Occupational transformation: Parental influence and social cognition of young adults with autism.

BACKGROUND: The Social Cognition and Interaction Training-Autism (SCIT-A) is a social cognition curriculum for young adults with autism developed at the University of North Carolina. This study seeks to further the use of SCIT-A as a tool for family centered practice. OBJECTIVE: This study explored the value of a complementary parent/caretaker support group on occupational performance of young adult children participating in the SCIT-A program. An interprofessional SCIT-A program for young adults with high functioning autism (HFA) was examined for its effect on transition. PARTICIPANTS: The program included five parents/caregivers and three young adult males with HFA. Final data collection was performed on three parents/caregivers and one young adult with HFA. METHODS: A mixed methods approach utilized two focus groups for caregivers and young adults. Quantitative results were obtained from the young adult. RESULTS: This paper describes themes among caregivers which included: (1) swapping family stories; (2) experiencing an epiphany; (3) place-making; and (4) transformation. Results for the young adult are also presented. CONCLUSIONS: This pilot study suggests a positive impact and possible future trajectories of research and programming of social cognition during transition to adult occupations. The importance of support and participation of caretakers to facilitate transition is elucidated.

Transfer of care of psychotherapy patients: implications for psychiatry training.

Transfers of care occur routinely in medical training, but the transfer of psychotherapy patients has received relatively little attention. This article discusses important issues concerning these transfers, using case examples and findings from a survey of the experience of psychiatry residents transitioning psychotherapy patients. Residents have difficulty telling patients they are leaving and often delay doing so. Because feelings of closeness and attachment can develop in long-term therapeutic relationships, residents describe feeling guilty, uncertain, anxious, sad, and occasionally relieved as they prepare their patients for transfer. Outgoing residents can feel anxious when recognizing and addressing their patients' and their own positive feelings. Incoming residents experience discomfort at being compared to the previous therapist and often encounter the patient's negative feelings at the transfer and the loss of the previous therapy. Teaching about the two poles of transfer of care is recommended to better understand and respond to this transition for both patient and therapist. This should include addressing the stresses involved and recommendations for management.

A structured PBL tutorial involving small teams for teaching the human nervous system.

BACKGROUND: The Human Nervous System and Behavior course at Harvard Medical School (HMS) incorporates a hybrid model of problem-based learning. Student preparation for and participation in the tutorial seemed to be insufficient. AIMS: We sought to increase student engagement in tutorial by creating a structured approach, which included assigned roles for students, weekly testing, formal cornerstone presentations, and a weekly self-assessment exercise. We wished to determine the students' and tutors' satisfaction with this structured approach as compared with the more traditional tutorial experienced in other courses at HMS. METHODS: For the first 4 years of the course, students (n = 160) were surveyed concerning their impressions of the quality of the structured approach in comparison with the traditional tutorial. In addition, they were surveyed concerning the cornerstone presentations and the self-assessment exercise. Tutors (n = 10) who had taught in both the traditional and structured tutorial formats were surveyed about their impressions of student performance as well as their own enjoyment in the structured format. RESULTS: Students and tutors found the structured approach superior to the previous method. Both groups noted increased student preparation, participation, and accountability. Tutors preferred teaching in the structured format. CONCLUSIONS: The structured approach increased student accountability, preparation, and participation. Students and tutors preferred this tutorial experience over the previous approach.

A faculty development program to train tutors to be discussion leaders rather than facilitators.

PURPOSE: During 2003, 2004, and 2005, the role of 70 tutors was changed from that of facilitator to discussion leader, in a preclinical PBL learning course, Gastrointestinal Pathophysiology, by use of three key business school teaching strategies: questions, summaries, and schematics. The purpose of this study was to learn what difference this new approach made. METHOD: During each of the three study years, 171 (2003), 167 (2004), and 170 (2005) students were given Likert-scale attitudinal questionnaires to rate whether their tutors encouraged student direction of the tutorials and whether the summaries and closure schematics benefited their learning. Students' overall course evaluations and mean USMLE scores were quantitatively analyzed, pre- and postintervention. A variety of statistical tests were used to assess the statistical significance of means at the confidence level of .05. RESULTS: In the third year of the program, student ratings indicated that their tutors were significantly better at encouraging student direction of the tutorials than in the first year (P < .05). The students reported that the tutorial made a more important contribution to their learning (P < .05), and the course objectives were better stated (P = .038) and better met (P = .007). Overall satisfaction with the course also improved significantly (P = .006). Part I gastrointestinal system mean scores of the USMLE showed a statistically significant increase in 2005 compared with 2001 or 2002. CONCLUSIONS: The tutor as a discussion leader who questions, summarizes, and uses schematics to illustrate concepts had a significant and positive impact on learning in tutorials, achieving course objectives, improving overall course satisfaction, and increasing a standardized national exam's mean score.