Jeffrey S. Cluver

Student assessment of psychiatry clinical simulation teaching modules

Recognizing a need for computer-based instruction in psychiatry education, a clinical simulation initiative (CSI) by the Association of Directors of Medical Student Education in Psychiatry (ADMSEP) developed a free database of psychiatry teaching modules, intended to enhance the learning that takes place during a clinical interaction, or provide a meaningful learning experience if the ideal of direct exposure to the desired clinical condition is not possible. The modules contain illness-specific information, including etiology, epidemiology, differential diagnosis, clinical manifestations and treatment, and are illustrated with video-clips of evolving patient cases played by actors. Interactive quizzes are included in each module to consolidate knowledge, promote critical thinking, and stimulate further learning. Of fourteen areas of psychopathology delineated by ADMSEP’s clinical learning objectives, to date modules that address the psychiatric interview, dementia, bipolar disorder, personality disorders, post-traumatic stress and anxiety disorders have been published on MedEdPORTAL for free access by educators, and additional modules are under development. We obtained data on student satisfaction and the modules’ impact on students’ confidence in disorder-specific knowledge, using surveys that evaluated the modules’ quality and effectiveness. Survey items include educational value, general feedback, and confidence in disorder-specific knowledge, diagnosis, and treatment. Items are rated on a 5-point Likert-type scale, where 11⁄4 Strongly Disagree and 51⁄4 Strongly Agree. Comparisons between preand post-module student confidence ratings were assessed using non-parametric Wilcoxon signed rank tests. Complete survey data from 215 students at seven universities in USA yielded mean ratings of 3.9–4.6 on items measuring module quality and effectiveness. All but one of the student confidence ratings were significantly higher post-module as compared to pre-module (p50.05). Data from our study demonstrate student satisfaction with the modules and positive impact on students’ confidence in disorder-specific knowledge. CSI modules help fulfill educational requirements in psychiatry clinical clerkships and the open access model fosters educational collaboration between institutions.

How to Get Help With Starting Your Research Project: ADMSEP Task Force on Research and Scholarship

Many, if not all, medical educators face their own academic commitment and/or external pressures to conduct research in the area of medical education. The educator’s personal interest in getting involved in medical education research could be triggered by her/his curiosity or the needs of her/his program. There is a great need for educational research in various areas, such as long-term outcomes of didactic and clinical teaching, evaluation and comparison of different teaching methods, or impact of educational settings. One may be curious to find out why certain interventions in her/his program work and others do not work, beyond the obvious reasons. The clerkship director may also come up with a broader question, such as: What is the real impact of the length of psychiatry clerkship on examination scores? Answering those and many other important questions is and should be the main reason for conducting and expanding educational research. However, there are also external pressures to conduct educational research, usually related to the old academic adage “publish or perish.” In many places, teaching is not necessarily treated as a scholarly activity, whereas publications and presentations are. Publications are also considered a necessary ingredient for getting promoted. Promotion and Tenure committees, frequently overpopulated by research faculty members, prefer publications reflecting one’s own research or at least participation in other faculty members’ research studies. They may not appreciate review articles, chapters, and/or letters to the editor as much as they appreciate “original” research. Some educators working in large, research-oriented departments may be able to get involved in clinical studies or other research. These opportunities are not always and not everywhere available. Nevertheless, for faculty whose careers involve an important educational component, evidence for research and scholarship in medical education is clearly increasingly crucial to academic promotion at many medical schools and is consistent with the increasing professionalism of medical educator roles generally. Thus, conducting or being involved in educational research studies would be another way to go about achieving these goals. Getting educational research projects started could be difficult, especially for young faculty members. They may face numerous obstacles. Personal ambivalence about starting a research project is often the first one. At times, the curiosity, need, and/or pressure may be there, but the support is lacking. At other times, the pressure and support are there, but the proposed project may be too difficult to conduct, or boring, or outside one’s interest. Time constraints and other demands, namely service ones, may also hinder one’s efforts to get involved in research. Then, once one gets over these obstacles, the next common major obstacle is the lack of expertise a beginner has, or lack of know-how. The expertise in educational research may be missing, even in major research departments. The young faculty member may start to look for help by reviewing the literature on how to do educational research, published in various educational journals such as Academic Psychiatry, Academic Medicine, Medical Teacher, or Journal of Graduate Medical Education, for example, the series of editorials published in the Journal of Graduate Medical Education (1–8) (all also available on the journal website), and an article in Received July 18, 2012; revised October 31 and December 20, 2012; accepted January 17, 2013. FromWayne State University, Detroit, MI (RB), Massachusetts General Hospital, Harvard Medical School, Boston, MA (JEA), Medical University of South Carolina, Charleston, SC (JSC), University of Connecticut, Farmington, CT (CL). Address correspondence to Richard Balon,M.D., UPC-Jefferson, Detroit, MI; e-mail: rbalon@wayne.edu Copyright

High-Stakes Collaborative Testing: Why Not?

ABSTRACT Phenomenon: Studies of high-stakes collaborative testing remain sparse, especially in medical education. We explored high-stakes collaborative testing in medical education, looking specifically at the experiences of students in established and newly formed teams. Approach: Third-year psychiatry students at 5 medical schools across 6 sites participated, with 4 participating as established team sites and 2 as comparison team sites. For the collaborative test, we used the National Board of Medical Examiners Psychiatry subject test, administering it via a 2-stage process. Students at all sites were randomly selected to participate in a focus group, with 8–10 students per site (N = 49). We also examined quantitative data for additional triangulation. Findings: Students described a range of heightened emotions around the collaborative test yet perceived it as valuable regardless if they were in established or newly formed teams. Students described learning about the subject matter, themselves, others, and interpersonal dynamics during collaborative testing. Triangulation of these results via quantitative data supported these themes. Insights: Despite student concerns, high-stakes collaborative tests may be both valuable and feasible. The data suggest that high-stakes tests (tests of learning or summative evaluation) could also become tests for learning or formative evaluation. The paucity of research into this methodology in medical education suggests more research is needed.

Mastering Panic Anxiety.

E cent of those diagnosed with panic disorder have at least 1 other psychiatric diagnosis. The etiology of this disorder is most likely a combination of biological, psychological, and social factors, and the treatment options include medications, therapy, and counseling. The symptoms of a panic attack often lead patients to seek initial evaluation at a medical clinic, making it very likely that a primary care or emergency physician will be the first to see a patient suffering from this disorder.

Mastering Panic Anxiety: (Psychotherapy Casebook)

E cent of those diagnosed with panic disorder have at least 1 other psychiatric diagnosis. The etiology of this disorder is most likely a combination of biological, psychological, and social factors, and the treatment options include medications, therapy, and counseling. The symptoms of a panic attack often lead patients to seek initial evaluation at a medical clinic, making it very likely that a primary care or emergency physician will be the first to see a patient suffering from this disorder.