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1.
Acad Psychiatry ; 45(2): 174-179, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33409938

RESUMO

OBJECTIVE: One possible factor associated with choosing psychiatry as a career is students rating their psychiatry clerkship as excellent. Although this suggests that an excellent clerkship may improve recruitment into psychiatry, to our knowledge there has never been a multi-site survey study of graduating medical students that identify what factors lead to an excellent clerkship rating. The purpose of this study was to determine factors that medical student find important for an excellent psychiatry clerkship experience. METHODS: A total of 1457 graduating medical students at eight institutions were sent a 22-item Likert-type survey about what clinical and administrative factors they considered when rating their psychiatry clerkship via email in the fall of their last year. 357 (24.5%) responded and Z-test, t-tests, and multiple regression analyses were carried out. RESULTS: The factors which students rated higher than the mean included planned application to psychiatry residency, clear expectations, a transparent grading process, feeling part of a team, timely feedback by faculty, and a competent clerkship coordinator and director. Lectures, active learning, and self-study were rated as less pertinent, and the overall clerkship rating did differ between students going into psychiatry versus other specialties. CONCLUSIONS: Although the low response undermines the validity of findings, by improving the administration of the clerkship with clear expectations, grading, feedback, and by encouraging clinical teams to fully integrate students clerkship ratings might improve which could potentially improve recruitment. Future research could further quantify and qualify these parameters and compare psychiatric clerkships to other clerkships.


Assuntos
Estágio Clínico , Psiquiatria , Estudantes de Medicina , Humanos , Aprendizagem Baseada em Problemas , Psiquiatria/educação , Inquéritos e Questionários
3.
Clin Teach ; 15(2): 151-155, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-28436156

RESUMO

BACKGROUND: Faculty member assessment of clerkship students' clinical performance has been noted as a consistently problematic issue within most medical student clerkships, and thus a worthy target of faculty development. One of the primary challenges in such faculty development is creating a change that improves the clinical assessment of students in a meaningful way. METHOD: In the current study we evaluated the effects of a pair of brief interventions designed to facilitate greater use of the 'Not observed' option in faculty member assessments of clerkship students (as opposed to use of 'Meets expectations' for skills actually not observed by the rater) within a psychiatry rotation for third-year medical students in the USA. RESULTS: The intervention demonstrated statistically significant effects, both intentional and unintentional. Specifically, faculty members rated themselves as having increased their own understanding and confidence regarding the use of the assessment forms after the intervention. With regard to actual ratings of clerkship students, faculty members were less likely to use the 'Not observed' option after the intervention. Also, the mean rating increased slightly, and to a greater degree than could be explained entirely by the shift away from using 'Meets expectations' when 'Not observed' was more appropriate. Faculty member assessment of … students' clinical performance [is] a consistently problematic issue DISCUSSION: Results are discussed with regards to suggestions for implementation of the intervention in other programmes, specifically with regard to proposed improvements and issues to consider and monitor.


Assuntos
Estágio Clínico , Avaliação Educacional/métodos , Docentes de Medicina , Capacitação em Serviço , Sucesso Acadêmico , Estudantes de Medicina , Inquéritos e Questionários
4.
Community Ment Health J ; 54(2): 149-157, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28255637

RESUMO

The involuntary hospitalization law provides a means by which love ones, caregivers and healthcare professionals can intervene when a mentally ill patient is a danger to self or others. Our study assessed the knowledge of professionals in one of the Greenville Health System (GHS) emergency department (ED) about the involuntary hospitalization process of mental health patients in South Carolina (SC). An eight item survey on the South Carolina involuntary hospitalization and commitment process was developed and distributed to GHS ED staff including: physicians, physician assistants, nurse practitioners, nurses, social workers and technicians. Our findings indicated that the knowledge base is not consistent across healthcare discipline, nor is it sufficient given that most professionals achieved less than 50% correct response. This study has implications for ongoing education for ED healthcare workers which will be of significant importance to promote beneficence and to uphold the standards of patientcentered practice and compassionate medicine.


Assuntos
Internação Compulsória de Doente Mental , Conhecimentos, Atitudes e Prática em Saúde , Recursos Humanos em Hospital , Internação Compulsória de Doente Mental/legislação & jurisprudência , Serviço Hospitalar de Emergência , Humanos , Transtornos Mentais/terapia , Recursos Humanos em Hospital/psicologia , Recursos Humanos em Hospital/estatística & dados numéricos , South Carolina , Inquéritos e Questionários , Centros de Atenção Terciária
5.
MedEdPORTAL ; 13: 10584, 2017 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-30800786

RESUMO

INTRODUCTION: Entrustable professional activities (EPAs) were developed as a way to ensure adequate skills of the medical school graduate. While the 12 EPAs apply to all medical specialties, EPA 1, "Gather a history and perform a physical examination," applies most explicitly to psychiatry through the performance of a mental status exam. Although proficiency in performing a psychiatric interview and mental status exam evolves throughout a psychiatrist's professional life, basic proficiency is essential in order to function as a psychiatry intern. We developed a tool for assessing the mental status exams conducted by future psychiatry residents. METHODS: Our tool contains both a video of a psychiatrist interviewing a patient and a mental status exam rating sheet that can be used when students present a mental status exam orally or in writing. We incorporated feedback from psychiatry educators at an annual meeting of the Association for Medical Student Educators in Psychiatry, followed by the reiteration of the video and the rubric. Subsequently, the rubric was verified on the performance of a cohort of 13 third- and fourth-year medical students from three institutions. RESULTS: In their mental status exam presentations, students covered all the items measured by the rubric. There was a significant difference between the third- and fourth-year medical students in describing the cognitive exam. DISCUSSION: Overall, our tool offers an opportunity to standardize mental status presentations by senior medical students who wish to specialize in psychiatry.

8.
Gen Hosp Psychiatry ; 33(6): 640.e3-4, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21749837

RESUMO

Marijuana is the most commonly used illegal substance by adolescents in the United States. According to a 2009 survey conducted by Monitoring the Future, there were about 11.8% of 8th graders, 26.7% of 10th graders and 32.8% of 12th graders who had abused marijuana at least once in the year (Johnston L.D., Bachman J.G., O'Malley P.M., Schulenberg J.E. Monitoring the Future: A Continuing Study of American Youth (12th-Grade Survey), 2009 [Computer file]. ICPSR28401-v1. Ann Arbor, MI: Interuniversity Consortium for Political and Social Research [distributor], 2010-10-27. doi:10.3886/ICPSR28401). A retrospective review of published literature disclosed case reports of marijuana-induced mania in adult patients with no prior psychiatric history (Bonnet U., Chang D.I., Wiltfang J., Scherbaum N., Weber R. A case of cannabis-induced mania. Fortschr Neurol Psychiatr. 2010 Apr; 78(4):223-5. Epub 2010 Feb3; Henquet C., Krabbendam L., de Graaf R., ten Have M., van Os J. Cannabis use and expression of mania in the general population. J Affect Disord. 2006 Oct;95(1-3):103-10. Epub 2006 Jun 21). To the best of our knowledge, this is the first report to document that marijuana induced manic symptoms in an adolescent with no known prior psychiatric history.


Assuntos
Transtorno Bipolar/etiologia , Cannabis/efeitos adversos , Abuso de Maconha/complicações , Adolescente , Humanos , Masculino
9.
Gen Hosp Psychiatry ; 33(3): 302.e11-2, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21601734

RESUMO

The lifetime prevalence of panic attacks is 28.3% in American adults 18 years and older. The age of onset of panic attack extends throughout adulthood; however, it typically develops in early adulthood, with median age of onset of 22 years [Kessler R.C., Chiu W.T., Jin R., Ruscio A.M., Shear K., Walters E.E. The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2006 Apr;63(4):415-24.]. As reported in our case, panic attacks could induce transient leukocytosis in healthy adults. If practitioners recognize this association, expensive investigations and extensive hospital stays may be prevented, although prudent practice would likely still require some type of investigations.


Assuntos
Leucocitose/sangue , Leucocitose/etiologia , Transtorno de Pânico/complicações , Adulto , Humanos , Masculino
10.
Psychosomatics ; 49(6): 538-9, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19122132

RESUMO

BACKGROUND: Previous literature has discussed the diagnosis of cancer with psychiatric symptoms. There are noted associations made between pancreatic cancer and depression and anxiety symptoms both in literature and textbooks. METHOD: The authors discuss the case of a patient who presented with anxiety and panic attacks before his diagnosis of pancreatic cancer. CONCLUSION: There has been a previous association noted between depression and anxiety and pancreatic cancer; however, this work and another report have noted panic episodes preceding diagnosis, as well. These symptoms could prove to be an important marker for early detection.


Assuntos
Neoplasias Hepáticas/secundário , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/psicologia , Transtorno de Pânico/etiologia , Transtorno de Pânico/psicologia , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/psicologia , Evolução Fatal , Humanos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/diagnóstico , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/patologia
11.
J ECT ; 23(3): 177-8, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17804993

RESUMO

Electroconvulsive therapy has been a novel treatment for about half a century, effective for severe psychiatric conditions. Over the years, the treatment has been refined with the addition of anesthesia. Different inducing agents have been used in clinical practice over the last few decades including propofol, methohexital, and etomidate. Previous literature rarely mentions seizures soon after induction with etomidate and typically only in anesthesia literature. We describe 2 cases with different demographics, diagnosis, and treatment that had seizures with the use of etomidate as an inducing agent.


Assuntos
Eletroconvulsoterapia , Etomidato/efeitos adversos , Etomidato/farmacologia , Convulsões/etiologia , Adulto , Negro ou Afro-Americano , Anestésicos Intravenosos/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Convulsões/induzido quimicamente , População Branca
12.
Psychiatr Serv ; 57(2): 258-9, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16452706

RESUMO

The authors describe difficulties encountered in the assessment and treatment of enemy prisoners of war and foreign civilians during Operation Enduring Freedom and Operation Iraqi Freedom. Of prime concern was the complexity of evaluating and working with patients through translators. Secondary concerns included self-protective behaviors of and fears experienced by patients, which complicated the patient-provider relationship. Future difficulties could be reduced by training translators in medical interviewing, training providers in the skills used by translators, informing providers of command and political policy, and producing concrete, portable information in written or other forms for enemy prisoners to reduce inherent mistrust.


Assuntos
Cultura , Emigração e Imigração , Idioma , Prisioneiros , Guerra , Humanos , Estados Unidos
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