Academic Psychiatry最新文献

Objectives: Mentorship supports faculty to succeed in their careers with confidence, resilience, and satisfaction. To address inequities evident with an informal approach, a formal mentorship program was designed and implemented.

Methods: The Quality Implementation Framework (QIF) was applied. Engagement with key stakeholders and users was emphasized. The goals of the program are to address inequities and create greater satisfaction with academic careers among diverse faculty working in various roles/sites. A central component is a primary 1:1 mentor/mentee model, supported with an online matching tool. 1:1 mentorship is augmented with several group mentorships, to support specific academic roles (e.g., clinician scientists; clinician teachers) or social identity. Mentorship training workshops and resources support mentors/mentees; topics include best practices, DEI, and mentorship and mentorship tools. Descriptive statistics (means, SDs, percentages) summarized findings on mentees/mentors at enrollment.

Results: Sixty-six mentors registered. Recently hired faculty (n = 136) were invited to participate, resulting in 105 mentees (77%). There is a significant improvement in mentor perception of the department's culture of mentorship (t(198) = 4.188, p < 0.001). Key mentee goals were to gain career guidance and support, information on academic promotion, skills in professional relationships, and networking. Identified challenges among mentors/mentees include having differing goals, time commitment, and managing difficult conversations. Mentorship groups were well-received with high satisfaction.

Conclusions: Uptake and participation is encouraging. QIF will help identify contextual factors related to uptake and use of the program and additional implementation strategies needed. The project will contribute to literature on implementation and sustainability of mentorship programs.

Objective: The authors aimed to determine if medical students' self-assessment of abilities and performance differed by gender during the psychiatry clerkship and if these differences were reflected objectively in test scores or clinical evaluations from educators.

Methods: Data from mid-clerkship self-assessments completed during the psychiatry core clerkship were reviewed from two classes of medical students. Students rated their performance on 14 items across five domains: knowledge/clinical reasoning, differential diagnosis, data presentation, studying skills, and teamwork as "below," "at," or "above expected level." Ratings were coded numerically, and statistical analysis was performed using Student's T-test. National Board of Medical Examiners (NBME) Subject Exam scores and clinical evaluations served as measures of actual performance.

Results: Female students (n = 123) rated their performance significantly below male peers (n = 114) in medical knowledge (female - 0.05 vs male 0.13), clinical reasoning (- 0.02 vs 0.06), differential diagnosis (- 0.09 vs 0.00), balancing work and studying (- 0.02 vs 0.11), keeping up with clerkship assignments (0.03 vs 0.13), understanding role on the team (0.11 vs 0.23), interacting with other team members (0.15 vs 0.31), and functioning as part of the team (0.13 vs 0.25). Clinical evaluation scores and NBME Subject Exam scores showed no significant difference (evaluation scores 138.1 vs 136.0; NBME scores 163.8 vs 162.2) in performance between students.

Conclusions: Female medical students tend to underrate their performance compared to male peers in clinical knowledge, studying skills, and teamwork, despite equivalent academic and clinical performance. This study highlights gender disparities in self-assessment during medical training.

Objectives: Substance use disorder (SUD) continues to be one of the most stigmatized and under-treated conditions in the United States. Stigmatizing language used by healthcare workers can transmit bias to others within healthcare, including medical trainees. This study investigates how stigmatizing language and undergraduate medical education (UME) curricula may influence trainees' clinical decision-making for patients with SUD.

Methods: Medical students from three Chicago-area medical schools were randomized to review either a stigmatizing or neutral version of a clinical scenario describing a patient experiencing opioid withdrawal. Participants (a) selected treatment plans for the fictional patient using two multiple-choice questions, (b) completed the Medical Condition Regard Scale (MCRS) to assess their attitudes, and (c) reported prior SUD experiences, both curricular and personal. Statistical analyses explored whether treatment decisions were influenced by attitudes, addiction medicine curricula, and exposure to the stigmatizing vignette.

Results: Among the 366 medical students who completed this study, exposure to stigmatizing language (n = 191) led to clinical decision-making that would be less effective in treating opioid withdrawal for the fictional patient (p = 0.027; η2 = 0.013). Exposure to more SUD education during UME was correlated with more effective clinical decision-making for opioid withdrawal (β = 0.181; R² = 0.033; p < 0.001) but was not correlated with attitudes toward patients with SUD (p = 0.231).

Conclusions: Stigmatizing language influences clinical decision-making when treating patients with SUD. Improving SUD education within UME may be an effective strategy for mitigating this effect within medical trainees.

Objective: Stigma toward mental illness has been extensively described among health care professionals and has important implications with respect to quality of care. Narrative medicine has the potential to bring about positive impacts on the practitioner-patient relationship and on patient outcomes. The authors carried out a pilot study investigating the impact of narrative medicine on residents' stigma toward bipolar disorder.

Methods: Psychiatry residents attended four narrative medicine workshops. During the encounters, the residents watched a video vignette displaying stigma-related experiences and life challenges faced by a standardized patient with bipolar disorder and were encouraged to discuss their personal reactions, opinions, and other reflections prompted by the video vignette, as well as to write reflective pieces on the content mobilized by the discussion. Stigma toward mental illnesses was measured through the Mental Illness: Clinicians' Attitudes Scale-Version 4 (MICA v4).

Results: A total of 22 psychiatry residents attended the four narrative medicine workshops. Overall, the activity was well received by the residents. There was a small, non-significant decline in the pre- and post-activity MICA v4 scores among residents.

Conclusion: The findings demonstrate the feasibility of implementing narrative medicine workshops for psychiatry residents and highlight the need for further studies with larger samples and a control group to evaluate its impact on stigma.