Academic Psychiatry最新文献

Objective: This study aimed to evaluate the feasibility, acceptability, and impact of a digital cognitive behavioral therapy (CBT)-based intervention to improve well-being in medical students.

Methods: The authors conducted a 16-week randomized (1:1) controlled trial of a digital CBT-based intervention (OptimalWork) compared to a podcast listening control in medical students. Both interventions were fully remote, self-paced, and designed to take 10-15 min per day, 5 days per week for 4 weeks. Primary outcomes were feasibility and acceptability; measures of impact included flourishing (Flourish Index) and burnout (Professional Fulfillment Index) at 8 weeks. Qualitative analysis of open-ended feedback and exit interviews was performed to understand participants' experience with the intervention, as well as barriers and facilitators of implementation.

Results: Thirty-five medical students were enrolled and randomized. The OptimalWork group showed improvements in work engagement, burnout, anxiety, and stress, and an increase in overall flourishing. Dropout rates were high in both arms (46% by 4 weeks, 56% by 16 weeks), with lower baseline work engagement and higher stress predicting attrition. Qualitative analysis revealed that students who completed OptimalWork found it feasible, relevant, and helpful, while participants who dropped out cited time constraints and difficulty with daily habit formation.

Conclusions: This pilot study demonstrates the feasibility of delivering a CBT-based digital intervention designed to improve well-being at work for medical students and offers insights into barriers and facilitators that can guide implementation efforts.

Trial registration: ClinicalTrials.gov identifier: NCT06914843 (July 24, 2024, retrospectively registered).

Objective: To systematically quantify demographic, logistical, and programmatic aspects of all research-track psychiatry residencies in the United States (US).

Methods: We collected cross-sectional data by sampling all psychiatry research residency tracks in the US using the National Residency Matching Program (NRMP) Program Directory database and the American Medical Association's Fellowship and Residency Electronic Interactive Database Access (FREIDA). We abstracted acceptance timing, number of positions, number of track directors, track length, protected research time by postgraduate year (PGY), guaranteed discretionary research funds, funding mechanisms, and trainee degree background.

Results: We identified 50 psychiatry research residency tracks; 26 (52.0%) verified information by email. Of these tracks, 28 (82.4% of those with degree data) tracks had at least one current resident without a Doctor of Philosophy (PhD) degree. Among programs with available funding data, 25/44 (56.8%) guaranteed discretionary research funding for their residents. Median (interquartile range (IQR)) protected research time was 0.0% (IQR 0-8.3%) in PGY1, 17.1% (15.3-25.0%) in PGY2, 40.0% (28.1-50.0%) in PGY3, and 58.3% (50.0-75.0%) in PGY4. Guaranteed discretionary research funds varied from $0 to $100,000 over the course of residency.

Conclusion: Psychiatry research tracks vary widely in trainee backgrounds and in the protected time and funding they offer. Adding a research-track indicator and basic standardized fields (e.g., protected time by year, guaranteed funding) to residency selection databases (e.g., NRMP, FREIDA) could reduce search costs and improve alignment between applicants and programs.

Objective: Given the critical role of medical students in future healthcare settings, understanding their attitudes towards suicide is important. The purpose of this research was to determine medical faculty students' levels of knowledge concerning suicide and their attitudes toward the stigmatization of suicide, and to evaluate the effect of medical training on those attitudes.

Methods: This cross-sectional study was performed with 684 students at the Ondokuz Mayıs University Medical Faculty between March and May 2024. Data were collected using an online questionnaire created via Google Forms. The form includes the Literacy of Suicide Scale (LOSS) and the Stigma of Suicide Scale (SOSS).

Results: The students' mean LOSS score was 17.17 ± 0.13, and their mean SOSS Stigma sub-dimension score was 67.95 ± 0.79. The findings indicated that medical students have a higher knowledge level regarding suicide than the general Turkish population. The knowledge levels of medical students increase significantly from the first year to the fourth year, coinciding with their progression to clinical training. Alongside this increase, there is a significant decrease in stigmatizing attitudes toward suicide among fourth-year students compared to first-year students. However, no significant further improvement in knowledge or reduction in stigma was observed once students enter clinical training in their sixth year and begin interacting with or treating patients who have attempted suicide, compared to the fourth year.

Conclusions: Crucially, the study demonstrated that the transition to hands-on clinical practice, including psychiatry internships and direct contact with suicidal patients, did not yield the expected advancements in suicide literacy or attitudes, highlighting a significant deficiency in the current clinical training model.

Objective: Applying to psychiatry residency has become increasingly competitive over the last decade. As such, increased weight is placed on each application element, including letters of recommendation (LOR). LOR has been shown to be sources of gender bias for applicants in other specialties. No studies currently exist that analyze gender bias in LOR for psychiatry applicants. This study aimed to evaluate the presence of gender bias in LOR for students applying to psychiatry.

Methods: LOR for residency applicants to a small to mid-sized university-based psychiatry program from the 2023-2024 residency match cycle was reviewed using linguistic text analysis. The software identified words in 96 thematic categories and word count. Text mining techniques were applied to determine word frequency for male and female letters. Logistic regression analyses were performed.

Results: A total of 975 traditional LOR for male applicants and 764 LOR for female applicants was analyzed. Only the "female reference" and "male reference" categories demonstrated statistical significance. The word frequency analysis indicated no difference in the top ten words written in LOR for male and female applicants. There was no statistical difference in word count for male or female letters, and logistic regression with least absolute shrinkage and selection operator (LASSO) method failed to identify any categories that would be more likely to predict a female letter vs. a male letter.

Conclusion: A linguistic text analysis of LOR for those applying to a single psychiatry residency program in the U.S. found no meaningful evidence of gender bias.

Objective: The Project ECHO® (Extension for Community Healthcare Outcomes) model was used to deliver training and case consultation to primary care clinicians and behavioral health teams, aiming to enhance their knowledge and confidence in addressing the behavioral health needs of young children.

Methods: Two Project ECHO programs were developed by the Massachusetts Child Psychiatry Access Program team in partnership with the Massachusetts Department of Public Health, targeting (1) primary care clinicians and (2) integrated behavioral health providers. Both ECHOs emphasized early relational health principles, introducing frameworks and tools to support understanding young children and their caregivers in their contexts. Quantitative and qualitative data were collected to assess impact and inform future iterations.

Results: Participants across the five ECHO runs provided both quantitative and qualitative feedback that knowledge gained through ECHO participation will impact their work with young children and families. Nearly 75% of primary care clinicians in one ECHO run were already implementing changes upon ECHO completion, with 100% anticipating doing so within 3 months. Participants reported increased self-rated confidence in evaluating early childhood mental health concerns and collaborating with early education providers and families, emphasizing the importance of considering relational, social, cultural, and systemic factors in their work.

Conclusions: These findings suggest that the Project ECHO model effectively enhances clinician self-rated confidence and knowledge of early childhood mental health concerns.

Objective: The aim of this study was to develop and assess the effectiveness of an online independent learning module for educating preclinical medical students about eating disorders.

Methods: The curriculum was designed using Kern's six-step framework. The 60-min eating disorders module incorporated case-based learning, narrative medicine, and real-time feedback to enhance engagement and critical thinking. Surveys were used to assess medical student attitudes, knowledge, and comfort with eating disorder diagnosis and treatment at pre-training and post-training. Paired t-tests and descriptive statistics were used for analysis.

Results: Among 130 preclinical medical students, significant improvements were observed from pre to post-training in diagnostic knowledge (p < 0.05). Students also reported significantly improved comfort with eating disorder screening and differential diagnosis (p < 0.001), as well as significantly improved attitudes about the importance of medical and psychological support for people with eating disorders (p = .008).

Conclusions: Findings provide preliminary evidence of the effectiveness of a brief self-paced independent learning module in improving medical students' knowledge, comfort, and attitudes in the initial identification and management of eating disorders. Future research can build on these initial findings to examine longer-term knowledge sustainment and additional interventions that may influence the application of knowledge or skills in real-world practice.