Medical School Factors Associated with Higher Rates of Recruitment into Psychiatry.

OBJECTIVE: The medical school a student attends appears to be a factor in whether students eventually match into psychiatry. Knowledge of which factors are associated with medical schools with higher recruitment rates into psychiatry may assist in developing strategies to increase recruitment. METHODS: Psychiatry leaders in medical student education in the 25 highest and lowest recruiting US allopathic schools were surveyed concerning various factors that could be important such as curriculum, educational leadership, and presence of anti-psychiatry stigma. The relationship between the survey results of high recruiting schools versus those of low recruiting schools was evaluated using Mann-Whitney U tests. RESULTS: Factors significantly associated (p < .05) with higher recruiting schools included better reputation of the psychiatry department and residents, perceived higher respect for psychiatry among non-psychiatry faculty, less perception that students dissuaded other students from pursuing psychiatry, and longer clerkship length. CONCLUSIONS: Educational culture and climate factors may have a significant impact on psychiatry recruitment rates. Clerkship length was associated with higher recruiting schools, but several previous studies with more complete samples have not shown this.

Integration of Basic and Clinical Science in the Psychiatry Clerkship.

OBJECTIVE: Integration of basic and clinical science is a key component of medical education reform, yet best practices have not been identified. The authors compared two methods of basic and clinical science integration in the psychiatry clerkship. METHODS: Two interventions aimed at integrating basic and clinical science were implemented and compared in a dementia conference: flipped curriculum and coteaching by clinician and physician-scientist. The authors surveyed students following each intervention. Likert-scale responses were compared. RESULTS: Participants in both groups responded favorably to the integration format and would recommend integration be implemented elsewhere in the curriculum. Survey response rates differed significantly between the groups and student engagement with the flipped curriculum video was limited. CONCLUSIONS: Flipped curriculum and co-teaching by clinician and physician-scientist are two methods of integrating basic and clinical science in the psychiatry clerkship. Student learning preferences may influence engagement with a particular teaching format.

Improving child and adolescent psychiatry education for medical students: an inter-organizational collaborative action plan.

OBJECTIVE: A new Child and Adolescent Psychiatry in Medical Education (CAPME) Task Force, sponsored by the Association for Directors of Medical Student Education in Psychiatry (ADMSEP), has created an inter-organizational partnership between child and adolescent psychiatry (CAP) educators and medical student educators in psychiatry. This paper outlines the task force design and strategic plan to address the long-standing dearth of CAP training for medical students. METHOD: The CAPME ADMSEP Task Force, formed in 2010, identified common challenges to teaching CAP among ADMSEP's CAPME Task Force members, utilizing focus-group discussions and a needs-assessment survey. The Task Force was organized into five major sections, with inter-organizational action plans to address identified areas of need, such as portable modules and development of benchmark CAP competencies. RESULTS/CONCLUSION: The authors predict that all new physicians, regardless of specialty, will be better trained in CAP. Increased exposure may also improve recruitment into this underserved area.

Medical student documentation in electronic health records: a collaborative statement from the Alliance for Clinical Education.

PURPOSE: The electronic health record (EHR) is an important advancement in health care. It facilitates improvement of health care delivery and coordination of care, but it creates special challenges for student education. This article represents a collaborative effort of the Alliance for Clinical Education (ACE), a multidisciplinary group formed in 1992. ACE recognizes the importance of medical student participation in patient care including the ability of documentation. This article proposes guidelines that can be used by educators to establish expectations on medical student documentation in EHRs. SUMMARY: To provide the best education for medical students in the electronic era, ACE proposes to use the following as practice guidelines for medical student documentation in the EHR: (a) Students must document in the patient's chart and their notes should be reviewed for content and format, (b) students must have the opportunity to practice order entry in an EHR--in actual or simulated patient cases--prior to graduation, (c) students should be exposed to the utilization of the decision aids that typically accompany EHRs, and (d) schools must develop a set of medical student competencies related to charting in the EHR and state how they would evaluate it. This should include specific competencies to be documented at each stage, and by time of graduation. In addition, ACE recommends that accreditation bodies such as the Liaison Committee for Medical Education utilize stronger language in their educational directives standards to ensure compliance with educational principles. This will guarantee that the necessary training and resources are available to ensure that medical students have the fundamental skills for lifelong clinical practice. CONCLUSIONS: ACE recommends that medical schools develop a clear set of competencies related to student in the EHR which medical students must achieve prior to graduation in order to ensure they are ready for clinical practice.

Psychiatry clerkship students' preparation, reflection, and results on the NBME Psychiatry Subject Exam.

OBJECTIVE: Psychiatry clerkship training involves many learning components, one of which is acquisition of scholarly knowledge. The authors investigate the reading materials and learning methods used by clinical clerks in their preparation for the National Board of Medical Examiners (NBME) Psychiatry Subject Exam (PSE). METHODS: Clerkship students from six U.S. medical schools who had recently completed their psychiatry clerkship and PSE were surveyed regarding reading material use, teaching methods encountered, and other relevant resources which may have influenced their PSE scores. RESULTS: The most frequently used PSE preparation material was a "step-or-prep" book, followed by practice questions, handouts, and assigned texts. No single preparation material type or combination proved significantly different in influencing PSE scores. The didactic methods used in clerkships did differ significantly in their influence on PSE scores. Students in the top quartile used slightly more books and different combinations of books than students in the bottom quartile. CONCLUSION: Students exhibited several trends in their preparation for the PSE. The most striking findings were the heavy student reliance on step-or-prep books over other learning resources and that step-or-prep books did not demonstrate significance as a superior preparation resource for the PSE. These trends in third-year psychiatric rotations have important implications for medical student education.

Students' and residents' perceptions regarding technology in medical training.

OBJECTIVE: This pilot study provides firsthand feedback from medical students and residents in training regarding their perceptions of technology in medicine. METHOD: The authors distributed an e-mail invitation to an anonymous Web-based survey to medical students and residents in two different U.S. training institutions. RESULTS: Respondents unanimously expressed that technology skills were important in medical training and felt it most important to learn about electronic medical records and accessing scientific information on the Internet. At the point of patient care, trainees' preferred reference sources were the Internet and PDA, in that order. Most clinical trainees felt PDAs were critical in patient care and met their clinical needs, and they were most likely to use them for medication reference. The majority of trainees preferred printed media over digital media for initial learning, but the converse for referencing. Instructor-led small groups were viewed as the best environment in which to receive instruction. CONCLUSIONS: Trainees in medical education are technologically savvy and provide invaluable feedback regarding initiation, development and refinement of technological systems in medical training.

Clinical grading in psychiatric clerkships.

OBJECTIVE: The clinical grade assessment is the most frequently used and heavily weighted component in the overall assessment of U.S. psychiatry clerkship students, yet the topic is understudied. The authors aimed to learn more about the nature, perceived virtues, and deficiencies of the clinical grade evaluation. METHODS: A 26-item questionnaire regarding the psychiatry clerkship clinical grading form was distributed to the clerkship directors of 129 medical schools in the U.S. and U.S. territories. The design of the document, its strengths, its weaknesses, grading outcomes, and utilization were assessed. RESULTS: Trends regarding clinical grading in psychiatry clerkships were detected. The clerkship grade form similarities, differences, desirable features, and utilization were ascertained, as were areas for improvement. CONCLUSIONS: The search for an optimal clinical grading process for the thousands of third-year medical students rotating annually is formidable. However, collaboration among psychiatry clerkship directors on development and improvement of clinical evaluation forms can clarify learning objectives and lead to better clinical evaluation tools.