Riding the rapids: COVID-19, the three rivers curriculum, and the experiences of the University of Pittsburgh School of Medicine.

When faced with the COVID-19 pandemic this past spring, the University of Pittsburgh's School of Medicine (UPSOM) took rapid steps to ensure the safety of students, staff, and the faculty as well as to maintain the educational process. Curriculum reform efforts, already underway, proved to be an advantage in the transformation. We quickly converted to a remote and then a hybrid curriculum. Research labs were reopened with appropriate safety measures. Clinical experiences for students restarted via a phased process that emphasized safety and graduation requirements. A variety of assessment mechanisms were restarted with appropriate modifications. New teaching models, such as flipped classrooms, have become the norm, and it seems hard to imagine our returning to our old pedagogy. The curriculum committee met continually to guide the process of change and reopening. The curricular adaptation process remains ongoing, and challenges remain. Nonetheless, we have learned from our experiences and hope to use this knowledge gained as we move forward.

Self-Assessment of Teaching Skills Among Psychiatric Residents.

OBJECTIVE: Psychiatry residency programs have increasingly emphasized the role of resident-as-teacher; however, little is known about resident self-perceptions of teaching skills. This study reports on psychiatry residents' self-perceived skills in teaching medical students and compares cohort ratings with anonymous medical student evaluations of residents as teachers at our large academic residency program. METHODS: In May-June 2016, 84 residents in our program were surveyed using an anonymous, web-based survey, and this data was then compared to 3 years of aggregate data from anonymous student evaluations of resident teaching at our institution. RESULTS: Forty-seven (47) residents responded to the survey (56% response rate). Residents reported self-perceived deficits in several specific teaching competencies. Medical students consistently rated residents higher with respect to teaching skills than residents rated themselves, and these data were highly statistically significant. CONCLUSION: This study underscores the benefits of resident self-assessment in comparison to medical student evaluations of residents as teachers and this information can be used to inform training programs' resident-as-teacher curricula.

Inadequate Sleep and Exercise Associated with Burnout and Depression Among Medical Students.

OBJECTIVE: The authors studied whether low levels of exercise or inadequate sleep correlated with higher levels of burnout and depression in medical students. METHODS: Medical students of all years at the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA, were invited to participate in an anonymous online survey in Fall 2012 and Winter 2013. Validated measures were used to assess exercise, sleep, burnout, and depression. RESULTS: Response rates were 28.7 % at the beginning of the school year and 22.6 % at the middle of the school year. Burnout rates overall were 22.4 % at the beginning of the year and 19.2 % in the middle of the year. Eight percent of students screened positive for depression at the beginning of the year and 9.3 % in the middle of the year. Decreased exercise frequency was significantly correlated with lower professional efficacy. Pathological sleepiness was significantly associated with a higher prevalence of burnout. Inadequate sleep correlated with significantly lower professional efficacy and higher exhaustion scores. Burnout was associated with a positive depression screen. Positive depression screening, pathological sleepiness, and sleeping less than 7 h a night were independent predictors of burnout. CONCLUSIONS: Sleep habits, exercise, and a positive depression screen were associated with burnout risk within the medical student population.

Training physicians for the real world of medicine: administration-based learning.

Tired of outdated teaching formats like case-based learning (CBL), problem-based learning (PBL) and team-based learning (TBL)? We wanted something fresh for our medical school, something that would prepare our graduates for the modern practice of medicine, something that would satisfy regulatory agencies and our deans. After doing an extensive needs assessment, which we ignored, we decided to replace basic science in our curriculum with something more practical: administration-based learning (ABL). We taught students how to fix fax machines, how to deal with angry team members, and how to maximise revenue in private practice - lessons that were well received and were more consistent with what physicians really need to learn to be effective practitioners. Educational outcomes have been positive, and although more research is needed, we call on other schools to add ABL tracks to their own curricula.

Web-based psychoeducational intervention for persons with schizophrenia and their supporters: one-year outcomes.

OBJECTIVE: This study examined the use of a uniquely designed Web site and home computers to deliver online multifamily psychoeducational therapy to persons with schizophrenia and their informal supports (family and friends). Web site usage and outcome benefits are reported. METHODS: Thirty-one persons with schizophrenia or schizoaffective disorder and 24 support persons were randomly assigned to the online intervention (telehealth) or treatment as usual (usual care) condition. At three, six, and 12 months, interviewer-administered assessments were conducted with participants. Intention-to-treat analyses compared persons with schizophrenia in the two study conditions on severity of positive symptoms and knowledge of schizophrenia. Support persons in the two study conditions were compared on knowledge of schizophrenia. Each participant's usage of the Web site was logged. RESULTS: Persons with schizophrenia in the telehealth condition had a large and significant reduction in positive symptoms (p=.042, d=-.88) and a large and significant increase in knowledge of schizophrenia compared with their counterparts in the usual care condition. Support persons in the telehealth condition showed a large and significant increase in knowledge about prognosis compared with those in the usual care condition (p=.036, d=1.94). Persons with schizophrenia used the Web site to a much greater extent (pages viewed and time spent) than support persons. CONCLUSIONS: These findings suggest that online delivery of psychotherapeutic treatment and educational resources to consumers' homes has considerable potential to improve consumer well-being and offers several advantages over standard clinic-based delivery models.

Distal support and community living among individuals diagnosed with schizophrenia and schizoaffective disorder.

Community integration for individuals diagnosed with schizophrenia is essential to successful community tenure. Most of the research and clinical emphasis on the process of integration has been focused on the successes in normative goals (e.g., employment, support networks). Little research has focused on how individuals diagnosed with schizophrenia and schizoaffective disorder integrate in the realm of public life involving the casual routine interactions with other community members, termed "distal support" in this study. This was a cross-sectional study specifically designed to develop a measure of distal support and to identify clinical and sociodemographic factors associated with fostering distal supports. Findings suggest that personality factors, specifically extroversion and openness, play a role in the process of fostering community distal supports. It was also found that a greater number of distal supports were associated with higher quality of life satisfaction ratings and sense of belonging scores with the participants who were diagnosed with schizophrenia. A greater number of distal supports were associated with higher hospitalization rates and emergency contacts among the participants diagnosed with schizoaffective disorder, but not among those diagnosed with schizophrenia.

Beyond a beautiful mind: film choices for teaching schizophrenia.

For psychiatric educators interested in using film to teach professional and lay audiences about schizophrenia, the 2001 release of A Beautiful Mind has made the process much easier. The movie shows a range of symptoms and complications, and it gives viewers-especially patients and families-hope for recovery. However, many other commercial films depict various aspects of the illness, and the choice of which one to use is determined by the audience, the pedagogical focus, and the time available. Clean, Shaven (1995), for instance, may be more challenging for professional audiences. Psychiatric educators should familiarize themselves with the variety of film options when teaching about schizophrenia.