Brenda Roman

Team cohesiveness, team size and team performance in team-based learning teams

The purpose of this study was to explore the relationships among variables associated with teams in team‐based learning (TBL) settings and team outcomes.

Residency Education on the Prevention of Physician-Patient Sexual Misconduct

Despite ethical prohibitions and legal sanctions, physician sexual misconduct continues to occur at alarming rates. Even in psychiatry, which historically addresses topics such as boundary issues for psychiatrists in residency training programs, little education exists about preventing physician sexual misconduct. The authors propose an outline for education in the prevention of sexual misconduct for psychiatry residency programs.

Alliance for Clinical Education Perspective Paper: Recommendations for Redesigning the “Final Year” of Medical School

Background: Although medical school typically lasts 4 years, little attention has been devoted to the structure of the educational experience that takes place during the final year of medical school. Summary: In this perspectives paper, we outline goals for the 4th year of medical school to facilitate a transition from undergraduate to graduate medical education. We provide recommendations for capstone courses, subinternship rotations, and specialty-specific schedules, and we conclude with recommendations to medical students and medical schools for how to use the recommendations contained in this document. Conclusions: We provide an overview of general competencies and specialty specific recommendations to serve as a foundation for medical schools to develop robust 4th-year curricula and for medical students to plan their 4th-year schedules.

Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes toward Homeless Persons.

ObjectiveThe purpose of the study was to explore changes in medical students ’ attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the “hidden curriculum” in medical education, in which values are communicated from teacher to student outside of the formal instruction.MethodsA group of 79 students on Psychiatry and 66 on Emergency Medicine clerkships were surveyed at the beginning and end of their rotation regarding their attitudes toward homeless persons by use of the Health Professionals’ Attitudes Toward the Homeless Inventory (HPATHI). The HPATHI was also administered to 31 Psychiatry residents and faculty and 41 Emergency Medicine residents and faculty one time during the course of this study.ResultsFor Psychiatry clerks, t -tests showed significant differences pre- and post-clerkship experiences on 2 of the 23 items on the HPATHI. No statistically significant differences were noted for the Emergency Medicine students. An analysis of variance revealed statistically significant differences on 7 out of the 23 survey questions for residents and faculty in Psychiatry, as compared with those in Emergency Medicine.ConclusionResults suggest that medical students showed small differences in their attitudes toward homeless people following clerkships in Psychiatry but not in Emergency Medicine. Regarding resident and faculty results, significant differences between specialties were noted, with Psychiatry residents and faculty exhibiting more favorable attitudes toward homeless persons than residents and faculty in Emergency Medicine. Given that medical student competencies should be addressing the broader social issues of homelessness, medical schools need to first understand the attitudes of medical students to such issues, and then develop curricula to overcome inaccurate or stigmatizing beliefs.

Competency-Based Curricular Design to Encourage Significant Learning

Most significant learning (SL) experiences produce long-lasting learning experiences that meaningfully change the learners thinking, feeling, and/or behavior. Most significant teaching experiences involve strong connections with the learner and recognition that the learner felt changed by the teaching effort. L. Dee Fink in Creating Significant Learning Experiences: An Integrated Approach to Designing College Course defines six kinds of learning goals: Foundational Knowledge, Application, Integration, Human Dimension, Caring, and Learning to Learn. SL occurs when learning experiences promote interaction between the different kinds of goals, for example, acquiring knowledge alone is not enough, but when paired with a learning experience, such as an effective patient experience as in Caring, then significant (and lasting) learning occurs. To promote SL, backward design principles that start with clearly defined learning goals and the context of the situation of the learner are particularly effective. Emphasis on defining assessment methods prior to developing teaching/learning activities is the key: this ensures that assessment (where the learner should be at the end of the educational activity/process) drives instruction and that assessment and learning/instruction are tightly linked so that assessment measures a defined outcome (competency) of the learner. Employing backward design and the AAMCs MedBiquitous standard vocabulary for medical education can help to ensure that curricular design and redesign efforts effectively enhance educational program quality and efficacy, leading to improved patient care. Such methods can promote successful careers in health care for learners through development of self-directed learning skills and active learning, in ways that help learners become fully committed to lifelong learning and continuous professional development.

The Education Chief Resident in Medical Student Education: Indicators of Success

ObjectiveAlthough residents are actively involved in teaching medical students, some students do not feel that they get adequate teaching from residents. The position of Education Chief Resident in Medical Student Education was developed to enhance the educational experience for the students, cultivate the academic skills of the education chief, and liaise between students and residents.MethodsThe education chiefs spend 10–12 hours a week teaching medical students, assisting primarily with clerkships. To determine student satisfaction with the position of education chief, 85 students were surveyed in the 2007–2008 academic year. The education chiefs were also surveyed regarding their perceptions of how this position benefited their academic development.ResultsSeventy-six medical students completed the survey for a response rate of 89%. Students rated highly having education chiefs as part of the psychiatry clerkship. The education chief residents felt that their teaching skills and educational development were enhanced and that the position helped prepare them for careers in academic psychiatry.ConclusionThe position of education chief was viewed as valuable to the medical student experience in the psychiatry clerkship, and the education chiefs felt that the position enhanced their professional and educational development.

Teaching Motivational Interviewing Skills to Third-Year Psychiatry Clerkship Students

BackgroundDespite a large percentage of health care costs being related to smoking, obesity, and substance abuse, most physicians are not confident in motivating patients to change health behaviors. Motivational interviewing (MI) is a directive, patient-centered approach for eliciting behavior change. The purpose of this study was to teach students MI skills and assess their confidence and knowledge during the psychiatry clerkship using smoking cessation as the target behavior.MethodsUsing a pretest/posttest design, 98 students were given a 10-item questionnaire during the psychiatry clerkship to assess their knowledge and confidence in health behavior change. Students received a 3-hour presentation on the principles of MI and practiced skills through role play. Students were encouraged to utilize these skills with patients.ResultsPaired t tests results showed significant differences pre- and postclerkship for nine of the 10 items, including the student’s confidence in working with patients in the area of smoking cessation.ConclusionStudents can gain basic knowledge and increased confidence in working with patients for promoting behavioral change, even with a brief session, taught by nonexperts in motivational interviewing theory.

The ADMSEP Milestones Project

ObjectiveCredentialing bodies mandate that a medical school’s curriculum be based upon recognized guidelines. Within the field of psychiatry, the Association of Directors of Medical Student Education in Psychiatry (ADMSEP) has previously published recommended guidelines for the pre-clinical and clerkship curriculum. Ongoing changes within the Liaison Committee on Medical Education’s requirements for medical school curricula, and the publication of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, necessitated review of these guidelines.MethodsADMSEP convened a task force of psychiatric educators to develop a consensus report outlining new guidelines. The ADMSEP membership reviewed and approved this final document.ResultsThe guidelines outline six core learning objectives with corresponding competencies. Each of these competencies specifies accompanying milestones to be achieved through the course of medical school.ConclusionsADMSEP believes these guidelines will aid educators in crafting a school’s psychiatric curriculum. Clearly articulated milestones may foster the further development of validated educational and assessment tools by ADMSEP and other organizations.

Medical Student Psychiatric Educators’ Perceptions of Supports, Resources, and Rewards

ObjectiveThe primary purpose of this study was to determine the adequacy of resources for medical student education in psychiatry in US medical schools.MethodsAn e-questionnaire was deployed to psychiatric educators in the Association of the Directors of Medical Student Education in Psychiatry (ADMSEP) regarding resources for fulfilling their educational mission.ResultsMedical student educators in psychiatry were neutral as to whether they had adequate mentoring, yet did report support from their chair. Participants’ roles in medical student education and membership in ADMSEP enhanced their work satisfaction, career satisfaction, and career development. Many participants reflected a lack of adequate resources to achieve student education goals.ConclusionsThere are opportunities for improvement in provision of teaching resources, mentoring for medical student educators, greater protected time for teaching and administration, and rewards (salary and non-monetary) for educators. If actualized, these improvements would promote optimization of medical student education in psychiatry.

Team Emotional Intelligence, Team Interactions, and Gender in Medical Students During a Psychiatry Clerkship

ObjectiveThis study examined the relationship between team emotional intelligence, quality of team interactions, and gender.MethodsPsychiatry clerkship students participating in Team-Based Learning (TBL, n = 484) or no TBL (control, n = 265) completed the Workgroup Emotional Intelligence Profile (WEIP-S) and the Team Performance Scale (TPS).ResultsSignificant correlations (p < 0.01) existed between quality of team interactions (i.e., TPS) and team emotional intelligence (i.e., WEIP-S) subscales, but not gender. Control and TBL groups experienced significant increases in WEIP-S subscales pre to post (p < 0.01, η2 = .08), with the TBL group experiencing significantly higher gains in three of four subscales. Control group scored higher on TPS.ConclusionsA significant relationship exists between team emotional intelligence and quality of team interactions. Gender was unrelated to TPS or WEIP-S subscales. TBL group experienced higher gains in WEIP-S subscales while the control group experienced slightly higher TPS scores. Results suggest implications for medical educators who use TBL.