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Arbuckle MR, Ferreira K, Skikic M, Travis MJ, Wilkey C, Ross DA. Assessment of Brief Online Approaches for Teaching Neuroscience in Psychiatry. Acad Psychiatry 2024; 48:227-232. [PMID: 38478200 DOI: 10.1007/s40596-024-01947-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 02/12/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE The goal of this study was to assess an online collection of brief educational resources (videos, case studies, articles) for teaching a broad range of concepts relating to neuroscience in psychiatry. METHODS A national sample of 52 psychiatrists enrolled in the study. Forty (77%) completed an assessment before and after having access to the educational resources for 4 weeks. Pre- and post-assessments were compared using paired t-tests. Fifteen participants were randomly selected to participate in a semi-structured interview. RESULTS The mean knowledge score increased on a multiple-choice quiz from 46.9 to 86.4% (p < .01). Based on a 5-point Likert rating, participants reported significant gains in self-confidence in their ability to integrate a neuroscience perspective into their clinical work (p = .03) and to discuss neuroscience with their patients (p = .008). Participants rated the extent that they applied neuroscience concepts (such as neurotransmitters, genetics, epigenetics, synaptic plasticity, and neural circuitry) to their overall case formulation and treatment plan over the past typical work week and how often they discussed these elements with patients. Significant gains were noted across all elements (p ≤ .001). Overall satisfaction with the resources were high: participants agreed that the content was useful and relevant (100%) and the teaching resources were engaging (95%). On semi-structured interviews, participants appreciated the mixed teaching approaches and the brief format. Many commented on how the resources impacted their clinical practice. CONCLUSIONS Brief online teaching resources may be an effective approach for enhancing neuroscience education among psychiatrists and may help facilitate the integration of neuroscience into clinical practice.
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Affiliation(s)
- Melissa R Arbuckle
- Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, USA.
| | | | - Maja Skikic
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael J Travis
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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2
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Avery J, Pacheco N, Arbuckle MR, Culas R, Cutler JL, Malone PK. Development of an Underrepresented in Medicine (URM) Program for Fourth Year Medical Students in Psychiatry. Acad Psychiatry 2024; 48:207-208. [PMID: 37770700 DOI: 10.1007/s40596-023-01865-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/30/2023] [Indexed: 09/30/2023]
Affiliation(s)
- Jade Avery
- Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY, USA
| | - Nicole Pacheco
- Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY, USA
| | - Melissa R Arbuckle
- Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY, USA
| | - Renu Culas
- Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY, USA
| | - Janis L Cutler
- Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY, USA
| | - Patrice K Malone
- Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY, USA.
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Nash E, Perlson JE, McCann R, Noy G, Lawrence R, Alves-Bradford JM, Akinade T, Perez D, Arbuckle MR. Mitigating Racism and Implicit Bias in Psychiatric Notes: a Quality Improvement Project Addressing How Race and Ethnicity Are Documented. Acad Psychiatry 2024; 48:211-212. [PMID: 37016174 DOI: 10.1007/s40596-023-01775-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Affiliation(s)
- Emily Nash
- Columbia University Irving Medical Center, New York, NY, USA.
| | - Jacob E Perlson
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | | | - Gad Noy
- Columbia University Irving Medical Center, New York, NY, USA
| | - Ryan Lawrence
- Columbia University Irving Medical Center, New York, NY, USA
| | - Jean-Marie Alves-Bradford
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | | | - Diana Perez
- Columbia University Irving Medical Center, New York, NY, USA
| | - Melissa R Arbuckle
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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4
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Kyzar EJ, Arbuckle MR, Abba-Aji A, Balachandra K, Cooper J, Dela Cruz A, Edens E, Heward B, Jibson M, Jordan A, Moreno-De-Luca D, Pazderka H, Singh M, Weleff JJ, Yau B, Young J, Ross DA. Leveraging neuroscience education to address stigma related to opioid use disorder in the community: a pilot study. Front Psychiatry 2024; 15:1360356. [PMID: 38563031 PMCID: PMC10982477 DOI: 10.3389/fpsyt.2024.1360356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Opioid use disorder (OUD) and overdose deaths are a public health crisis. One contributing factor is stigma towards people who use opioids. We developed and conducted a public-facing, half-day educational event designed to challenge misperceptions about OUD from a contemporary neuroscience perspective. Participants engaged with three different resources on the neurobiology of addiction, and, at the end of the event, they rated its effectiveness. We also collected and compared pre- and post-event composite OUD stigma scales. Participants rated our approach and the overall event as highly effective. Additionally, OUD stigma scores were lower immediately following the event, and this decrease was primarily driven by decreased internalized stigma. Here, we demonstrate an effective proof-of-concept that an accessible, public-facing, neuroscience education event may reduce OUD stigma in the community.
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Affiliation(s)
- Evan J Kyzar
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, United States
| | - Melissa R Arbuckle
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, United States
| | - Adam Abba-Aji
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
| | - Krishna Balachandra
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
| | - Joseph Cooper
- Department of Psychiatry, University of Illinois, Chicago, IL, United States
| | - Adriane Dela Cruz
- Department of Psychiatry, University of Texas, Dallas, TX, United States
| | - Ellen Edens
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Brady Heward
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington, VT, United States
| | - Michael Jibson
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan MI, United States
| | - Ayana Jordan
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States
| | - Daniel Moreno-De-Luca
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
- CASA Mental Health, Edmonton, AB, Canada
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
| | - Mohit Singh
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
| | - Jeremy J Weleff
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Bernice Yau
- Department of Psychiatry, University of Texas, Dallas, TX, United States
| | - Justin Young
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - David A Ross
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
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5
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Erickson BR, Graca GM, Arbuckle MR. Defining and Assessing the Psychiatric Clinician-Educator through Holistic Productivity and Impact. Acad Psychiatry 2023; 47:696-697. [PMID: 37072668 PMCID: PMC10918647 DOI: 10.1007/s40596-023-01786-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/05/2023] [Indexed: 05/03/2023]
Affiliation(s)
| | - Gary M Graca
- New York State Psychiatric Institute, New York, NY, USA
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6
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Nathanson M, Abramov M, Anabtawi N, Nakhla M, Cruz K, Arbuckle MR, Hamilton MS. Improving Cohesion in a Geographically Separate Geriatric Psychiatry Fellowship: a Silver Lining of the COVID-19 Pandemic. Acad Psychiatry 2023; 47:224-225. [PMID: 36324038 PMCID: PMC9629755 DOI: 10.1007/s40596-022-01723-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/18/2022] [Indexed: 05/25/2023]
Affiliation(s)
- Mark Nathanson
- Columbia University Irving Medical Center, New York, NY, USA
| | | | | | - Mark Nakhla
- Icahn School of Medicine and World Trade Center Health Program Mental Health Services Clinical Center of Excellence at Mount Sinai, New York, NY, USA
| | - Karen Cruz
- Columbia University Irving Medical Center, New York, NY, USA
| | - Melissa R Arbuckle
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Margaret S Hamilton
- Columbia University Irving Medical Center, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
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Hamilton MS, Friederwitzer K, Culas R, Hamilton ES, Arbuckle MR. Developing a Psychiatric Observership Program for International Medical Students and Graduates. Acad Psychiatry 2022:1-2. [PMID: 36348229 PMCID: PMC9643890 DOI: 10.1007/s40596-022-01727-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Margaret S Hamilton
- Columbia University Irving Medical Center, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
| | | | - Renu Culas
- New York State Psychiatric Institute, New York, NY, USA
| | - Emily S Hamilton
- Staten Island University Hospital, Northwell Health, Staten Island, NY, USA
| | - Melissa R Arbuckle
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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8
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Houston LJ, DeJong SM, Brenner AM, Macaluso M, Kinzie JM, Arbuckle MR, Janssen F, Cowley DS, Bentman AL. Challenges of Assessing Resident Competency in Well-Being: Development of the Psychiatry Milestones 2.0 Well-Being Subcompetency. Acad Med 2022; 97:351-356. [PMID: 34192719 DOI: 10.1097/acm.0000000000004220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Burnout and depression are major problems facing physicians, with 300-400 physicians dying by suicide each year. In an effort to address this issue, the Accreditation Council for Graduate Medical Education (ACGME) revised the Common Program Requirements for residency and fellowship programs to include a strong emphasis on well-being, and this revision has been extended to including a subcompetency on well-being in the Milestones 2.0. The Psychiatry Milestones 2.0 Work Group was convened to draft updated psychiatry milestones. As part of the open feedback period, the American Association of Directors of Psychiatric Residency Training submitted an organizational letter outlining several points to consider regarding the original draft of the well-being subcompetency. The ACGME was receptive to this feedback and allowed the Psychiatry Milestones 2.0 Work Group to revise the subcompetency. Current research indicates that burnout is largely driven by systemic factors, but well-being literature and initiatives often focus on individual factors and responsibility for burnout rather than systemic change. Program directors tasked with assessing resident well-being can additionally encounter several professionalism concerns, including how to (1) define a subcompetency within a competency that itself has not been well defined; (2) decide the appropriate balance between individual and systemic responsibility for well-being; (3) consider mental health as a parameter of well-being; (4) balance roles as physicians, psychiatrists, and training directors in thinking about the mental health of residents without overstepping boundaries and while maintaining privacy, confidentiality, and resident safety; and (5) measure well-being in a sociocultural context. This article describes how these considerations were incorporated into the revision of the Psychiatry Milestones 2.0 version of the well-being subcompetency, which has subsequently been made available to other specialty work groups for potential use as they develop their specialty-specific Milestones 2.0.
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Affiliation(s)
- L Joy Houston
- L.J. Houston is associate professor and vice chair of education, Department of Psychiatry, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Sandra M DeJong
- S.M. DeJong is assistant professor, Cambridge Health Alliance Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts
| | - Adam M Brenner
- A.M. Brenner is professor of psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Matthew Macaluso
- M. Macaluso is Bee McWane Reid Professor and clinical director, Department of Psychiatry and Behavioral Neurobiology, Depression and Suicide Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - J Mark Kinzie
- J.M. Kinzie is associate professor, Department of Psychiatry, Oregon Health and Science University, Portland, Oregon
| | - Melissa R Arbuckle
- M.R. Arbuckle is professor of psychiatry, Department of Psychiatry, Columbia University Irving Medical Center, the New York State Psychiatric Institute, New York, New York
| | - Furhut Janssen
- F. Janssen is psychiatry residency program director and assistant professor, Central Michigan University College of Medicine, Saginaw, Michigan
| | - Deborah S Cowley
- D.S. Cowley is professor emeritus, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Adrienne L Bentman
- A.L. Bentman is general psychiatry program director, Department of Psychiatry, Institute of Living, Hartford Hospital, Hartford, Connecticut
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Affiliation(s)
- Deborah L Cabaniss
- Professor of clinical psychiatry, Columbia University Department of Psychiatry, New York State Psychiatric Institute, New York, New York;
| | - Melissa R Arbuckle
- Professor of psychiatry, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York
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10
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Shalev D, Nakagawa S, Stroeh OM, Arbuckle MR, Rendleman R, Blinderman CD, Shapiro PA. The Creation of a Psychiatry-Palliative Care Liaison Team: Using Psychiatrists to Extend Palliative Care Delivery and Access During the COVID-19 Crisis. J Pain Symptom Manage 2020; 60:e12-e16. [PMID: 32544648 PMCID: PMC7293533 DOI: 10.1016/j.jpainsymman.2020.06.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/31/2020] [Accepted: 06/08/2020] [Indexed: 12/04/2022]
Abstract
CONTEXT During the course of March and April 2020, New York City experienced a surge of a 170,000 coronavirus disease 2019 (COVID-19) cases, overwhelming hospital systems and leading to an unprecedented need for palliative care services. OBJECTIVES To present a model for rapid palliative care workforce expansion under crisis conditions, using supervised advanced psychiatry trainees to provide primary palliative services in the acute care and emergency setting. METHODS In response to the New York City COVID-19 surge, advanced psychiatry trainees at New York-Presbyterian Columbia University Irving Medical Center were rapidly trained and redeployed to a newly formed psychiatry-palliative care liaison team. Under the supervision of consultation-liaison psychiatrists (who also served as team coordinators), these trainees provided circumscribed palliative care services to patients and/or their families, including goals-of-care discussions and psychosocial support. Palliative care attendings remained available to all team members for more advanced and specialized supervision. RESULTS The psychiatry-palliative care liaison team effectively provided palliative care services during the early phase and peak of New York City's COVID-19 crisis, managing up to 16 new cases per day and provided longitudinal follow-up, thereby enabling palliative care specialists to focus on providing services requiring specialist-level palliative care expertise. CONCLUSION By training and supervising psychiatrists and advanced psychiatry trainees in specific palliative care roles, palliative care teams could more effectively meet markedly increased service needs of varying complexity during the COVID-19 crisis. As new geographic regions experience possible COVID-19 surges in the coming months, this may serve as a model for rapidly increasing palliative care workforce.
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Affiliation(s)
- Daniel Shalev
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA.
| | - Shunichi Nakagawa
- Department of Medicine, Adult Palliative Care Service, Columbia University Irving Medical Center, New York, New York, USA
| | - Oliver M Stroeh
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - Melissa R Arbuckle
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
| | - Rebecca Rendleman
- Department of Psychiatry, Weill Cornell Medicine, New York, New York, USA
| | - Craig D Blinderman
- Department of Medicine, Adult Palliative Care Service, Columbia University Irving Medical Center, New York, New York, USA
| | - Peter A Shapiro
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, USA
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11
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Arbuckle MR, Stern DA, Barkil-Oteo A, Asghar-Ali AA. Training Residents in High-Value, Cost-Effective Care: a National Survey of Psychiatry Program Directors. Acad Psychiatry 2020; 44:324-329. [PMID: 32212096 DOI: 10.1007/s40596-020-01218-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 03/02/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The goal of this study was to explore how prepared psychiatry programs are to teach residents to practice resource management and high-value, cost-effective care. METHODS An anonymous online survey was sent to 187 psychiatry training directors between July and September 2015. RESULTS Forty-four percent of training directors responded to the survey. While most training directors who responded (88%) agreed that that graduate medical education has a responsibility to respond to the rising cost of health care, fewer than half agreed that that their faculty members consistently model cost-effective care (48%), that residents have access to information regarding the cost of tests and procedures (32%), and that residents are prepared to integrate the cost of care with available evidence when making medical decisions (44%). Only 11% reported providing training in resource management. Barriers cited to teaching cost-effective care included a lack of information regarding health care costs (45%), a lack of time (24%), a lack of faculty with relevant skills (19%), and competing training demands and priorities (18%). Training directors also noted a lack of available curricular resources and assessment tools (21%). Another 12% cited concerns about cost containment overriding treatment guidelines. Ninety percent of training directors agreed that they would be interested in resources to help teach high-value, cost-effective care. CONCLUSIONS Most psychiatry programs do not provide formal training in resource management but are interested in resources to teach high-value, cost-effective care. Curricula for residents and faculty may help meet this need.
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Affiliation(s)
- Melissa R Arbuckle
- The New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA.
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12
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Arbuckle MR, Barkil-Oteo A, Asghar-Ali AA, Stern DA. Training in High-Value, Cost-Effective Care: a Curriculum for Psychiatry Residents. Acad Psychiatry 2020; 44:330-334. [PMID: 32212097 DOI: 10.1007/s40596-020-01199-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/04/2020] [Indexed: 06/10/2023]
Affiliation(s)
- Melissa R Arbuckle
- Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, USA.
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13
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Arbuckle MR, Travis MJ, Eisen J, Wang A, Walker AE, Cooper JJ, Neeley L, Zisook S, Cowley DS, Ross DA. Transforming Psychiatry from the Classroom to the Clinic: Lessons from the National Neuroscience Curriculum Initiative. Acad Psychiatry 2020; 44:29-36. [PMID: 31797322 PMCID: PMC7018606 DOI: 10.1007/s40596-019-01119-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 09/02/2019] [Accepted: 09/12/2019] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Individual residency programs often struggle to keep pace with scientific advances and new training requirements. Integrating a modern neuroscience perspective into the clinical practice of psychiatry is particularly emblematic of these challenges. The National Neuroscience Curriculum Initiative (NNCI) was established in 2013 to develop a comprehensive set of shared, open-access resources for teaching neuroscience in psychiatry. METHODS The NNCI developed a collaborative, team-based approach with a peer-review process for generating and reviewing content. Teaching resources have included interactive sessions for the classroom paired with a comprehensive facilitator's guide. Brief accessible reviews and short videos have been developed for self-study and teaching in clinical settings. Dissemination efforts have included hands-on training for educators through national workshops. All resources are freely available on the NNCI website. Outcome measures have included the number of educational resources developed, feedback from workshop attendees, the number of US psychiatry residency programs who have adopted NNCI resources, as well as analytics from the NNCI website. RESULTS To date, the NNCI has developed over 150 teaching sessions, reflecting the work of 129 authors from 49 institutions. The NNCI has run over 50 faculty development workshops in collaboration with numerous national and international organizations. Between March 2015 and June 2019, the website (www.NNCIonline.org) has hosted 48,640 unique users from 161 countries with 500,953 page views. More than 200 psychiatry training programs have reported implementing NNCI teaching materials. CONCLUSIONS This multisite collaborative provides a model for integrating cutting-edge science into medical education and the practice of medicine more broadly.
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Affiliation(s)
| | - Michael J Travis
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Amanda Wang
- Research Foundation for Mental Hygiene, New York, NY, USA
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Jones-Bourne C, Miller B, Arbuckle MR. Promoting Mental Health Awareness in the Christian Community Through Collaboration. Psychiatr Serv 2019; 70:1073. [PMID: 31672110 DOI: 10.1176/appi.ps.701103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Claudine Jones-Bourne
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York (Jones-Bourne, Arbuckle); Trinity Church, New York (Miller)
| | - Benjamin Miller
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York (Jones-Bourne, Arbuckle); Trinity Church, New York (Miller)
| | - Melissa R Arbuckle
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York (Jones-Bourne, Arbuckle); Trinity Church, New York (Miller)
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15
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Nguyen BT, Arbuckle MR, Jones-Bourne C. Re-examining Psychiatry Residents' Perspectives of Primary Care. Acad Psychiatry 2019; 43:553-554. [PMID: 31396880 DOI: 10.1007/s40596-019-01098-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/12/2019] [Accepted: 07/28/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Bianca T Nguyen
- Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY, USA.
| | - Melissa R Arbuckle
- Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY, USA
| | - Claudine Jones-Bourne
- Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY, USA
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16
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Jones-Bourne C, Arbuckle MR. Psychiatry Residents' Perspectives of Primary Care in the Psychiatric Setting. Acad Psychiatry 2019; 43:196-199. [PMID: 30560349 DOI: 10.1007/s40596-018-1001-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 11/05/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Given the growing interest in integrated care, this study sought to investigate the perception of psychiatry residents towards managing general medical conditions in their psychiatric patients. METHODS Between July-October 2017, all 46 residents at an adult psychiatry program were asked to complete an online survey. RESULTS Sixty-seven percent responded. Most residents (81%) indicated they were knowledgeable and/or comfortable in managing medical conditions with supervision/consultation from a primary care provider. Residents also indicated that they would "like to" (48%) and/or "should" be able to (71%) manage the general medical conditions of their patients in the future with supervision/consultation from a primary care provider. An additional 26% indicated that they would like to and/or should be able to independently manage both behavioral and general medical conditions for their patients. Nicotine dependence, hypertension, dyslipidemias, and non-insulin-dependent diabetes were among the top conditions residents felt they should be able to manage (≥ 74%). A lack of knowledge, experience, training, and supervision were the most frequent barriers residents listed in providing general medical care to patients (71%). Residents noted that supervision from a primary care physician (29%) and additional education (54%) would help increase their comfort in managing medical conditions. CONCLUSIONS Psychiatry residents were generally interested in managing basic medical issues. Opportunities to expand residency training in integrated care should be considered. With new models of integrated care emerging, future studies should explore how resident attitudes might evolve over time, as well as the attitudes and opinions of practicing psychiatrists and supervisors on this topic.
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Affiliation(s)
- Claudine Jones-Bourne
- Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY, USA.
| | - Melissa R Arbuckle
- Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY, USA
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Robinson LA, Osborne LM, Hsu AJ, Park H, Arbuckle MR. Moonlighting by Psychiatry Residents: a Survey of Residents and Training Directors. Acad Psychiatry 2019; 43:46-50. [PMID: 30456706 DOI: 10.1007/s40596-018-1004-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 11/05/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE This study sought to assess the prevalence of moonlighting among psychiatry residents; the perceived effects of moonlighting on resident recruitment, education, and liability; and policies and practices governing oversight. METHODS In 2013, surveys were emailed to all general psychiatry residency programs that were accredited by the Accreditation Council for Graduate Medical Education and had available contact information (n = 183). Resident surveys were emailed to program coordinators with a request to forward the survey link to their residents. RESULTS Responses were received from 63 program directors (34% response rate) and 238 residents (about 5% of total general psychiatry residents). Most psychiatry program directors (95%) indicated that their programs permit moonlighting. Moonlighting participation increased with each year of training, culminating with 67% of fourth year residents. Most residents and faculty (87%) agreed that moonlighting enhanced resident education. Thirty-seven percent of program directors reported having no oversight procedures in place to monitor moonlighting activities. Thirty-nine percent of resident survey responders reported having no supervision for at least one of their moonlighting activities and only 9% reported always having access to on-site supervision. CONCLUSION Though limited by a low response rate, this study found that moonlighting seems to remain prevalent among psychiatry residents and widely accepted by psychiatry residency training programs. There appears to be relatively limited program oversight for moonlighting activities, many of which seem to lack close supervision.
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Affiliation(s)
| | - Lauren M Osborne
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alan J Hsu
- University of California, San Diego and the Veterans Affairs (VA) San Diego Healthcare System, San Diego, CA, USA
| | - Henry Park
- Columbia University Irving Medical Center, New York, NY, USA
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Latov DR, Levine M, Cutler JL, Park HC, Arbuckle MR, Cabaniss DL. Developing an Observed Structured Teaching Exercise for Psychiatry Residents. Acad Psychiatry 2018; 42:867-868. [PMID: 30066244 DOI: 10.1007/s40596-018-0953-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 07/03/2018] [Indexed: 06/08/2023]
Affiliation(s)
- David R Latov
- New York State Psychiatric Institute, New York, NY, USA.
| | - Mimi Levine
- New York State Psychiatric Institute, New York, NY, USA
| | | | - Henry C Park
- Columbia University Medical Center, New York, NY, USA
| | - Melissa R Arbuckle
- New York State Psychiatric Institute, New York, NY, USA
- Columbia University Medical Center, New York, NY, USA
| | - Deborah L Cabaniss
- New York State Psychiatric Institute, New York, NY, USA
- Columbia University Medical Center, New York, NY, USA
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19
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Lieberman JA, Ehrhardt AA, Simpson HB, Arbuckle MR, Fyer AJ, Essock SM. Eliminating the Glass Ceiling in Academic Psychiatry. Acad Psychiatry 2018; 42:523-528. [PMID: 29110268 PMCID: PMC6096872 DOI: 10.1007/s40596-017-0810-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 09/06/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Jeffrey A Lieberman
- Columbia University, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
| | - Anke A Ehrhardt
- Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - H Blair Simpson
- Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Melissa R Arbuckle
- Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Abby J Fyer
- Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Susan M Essock
- Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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20
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Arbuckle MR, Luo SX, Pincus HA, Gordon JA, Chung JY, Chavez M, Oquendo MA. Trends in MD/PhD Graduates Entering Psychiatry: Assessing the Physician-Scientist Pipeline. Acad Psychiatry 2018; 42:346-353. [PMID: 29302928 PMCID: PMC5943155 DOI: 10.1007/s40596-017-0870-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 12/06/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The goal of this study was to identify trends in MD/PhD graduates entering psychiatry, to compare these trends with other specialties, and to review strategies for enhancing the physician-scientist pipeline. METHODS Data on 226,588 medical students graduating from Liaison Committee on Medical Education accredited programs between 1999 and 2012 (6626 MD/PhDs) were used to evaluate the number, percentage, and proportion of MD/PhDs entering psychiatry in comparison with other specialties (neurology, neurosurgery, internal medicine, family medicine, and radiation oncology). Linear regression and multiple linear regression determined whether these values increased over time and varied by sex. RESULTS Over 14 years, an average of 18 MD/PhDs (range 13-29) enrolled in psychiatry each year. The number of MD/PhDs going into psychiatry significantly increased, although these gains were modest (less than one additional MD/PhD per year). The proportion of students entering psychiatry who were MD/PhDs varied between 2.9 and 5.9 per 100 residents, with no significant change over time. There was also no change in the percentage of MD/PhDs entering psychiatry from among all MD/PhD graduates. The rate of increase in the number of MD/PhDs going into psychiatry did not differ significantly from other specialties except for family medicine, which is decreasing. The rate of MD/PhDs going into psychiatry was higher for women, suggesting closure of the sex gap in 17 years. CONCLUSIONS Despite the increase in the number of MD/PhDs entering psychiatry, these numbers remain low. Expanding the cohort of physician-scientists dedicated to translational research in psychiatry will require a multipronged approach.
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Affiliation(s)
- Melissa R Arbuckle
- Columbia University Medical Center, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
| | - Sean X Luo
- Columbia University Medical Center, New York, NY, USA
| | - Harold Alan Pincus
- Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- New York-Presbyterian Hospital, New York, NY, USA
| | - Joshua A Gordon
- Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Joyce Y Chung
- US National Institute of Mental Health, Bethesda, MD, USA
| | - Mark Chavez
- US National Institute of Mental Health, Bethesda, MD, USA
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21
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Weinberg M, Arbuckle MR, Ranz JM. Broadening the Lens of System-Based Practice: From Micro to Macro and Basic to Complex in Residency Training. Acad Psychiatry 2018; 42:212-216. [PMID: 28510804 DOI: 10.1007/s40596-017-0716-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 04/24/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This paper aimed to develop a model for understanding the various dimensions of system-based practice (SBP) and determine the extent to which psychiatry residents perform behaviors along these dimensions. METHODS Sixty-one supervisors from seven psychiatry programs rated resident performance of SBP behaviors using a 60-item instrument. Multi-dimensional scaling and cluster analysis were conducted to determine how the instrument items related to one another and the larger concept of SBP. Average supervisor ratings between clusters were compared to determine resident performance along the identified SBP dimensions. RESULTS The data supports a model of SBP defined along two dimensions: (1) from micro (patient) to macro (population-based) interventions and (2) from low to high system complexity. Residents were more likely to perform behaviors at the patient level compared to those at the population-based level. CONCLUSIONS Training in SBP remains predominately focused on the doctor-patient level and not the greater system of health-care delivery.
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Affiliation(s)
- Michael Weinberg
- Columbia University Department of Psychiatry, New York, NY, USA.
| | | | - Jules M Ranz
- Columbia University Department of Psychiatry, New York, NY, USA
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Affiliation(s)
- Daniel Shalev
- Department of Psychiatry, Columbia University, New York, New York; New York State Psychiatric Institute, New York, New York.
| | - Melissa R Arbuckle
- Department of Psychiatry, Columbia University, New York, New York; New York State Psychiatric Institute, New York, New York
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Bhugra D, Tasman A, Pathare S, Priebe S, Smith S, Torous J, Arbuckle MR, Langford A, Alarcón RD, Chiu HFK, First MB, Kay J, Sunkel C, Thapar A, Udomratn P, Baingana FK, Kestel D, Ng RMK, Patel A, Picker LD, McKenzie KJ, Moussaoui D, Muijen M, Bartlett P, Davison S, Exworthy T, Loza N, Rose D, Torales J, Brown M, Christensen H, Firth J, Keshavan M, Li A, Onnela JP, Wykes T, Elkholy H, Kalra G, Lovett KF, Travis MJ, Ventriglio A. The WPA-Lancet Psychiatry Commission on the Future of Psychiatry. Lancet Psychiatry 2017; 4:775-818. [PMID: 28946952 DOI: 10.1016/s2215-0366(17)30333-4] [Citation(s) in RCA: 184] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 07/28/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Dinesh Bhugra
- Department of Health Services and Population Research, King's College London and South London and Maudsley NHS Foundation Trust, London, UK; World Psychiatric Association, Geneva, Switzerland.
| | - Allan Tasman
- Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA
| | - Soumitra Pathare
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Shubulade Smith
- Department of Forensic and Neurodevelopmental Science, King's College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - John Torous
- Department of Psychiatry and Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Melissa R Arbuckle
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Alex Langford
- Psychological Medicine Service, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Renato D Alarcón
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA; Department of Psychiatry, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Helen Fung Kum Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Michael B First
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Jerald Kay
- Department of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Charlene Sunkel
- SA Federation for Mental Health, Johannesburg, South Africa; Movement for Global Mental Health, Johannesburg, South Africa
| | - Anita Thapar
- Child & Adolescent Psychiatry Section, Division of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics & Genomics, School of Medicine, Cardiff University, Cardiff, UK
| | - Pichet Udomratn
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Florence K Baingana
- Mental Health Lead Basic Package of Essential Health Services Cluster, WHO Sierra Leone Country Office, Freetown, Sierra Leone
| | - Dévora Kestel
- Mental Health and Substance Use Unit, Pan American Health Organization/World Health Organization, Washington DC, USA
| | | | - Anita Patel
- Centre for Primary Care & Public Health, Blizard Institute, Queen Mary University of London, London, UK
| | - Livia De Picker
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium
| | - Kwame Julius McKenzie
- Wellesley Institute, Toronto, Ontario, Canada; General Psychiatry and Health Systems, Centre for Addictions and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Driss Moussaoui
- Ibn Rushd University Psychiatric Center, Casablanca, Morocco
| | - Matt Muijen
- Danish Mental Health Association, Copenhagen, Denmark
| | - Peter Bartlett
- School of Law and Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Sophie Davison
- State Forensic Mental Health Service, Department of Health, Clinical Research Centre, Mount Claremont, WA, Australia; School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia
| | - Tim Exworthy
- Department of Forensic and Neurodevelopmental Science, King's College London and South London and Maudsley NHS Foundation Trust, London, UK; Cygnet Healthcare, Stevenage, UK
| | | | - Diana Rose
- Service User Research Enterprise, King's College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - Julio Torales
- Department of Psychiatry, National University of Asunción, San Lorenzo, Paraguay
| | | | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Joseph Firth
- NICM, School of Science and Health, University of Western Sydney, Sydney, NSW, Australia
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ang Li
- Department of Psychology, Beijing Forestry University, Beijing, China
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Til Wykes
- Institute of Psychiatry, Psychology & Neuroscience, King's College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - Hussien Elkholy
- World Psychiatric Association, Geneva, Switzerland; Institute of Psychiatry, Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Gurvinder Kalra
- Flynn Adult Inpatient Psychiatric Unit, Latrobe Regional Hospital Mental Health Services (LRH-MHS), Traralgon, VIC, Australia; School of Rural Health (La Trobe Valley & West Gippsland), Monash University, VIC, Australia
| | | | - Michael J Travis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Arbuckle MR. Maria Oquendo, M.D., Ph.D., 143rd President, 2016-2017. Am J Psychiatry 2017; 174:737. [PMID: 28760013 DOI: 10.1176/appi.ajp.2017.174802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Melissa R Arbuckle
- Presented at the 170th Annual Meeting of the American Psychiatric Association, San Diego, May 20, 2017. Dr. Arbuckle is Vice Chair for Education and Director of Residency Training, Department of Psychiatry at Columbia and the New York State Psychiatric Institute
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25
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Kavanagh EP, Cahill J, Arbuckle MR, Lenet AE, Subramanyam K, Winchel RM, Nossel I, DeSilva R, Caravella RA, Ackerman M, Park HC, Ross DA. Psychopharmacology Prescribing Workshops: A Novel Method for Teaching Psychiatry Residents How to Talk to Patients About Medications. Acad Psychiatry 2017; 41:491-496. [PMID: 28194682 DOI: 10.1007/s40596-017-0662-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 01/08/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Traditional, lecture-based methods of teaching pharmacology may not translate into the skills needed to communicate effectively with patients about medications. In response, the authors developed an interactive course for third-year psychiatry residents to reinforce prescribing skills. METHODS Residents participate in a facilitated group discussion combined with a role-play exercise where they mock-prescribe medication to their peers. Each session is focused on one medication or class of medications with an emphasis on various aspects of informed consent (such as describing the indication, dosing, expected benefits, potential side effects, and necessary work-up and follow up). In the process of implementing the course at a second site, the original format was modified to include self-assessment measures and video examples of experienced faculty members prescribing to a simulated patient. RESULTS The course was initially developed at one site and has since been disseminated to a number of other institutions. Between 2010 and 2016, 144 residents participated in the course at the authors' two institutions. Based upon pre/post surveys conducted with a subset of residents, the course significantly improved comfort with various aspects of prescribing. Although residents may also gain comfort in prescribing with experience (as the course coincides with the major outpatient clinical training year), improvement in comfort-level was also noted for medications that residents had relatively little experience initiating. At the end of the year, half of the residents indicated the course was one of their top three preferred methods for learning psychopharmacology in addition to direct clinical experience and supervision (with none listing didactics). CONCLUSION An interactive prescribing workshop can improve resident comfort with prescribing and may be preferred over a traditional, lecture-based approach. The course may be particularly helpful for those medications that are less commonly used. Based upon our experience, this approach can be easily implemented across institutions..
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Affiliation(s)
| | | | | | | | | | | | - Ilana Nossel
- Columbia University Medical Center, New York, NY, USA
| | - Ravi DeSilva
- Columbia University Medical Center, New York, NY, USA
| | | | - Marra Ackerman
- New York University School of Medicine, New York, NY, USA
| | - Henry C Park
- Columbia University Medical Center, New York, NY, USA
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26
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Affiliation(s)
- Alejandro Ramirez
- Department of Psychiatry, Columbia University, New York, New York; New York State Psychiatric Institute, New York, New York.
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27
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Wainberg ML, Scorza P, Shultz JM, Helpman L, Mootz JJ, Johnson KA, Neria Y, Bradford JME, Oquendo MA, Arbuckle MR. Challenges and Opportunities in Global Mental Health: a Research-to-Practice Perspective. Curr Psychiatry Rep 2017; 19:28. [PMID: 28425023 PMCID: PMC5553319 DOI: 10.1007/s11920-017-0780-z] [Citation(s) in RCA: 254] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Globally, the majority of those who need mental health care worldwide lack access to high-quality mental health services. Stigma, human resource shortages, fragmented service delivery models, and lack of research capacity for implementation and policy change contribute to the current mental health treatment gap. In this review, we describe how health systems in low- and middle-income countries (LMICs) are addressing the mental health gap and further identify challenges and priority areas for future research. RECENT FINDINGS Common mental disorders are responsible for the largest proportion of the global burden of disease; yet, there is sound evidence that these disorders, as well as severe mental disorders, can be successfully treated using evidence-based interventions delivered by trained lay health workers in low-resource community or primary care settings. Stigma is a barrier to service uptake. Prevention, though necessary to address the mental health gap, has not solidified as a research or programmatic focus. Research-to-practice implementation studies are required to inform policies and scale-up services. Four priority areas are identified for focused attention to diminish the mental health treatment gap and to improve access to high-quality mental health services globally: diminishing pervasive stigma, building mental health system treatment and research capacity, implementing prevention programs to decrease the incidence of mental disorders, and establishing sustainable scale up of public health systems to improve access to mental health treatment using evidence-based interventions.
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Affiliation(s)
- Milton L Wainberg
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 24, New York, NY, 10032, USA.
| | - Pamela Scorza
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 24, New York, NY, 10032, USA
| | - James M Shultz
- Center for Disaster and Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine, Miami, FL, 33160, USA
| | - Liat Helpman
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 24, New York, NY, 10032, USA
| | - Jennifer J Mootz
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 24, New York, NY, 10032, USA
| | - Karen A Johnson
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 24, New York, NY, 10032, USA
| | - Yuval Neria
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 24, New York, NY, 10032, USA
| | - Jean-Marie E Bradford
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 24, New York, NY, 10032, USA
| | - Maria A Oquendo
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Suite 200, Philadelphia, PA, 19104-3309, USA
| | - Melissa R Arbuckle
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 24, New York, NY, 10032, USA
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Ross DA, Arbuckle MR, Travis MJ, Dwyer JB, van Schalkwyk GI, Ressler KJ. An Integrated Neuroscience Perspective on Formulation and Treatment Planning for Posttraumatic Stress Disorder: An Educational Review. JAMA Psychiatry 2017; 74:407-415. [PMID: 28273291 PMCID: PMC5504531 DOI: 10.1001/jamapsychiatry.2016.3325] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
IMPORTANCE Posttraumatic stress disorder (PTSD) is a common psychiatric illness, increasingly in the public spotlight in the United States due its prevalence in the soldiers returning from combat in Iraq and Afghanistan. This educational review presents a contemporary approach for how to incorporate a modern neuroscience perspective into an integrative case formulation. The article is organized around key neuroscience "themes" most relevant for PTSD. Within each theme, the article highlights how seemingly diverse biological, psychological, and social perspectives all intersect with our current understanding of neuroscience. OBSERVATIONS Any contemporary neuroscience formulation of PTSD should include an understanding of fear conditioning, dysregulated circuits, memory reconsolidation, epigenetics, and genetic factors. Fear conditioning and other elements of basic learning theory offer a framework for understanding how traumatic events can lead to a range of behaviors associated with PTSD. A circuit dysregulation framework focuses more broadly on aberrant network connectivity, including between the prefrontal cortex and limbic structures. In the process of memory reconsolidation, it is now clear that every time a memory is reactivated it becomes momentarily labile-with implications for the genesis, maintenance, and treatment of PTSD. Epigenetic changes secondary to various experiences, especially early in life, can have long-term effects, including on the regulation of the hypothalamic-pituitary-adrenal axis, thereby affecting an individual's ability to regulate the stress response. Genetic factors are surprisingly relevant: PTSD has been shown to be highly heritable despite being definitionally linked to specific experiences. The relevance of each of these themes to current clinical practice and its potential to transform future care are discussed. CONCLUSIONS AND RELEVANCE Together, these perspectives contribute to an integrative, neuroscience-informed approach to case formulation and treatment planning. This may help to bridge the gap between the traditionally distinct viewpoints of clinicians and researchers.
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Affiliation(s)
- David A. Ross
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Melissa R. Arbuckle
- Department of Psychiatry, Columbia University Medical Center, New York, New York; New York State Psychiatric Institute, New York
| | - Michael J. Travis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jennifer B. Dwyer
- Department of Psychiatry and Child Study Center, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Gerrit I. van Schalkwyk
- Department of Psychiatry and Child Study Center, Yale School of Medicine, Yale University, New Haven, Connecticut
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Affiliation(s)
- Melissa R. Arbuckle
- Department of Psychiatry, Columbia University Medical Center, New York, New York; and New York State Psychiatric Institute, New York
| | - Michael J. Travis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - David A. Ross
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
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Affiliation(s)
- David A. Ross
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Michael J. Travis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Melissa R. Arbuckle
- Department of Psychiatry, Columbia University Medical Center, New York, New York4New York State Psychiatric Institute, New York, New York
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Havel LK, Powell SD, Cabaniss DL, Arbuckle MR. Smartphones, Smart Feedback: Using Mobile Devices to Collect In-the-Moment Feedback. Acad Psychiatry 2017; 41:76-80. [PMID: 27160895 DOI: 10.1007/s40596-016-0564-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 04/18/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The goal of this study was to streamline the collection of resident feedback in order to support faculty development and program improvement in psychiatry training. METHODS The authors developed and implemented a brief, free, mobile survey to track resident feedback and class attendance. RESULTS Prior to instituting this system, resident feedback was obtained semi-annually for each course (n = 90) and not each individual class. In comparison, this new system allowed the authors to collect feedback on 477 of the 519 classes held over the 2014-15 academic year (92 %). Written comments about the curriculum increased over tenfold from 42 in 2013-14 to 541 during a comparative time period in 2014-15. One year after instituting this new system, resident participation increased to 81 % on average (compared to 64 % previously). CONCLUSION Mobile devices may provide an inexpensive and relatively untapped mechanism for improving the process of collecting resident feedback and tracking class attendance.
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Affiliation(s)
- Lauren Koehler Havel
- New York Presbyterian Hospital Child and Adolescent Psychiatry Residency Training Program of Columbia and Cornell Universities, New York, NY, USA
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Blumenshine P, Lenet AE, Havel LK, Arbuckle MR, Cabaniss DL. Thinking Outside of Outpatient: Underutilized Settings for Psychotherapy Education. Acad Psychiatry 2017; 41:16-19. [PMID: 27283018 DOI: 10.1007/s40596-016-0554-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 03/29/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Although psychiatry residents are expected to achieve competency in conducting psychotherapy during their training, it is unclear how psychotherapy teaching is integrated across diverse clinical settings. METHODS Between January and March 2015, 177 psychiatry residency training directors were sent a survey asking about psychotherapy training practices in their programs, as well as perceived barriers to psychotherapy teaching. RESULTS Eighty-two training directors (44%) completed the survey. While 95% indicated that psychotherapy was a formal learning objective for outpatient clinic rotations, fifty percent or fewer noted psychotherapy was a learning objective in other settings. Most program directors would like to see psychotherapy training included (particularly supportive psychotherapy and cognitive behavioral therapy) on inpatient (82%) and consultation-liaison settings (57%). The most common barriers identified to teaching psychotherapy in these settings were time and perceived inadequate staff training and interest. CONCLUSIONS Non-outpatient rotations appear to be an underutilized setting for psychotherapy teaching.
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Lockhart BJ, Capurso NA, Chase I, Arbuckle MR, Travis MJ, Eisen J, Ross DA. The Use of a Small Private Online Course to Allow Educators to Share Teaching Resources Across Diverse Sites: The Future of Psychiatric Case Conferences? Acad Psychiatry 2017; 41:81-85. [PMID: 26620806 PMCID: PMC5371021 DOI: 10.1007/s40596-015-0460-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 11/02/2015] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The authors sought to demonstrate the feasibility of integrating small private online course (SPOC) technology with flipped classroom techniques in order to improve neuroscience education across diverse training sites. METHODS Post-graduate medical educators used SPOC web conferencing software and video technology to implement an integrated case conference and in-depth neuroscience discussion. RESULTS Ten psychiatry training programs from across the USA and from two international sites took part in the conference. Feedback from participants was largely positive. CONCLUSION This pilot demonstrated the feasibility of such a program and provided a diverse audience with the opportunity to engage in an interactive learning experience with expert faculty discussants. This may be a useful model for programs with limited local expertise to expand their teaching efforts in a wide range of topics.
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Affiliation(s)
| | | | | | | | - Michael J Travis
- Western Psychiatric Institute and Clinic at the University of Pittsburgh, Pittsburgh, PA, USA
| | - Jane Eisen
- Warren Alpert Medical School of Brown University, Providence, RI, USA
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Cabaniss DL, Havel LK, Berger S, Deo A, Arbuckle MR. The Microprocess Moment: A Tool for Evaluating Skills in Psychodynamic Psychotherapy. Acad Psychiatry 2017; 41:51-54. [PMID: 26646408 DOI: 10.1007/s40596-015-0450-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 10/19/2015] [Indexed: 06/05/2023]
Affiliation(s)
| | | | - Seth Berger
- Columbia University Medical Center, New York, NY, USA
| | - Anthony Deo
- Columbia University Medical Center, New York, NY, USA
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Shalev D, Brewster K, Arbuckle MR, Levenson JA. A staggered edge: End-of-life care in patients with severe mental illness. Gen Hosp Psychiatry 2017; 44:1-3. [PMID: 28041569 PMCID: PMC5849470 DOI: 10.1016/j.genhosppsych.2016.10.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 10/15/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Daniel Shalev
- New York State Psychiatric Institute/Columbia University Department of Psychiatry, 1051 Riverside Drive, Box 103, New York, NY 10032, United States.
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Affiliation(s)
- Melissa R Arbuckle
- Form the Department of Psychiatry, Columbia University Medical Center, and the New York State Psychiatric Institute, New York
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Affiliation(s)
- Alejandro Ramirez
- Columbia University Department of Psychiatry and the New York State Psychiatric Institute, New York, New York
| | - Melissa R Arbuckle
- Columbia University Department of Psychiatry and the New York State Psychiatric Institute, New York, New York.
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Caravella RA, Robinson LA, Wilets I, Weinberg M, Cabaniss DL, Cutler JL, Kymissis C, Arbuckle MR. A Qualitative Study of Factors Affecting Morale in Psychiatry Residency Training. Acad Psychiatry 2016; 40:776-782. [PMID: 27251705 DOI: 10.1007/s40596-016-0567-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 04/26/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Resident morale is an important yet poorly understood aspect of the residency training experience. Despite implications for program quality, resident satisfaction, patient care, and recruitment, little is known about the variables influencing this complex phenomenon. This study sought to identify important factors affecting morale in psychiatry residency training. METHODS The authors conducted four semi-structured focus groups at a moderately sized, urban, psychiatry residency program during the 2013-2014 academic year. They used qualitative data analysis techniques, including grounded theory and content analysis, to identify key themes affecting resident morale across training levels. RESULTS Twenty-seven residents participated in the focus groups with equal distribution across post-graduate years (PGY) 1-4. Five major conceptual categories affecting resident morale emerged: Sense of Community, Individual Motivators, Clinical Work, Feeling Cared For, and Trust in the Administration. CONCLUSIONS Morale is an important topic in residency education. The qualitative results suggest that factors related to a Sense of Community and Individual Motivators generally enhanced resident morale whereas factors related to a lack of Feeling Cared For and Trust in the Administration tended to contribute to lower morale. The authors describe the possible interventions to promote stronger program morale suggested by these findings.
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Affiliation(s)
- Rachel A Caravella
- New York University School of Medicine, New York, NY, USA.
- NYU Langone Medical Center, New York, NY, USA.
| | | | - Ilene Wilets
- New York State Psychiatric Institute, New York, NY, USA
- Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Michael Weinberg
- Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Deborah L Cabaniss
- New York State Psychiatric Institute, New York, NY, USA
- Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Janis L Cutler
- New York State Psychiatric Institute, New York, NY, USA
- Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Carisa Kymissis
- Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Melissa R Arbuckle
- New York State Psychiatric Institute, New York, NY, USA
- Columbia University College of Physicians and Surgeons, New York, NY, USA
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40
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Affiliation(s)
- David A. Ross
- Department of Psychiatry, Yale School of Medicine, New Haven,
Connecticut
| | - Michael J. Travis
- Department of Psychiatry, University of Pittsburgh School of
Medicine, Pittsburgh, Pennsylvania
| | - Melissa R. Arbuckle
- Department of Psychiatry, Columbia University Medical Center, New
York, New York
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Arbuckle MR, Reardon CL, Young JQ. Residency training in handoffs: a survey of program directors in psychiatry. Acad Psychiatry 2015; 39:132-138. [PMID: 25026947 DOI: 10.1007/s40596-014-0167-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 05/12/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate how psychiatry programs are addressing the new Accreditation Council for Graduate Medical Education (ACGME) training requirements regarding transitions in patient care effective July 1, 2011. METHODS An anonymous online survey was distributed to program directors of general psychiatry residencies within the USA. Survey questions pertaining to the 2011 ACGME handoff requirements focused on training modalities, assessment of competence, and oversight of appropriate handoff procedures. In addition, program directors were asked to share specific challenges in implementing the new handoff regulations as well as their view on how the new regulations would impact patient care. RESULTS Of the 177 recipients, 108 completed at least part of the survey (61 % response rate). Only 11.4 % of programs indicated that they did not need to make any changes to their program in order to meet the new guidelines. Approximately a third of survey respondents reported that they did not yet have a formal curriculum in handoffs (32.4 %) and/or did not specifically assess competence at handoffs (30.5 %). Program directors cited the challenge of working with a variety of clinical settings with unique cultures, infrastructure, and policies and procedures and suggested that implementation and ownership of handoff training and assessment should be at the level of the clinical services. Despite these challenges, most program directors agreed that the new ACGME requirements would improve patient care and safety. CONCLUSIONS The high frequency of programs without established handoff curricula or competence evaluations highlights the potential value of published resources and tools to provide standardized training and assessment in handoffs. The results also underscore the importance of developing training and assessment in close collaboration with the clinical services and recognizing the need to tailor handoff communications to address the types of transitions that occur within each clinical setting.
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Affiliation(s)
- Melissa R Arbuckle
- Columbia University Medical Center, New York State Psychiatric Institute, New York, NY, USA,
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Sciutto M, Levenson J, Perez A, Oquendo MA, Arbuckle MR. Developing an advisor program for psychiatry residents. Acad Psychiatry 2015; 39:119-121. [PMID: 24840667 DOI: 10.1007/s40596-014-0153-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 04/28/2014] [Indexed: 06/03/2023]
Affiliation(s)
- Mary Sciutto
- Columbia University Medical Center, New York, NY, USA
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Abstract
Although learning objectives, often in the form of competencies, are now standard for training mental health professionals, they are not generally used to guide psychotherapy supervision. Nevertheless, when learning objectives are not used to guide supervision, supervisors and supervisees often remain uncertain about the goals of supervision, how those goals should be attained, and how they should be assessed. In this paper we review the literature on learning objectives for psychotherapy training and supervision, outline reasons for using learning objectives in psychotherapy supervision, and suggest ways to use learning objectives in training.
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Arbuckle MR, Weinberg M, Barkil-Oteo A, Stern DA, Ranz JM. The neglected role of resource manager in residency training. Acad Psychiatry 2014; 38:481-484. [PMID: 24771531 DOI: 10.1007/s40596-014-0136-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 04/07/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The goal of this study was to investigate residency training in the four roles of systems-based practice: patient care advocate, team member, information integrator, and resource manager. METHODS The authors surveyed 457 psychiatry residents and fellows across 12 programs from April 2009 to November 2010. Residents were asked to rate the extent in which they were encouraged to perform behaviors consistent with systems-based practice. RESULTS Approximately 52% residents (n=237) completed the survey. Differences in the average Likert ratings for the four roles were significant [F (3, 4,021)=122.152, p<0.001]. Residents were more likely to report routine encouragement to function as a team member (82%, OR=7.2, 95% CI=4.7-11.0), information integrator (77%, OR=5.4, 95% CI=3.6-8.1), or patient care advocate (74%, OR=4.6, 95% CI=3.1-6.8) compared to resource manager (38%). CONCLUSIONS Based upon this study, residency training in resource management is relatively limited compared to other aspects of systems-based practice.
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Affiliation(s)
- Melissa R Arbuckle
- Columbia University Medical Center and New York State Psychiatric Institute, New York, NY, USA,
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Fried JL, Arbuckle MR, Weinberg M, Carino A, McQuistion HL, Shoyinka SO, Skiandos A, Stern DA, Ranz JM. Psychiatry residents' experiences with systems-based practice: a qualitative survey. Acad Psychiatry 2014; 38:414-419. [PMID: 24570030 DOI: 10.1007/s40596-014-0038-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 01/09/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The aim of this study is to analyze qualitative data collected during field-testing of an instrument to assess psychiatric residents' experiences with systems-based practice (SBP). METHODS A total of 237 psychiatry residents from 6 levels of training in 12 different psychiatry residency training programs responded to a 60-item instrument measuring their experiences with SBP during residency. Qualitative techniques adapted from content analysis were used to review narrative responses to open-ended questions on the instrument. RESULTS Certain themes emerged in the residents' answers reflecting their opinions about the opportunities for (and barriers to) performing SBP in their work. CONCLUSIONS Psychiatric residents express an eagerness for opportunities to learn about and perform SBP but often feel constrained by the lack of resources, teaching, and supervision. Moreover, many residents desire a better understanding of healthcare economics and how to factor cost consideration into clinical care.
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Affiliation(s)
- Joanna L Fried
- New York University School of Medicine, New York, NY, USA,
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Affiliation(s)
- Andres Barkil-Oteo
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - David A Stern
- Department of Psychiatry, New York Medical College, Valhalla
| | - Melissa R Arbuckle
- Department of Psychiatry, Columbia University Medical Center, New York, New York4New York State Psychiatric Institute, New York
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Sudak DM, Arbuckle MR. "Louis, I think this is the beginning of a beautiful friendship:" a mentoring journey. Acad Psychiatry 2013; 37:441. [PMID: 24185297 DOI: 10.1007/bf03340091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Arbuckle MR, Weinberg M, Kistler SC, Cabaniss DL, Isaacs AJ, Sederer LI, Essock SM. A curriculum in measurement-based care: screening and monitoring of depression in a psychiatric resident clinic. Acad Psychiatry 2013; 37:317-320. [PMID: 24026369 DOI: 10.1176/appi.ap.12080152] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The goal of this curriculum was to train residents in measurement-based care (MBC). METHOD Third-year psychiatry residents were educated in MBC through didactic seminars and a quality-improvement (QI) initiative with the goal of implementing the Patient Health Questionnaire Depression Scale (PHQ-9) to screen and monitor patients for symptoms of depression. RESULTS Residents suggested strategies for integrating the PHQ-9 into the clinic. Over the first 6 months, residents showed an increase in rate of depression screening from 4% to 92% of patients. Also, they increased monthly monitoring of outpatients with a diagnosis of depression from 1% to 76%. Residents who used the PHQ-9 to monitor patients with depression were significantly more likely to use additional standardized assessments. CONCLUSIONS Combining an educational intervention with QI strategies can significantly affect residents' use of standardized assessments in an outpatient setting. Using standardized measures allows residents to assess their own clinical effectiveness, an emerging priority in training.
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Arbuckle MR, Gordon JA, Pincus HA, Oquendo MA. Bridging the gap: supporting translational research careers through an integrated research track within residency training. Acad Med 2013; 88:759-65. [PMID: 23619070 PMCID: PMC3773852 DOI: 10.1097/acm.0b013e31828ffacb] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
In the setting of traditional residency training programs, physician-scientists are often limited in their ability to pursue research training goals while meeting clinical training requirements. This creates a gap in research training at a critical developmental stage. In response, Columbia University Medical Center's Department of Psychiatry, in partnership with the New York State Psychiatric Institute, has created a formal Research Track Program (RTP) for psychiatry residents so that interested individuals can maintain their attention on research training during formative residency years. Clinical and research training are integrated through core clinical rotations on research units. With protected research time and clear developmental milestones for each year of training, the RTP allows research track residents to meet both clinical and research training goals while maintaining a healthy work-life balance. In coordination with existing postdoctoral research fellowship programs, research track residents can effectively jump-start fellowship training with advanced course work and consistent, continuous mentorship bridging residency and fellowship years. A key element of the program is its provision of core training in research literacy and extensive research opportunities for all residents, stimulating research interest across the whole residency program. Supported by the National Institutes of Health and a private foundation, this RTP capitalizes on a unique academic-private partnership to address many of the challenges facing physician-scientists. By integrating clinical and research exposures and offering protected research time, careful mentoring, and financial resources, the program aims to further the development of those most poised to establish careers in translational research.
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Affiliation(s)
- Melissa R Arbuckle
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, New York, New York 10032, USA.
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Arbuckle MR, Weinberg M, Harding KJK, Isaacs AJ, Covell NH, Cabaniss DL, Essock SM, Sederer LI. The feasibility of standardized patient assessments as a best practice in an academic training program. Psychiatr Serv 2013; 64:209-11. [PMID: 23450383 DOI: 10.1176/appi.ps.002732012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The use of standardized patient assessments (SPAs) in psychiatry is an emerging best practice. This column describes a survey of resident and faculty supervisors at a large academic department examining current practices, attitudes, and perceived barriers to incorporating SPAs into clinical practice. Although the study found that SPAs were not routinely used in clinical practice or supervision, residents and faculty were fairly optimistic about their potential value. The results suggest that educational initiatives should be integrated into clinical practice, start early within training, include both trainees and faculty supervisors, and set use of SPAs as an expected standard of care.
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Affiliation(s)
- Melissa R Arbuckle
- Department of Psychiatry, College of Physicians and Surgeon, Columbia University, New York, NY 10032, USA.
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