ABSTRACT
OBJECTIVE: The aim of this study was to determine if communication skills differ for medical students entering person or technique-oriented specialties. METHODS: Communication ratings by clerkship preceptors on an institutionally required end of clerkship medical student performance evaluation (SPE) form were compiled for 2011/2012 academic year (Class of 2013). M3 clerkships and the Class of 2013 match appointments were categorized as person or technique-oriented clerkships/specialties. Mean differences in SPE communication scores were determined by analyses of variance (ANOVA) and independent t tests. Score associations were determined by Pearson correlations. Inter-item reliability was reported with Cronbach alpha. RESULTS: The Class of 2013 match appointments were as follows: person-oriented (N = 91) and technique-oriented (N = 91) residency specialties. There was no significant difference in mean communication scores for medical students who entered person-oriented (mean 7.8, SD 0.4) versus technique-oriented (mean 7.9, SD 0.4) specialties (p = 0.258) or for person-oriented clerkship (mean 7.8, SD 0.4) versus technique-oriented clerkship (mean 7.9, SD 0.6) ratings for medical students who matched into person-oriented specialties (p = 0.124). Medical students who matched into technique-oriented specialties (mean 8.1, SD 0.5) received significantly higher (p = 0.001) communication ratings as compared with those matching into person-oriented specialties (mean 7.8, SD 0.5) from technique-oriented clerkships. CONCLUSIONS: Communication with patients and families is a complex constellation of specific abilities that appear to be influenced by the rater's specialty. Further study is needed to determine if technique-oriented specialties communication skill rating criteria differ from those used by raters from person-oriented specialties.
Subject(s)
Career Choice , Communication , Professional-Patient Relations , Students, Medical/psychology , Adult , Clinical Clerkship , Employee Performance Appraisal , Female , Humans , Male , Young AdultSubject(s)
Nipples/injuries , Penis/injuries , Self Mutilation , Humans , Male , Middle Aged , SuicideABSTRACT
Potential ethical issues and challenges to professionalism arise commonly in the care of patients with psychiatric illnesses. As such, education and training in medical ethics especially as applied to psychiatry and professionalism should be offered to trainees during the formative years of residency and fellowship. This article proposes a curriculum for senior residents and fellows that uses a case-centred seminar to discuss ethical dilemmas, approaches to analysing ethical issues, and to develop a course of action for resolution. Representative ethical issues and the clinical arenas in which these are most likely to arise are suggested.
Subject(s)
Curriculum , Ethics, Professional , Internship and Residency , Professional Competence , Psychiatry/education , HumansSubject(s)
Dementia, Vascular/complications , Hospitalization , Psychiatric Department, Hospital , Thromboembolism/prevention & control , Venous Thrombosis/prevention & control , Aged, 80 and over , Diagnostic Tests, Routine/standards , Humans , Male , Patient Admission/standards , Risk Factors , Thromboembolism/diagnosis , Venous Thrombosis/diagnosisSubject(s)
Malpractice , Psychiatry/education , Curriculum , Faculty, Medical , Humans , Interdisciplinary Communication , Jurisprudence , United StatesABSTRACT
PURPOSE OF REVIEW: To summarize important recent contributions to the literature on the subject of ethics in psychiatric research. RECENT FINDINGS: Current literature reflects an expansion in the range of psychiatric research on ethics topics. Articles continue to appear on core ethics subjects such as informed consent, but many recent contributions focus on diverse issues such as third-party privacy, the ethics of Internet-based research, revisiting the wisdom of imposing medical ethics requirements on observational research, and psychiatric research ethics as applied to special populations such as children or older persons. SUMMARY: Psychiatric research is critical for the elucidation, prevention, and treatment of mental diseases. Increased attention and novel approaches taken to obtain informed consent, correcting therapeutic misconception, and guarding privacy will advance the research enterprise and continue to ensure that the subjective experiences of participants in psychiatric research remain positive.
Subject(s)
Biomedical Research/ethics , Ethics, Professional , Psychiatry/ethics , HumansSubject(s)
Criminal Law/statistics & numerical data , Malpractice/legislation & jurisprudence , Psychiatry/legislation & jurisprudence , Clinical Competence/legislation & jurisprudence , Clinical Competence/statistics & numerical data , Compensation and Redress/legislation & jurisprudence , Humans , Jurisprudence , Patient Compliance , United StatesABSTRACT
The literature suggests that self-amputation is an outgrowth of either psychosis or paraphilia. In the case we present, the patient was neither psychotic at the time of amputation, nor did he ascribe a sexual motivation for his act. Instead, he had a long-standing idea that being an amputee was a critical aspect of his identity. The patient used the internet to research the method for his amputation and sought support from individuals with the same desire via e-mail, web sites, and Usenet news groups.
Subject(s)
Amputation, Surgical , Internet , Self-Injurious Behavior/psychology , Hospitalization , Humans , Male , Middle Aged , Self-Injurious Behavior/rehabilitation , Transsexualism/psychologyABSTRACT
Maintenance electroconvulsive therapy (ECT) can sometimes be the only treatment that yields extended periods of euthymia to patients with severe, treatment-resistant mania. We describe a case of a patient with recurrent and severe mania who responded acutely to ECT after failing various medication trials and could only maintain euthymia with maintenance ECT.
