
| | - Steven T Szabo
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
- Mental Health Service Line, Veterans Affairs Medical Center, Durham, NC, USA
| |
Collapse
|
14
|
Schlozman S, Beresin EV, Balon R, Coverdale JH, Brenner AM, Louie AK, Guerrero APS, Roberts LW. Stigma and Mental Health: A Proposal for Next Steps. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2016; 40:735-739. [PMID: 27502201 DOI: 10.1007/s40596-016-0601-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 07/22/2016] [Indexed: 06/06/2023]
Affiliation(s)
| | | | | | | | - Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | | | | |
Collapse
|
15
|
Schildkrout B, Benjamin S, Lauterbach MD. Integrating Neuroscience Knowledge and Neuropsychiatric Skills Into Psychiatry: The Way Forward. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:650-6. [PMID: 26630604 DOI: 10.1097/acm.0000000000001003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Increasing the integration of neuroscience knowledge and neuropsychiatric skills into general psychiatric practice would facilitate expanded approaches to diagnosis, formulation, and treatment while positioning practitioners to utilize findings from emerging brain research. There is growing consensus that the field of psychiatry would benefit from more familiarity with neuroscience and neuropsychiatry. Yet there remain numerous factors impeding the integration of these domains of knowledge into general psychiatry.The authors make recommendations to move the field forward, focusing on the need for advocacy by psychiatry and medical organizations and changes in psychiatry education at all levels. For individual psychiatrists, the recommendations target obstacles to attaining expanded neuroscience and neuropsychiatry education and barriers stemming from widely held, often unspoken beliefs. For the system of psychiatric care, recommendations address the conceptual and physical separation of psychiatry from medicine, overemphasis on the Diagnostic and Statistical Manual of Mental Disorders and on psychopharmacology, and different systems in medicine and psychiatry for handling reimbursement and patient records. For psychiatry residency training, recommendations focus on expanding neuroscience/neuropsychiatry faculty and integrating neuroscience education throughout the curriculum.Psychiatry traditionally concerns itself with helping individuals construct meaningful life narratives. Brain function is one of the fundamental determinants of individuality. It is now possible for psychiatrists to integrate knowledge of neuroscience into understanding the whole person by asking, What person has this brain? How does this brain make this person unique? How does this brain make this disorder unique? What treatment will help this disorder in this person with this brain?
Collapse
Affiliation(s)
- Barbara Schildkrout
- B. Schildkrout is assistant professor of psychiatry, part-time, Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. She is a neuropsychiatrist in private practice in Newton, Massachusetts. S. Benjamin is professor, Departments of Psychiatry and Neurology, and vice chair for education in psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts. He is past president, American Neuropsychiatric Association. M.D. Lauterbach is clinical assistant professor, volunteer faculty, Department of Psychiatry, University of Maryland School of Medicine, and neuropsychiatrist, Neuropsychiatry Program, Sheppard Pratt Health System, both in Baltimore, Maryland
| | | | | |
Collapse
|
16
|
Torous J, Stern AP, Padmanabhan JL, Keshavan MS, Perez DL. A proposed solution to integrating cognitive-affective neuroscience and neuropsychiatry in psychiatry residency training: The time is now. Asian J Psychiatr 2015; 17:116-21. [PMID: 26054985 DOI: 10.1016/j.ajp.2015.05.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 05/05/2015] [Indexed: 01/07/2023]
Abstract
Despite increasing recognition of the importance of a strong neuroscience and neuropsychiatry education in the training of psychiatry residents, achieving this competency has proven challenging. In this perspective article, we selectively discuss the current state of these educational efforts and outline how using brain-symptom relationships from a systems-level neural circuit approach in clinical formulations may help residents value, understand, and apply cognitive-affective neuroscience based principles towards the care of psychiatric patients. To demonstrate the utility of this model, we present a case of major depressive disorder and discuss suspected abnormal neural circuits and therapeutic implications. A clinical neural systems-level, symptom-based approach to conceptualize mental illness can complement and expand residents' existing psychiatric knowledge.
Collapse
Affiliation(s)
- John Torous
- Harvard Longwood Psychiatry Residency Training Program, Boston, MA, USA; Brigham and Women's Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Adam P Stern
- Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Berenson Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, USA
| | - Jaya L Padmanabhan
- Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Department of Behavioral Neurology and Neuropsychiatry, Belmont, MA, USA
| | - Matcheri S Keshavan
- Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - David L Perez
- Brigham and Women's Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
17
|
Cortese S. Here/In This Issue and There/Abstract Thinking: Neurosciences and (Child) Psychiatry. J Am Acad Child Adolesc Psychiatry 2015. [PMID: 26210326 DOI: 10.1016/j.jaac.2015.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Samuele Cortese
- Developmental Brain-Behaviour Laboratory, University of Southampton, UK; New York University Child Study Center, New York.
| |
Collapse
|