Designing a therapeutic model of personality biopsychological approach for personality difficulty: A new setting for psychiatric residents’ clinical education

Subclinical personality difficulties are the source of many interpersonal problems, and it is necessary for psychiatry residents to gain a comprehensive knowledge of the concepts of personality and personality disorders, including subclinical disorders. Clinical education is one of the most important aspects of medical students’ training. Improving the quality of this course is of particular importance. The services provided at the Personality Modulation Clinic of Razi Educational and Medical Center in Tabriz have been designed based on available scientific evidence and experiences for individuals with personality difficulties. The current research evaluates the effects of a new treatment known as the "Personality Biopsychological Approach" for individuals with personality difficulty for the first time given the absence of such an integrated and coherent program in clinical education. There are five main phases of study design: assessing patients’ needs, assessing psychiatric residents’ needs, formulating educational goals, the design of treatment model, and implementation. The current study found that society’s mental health is a top priority for national growth and development. Therefore, training psychiatrists in this field plays a crucial role in ensuring both individuals’ and society’s health and well-being. This study indicates that psychiatry residents’ acquaintance with this issue can increase their ability in the correct diagnosis and intervention in preventing the exacerbation of psychiatric disorders.

Teaching emergency situations during a psychiatry residency programme using a blended learning approach: a pilot study

Background Emergency psychiatry is an essential component in the training of psychiatry residents who are required to make patient-centred orientation decisions. This training calls for specific knowledge as well as skills and attitudes requiring experience. Kolb introduced a theory on experiential learning which suggested that effective learners should have four types of abilities: concrete experience, reflective observation, abstract conceptualisation and active experimentation. We aimed to evaluate a resident training programme that we designed for use in an emergency psychiatry setting based on the experimental learning theory. Methods We designed a four-step training programme for all first-year psychiatry residents: (i) theoretical teaching of psychiatric emergency knowledge, (ii) concrete experience of ability teaching involving an initial simulation session based on three scenarios corresponding to clinical situations frequently encountered in emergency psychiatry (suicidal crisis, hypomania and depressive episodes), (iii) reflective observation and abstract conceptualisation teaching based on videos and clinical interview commentary by a senior psychiatrist for the same three scenarios, (iv) active experimentation teaching during a second simulation session based on the same three frequently encountered clinical situations but with different scenarios. Training-related knowledge acquisition was assessed after the second simulation session based on a multiple-choice quiz (MCQ), short-answer questions and a script concordance test (SCT). The satisfaction questionnaire was assessed after the resident had completed his/her initial session in order to evaluate the relevance of teaching in clinical practice. The descriptive analyses were described using the mean (+/- standard deviation). The comparative analyses were conducted with the Wilcoxon or Student’s t tests depending on data distribution. Results The residents’ mean MCQ and short-answer question scores and SCT were 7.25/10 (SD = 1.2) 8.33/10 (SD = 1.4), 77.5/100 (SD = 15.8), respectively. The satisfaction questionnaire revealed that 67 % of residents found the teaching consistent. Conclusion We designed a blended learning programme that associated, classical theoretical learning to acquire the basic concepts, a learning with simulation training to experiment the clinical situations and a video support to improve learning of interview skills and memory recall. The residents indicate that this training was adequate to prepare them to be on duty. However, despite this encouraging point, this program needs further studies to attest of its efficiency.

Using objective clinical metrics to understand the relationship between the electronic health record and physician well-being: observational pilot study

Background Electronic health records (EHRs) are a significant contributor to physicians’ low satisfaction, reduced engagement and increased burnout. Yet the majority of evidence around EHR and physician harms is based on self-reported screen time, which may both over- and underreport actual exposure. Aims The purpose of this study was to examine how objective EHR use correlates with physician well-being and to develop preliminary recommendations for well-being-based EHR interventions. Method Prior to the onset of COVID-19, psychiatry residents and attending physicians working in an out-patient clinic at an academic medical centre provided consent for access to EHR-usage logs and completed a well-being assessment made up of three scales: the Maslach Burnout Inventory, the Urecht Work Engagement Scale and the Professional Quality of Life Measure. Survey responses and objective EHR data were analysed with descriptive statistics. Results Responses were obtained from 20 psychiatry residents (total eligible residents n = 27; 74% participation) and 16 clinical faculty members (total eligible faculty n = 24; 67% participation) with an overall response rate of 71% (total eligible residents and faculty n = 51 and total residents and faculty who completed survey n = 36). Moderate correlations for multiple well-being domains emerged in analysis for all participants, especially around the time spent per note and patient visits closed the same day. Conclusions EHR-usage logs represent an objective tool in the evaluation and enhancement of physician well-being. Results from our pilot study suggest that metrics for note writing efficiency and closing patient visits the same day are associated with physician well-being. These metrics will be important to study in ongoing efforts involving well-being-based EHR interventions.