Academic Psychiatry最新文献

Objective: Diversity, equity, and inclusion (DEI) curricula have a growing role in medical education environments. As students and educators team up to combat racist practices in medicine and medical education, spaces are opening for learners to engage with these topics. One such space has become available for students in their psychiatry rotation. A DEI curriculum was created for medical students at the University of Minnesota on their psychiatry rotation. This program aimed to provide opportunities for self-reflection, analyze historic and present systemic bias, and discuss how individuals and communities with disabilities face barriers in health care.

Methods: The authors created a DEI curriculum for the University of Minnesota medical student psychiatry clerkship. Resources focusing on culturally informed psychiatric care of individuals from groups underrepresented in psychiatry were identified. The authors asked students to engage with three resources and attend an in-person processing group to discuss the resources and clerkship experiences. After the course, students filled out two mixed quantitative and qualitative surveys about the resources and the curriculum.

Results: Between May 2022 and March 2023, 176 students participated in the third-year psychiatry clerkship and DEI curriculum. Of these, 125 (71%) indicated an increased level of comfort engaging with psychiatric patients from backgrounds different from their own, 46 (26%) indicated their level of comfort had not changed, and 5 (3%) reported decreased comfort.

Conclusions: The DEI curriculum integrated into the University of Minnesota third-year psychiatry clerkship was well received by students, with positive feedback about the curriculum and an increased ability to work with psychiatric patients from diverse backgrounds.

Objective: This study examined the potential of ChatGPT-4, a large language model (LLM), to generate case-based multiple-choice questions (MCQs) in undergraduate psychiatry education and assessed the quality and clinical relevance of the outputs through expert evaluation.

Methods: Twelve psychiatric diagnoses commonly encountered in clinical practice were selected. For each diagnosis, a clinical vignette and five MCQs addressing diagnosis, treatment, differential diagnosis, prognosis, and complications were generated using ChatGPT-4, based on structured prompts. The resulting 12 vignettes and 60 questions were divided into six forms. Each form was evaluated by two psychiatrists via an online survey. Evaluators responded to the questions, reviewed the suggested correct answers, and rated the quality and relevance of the items and vignettes using a standardized form. Evaluators also indicated whether each question assessed clinical reasoning or rote knowledge.

Results: Twelve psychiatrists completed evaluations. A majority of the items (71%) were rated as having an appropriate level of difficulty, and 72% of distractors were deemed plausible. However, 28% of questions were reported to contain more than one seemingly correct answer. Clinical vignettes were judged to be representative and diagnostically relevant in 23 out of 24 evaluations. On average, 81.5% of the ChatGPT-selected correct answers were chosen by evaluators. Most reviewers (21/24) stated that the questions assessed clinical reasoning.

Conclusions: ChatGPT-4 can generate clinically relevant vignettes and MCQs that may support case-based learning in psychiatry education. While promising, expert oversight remains essential, especially in generating questions targeting deeper clinical judgment and minimizing ambiguity in answer options.

Objective: Medical students often experience high levels of loneliness due to the demanding nature of their academic, clinical, and personal responsibilities.

Methods: This study investigated the contributions of perceived and received social support to loneliness among Canadian medical students (N = 154). Participants completed self-report measures assessing perceived support, received support, and loneliness.

Results: Bayesian regression model-based analyses revealed that, after controlling for demographics and overall received support, perceived social integration and attachment were significant predictors of lower loneliness (integration and attachment model: BF_M = 68.99, R² = 0.71), providing very strong evidence in favor of these predictors over simpler models. Specifically, integration (BF_inclusion = 3.60 × 10), reflecting a sense of belonging, and attachment (BF_inclusion = 87.10), reflecting emotional closeness, emerged as the strongest correlates of lower loneliness.

Conclusion: This study emphasized the importance of integration and acceptance in mitigating medical student loneliness. Tailored interventions focusing on integration and attachment could help reduce loneliness and enhance well-being in this population.

Objective: Adults with intellectual and developmental disabilities (IDD) face significant barriers to appropriate psychiatric care, disproportionately utilize emergency departments, and report lower care quality. They are also more likely to display agitation in the form of challenging behaviors. This study evaluated the impact of a didactic training on resident psychiatrist knowledge and comfort in managing agitation in individuals with IDD in acute psychiatric settings.

Methods: A 1-h training session was delivered to resident psychiatrists, facilitated by clinicians from a county-level Developmental Disabilities Services. The session focused on communication strategies, agitation management, and local resources. Pre- and post-training surveys were used to assess the knowledge and comfort of residents in caring for this population. A follow-up survey was conducted 1 month later to assess the retention and application of learned skills.

Results: Twenty residents completed both the pre- and post-surveys, with nine participating in the 1-month follow-up. Residents reported that the training improved their comfort identifying, evaluating, and managing agitation in individuals with IDD, as well as teaching others to better manage agitation in this population. Knowledge of available resources and confidence in the ability to care for agitated patients with IDD also improved. At 1 month, most respondents reported applying skills from the training, and confidence in their care abilities remained significantly elevated.

Conclusions: A brief, targeted training significantly improved resident psychiatrists' knowledge and comfort in managing agitation in individuals with IDD. Future efforts should explore expanding training to include all psychiatric care team members and assess long-term impacts on patient care quality.