Psychiatric Education

CONTEXT: As the practice of medicine evolves, the knowledge, skills and attitudes required to provide patient care will continue to change. These competency-based changes will necessitate the restructuring of assessment systems. High-quality assessment programmes are needed to fulfil health professions education's contract with society. OBJECTIVES: We discuss several issues that are important to consider when developing assessments in health professions education...

Categories are essential to doctors' thinking and reasoning about their patients. Much of the clinical categorization learned in medical school serves useful purposes, but an extensive literature exists on students' reliance on broad systems of social categorization. In this article, the authors challenge some of the orthodoxies of categorization by combining narrative approaches to medical practice with the theoretical term "intersectionality" in order to draw students' attention to the important intersecting, but often overlooked, identities of their patients...

No consensus on the definition of empathy exists. Empathy has been described as emotional and spontaneous, cognitive and deliberate, or some combination of the two. Attentive non-verbal reactions, feeling reflections, reassurance, sympathy, and compassion all have been conflated with empathy, making it impossible to differentiate empathy from other communication skills. This confusion over the definition of empathy has affected its measurement. For example, the authors of the Interpersonal Reactivity Index see empathy as multidimensional, involving both emotional and cognitive aspects, while the authors of the Jefferson Scale of Physician Empathy see empathy as a predominately cognitive process...

PURPOSE: To identify the different machine learning (ML) techniques that have been applied to automate physician competence assessment and evaluate how these techniques can be used to assess different competence domains in several medical specialties. METHOD: In May 2017, MEDLINE, EMBASE, PsycINFO, Web of Science, ACM Digital Library, IEEE Xplore Digital Library, PROSPERO, and Cochrane Database of Systematic Reviews were searched for articles published from inception to April 30, 2017...

OBJECTIVE: Integrated or collaborative care is a well-evidenced and widely practiced approach to improve access to high-quality mental health care in primary care and other settings. Psychiatrists require preparation for this emerging type of practice, and such training is now mandatory for Canadian psychiatry residents. However, it is not known how best to mount such training, and in the absence of such knowledge, the quality of training across Canada has suffered. To guide integrated care education nationally, we conducted a systematic review of published and unpublished training programs...

The expression "shame and blame" has often been used to describe the culture within healthcare when a mistake is made. There has been little exploration, however, on the shame healthcare professionals experience after a mistake. Based on an original grounded theory study on the psychological impact of mistakes on health professionals, this article explores why the healthcare environment is a perfect ecosystem for growing shame, how individuals are coping or not coping with the negative effects of this powerful emotion and what might be done at the system, organizational and team level to mitigate these negative effects...

CONTEXT: Direct observation (DO) of residents' performance, despite the importance that is ascribed to it, does not readily fit in with the practice of postgraduate medical education (PGME); it is infrequent and the quality of observation may be poor in spite of ongoing efforts towards improvement. In recent literature, DO is mostly portrayed as a means to gather information on the performance of residents for purposes of feedback and assessment. The role of DO in PGME is likely to be more complex and poorly understood in the era of outcome-based education...

BACKGROUND: Audit and feedback interventions may be strengthened using social interaction. With this in mind, the Calgary office of the Alberta Physician Learning Program developed a process for audit and group feedback for physician groups. As a part of a larger project to develop a practical approach to the design and implementation of audit and group feedback projects, we explored patterns of physician behavior during facilitated audit and group feedback sessions. METHODS: Six audit and group feedback sessions were recorded, transcribed, and analyzed thematically to derive a conceptual model of physicians' behaviors during audit and group feedback sessions...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

PURPOSE: Many who seek primary health care advice about mental health may be using mobile applications (apps) claiming to improve well-being or relieve symptoms. We aimed to identify how prominent mental health apps frame mental health, including who has problems and how they should be managed. METHODS: We conducted a qualitative content analysis of advertising material for mental health apps found online in the United States, the United Kingdom, Canada, and Australia during late 2016...

This study compared the profile of those who, after initial failure to be selected, choose to reapply to study medicine with those who did not reapply. It also evaluates the chance of a successful outcome for re-applicants. In 2013, 4007 applicants to undergraduate medical schools in the largest state in Australia were unsuccessful. Those who chose to reapply (n = 665) were compared to those who did not reapply (n = 3342). Results showed that the odds of re-applying to medicine were 55% less for those from rural areas, and 39% more for those from academically-selective schools...

OBJECTIVE: The primary purpose of this article is to review the findings of a 2017 survey of psychiatry training program directors to identify current gaps and barriers in addictions training in general adult psychiatry programs. METHODS: The American Association of Directors of Psychiatric Residency Training (AADPRT) Taskforce on Addictions was created in 2017 with the aim of determining what programs need to improve addictions training in psychiatry residency programs and identifying ways to meet these needs...

In 2009, the National Patient Safety Foundation's Lucian Leape Institute (LLI) published a paper identifying five areas of healthcare that require system-level attention and action to advance patient safety.The authors argued that to truly transform the safety of healthcare, there was a need to address medical education reform; care integration; restoring joy and meaning in work and ensuring the safety of the healthcare workforce; consumer engagement in healthcare and transparency across the continuum of care...

BACKGROUND: Depression is a common mental health disorder for which clinical practice guidelines have been developed. Prior systematic reviews have identified complex organizational interventions, such as collaborative care, as effective for guideline implementation; yet, many healthcare delivery organizations are interested in less resource-intensive methods to increase provider adherence to guidelines and guideline-concordant practices. The objective of this systematic review was to assess the effectiveness of healthcare provider interventions that aim to increase adherence to evidence-based treatment of depression in routine clinical practice...

CONTEXT: The concept of entrustment has garnered significant attention in medical specialties, despite variability in supervision styles and entrustment decisions. There is a need to further study the enactment of supervision on inpatient wards to inform competency-based assessment design. METHODS: Attending physicians, while supervising on clinical teaching inpatient wards, were invited to describe a recent moment of enacting supervision with an internal medicine resident...

CONTEXT: The flipped classroom (FC), reversing lecture and homework elements of a course, is popular in medical education. The FC uses technology-enhanced pre-class learning to transmit knowledge, incorporating in-class interaction to enhance higher cognitive learning. However, the FC model is expensive and research on its effectiveness remains inconclusive. The aim of this study was to compare the efficacy of the FC model over traditional lecture-based (LB) learning by meta-analysis...