Julia B. Frank

Relationships Between Drug Company Representatives and Medical Students: Medical School Policies and Attitudes of Student Affairs Deans and Third-Year Medical Students

ObjectivesThe authors sought to ascertain the details of medical school policies about relationships between drug companies and medical students as well as student affairs deans’ attitudes about these interactions.MethodsIn 2005, the authors surveyed deans and student affairs deans at all U.S. medical schools and asked whether their schools had a policy about relationships between drug companies and medical students. They asked deans at schools with policies to summarize them, queried student affairs deans regarding their attitudes about gifts, and compared their attitudes with those of students who were studied previously.ResultsIndependently of each other, 114 out of 126 deans (90.5%) and 114 out of 126 student affairs deans (90.5%) responded (identical numbers are not misprints). Ten schools had a policy regarding relationships between medical students and drug company representatives. Student affairs deans were much more likely than students to perceive that gifts were inappropriate.ConclusionThese 2005 policies show trends meriting review by current medical schools in considering how to comply with the 2008 Association of American Medical Colleges recommendations about relationships between drug companies and medical students or physicians.

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.

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.

Teaching medical students to recognize demoralization

Background and Objectives: Concepts such as demoralization fit well into Problem or Case-based learning methods that encourage students to organize knowledge based on clinical problems, rather than according to the disciplines of basic science. Methods: At two US schools, psychiatry clerkship students learn about demoralization and psychotherapy through structured, case based exercises that teach them to elicit and respond to patients� life stories in ways that emphasize hope and empowerment. Results: Students� reactions to these exercises, though mixed, suggest that they may enhance students� understanding of the universal elements of distress (demoralization) that cut across many disabling conditions and of the role that caregivers may play in compounding or relieving this distress. Conclusions: Learning to recognize and respond to demoralization is an advanced communication skill that can be introduced during a psychiatry clerkship.

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.

Psychiatric Implications of Acquired Immune Deficiency Syndrome

Even among life-threatening illnesses, the acquired immunodeficiency syndrome (AIDS) is unique. First recognized only five years ago, it is a lethal, contagious disease that preferentially affects members of stigmatized social groups (male homosexuals and drug abusers), and its victims are often relatively young, potentially productive members of society. The intense responses it evokes from sufferers, populations at risk, and society as a whole present a special challenge to psychiatry. This American Psychiatric Association monograph is a concise, inexpensive, and timely report on the state of psychiatric knowledge and practice in this area. Overall, the book contains valuable information that will be new to those who have not yet seen many persons with AIDS. The quality of the reports is uneven, however, and certain important questions are hardly discussed. The strongest articles are those on the medical and neurological implications of the syndrome. Uniformly clear and concise, these three chapters discuss

Psychiatric Drugs: Hazards to the Brain

The central thesis of this polemical exposure of psychopharmacology is that the seeming illnesses of psychiatric patients are only manifestations of a social breakdown syndrome, and that treatment is a thinly disguised effort on the part of psychiatrists to bring patients under control by disrupting brain function and disabling their minds. In support of this radical point of view, Dr Breggin extensively reviews the toxicity of various psychotropic drugs and argues that whatever claims are made for the specific efficacy of one or the other agent, their main effect is to sedate and confuse patients so that they become tractable either in institutions or in frustrating, deprived home or community settings. The strongest part of Breggins argument, and the one to which he devotes most of the book, is his review of the effects of the phenothiazines. He believes that they produce a chemical lobotomy and suggests that there may