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Office of Medical Student Education (OMSE)
Newsletter
September/October 2007
Vol 1, No 3
CONTENTS
CNC Update: what’s going on in the Clinical Neurosciences Clerkship for MS3s [Pg2]
Introduction to Psychiatry: planning and evaluation of the MS1 psychiatry course [Pg3]
AOC News: What’s going on with the Area of Concentration in Neuroscience [Pg4]
Recruitment: convincing students to choose psychiatry as a specialty [Pg4]
Data Corner: statistics and trends from OMSE [Pg5]
Educational Scholarship: what’s out there in the literature—research on education [Pg6]
Teaching Tips: a short burst of “how-to” advice or strategies to help your teaching [Pg7]
Teachers Who Excel: student feedback on particularly exceptional teachers at WPIC [Pg8]
Upcoming Events: what’s coming up in medical student education [Pg9]
Help Wanted: activities we really need faculty/resident teaching help with [Pg9]
OMSE Mission Statement:
Providing all medical students with psychiatric knowledge and skills
Providing all medical students with psychiatric knowledge and skills to incorporate
to incorporate into their future practice/research, inspiring them to
into their future practice/research, inspiring them to consider psychiatry as a
consider psychiatry as a specialty, and advising/supporting them as
specialty, and advising/supporting them as they embark on their medical careers.
they embark on their medical careers.
OMSE Staff:
Jason Rosenstock, MD
Director, Medical Student Education
Angela Labuda
Education Coordinator
MS1-2 Issues, AOC, Detre/Schizophrenia Awards, Visiting Students, Recruitment
Kesha Fincher
Education Coordinator
MS3-4 Issues, CNC/Electives
9/07 1 Vol.1(3)
CNC Update
The biggest change to the Clinical Neurosciences Clerkship is the introduction of
standardized patient (SP) experiences to the Wednesday didactics. Previously, we’d run
mainly lectures with some case discussions, covering key disorders and other topics. But
students consistently complain about powerpoint/lecture formats, and not everyone learns
well that way. Moreover, while these sessions may have helped enhance knowledge to
some extent, it did nothing for skills.
So we decided to develop OSCEs (objective standardized clinical examinations) using
SPs, which we hope accomplish several things:
1) insure that all students see a consistent batch of almost identical patients
2) allow students an opportunity to hone their interviewing skills in front of a faculty
or senior resident supervision, with feedback from facilitators as well as other
students and the patient themselves (not something they get on the floors)
3) target specific management skills that students don’t get as much of on the floors:
telling a patient about their diagnosis, recommending a medication and giving
informed consent on it, making behavioral therapy interventions, etc.
4) create a safe, learner-centered environment that allows students to practice
formatively, without worrying about their grade
We piloted four cases this month: geriatric depression with suicidality (disposition and
treatment decisions required), bipolar disorder with comorbid substance use, PTSD, and
schizophrenia with non-adherence. Faculty were trained in the method, and SPs learned
the cases beforehand. The feedback from both facilitators and students was extremely
positive—a faculty member reported that the SP sessions were “a thousand times better
than the case discussions.” Students loved the mix of process (interviewing skills) and
content (suicide risk factors, how to pick an SSRI). And the SPs in my opinion did a
fabulous job portraying cases in an authentic fashion.
We plan on continuing the cases in every eight-week rotation, with the next ones on
November 28. If you have an interest in getting trained to do these OSCEs with the
students, let me know.
I also want to follow up on medical student access to information systems.
Just trying to summarize where we stand:
MS3s should get PsychConsult access that allows them to read outpatient notes on
patients admitted to their primary service.
They do NOT have the ability to write notes, either themselves or by proxy, on an
inpatient service or in the DEC.
We are NOT allowed to give them passwords/usernames to let them log in and do work
for us.
9/07 2 Vol.1(3)
We are NOT allowed to log on ourselves, then let the student use our accounts to
complete documentation.
For the DEC, the flow is too fast for the students to have this responsibility anyway, and it’s not a
learning objective at that site. D/c summaries might be nice educationally but MS3s don’t do a
great job with the d/c summaries, and other specialties don’t use MS3s for this purpose. They
are allowed to do a paper summary of the admission, give it the resident/attending for teaching
purposes, which then allows the resident/attending to use the document to make it easier to
complete a d/c summary.
MS3s can write outpatient notes, however, by attaching their note to an MD service and serving
as a 2nd clinician.
MS4s doing electives WILL be able to get PsychConsult “write” privileges to do d/c summaries
and DEC notes; they have more experience and need to learn this stuff. And you all will need to
supervise them to make sure they’re doing these correctly.
On Cerner, we’ve been told that students will be able to continue having list capability (at least
one list), to search patients by MR# (not name), and to access a unit’s census as their default.
Hopefully this makes sense—let me know if you have any questions about this.
As always, for more information on the course, check out the clerkship website:
http://navigator.medschool.pitt.edu/34_viewFolder.asp?folderID=614121038
Intro to Psych
As we prepare for the 2008 Introduction to Psychiatry course, we’re constantly looking to
revise, freshen, update, and improve our teaching material and formats. If you’re
interested in getting involved, please let me know. We’ll have a formal course design
group getting together in winter.
One part of the course we definitely want to revise is our depression small group. In the
past (see link below), we’ve used a written case that prompts students to talk about
depression phenomenologically, the differential diagnosis, interviewing strategies, etc.
http://navigator.medschool.pitt.edu/34_viewPage.asp?pageID=1659537967
But it may be too broad, and we also want to add a bit more on bereavement to the
preclinical curriculum—this small group activity seems like a perfect place.
We may want to add small groups on psychopharmacology—previously, we’ve had two
hours of lecture time, but it might make more sense to add time and do it in a small group
or PBL format.
If you’re interested in working on either of these two small groups, let me know.
9/07 3 Vol.1(3)
AOC News
Our last AOC workshop was an exciting grab-bag of hands-on stations. We had folks from psych
and neurology, with about 20 students attending. They visited a virtual hallucination simulator
experience, listened to a stroke case and saw the imaging, watched and discussed a movement
disorder video, and got hooked up to an EMG machine to find out what that was all about. We
also had a link-up to the neurosurgery website which showed videos of gamma-knife surgery,
among other things. Future topics include pediatric epilepsy, traumatic brain injury, management
of increased intracranial pressure, the role of industry in neuroscience, and neuroimaging in
psychiatry.
We also wanted to extend our gratitude to the many faculty and residents who have served as
mentors for scholarly work, clinical experiences, and general career guidance. Thanks to
everyone!
Faculty scholarly project mentors
Howard Aizenstein William Klunk Charles Reynolds
David Brent Beatriz Luna Greg Siegle
Oscar Bukstein Nancy Minshew Jennifer Silk
Ron Dahl Vish Nimgaonkar Eva Szigethy
Andrew Gilbert David Kolko
Clinical experience preceptors
Benedum attendings Benjamin Handen Eva Szigethy
Ron Garbutt Charles Reynolds Petronilla Vaulx-Smith
Andrew Gilbert Stephanie Richards
Resident mentors
Mark Demidovich Sid Li Alex Strauss
Matthew Keener Ed MacPhee
Sharon Kohnen Jason Rock
Recruitment
WPIC continues to encourage interest among visiting medical students by offering a
$1000 travel grant program (the Thomas Detre Award) that partially funds “away”
electives for highly accomplished medical students. Four Detre awardees have been
announced, and you may have contact with them as they come to WPIC. These students
are visiting us from all around the country and are outstanding, selected for their
references, their personal statements, their interests and backgrounds. And each one
should be a recruitment target for our residency program.
Here are the remaining students coming in 2007-08, along with their home schools:
Ashley Zucker University of Vermont Triple Board AI (9/07)
Stacey Carloni Mercer School of Medicine Community Psych (12/07)
9/07 4 Vol.1(3)
We’re also farther along in our recruitment of Pitt students to the field. Currently we
have seven applying to general psychiatry residencies, and one to combined
psych/family. Some of these students may be contacting you asking your opinions about
programs, or advice on interviewing. We’d of course love to encourage as many of these
students as possible to consider WPIC as a site for their residency:
Wiktoria Bielska Michelle Landy
Shawna Bouwers [combined] Michael Pauly
Nicole Christian Esther Teverovsky [nee Glick]
Henry Driscoll David Yankura
This number of students reflects an increase over the past two years; it represents about
5.5% of the senior class (expected to graduate), above the national average of 4.2%.
Data Corner
What happens to Pitt students who choose psychiatry as a specialty? How do they do in
the match?
Pitt Students in the Match, 2004-2007
Rank of Matched Progr: 1.5
Programs Ranked: 6.8
2004-present
Received Interview: 10.5
Programs Applied to: 15.9
0 2 4 6 8 10 12 14 16 18
Programs
The typical Pitt student over the past four years applied to about 16 psychiatry programs,
got interviews at 11, ranked 7 and matched at program rank #1.5. Or, put another way,
63% of Pitt students get their 1 st choice program, and every single one got a program in
their top 3.
9/07 5 Vol.1(3)
Educational Scholarship
Acad Psychiatry. 2006 Nov-Dec;30(6):470-9.
Students' and residents' perceptions regarding technology in
medical training.
Briscoe GW, Fore Arcand LG, Lin T, Johnson J, Rai A, Kollins K.
Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical
School, Norfolk, Virginia 23507, USA. briscogw@evms.edu
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.
These conclusions are certainly consistent with what we’ve observed here at Pitt. PDAs
are widely used, although Pitt doesn’t currently have any formal platforms directly
related to the curriculum. It’s interesting to me that Pitt students still routinely search the
internet by Google, although some have found more efficient ways to get info (e.g., the
HSLS website, PubMed). Trainees still like regular paper textbooks for initial learning,
and for studying.
We’ve added 30 minutes to our clerkship orientation so that Jeff Sivek can tell folks
about the electronic medical record, how to use PsychConsult, and security issues.
Students have been pretty receptive to this, and I know that many of you interact with
students routinely around technology.
If any of you have tips on how best to encourage technology use among students, or great
websites for teaching, let me know.
RAT 9/07 6 Rosenstock
Teaching Tips
When giving feedback, remember the cardinal rules:
Make it timely
Ask learners to self-assess first
Refer to goals to guide discussion
Be specific
Use objective language
Make it valid
Make it useful
Make plans for improvement
To structure a constructive feedback session:
Conduct feedback sessions in a private, relaxed, and supportive atmosphere.
Outline an agenda for the session.
Check for degree of agreement with other teachers and staff.
Allow the learner to discuss his/her experience or performance first. Be a good
listener.
Share your information. Link to the learner’s goals.
Compare your assessment with the learner’s and discuss.
Establish follow-up plans.
Summarize.
RAT 9/07 7 Rosenstock
Teachers Who Excel
We’ve trumpeted the educational successes of some of our faculty, and we thought it
might be useful to talk more about teaching philosophy—to show exactly what high-
achieving faculty do, and why. Let’s start with Dr. Antoine Douaihy, Medical Director
of the Addictions service line and the 10 th floor inpatient unit, associate training director
for the residency.
Dr. Douaihy’s success in teaching is based on several factors. One is his ability to
connect and develop a mentorship relationship with medical students and residents. He
evidences great passion towards teaching and mentoring and spends a good amount of
time with students, conveying the attitude that they are the next generation of physicians
who will need to continue the mission. Although a very busy professional with many
responsibilities, Dr. Douaihy is never too busy to take time with medical students and
residents after morning rounds, in individual or group supervision or by telephone. He
will meet with students and residents before and after the regular work day to ensure each
gets time needed.
Another factor in his success is that he conveys passion for his work with patients, which
others see clearly when they observe him in action working with patients, families, and
other team members. He connects with patients on a highly empathic level, injecting his
strong belief that what he does and how he does it make a huge difference in their lives.
Dr. Douaihy treats students professionally and provides opportunities for them to make
clinical decisions and treatment formulation. During rounds, he lets the students and
residents take a lead role in interviewing their patients and implementing the appropriate
therapeutic interventions. He also shows them by example some of the interventions that
they could learn form. After rounds, he initiates in-depth discussion of constructive
criticism about the interview and interventions and also discussion of issues pertinent to
patient care—especially always working with the patients not just to address the
treatment episode but also to understand how this treatment episode fits into their whole
life in general. However, within his “clinical” teaching, Dr. Douaihy also emphasizes the
importance of self-awareness and encourages his students to be aware of their reactions
to their patients, include those reactions that could impede the development of a
therapeutic alliance. He promotes active learning in many ways: he encourages his
students to learn from non-physicians staff members as well as him, and also to teach
them from their own experiences. He strongly advocates for the implementation of
evidence-based practices and helps them deal with the challenges to apply them in
working with patients.
Dr. Douaihy was generous to share with us his educational strategies and tactics;
hopefully this will be helpful for everyone.
RAT 9/07 8 Rosenstock
Upcoming Events
October 12 Grand Rounds: Teaching the Teachers 11a-12:30p
October 18 PGY-II Resident As Teacher Training 1p-3p
November 7 Teaching Excellence Fair [Alumni Hall] 9a-1p
November 9 Motivating Your Students to Learn (CIDDE) Noon-1:30p
Help Wanted
Residents/Fellows:
If you are interested in serving as a mentor for AOC-N students who might be
interested in a career in psychiatry, please let me know. You rarely get contacted, but
students like having names of people they could call for advice about programs,
applications, and the field in general.
Faculty:
We’re always looking for good ambulatory psychiatry sites, and faculty preceptors to
supervise MS3s on their psychiatry rotation. As part of the Clinical Neurosciences
Clerkship, we include an ambulatory psychiatry experience: a four-week, one afternoon
per week, required part of their clerkship. The student role would be to help out in any
way the preceptor saw fit, but ideally they would do some interviewing, help with
documentation or collateral contact, review the chart, do weights/vitals, write scripts,
whatever. Especially in the beginning, there’s shadowing involved as they learn what to
do, but we want the experience to be as active as possible for them, so that even on the
first day they would be doing more than just observing. Faculty would evaluate them by
writing a sentence or two about how they did on a form they’d give you on the final day.
That’s pretty much it. We’re flexible in terms of scheduling—morning, afternoon,
whatever—as long as you could assure us of four scheduled clinics per student. We
could do this on a regular basis (one student per month) or on an intermittent basis
(asking you periodically if you could help out). Let me know if you think you might be
interested to have students come to your outpatient site!
Anyone:
What happened to the psychiatry and film group? I know it’s been on hiatus for a while
as people of fluxed in and out. I’d really like to revive it. If any of you are interested in
being part of it, especially residents, please get back to me.
RAT 9/07 9 Rosenstock
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