Course design: an integration of didactic and experiential approaches to graduate training of group therapy

Group Training for Psychiatric Residents: Support Group Facilitation and Supervision with Didactics

OBJECTIVE

Group psychotherapy merits dedicated training during psychiatry residency yet is challenging to implement given competing educational requirements. The authors implemented a voluntary support group training intervention for psychiatry residents consisting of a 6-h didactic series followed by at least 6 months of in vivo group facilitation and supervision. We hypothesized participation would improve residents' self-reported skill and knowledge in group facilitation.

METHODS

Psychiatry residents (PGY I-IV) voluntarily participated in this novel intervention that included a didactic series followed by experiential group facilitation and supervision. To assess confidence and self-reported skill level in group facilitation, residents completed two brief self-report surveys: before the didactic series (pre-intervention) and after group facilitation for at least 6 months (post-intervention). Surveys included Likert scales and open-ended questions. Quantitative data were analyzed with descriptive statistics and open-ended qualitative data were analyzed using thematic analysis.

RESULTS

Twenty-three residents attended 4 to 6 h of didactics between 2016 and 2018. Of these 23 residents, 12 facilitated groups and attended supervision for at least 6 months. Twenty residents responded to pre-intervention surveys and 14 responded to post-intervention surveys. After the intervention, respondents reported a significant increase in knowledge and skills in group facilitation of 88% (15/17) on Likert scale questions.

CONCLUSIONS

This study implemented a novel educational intervention to train psychiatric residents in group dynamics and group facilitation. Participation increased residents' self-reported knowledge and skills in group facilitation. Future directions include incorporating feedback about group curriculum, evaluating resident knowledge and skills using assessment measures, recruiting more group participants, and focusing on peer-to-peer mentoring.

Integrating Competency-Based Didactic and Experiential Global Health Learning for Dental Students: The Global Health Learning Helix Model

The aim of this study was to evaluate the feasibility and preliminary outcomes of immersive integrated experiential and didactic courses in strengthening competency-based global health learning in dental education. To address global inequities in oral health and student interest in global health, the Harvard School of Dental Medicine introduced two global health courses in 2017-18. The first was a didactic course in the core predoctoral curriculum, and the second, in collaboration with the Inter-American Center for Global Health, was a five-day elective experiential learning course in rural Costa Rica. The experiential course was an extension of the didactic course. All 33 second-year dental students completed the didactic course, and three of those students completed the experiential course. A pre-post survey and a six-month follow-up survey on self-reported knowledge based on course learning objectives were administered. The experiential course students also completed journals and interviews for qualitative analysis. Thirty-two students completed the pre-post didactic course surveys, for a response rate of 94%. There was a 100% response rate on the pre-post didactic surveys by those students who participated in the experiential learning course. While the experiential learning group scored similarly to the class average before the didactic course, they had higher scores than the class averages both immediately after and at the six-month follow-up. All three students reported that the experiential learning course was "extremely effective" in building on what they learned in the didactic course. Qualitative analysis of the journals and interviews suggested enhanced learning from the combination of didactic and experiential methods. These preliminary results support the Global Health Learning Helix Model, a theoretical competency-based teaching model for ethical student global health engagement to better prepare the future generation in tackling oral health disparities both locally and worldwide.

Group Therapy Graduate Seminar: A Developmental Perspective

Teaching group therapy is an essential aspect of graduate studies within the helping professions. Existing models discuss four basic elements required for such training: experience, observation, supervised practice, and theory. The present paper offers a model for a group therapy seminar based on these four elements and organized along developmental concepts. Clinical observations of 120 psychology students who participated in the seminar were gathered over a five-year period. Teaching techniques included supervised observation, fish-bowl, one-way mirror, and a final paper integrating theory and practice. The seminar enabled students to practice and to theorize about group processes, both as participants and as co-leaders. Seminar outcomes and conclusions are discussed.

Self-practice and self-reflection in cognitive behaviour therapy training: what factors influence trainees' engagement and experience of benefit?

BACKGROUND

Previous studies of self-practice/self-reflection (SP/SR) CBT training have found that trainees report significant benefits from practising CBT techniques on themselves (self-practice) and reflecting on their experience (self-reflection) as a formal part of their CBT training. However, not all trainees experience the same level of benefit from SP/SR and not all types of training course produce benefits to the same extent.

AIMS

This paper examines the question: What factors influence trainees' reported benefit from SP/SR? The aim was to develop a model to maximize the value of SP/SR training.

METHOD

The authors used a grounded theory analysis of four SP/SR training courses, varying along several dimensions, to derive a model that could account for the data.

RESULTS

A model was derived comprising of seven elements: Two outcomes - "Experience of Benefit" and "Engagement with the Process" - that mutually influence one another; and five other influencing factors - "Course Structure and Requirements", "Expectation of Benefit", "Feeling of Safety with the Process", "Group Process", and "Available Personal Resources" - that mediate the impact on Engagement with the Process and Experience of Benefit from SP/SR.

CONCLUSIONS

A model that provides guidance about the best ways to set up and develop SP/SR programs has been developed. This model may now be subject to empirical testing by trainers and researchers. Implications and recommendations for the design and development of future SP/SR programs are discussed.

Geriatric care as an introductory pharmacy practice experience

OBJECTIVE

To describe the design, delivery, and impact of a geriatric introductory pharmacy practice experience (IPPE) to develop students' skills related to consultant pharmacists' roles and patient care responsibilities.

DESIGN

A required 2-unit geriatric IPPE, involving 40 hours in a geriatric-care facility, 5 reflection hours, and 12 classroom-discussion hours, was developed for first- and second-year pharmacy students. Students interviewed patients and caregivers, reviewed patient charts, triaged patient needs, prepared care plans, and performed quality-assurance functions.

ASSESSMENT

After completing the IPPE, students' geriatric- and patient-care abilities were enhanced, based on review of their interactions, care plans, reflections, and examinations, and they demonstrated cognitive, affective, and psychomotor-domain learning skills. Students' care plans and quality assurance activities revealed positive patient outcomes, opportunities for measurable patient health improvement, and a positive impact on quality assurance activities. Student evaluations and feedback from health workers at the facilities also were positive.

CONCLUSIONS

This geriatric IPPE in which students cared for a specific patient and interacted with other health care providers is an innovative approach to enhancing students' abilities to serve the growing geriatric population.

Learning bridge: curricular integration of didactic and experiential education

OBJECTIVES

To assess the impact of a program to integrate introductory pharmacy practice experiences with pharmaceutical science topics by promoting active learning, self-directed learning skills, and critical-thinking skills.

DESIGN

The Learning Bridge, a curriculum program, was created to better integrate the material first-year (P1) students learned in pharmaceutical science courses into their introductory pharmacy practice experiences. Four Learning Bridge assignments required students to interact with their preceptors and answer questions relating to the pharmaceutical science material concurrently covered in their didactic courses.

ASSESSMENT

Surveys of students and preceptors were conducted to measure the effectiveness of the Learning Bridge process. Feedback indicated the Learning Bridge promoted students' interaction with their preceptors as well as development of active learning, self-directed learning, and critical-thinking skills. Students also indicated that the Learning Bridge assignments increased their learning, knowledge of drug information, and comprehension of relevant data in package inserts.

CONCLUSION

The Learning Bridge process integrated the didactic and experiential components of the curriculum, enhancing student learning in both areas, and offered students educational opportunities to interact more with their preceptors.

Group therapists' training: what predicts learning?

This field study represents the continuing effort to identify the determinants of learning within experiential small study groups. Thirty-seven training groups from the 1996 Institute of the American Group Psychotherapy Association were studied. Three process measures (Group Relationship Questionnaire [GRQ], Leader Adjective Measure [LAM], and Group Climate Questionnaire [GCQ]) were administered to 434 group members after the first two of four group sessions. Process variables were used to predict learning (measured by the Learning Evaluation Form [LEF]) at the end of the training groups. The factors derived from each of the measures showed good to excellent correspondence with previous studies employing the same instruments. Results suggest that perceptions of the leader and the group, rather than perceptions of one's own relationship to other group members, are more robust predictors of learning in these short-term training groups. Specifically, perceptions of an emotionally engaged group willing to confront conflict, and perceptions of a skillful leader, proved to be significant predictors of learning. Implications for the training of group therapists and group therapy research are discussed.

The demonstration group: a tool for observing group process and leadership style

Demonstration groups, a major modality for observing group process, have not been addressed in the group psychotherapy literature. This article defines the demonstration group and describes and discusses its various components: the volunteers (group members) and their recruitment, the demonstration group itself, group member debriefing, and the didactic component. Discussion of the physical setting, group agreements, and boundary considerations, as well as leadership tasks, challenges, and pitfalls are illustrated with examples. Leadership tasks in demonstration groups are compared with those in therapy groups. Guidelines that are likely to promote successful demonstration group experiences are provided. The leader's facility with the unconscious defense mechanism of projective identification is stressed.