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Arbuckle MR, Ferreira K, Skikic M, Travis MJ, Wilkey C, Ross DA. Assessment of Brief Online Approaches for Teaching Neuroscience in Psychiatry. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2024; 48:227-232. [PMID: 38478200 DOI: 10.1007/s40596-024-01947-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 02/12/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE The goal of this study was to assess an online collection of brief educational resources (videos, case studies, articles) for teaching a broad range of concepts relating to neuroscience in psychiatry. METHODS A national sample of 52 psychiatrists enrolled in the study. Forty (77%) completed an assessment before and after having access to the educational resources for 4 weeks. Pre- and post-assessments were compared using paired t-tests. Fifteen participants were randomly selected to participate in a semi-structured interview. RESULTS The mean knowledge score increased on a multiple-choice quiz from 46.9 to 86.4% (p < .01). Based on a 5-point Likert rating, participants reported significant gains in self-confidence in their ability to integrate a neuroscience perspective into their clinical work (p = .03) and to discuss neuroscience with their patients (p = .008). Participants rated the extent that they applied neuroscience concepts (such as neurotransmitters, genetics, epigenetics, synaptic plasticity, and neural circuitry) to their overall case formulation and treatment plan over the past typical work week and how often they discussed these elements with patients. Significant gains were noted across all elements (p ≤ .001). Overall satisfaction with the resources were high: participants agreed that the content was useful and relevant (100%) and the teaching resources were engaging (95%). On semi-structured interviews, participants appreciated the mixed teaching approaches and the brief format. Many commented on how the resources impacted their clinical practice. CONCLUSIONS Brief online teaching resources may be an effective approach for enhancing neuroscience education among psychiatrists and may help facilitate the integration of neuroscience into clinical practice.
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Affiliation(s)
- Melissa R Arbuckle
- Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, USA.
| | | | - Maja Skikic
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael J Travis
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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2
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Troisi A. An evolutionary analysis of the applicability and utility of the clinico-pathological method in psychiatry. Neurosci Biobehav Rev 2024; 159:105599. [PMID: 38387837 DOI: 10.1016/j.neubiorev.2024.105599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/09/2024] [Accepted: 02/19/2024] [Indexed: 02/24/2024]
Abstract
Unlike other medical specialties, psychiatry has not been involved in the theoretical shift that replaced the syndromal approach with the clinico-pathological method, which consists in explaining clinical manifestations by reference to morbid anatomical and physiological changes. Past and present discussions on the applicability of the clinico-pathological method in psychiatry are based on a pre-Darwinian concept of biology as the study of proximate causation. Distinguishing between mediating mechanisms and evolved functions, an evolutionary perspective offers an original contribution to the debate by overcoming the opposite views of dualism (i.e., the clinico-pathological method is not applicable to disorders of the mind) and neuroessentialism (i.e., the definitive way of explaining psychiatric disorders is by reference to the brain and its activity). An evolutionary perspective offers original insights on the utility of the clinico-pathological method to solve critical questions of psychiatric research and clinical practice, including the distinction between mental health and illness, a better understanding of the etiology and pathophysiology, the classification and differential diagnosis of psychiatric disorders, and the development of more efficacious psychiatric treatments.
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Affiliation(s)
- Alfonso Troisi
- Department of Systems Medicine, University of Rome Tor Vergata, Viale Montpellier 1, Rome 00133, Italy.
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3
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Molina-Ruiz R, Nakagami Y, Mörkl S, Vargas M, Shalbafan M, Chang JPC, Rai Y, Seun-Fadipe CT, Erzin G, Kazhungil F, Vidal P, Brihastami S, Yıldızhan E, Maiti T, Fedotov I, Rojnic-Palavra I, Horinouchi T, Renganathan V, Pinto da Costa M. Training in neuropsychiatry: views of early career psychiatrists from across the world. BJPsych Bull 2024; 48:78-84. [PMID: 37395121 PMCID: PMC10985715 DOI: 10.1192/bjb.2023.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 02/01/2023] [Accepted: 04/16/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Training and practice in neuropsychiatry varies across the world. However, little is known about the experiences and opinions of early career psychiatrists (ECPs) across different countries regarding neuropsychiatry. AIMS AND METHOD To investigate neuropsychiatry training experiences, practices and opinions among ECPs across different countries. An online survey was distributed to ECPs in 35 countries across the world. RESULTS A total of 522 participants took part in this study. Responses show that neuropsychiatry is integrated to a variable extent in psychiatric training curricula across the world. Most respondents were not aware of the existence of neuropsychiatric training or of neuropsychiatric units. Most agreed that training in neuropsychiatry should be done during or after the psychiatry training period. Lack of interest among specialty societies, lack of time during training, and political and economic reasons are regarded as the main barriers. CLINICAL IMPLICATIONS These findings call for an improvement in the extent and in the quality of neuropsychiatry training across the world.
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Affiliation(s)
| | | | | | | | - Mohammadreza Shalbafan
- Iran University of Medical Sciences, Tehran, Iran
- Institute for Cognitive Sciences Studies, Tehran, Iran
| | | | - Yugesh Rai
- Essex Partnership University NHS Foundation Trust, Colchester, UK
| | | | - Gamze Erzin
- Diskapi Training and Research Hospital, Ankara, Turkey
| | | | - Pablo Vidal
- Hospitalario Universitario A Coruña, A Coruña, Spain
| | | | - Eren Yıldızhan
- Bakirkoy Mazhar Osman Research and Training Hospital for Psychiatry, Istanbul, Turkey
| | - Tanay Maiti
- South Yorkshire NHS Foundation Trust, Dewsbury, UK
| | | | | | - Toru Horinouchi
- Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Mariana Pinto da Costa
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
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4
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Schildkrout B, Niu K, Cooper JJ. Clinical Neuroscience Continuing Education for Psychiatrists. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023:10.1007/s40596-023-01776-8. [PMID: 37106262 DOI: 10.1007/s40596-023-01776-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Affiliation(s)
| | - Kathy Niu
- Vanderbilt University Medical Center, Nashville, TN, USA
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5
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de Cates A, Lane V, Turner E. The core trainee 'residential': an opportunity for trainees to feel connected in a world of virtual teaching. BJPsych Bull 2022; 46:336-341. [PMID: 34231454 PMCID: PMC9813769 DOI: 10.1192/bjb.2021.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
MRCPsych courses play a key role in helping trainees prepare for Membership examinations and specialist training. Historically, their social aspect, although arguably as important, has perhaps not been sufficiently prioritised. During a pandemic, when teaching is largely delivered virtually, the social benefit of meeting peers is highlighted by its absence. Given the future likelihood of increased virtual teaching, it is of paramount importance to explore ways of enhancing the sociability of teaching courses. In addition to the social needs of trainees, there is a recognised need to increase and integrate the neuroscience component of the curriculum to better meet the needs of modern day mental health research, treatment and practice. This article describes how the Birmingham MRCPsych course successfully addressed both these issues with a 2-day 'residential' in October 2019, and considers whether future residentials could be delivered virtually.
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Affiliation(s)
| | - Victoria Lane
- Birmingham Women's and Children's NHS Foundation Trust, UK
| | - Erin Turner
- Birmingham and Solihull Mental Health NHS Foundation Trust, UK
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6
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Mancini F, Mancini A, Castelfranchi C. Unhealthy mind in a healthy body: A criticism to eliminativism in psychopathology. Front Psychiatry 2022; 13:889698. [PMID: 36245873 PMCID: PMC9563240 DOI: 10.3389/fpsyt.2022.889698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 09/08/2022] [Indexed: 11/15/2022] Open
Abstract
In this article we criticize the thesis "The diseases we treat are diseases of the brain". A first criticism is against the eliminativist perspective and in favor of a perspective that is still reductionist but emergentist and functionalist. In a second part, we try to answer the question "under which conditions can we consider this statement legitimate?". We argue that only those mental disorders whose neural substrate has clearly neuropathological characteristics, i.e., anomalies with respect to the laws of good neural functioning, can be considered "brain diseases." We propose that it is not sufficient to observe a simple difference between the brains of people with psychopathology, that is, with anomalies with respect to the laws of good psychological functioning, and that of people without psychopathology. Indeed, we believe it is a categorical error to postulate a neuropathology starting from a psychopathology. Finally, we summarize some research that shows how purely psychological interventions can reduce or eliminate the differences between the brains of people with or psychopathology and those of people without.
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Affiliation(s)
- Francesco Mancini
- Schools of Cognitive Psychotherapy (APC-SPC), Rome, Italy
- Department of Psychology, Telematic University of Rome “Guglielmo Marconi”, Rome, Italy
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7
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Boland RJ, Dingle AD, Travis MJ, Osborne LM, Shapiro MA, Madaan V, Ahmed I. Using the Psychiatry Resident-In-Training Examination (PRITE) to Assess the Psychiatry Medical Knowledge Milestones in Psychiatry. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:331-337. [PMID: 34623622 DOI: 10.1007/s40596-021-01537-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 09/09/2021] [Indexed: 05/13/2023]
Abstract
OBJECTIVE The introduction of the Milestone Project underscored the need for objective assessments of resident progress across the competencies. Therefore, the authors examined the Psychiatry Resident-In-Training Examination (PRITE) utility for measuring improvements in medical knowledge (MK). METHODS The authors compared the mean performance for each MK subcompetency by resident year for all residents taking the PRITE from 2015 to 2017 (18,175 examination administrations). In addition, they surveyed psychiatry residency program directors regarding how well they thought they teach these subcompetencies. RESULTS Increases in MK subcompetencies by resident year were significant for Psychopathology (p < 0.003), Psychotherapy (p < 0.002), and Somatic Therapies (p < 0.000). Development, Clinical Neuroscience, and Practice of Psychiatry did not show statistically significant differences between postgraduate years. Eighty psychiatry program directors responded to the survey and felt optimistic about their ability to teach the Psychopathology, Psychotherapy, Somatic Therapies, and Practice of Psychiatry subcompetencies. CONCLUSIONS The PRITE measured significant improvements in medical knowledge for several of the core subcompetencies. The program director's responses would suggest that the lack of statistically significant differences found for Development and Clinical Neuroscience reflects areas in need of curricular development. The disparity between PRITE performance and program director perception of the Practice of Psychiatry subcompetency may reflect difficulties in defining the scope of this subcompetency. Overall, this suggests that structured examinations help measure improvements in certain subcompetencies and may also help identify curricular needs. However, there may be potential problems with the definition of some subcompetencies.
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Affiliation(s)
- Robert J Boland
- Baylor College of Medicine and the Menninger Clinic, Houston, TX, USA.
| | - Arden D Dingle
- University of Nevada, Reno School of Medicine, Reno, NV, USA
| | - Michael J Travis
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | | | - Vishal Madaan
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Iqbal Ahmed
- Tripler Army Medical Center Psychiatry Residency Program, Honolulu, HI, USA
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8
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Davis JE. 'The Explanation You Have Been Looking For': Neurobiology as Promise and Hermeneutic Closure. Cult Med Psychiatry 2022; 46:76-100. [PMID: 34351549 DOI: 10.1007/s11013-021-09737-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2021] [Indexed: 11/26/2022]
Abstract
The biomedical aspiration of psychiatry has fundamentally reoriented clinical practice since the DSM-III in 1980 and reverberated in the public sphere. Over time, lay public understanding of the causes of mental suffering has increasingly endorsed biological conceptions. In this paper, I explore the sources from which a neurobiological model for mental suffering reaches ordinary people, and investigate its rhetorical appeal, personal appropriation, and consequences. Drawing on interviews and other data, I show that these sources-physicians, popular media, and advertising-share common ontological and moral assumptions. These assumptions, in turn, influence how people take up neurobiological explanation to account for their suffering, and how, paradoxically, they join it to their projects of self-determination. I conclude by considering how, from a phenomenological perspective, a neurobiological account fails to enhance self-knowledge or determination but leads to a hermeneutic dead end.
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Affiliation(s)
- Joseph E Davis
- Institute for Advanced Studies in Culture, University of Virginia, 3 University Circle, Charlottesville, VA, 22903, USA.
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9
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Boland RJ, Amonoo HL. The Psychiatric Clinics of North America Special Issue on Medical Education. Psychiatr Clin North Am 2021; 44:xiii-xvii. [PMID: 34049653 DOI: 10.1016/j.psc.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Robert J Boland
- The Menninger Clinic, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
| | - Hermioni L Amonoo
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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10
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Goodman ZT, Bainter SA, Kornfeld S, Chang C, Nomi JS, Uddin LQ. Whole-Brain Functional Dynamics Track Depressive Symptom Severity. Cereb Cortex 2021; 31:4867-4876. [PMID: 33774654 DOI: 10.1093/cercor/bhab047] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/14/2021] [Accepted: 02/11/2021] [Indexed: 02/06/2023] Open
Abstract
Depressive symptoms are reported by 20% of the population and are related to altered functional integrity of large-scale brain networks. The link between moment-to-moment brain function and depressive symptomatology, and the implications of these relationships for clinical and community populations alike, remain understudied. The present study examined relationships between functional brain dynamics and subclinical-to-mild depressive symptomatology in a large community sample of adults with and without psychiatric diagnoses. This study used data made available through the Enhanced Nathan Kline Institute-Rockland Sample; 445 participants between 18 and 65 years of age completed a 10-min resting-state functional MRI scan. Coactivation pattern analysis was used to examine the dimensional relationship between depressive symptoms and whole-brain states. Elevated levels of depressive symptoms were associated with increased frequency and dwell time of the default mode network, a brain network associated with self-referential thought, evaluative judgment, and social cognition. Furthermore, increased depressive symptom severity was associated with less frequent occurrences of a hybrid brain network implicated in cognitive control and goal-directed behavior, which may impair the inhibition of negative thinking patterns in depressed individuals. These findings demonstrate how temporally dynamic techniques offer novel insights into time-varying neural processes underlying subclinical and clinically meaningful depressive symptomatology.
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Affiliation(s)
- Zachary T Goodman
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Sierra A Bainter
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Salome Kornfeld
- REHAB Basel - Klinik für Neurorehabilitation und Paraplegiologie, Basel, Switzerland
| | - Catie Chang
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.,Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
| | - Jason S Nomi
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Lucina Q Uddin
- Department of Psychology, University of Miami, Coral Gables, FL, USA.,Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL, USA
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11
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Abstract
Mental health disorders cause a large burden on global public health, with many patients living years with the disability. However, many doctors are ill-equipped to treat mental health disorders given inadequate training during their undergraduate years. In some countries, psychiatry is even considered an elective course rather than a core module. There is, therefore, a pressing need to improve the training of medical students in managing mental health disorders. Measures need to be implemented to attract students to choose psychiatry as their career. Given the developments in the fields and the challenges currently faced by trainees and early career psychiatrists, changes may also be made to the training programme in the postgraduate stage to unify the variations across the world in terms of the training duration and format. This paper will describe the ways that undergraduate and postgraduate psychiatry training may be ameliorated to improve the delivery of mental healthcare around the world and to equip doctors to face challenges in the future.
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Affiliation(s)
- Keith Hariman
- Department of General Adult Psychiatry, Castle Peak Hospital, Hong Kong, China
| | | | - Mariana Pinto da Costa
- Hospital de Magalhães Lemos, Porto, Portugal.,Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal.,Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK
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12
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Hassan T, Prasad B, Meek BP, Modirrousta M. Attitudes of Psychiatry Residents in Canadian Universities toward Neuroscience and Its Implication in Psychiatric Practice. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:174-183. [PMID: 31648547 PMCID: PMC7019466 DOI: 10.1177/0706743719881539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Despite recent advances in neuroscience highlighting its potential applications in the assessment and treatment of psychiatric disorders, the training of psychiatrists in neuroscience is lacking. However, it is not clear to what extent Canadian trainees are interested in further learning and using neuroscience in their daily clinical practice. This study explored the attitudes of Canadian psychiatry trainees with regard to neuroscience education and training by asking them to assess their own understanding of neuroscience and the perceived relevance of neuroscience knowledge to effective psychiatric practice. METHODS An online questionnaire was sent to psychiatry residents at Canadian universities. This questionnaire consisted of self-assessments of neuroscience knowledge, attitudes toward neuroscience education, preferences in learning modalities, and interest in specific neuroscience topics. RESULTS One hundred and eleven psychiatry residents from psychiatry residency programs at Canadian universities responded to this survey. Participants represented trainees from all 5 years of residency. Almost half of all trainees (49.0%) reported their knowledge of neuroscience to be either "inadequate" or "less than adequate," and only 14.7% of trainees reported that they feel "comfortable" or "very comfortable" discussing neuroscience findings with their patients. 63.7% of Canadian trainees rated the quantity of neuroscience education in their residency program as either less than adequate or inadequate, and 46.1% rated the quality of their neuroscience education as "poor" or "very poor." The vast majority of participants (>70%) felt that additional neuroscience education would be moderately-to-hugely helpful in finding personalized treatments, discovering future treatments, destigmatizing patients with psychiatric illness, and understanding mental illness. CONCLUSIONS Canadian trainees generally feel that their neuroscience knowledge and the neuroscience education they receive during their psychiatry residencies is inadequate. However, as the first step for any change, the majority of future Canadian psychiatrists are very motivated and have a positive attitude toward neuroscience learning.
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Affiliation(s)
- Taghreed Hassan
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Benjamin Prasad
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Benjamin P Meek
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mandana Modirrousta
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
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13
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Arbuckle MR, Travis MJ, Eisen J, Wang A, Walker AE, Cooper JJ, Neeley L, Zisook S, Cowley DS, Ross DA. Transforming Psychiatry from the Classroom to the Clinic: Lessons from the National Neuroscience Curriculum Initiative. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2020; 44:29-36. [PMID: 31797322 PMCID: PMC7018606 DOI: 10.1007/s40596-019-01119-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 09/02/2019] [Accepted: 09/12/2019] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Individual residency programs often struggle to keep pace with scientific advances and new training requirements. Integrating a modern neuroscience perspective into the clinical practice of psychiatry is particularly emblematic of these challenges. The National Neuroscience Curriculum Initiative (NNCI) was established in 2013 to develop a comprehensive set of shared, open-access resources for teaching neuroscience in psychiatry. METHODS The NNCI developed a collaborative, team-based approach with a peer-review process for generating and reviewing content. Teaching resources have included interactive sessions for the classroom paired with a comprehensive facilitator's guide. Brief accessible reviews and short videos have been developed for self-study and teaching in clinical settings. Dissemination efforts have included hands-on training for educators through national workshops. All resources are freely available on the NNCI website. Outcome measures have included the number of educational resources developed, feedback from workshop attendees, the number of US psychiatry residency programs who have adopted NNCI resources, as well as analytics from the NNCI website. RESULTS To date, the NNCI has developed over 150 teaching sessions, reflecting the work of 129 authors from 49 institutions. The NNCI has run over 50 faculty development workshops in collaboration with numerous national and international organizations. Between March 2015 and June 2019, the website (www.NNCIonline.org) has hosted 48,640 unique users from 161 countries with 500,953 page views. More than 200 psychiatry training programs have reported implementing NNCI teaching materials. CONCLUSIONS This multisite collaborative provides a model for integrating cutting-edge science into medical education and the practice of medicine more broadly.
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Affiliation(s)
| | - Michael J Travis
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Amanda Wang
- Research Foundation for Mental Hygiene, New York, NY, USA
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14
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Manning KJ, Gunning FM, Aizenstein HJ, Steffens DC. Training the Next Generation of Geriatric-Focused Clinical Neuroscientists. Am J Geriatr Psychiatry 2019; 27:720-727. [PMID: 30928155 DOI: 10.1016/j.jagp.2019.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/26/2019] [Accepted: 03/07/2019] [Indexed: 01/21/2023]
Abstract
It remains challenging to integrate clinical neuroscience into clinical practice. Hindrances at the training level (e.g., lack of qualified faculty and curriculum) contribute to this impasse. To help address this, we present a model of training in clinical neuroscience. We expand on a growing literature on incorporating neuroscience into psychiatry training by emphasizing two points. That is, 1) we propose a training model designed for the geriatric-minded clinician; and 2) that extends across several phases of education and career development. Considering the relevance of dementia to our population of interest, and the potential impact expertise in clinical neuroscience can have in elders with cognitive impairment, we provide relevant curriculum examples at various training stages. Clinical research, both as a practitioner and consumer, figures prominently into our training model. We discuss two mentoring programs, T32 fellowships and Research Career Institute in the Mental Health of Aging, as ways to engage geriatric psychiatrists early in their training and transition them successfully to post-residency clinical investigator positions. Although there is increasing opportunity for geriatric psychiatrists and other clinicians to become leaders in the field of neuroscience, this remains a work in progress; ours and others' training programs continue to evolve based on input from trainers and trainees alike, as well as from the increasing literature on this important topic.
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Affiliation(s)
- Kevin J Manning
- Department of Psychiatry (KJM, DCS), University of Connecticut Health Center, Farmington, CT.
| | - Faith M Gunning
- Department of Psychiatry (FMG), Weill Cornell Medical College, White Plains, NY
| | | | - David C Steffens
- Department of Psychiatry (KJM, DCS), University of Connecticut Health Center, Farmington, CT
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15
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Abstract
The biological mechanisms underlying psychiatric diagnoses are not well defined. Clinical diagnosis based on categorical systems exhibit high levels of heterogeneity and co-morbidity. The Research Domain Criteria (RDoC) attempts to reconceptualize psychiatric disorders into transdiagnostic functional dimensional constructs based on neurobiological measures and observable behaviour. By understanding the underlying neurobiology and pathophysiology of the relevant processes, the RDoC aims to advance biomarker development for disease prediction and treatment response. This important evolving dimensional framework must also consider environmental factors. Emerging evidence suggests that gut microbes (microbiome) play a physiological role in brain diseases by modulating neuroimmune, neuroendocrine and neural signalling pathways between the gut and the brain. The integration of the gut microbiome signature as an additional dimensional component of the RDoC may enhance precision psychiatry.
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16
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Shalev D, Jacoby N. Neurology Training for Psychiatry Residents: Practices, Challenges, and Opportunities. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2019; 43:89-95. [PMID: 29777396 DOI: 10.1007/s40596-018-0932-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 04/30/2018] [Indexed: 05/23/2023]
Affiliation(s)
- Daniel Shalev
- Columbia University Medical Center, New York, NY, USA.
| | - Nuri Jacoby
- Maimonides Medical Center, Brooklyn, NY, USA
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18
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Travis MJ. Neuroscience and the Future of Psychiatry. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2019; 17:30-31. [PMID: 31975956 PMCID: PMC6493157 DOI: 10.1176/appi.focus.20180032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Michael J Travis
- Department of Psychiatry, University of Pittsburgh Medical Center Western Psychiatric Hospital, Pittsburgh
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Nurnberger JI, Austin J, Berrettini WH, Besterman AD, DeLisi LE, Grice DE, Kennedy JL, Moreno-De-Luca D, Potash JB, Ross DA, Schulze TG, Zai G. What Should a Psychiatrist Know About Genetics? Review and Recommendations From the Residency Education Committee of the International Society of Psychiatric Genetics. J Clin Psychiatry 2018; 80:17nr12046. [PMID: 30549495 PMCID: PMC6480395 DOI: 10.4088/jcp.17nr12046] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 06/01/2018] [Indexed: 01/23/2023]
Abstract
The International Society of Psychiatric Genetics (ISPG) created a Residency Education Committee with the purpose of identifying key genetic knowledge that should be taught in psychiatric training programs. Thirteen committee members were appointed by the ISPG Board of Directors, based on varied training, expertise, gender, and national origin. The Committee has met quarterly for the past 2 years, with periodic reports to the Board and to the members of the Society. The information summarized includes the existing literature in the field of psychiatric genetics and the output of ongoing large genomics consortia. An outline of clinically relevant areas of genetic knowledge was developed, circulated, and approved. This document was expanded and annotated with appropriate references, and the manuscript was developed. Specific information regarding the contribution of common and rare genetic variants to major psychiatric disorders and treatment response is now available. Current challenges include the following: (1) Genetic testing is recommended in the evaluation of autism and intellectual disability, but its use is limited in current clinical practice. (2) Commercial pharmacogenomic testing is widely available, but its utility has not yet been clearly established. (3) Other methods, such as whole exome and whole genome sequencing, will soon be clinically applicable. The need for informed genetic counseling in psychiatry is greater than ever before, knowledge in the field is rapidly growing, and genetic education should become an integral part of psychiatric training.
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Affiliation(s)
- John I Nurnberger
- 320 W 15th St, Indianapolis, IN 46202.
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jehannine Austin
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Wade H Berrettini
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Aaron D Besterman
- University of California Los Angeles Semel Institute of Neuroscience and Human Behavior, Los Angeles, California, USA
| | - Lynn E DeLisi
- VA Boston Healthcare System and Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | | | - James L Kennedy
- Centre for Addiction and Mental Health and University of Toronto, Toronto, Ontario, Canada
| | | | - James B Potash
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David A Ross
- Yale University School of Medicine, Hartford, Connecticut, USA
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, Germany
| | - Gwyneth Zai
- Centre for Addiction and Mental Health and University of Toronto, Toronto, Ontario, Canada
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20
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Arbuckle MR, Luo SX, Pincus HA, Gordon JA, Chung JY, Chavez M, Oquendo MA. Trends in MD/PhD Graduates Entering Psychiatry: Assessing the Physician-Scientist Pipeline. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2018; 42:346-353. [PMID: 29302928 PMCID: PMC5943155 DOI: 10.1007/s40596-017-0870-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 12/06/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The goal of this study was to identify trends in MD/PhD graduates entering psychiatry, to compare these trends with other specialties, and to review strategies for enhancing the physician-scientist pipeline. METHODS Data on 226,588 medical students graduating from Liaison Committee on Medical Education accredited programs between 1999 and 2012 (6626 MD/PhDs) were used to evaluate the number, percentage, and proportion of MD/PhDs entering psychiatry in comparison with other specialties (neurology, neurosurgery, internal medicine, family medicine, and radiation oncology). Linear regression and multiple linear regression determined whether these values increased over time and varied by sex. RESULTS Over 14 years, an average of 18 MD/PhDs (range 13-29) enrolled in psychiatry each year. The number of MD/PhDs going into psychiatry significantly increased, although these gains were modest (less than one additional MD/PhD per year). The proportion of students entering psychiatry who were MD/PhDs varied between 2.9 and 5.9 per 100 residents, with no significant change over time. There was also no change in the percentage of MD/PhDs entering psychiatry from among all MD/PhD graduates. The rate of increase in the number of MD/PhDs going into psychiatry did not differ significantly from other specialties except for family medicine, which is decreasing. The rate of MD/PhDs going into psychiatry was higher for women, suggesting closure of the sex gap in 17 years. CONCLUSIONS Despite the increase in the number of MD/PhDs entering psychiatry, these numbers remain low. Expanding the cohort of physician-scientists dedicated to translational research in psychiatry will require a multipronged approach.
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Affiliation(s)
- Melissa R Arbuckle
- Columbia University Medical Center, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
| | - Sean X Luo
- Columbia University Medical Center, New York, NY, USA
| | - Harold Alan Pincus
- Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- New York-Presbyterian Hospital, New York, NY, USA
| | - Joshua A Gordon
- Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Joyce Y Chung
- US National Institute of Mental Health, Bethesda, MD, USA
| | - Mark Chavez
- US National Institute of Mental Health, Bethesda, MD, USA
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Moreira-Almeida A, Araujo SDF, Cloninger CR. The presentation of the mind-brain problem in leading psychiatry journals. BRAZILIAN JOURNAL OF PSYCHIATRY 2018; 40:335-342. [PMID: 29412337 PMCID: PMC6899399 DOI: 10.1590/1516-4446-2017-2342] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 07/19/2017] [Indexed: 11/28/2022]
Abstract
Objective: The mind-brain problem (MBP) has marked implications for psychiatry, but has been poorly discussed in the psychiatric literature. This paper evaluates the presentation of the MBP in the three leading general psychiatry journals during the last 20 years. Methods: Systematic review of articles on the MBP published in the three general psychiatry journals with the highest impact factor from 1995 to 2015. The content of these articles was analyzed and discussed in the light of contemporary debates on the MBP. Results: Twenty-three papers, usually written by prestigious authors, explicitly discussed the MBP and received many citations (mean = 130). The two main categories were critiques of dualism and defenses of physicalism (mind as a brain product). These papers revealed several misrepresentations of theoretical positions and lacked relevant contemporary literature. Without further discussion or evidence, they presented the MBP as solved, dualism as an old-fashioned or superstitious idea, and physicalism as the only rational and empirically confirmed option. Conclusion: The MBP has not been properly presented and discussed in the three leading psychiatric journals in the last 20 years. The few articles on the topic have been highly cited, but reveal misrepresentations and lack of careful philosophical discussion, as well as a strong bias against dualism and toward a materialist/physicalist approach to psychiatry.
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Affiliation(s)
- Alexander Moreira-Almeida
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
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Bhugra D, Tasman A, Pathare S, Priebe S, Smith S, Torous J, Arbuckle MR, Langford A, Alarcón RD, Chiu HFK, First MB, Kay J, Sunkel C, Thapar A, Udomratn P, Baingana FK, Kestel D, Ng RMK, Patel A, Picker LD, McKenzie KJ, Moussaoui D, Muijen M, Bartlett P, Davison S, Exworthy T, Loza N, Rose D, Torales J, Brown M, Christensen H, Firth J, Keshavan M, Li A, Onnela JP, Wykes T, Elkholy H, Kalra G, Lovett KF, Travis MJ, Ventriglio A. The WPA-Lancet Psychiatry Commission on the Future of Psychiatry. Lancet Psychiatry 2017; 4:775-818. [PMID: 28946952 DOI: 10.1016/s2215-0366(17)30333-4] [Citation(s) in RCA: 184] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 07/28/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Dinesh Bhugra
- Department of Health Services and Population Research, King's College London and South London and Maudsley NHS Foundation Trust, London, UK; World Psychiatric Association, Geneva, Switzerland.
| | - Allan Tasman
- Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA
| | - Soumitra Pathare
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Shubulade Smith
- Department of Forensic and Neurodevelopmental Science, King's College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - John Torous
- Department of Psychiatry and Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Melissa R Arbuckle
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Alex Langford
- Psychological Medicine Service, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Renato D Alarcón
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA; Department of Psychiatry, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Helen Fung Kum Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Michael B First
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Jerald Kay
- Department of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Charlene Sunkel
- SA Federation for Mental Health, Johannesburg, South Africa; Movement for Global Mental Health, Johannesburg, South Africa
| | - Anita Thapar
- Child & Adolescent Psychiatry Section, Division of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics & Genomics, School of Medicine, Cardiff University, Cardiff, UK
| | - Pichet Udomratn
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Florence K Baingana
- Mental Health Lead Basic Package of Essential Health Services Cluster, WHO Sierra Leone Country Office, Freetown, Sierra Leone
| | - Dévora Kestel
- Mental Health and Substance Use Unit, Pan American Health Organization/World Health Organization, Washington DC, USA
| | | | - Anita Patel
- Centre for Primary Care & Public Health, Blizard Institute, Queen Mary University of London, London, UK
| | - Livia De Picker
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium
| | - Kwame Julius McKenzie
- Wellesley Institute, Toronto, Ontario, Canada; General Psychiatry and Health Systems, Centre for Addictions and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Driss Moussaoui
- Ibn Rushd University Psychiatric Center, Casablanca, Morocco
| | - Matt Muijen
- Danish Mental Health Association, Copenhagen, Denmark
| | - Peter Bartlett
- School of Law and Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Sophie Davison
- State Forensic Mental Health Service, Department of Health, Clinical Research Centre, Mount Claremont, WA, Australia; School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia
| | - Tim Exworthy
- Department of Forensic and Neurodevelopmental Science, King's College London and South London and Maudsley NHS Foundation Trust, London, UK; Cygnet Healthcare, Stevenage, UK
| | | | - Diana Rose
- Service User Research Enterprise, King's College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - Julio Torales
- Department of Psychiatry, National University of Asunción, San Lorenzo, Paraguay
| | | | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Joseph Firth
- NICM, School of Science and Health, University of Western Sydney, Sydney, NSW, Australia
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ang Li
- Department of Psychology, Beijing Forestry University, Beijing, China
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Til Wykes
- Institute of Psychiatry, Psychology & Neuroscience, King's College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - Hussien Elkholy
- World Psychiatric Association, Geneva, Switzerland; Institute of Psychiatry, Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Gurvinder Kalra
- Flynn Adult Inpatient Psychiatric Unit, Latrobe Regional Hospital Mental Health Services (LRH-MHS), Traralgon, VIC, Australia; School of Rural Health (La Trobe Valley & West Gippsland), Monash University, VIC, Australia
| | | | - Michael J Travis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Muzyk AJ, Gagliardi JP, Rakesh G, Jiroutek MR, Radhakrishnan R, Pae CU, Masand PS, Szabo ST. Development of a Diverse Learning Experience for Diverse Psychiatry Resident Needs: A Four-Year Biological Psychiatry Curriculum Incorporating Principles of Neurobiology, Psychopharmacology, and Evidence-Based Practice. Psychiatry Investig 2017; 14:289-297. [PMID: 28539947 PMCID: PMC5440431 DOI: 10.4306/pi.2017.14.3.289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 03/15/2016] [Accepted: 06/03/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE A clinically relevant approach to patient care grounded in neurobiological constructs and evidence based practice which emphasizes a relevant psychopharmacology is needed to optimally train psychiatry residents. METHODS We implemented a biological psychiatry course that now incorporates neurobiology, psychopharmacology, and evidence-based practice in conjunction with a Research Domain Criteria (RDoC) perspective. A survey launched prior to course implementation and following each class session, served as the outcome metric of residents' attitudes toward the new curriculum and followed a baseline attitudinal survey designed to evaluate the program. RESULTS Greater than 90% of the psychiatry residents at Duke University who took the attitudinal survey agreed or strongly agreed with needing a course that helped them develop an understanding of neurobiology, psychopharmacology, and evidence-based practice concepts. Most residents also indicated a less than adequate understanding of the neurobiology and psychopharmacology of psychiatric disorders prior to sessions. CONCLUSION Our biological psychiatry curriculum was associated with enthusiasm among residents regarding the incorporation of neurobiology, psychopharmacology, and evidence-based practice into course topics and discussions. A biological psychiatry curriculum with integrated neurobiology and psychopharmacology built on an evidence base approach is possible, well-received, and needed in training of future psychiatrists.
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Affiliation(s)
- Andrew J Muzyk
- Department of Pharmacy Practice, Campbell University School of Pharmacy and Health Sciences, Buies Creek, NC, USA
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
| | - Jane P Gagliardi
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
- Department of Medicine, Duke University, Durham, NC, USA
| | - Gopalkumar Rakesh
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
| | - Michael R Jiroutek
- Department of Clinical Research, Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC, USA
| | | | - Chi-Un Pae
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
- Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Prakash S Masand
- Academic Medicine Education Institute, Duke-NUS Medical School, Singapore
- Global Medical Education, New York, NY, USA
| | - Steven T Szabo
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
- Mental Health Service Line, Veterans Affairs Medical Center, Durham, NC, USA
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Brenner AM, Balon R, Coverdale JH, Beresin EV, Guerrero APS, Louie AK, Roberts LW. Psychiatry Workforce and Psychiatry Recruitment: Two Intertwined Challenges. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2017; 41:202-206. [PMID: 28205068 DOI: 10.1007/s40596-017-0679-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 01/25/2017] [Indexed: 06/06/2023]
Affiliation(s)
- Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA.
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25
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Affiliation(s)
- Melissa R. Arbuckle
- Department of Psychiatry, Columbia University Medical Center, New York, New York; and New York State Psychiatric Institute, New York
| | - Michael J. Travis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - David A. Ross
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
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26
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Goldenberg MN, Krystal JH. Undergraduate Neuroscience Majors: A Missed Opportunity for Psychiatry Workforce Development. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2017; 41:239-242. [PMID: 28188505 DOI: 10.1007/s40596-017-0670-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/19/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This study sought to determine whether and to what extent medical students with an undergraduate college major in neuroscience, relative to other college majors, pursue psychiatry relative to other brain-based specialties (neurology and neurosurgery) and internal medicine. METHODS The authors analyzed data from AAMC matriculation and graduation surveys for all students who graduated from US medical schools in 2013 and 2014 (n = 29,714). Students who majored in neuroscience, psychology, and biology were compared to all other students in terms of their specialty choice at both time points. For each major, the authors determined rates of specialty choice of psychiatry, neurology, neurosurgery, and, for comparison, internal medicine. This study employed Chi-square statistic to compare odds of various specialty choices among different majors. RESULTS Among medical students with an undergraduate neuroscience major (3.5% of all medical students), only 2.3% preferred psychiatry at matriculation, compared to 21.5% who chose neurology, 13.1% neurosurgery, and 11% internal medicine. By graduation, psychiatry specialty choice increased to 5.1% among neuroscience majors while choice of neurology and neurosurgery declined. Psychology majors (OR = 3.16, 95% CI 2.60-4.47) but not neuroscience majors (OR 1.28, 0.92-1.77) were more likely than their peers to choose psychiatry. CONCLUSIONS Psychiatry struggles to attract neuroscience majors to the specialty. This missed opportunity is an obstacle to developing the neuroscience literacy of the workforce and jeopardizes the neuroscientific future of our field. Several potential strategies to address the recruitment challenges exist.
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Lockhart BJ, Capurso NA, Chase I, Arbuckle MR, Travis MJ, Eisen J, Ross DA. The Use of a Small Private Online Course to Allow Educators to Share Teaching Resources Across Diverse Sites: The Future of Psychiatric Case Conferences? ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2017; 41:81-85. [PMID: 26620806 PMCID: PMC5371021 DOI: 10.1007/s40596-015-0460-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 11/02/2015] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The authors sought to demonstrate the feasibility of integrating small private online course (SPOC) technology with flipped classroom techniques in order to improve neuroscience education across diverse training sites. METHODS Post-graduate medical educators used SPOC web conferencing software and video technology to implement an integrated case conference and in-depth neuroscience discussion. RESULTS Ten psychiatry training programs from across the USA and from two international sites took part in the conference. Feedback from participants was largely positive. CONCLUSION This pilot demonstrated the feasibility of such a program and provided a diverse audience with the opportunity to engage in an interactive learning experience with expert faculty discussants. This may be a useful model for programs with limited local expertise to expand their teaching efforts in a wide range of topics.
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Affiliation(s)
| | | | | | | | - Michael J Travis
- Western Psychiatric Institute and Clinic at the University of Pittsburgh, Pittsburgh, PA, USA
| | - Jane Eisen
- Warren Alpert Medical School of Brown University, Providence, RI, USA
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28
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Brenner AM. Revisiting the Biopsychosocial Formulation: Neuroscience, Social Science, and the Patient's Subjective Experience. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2016; 40:740-746. [PMID: 27060094 DOI: 10.1007/s40596-016-0542-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 03/21/2016] [Indexed: 06/05/2023]
Affiliation(s)
- Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA.
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Blackwell KA, Travis MJ, Arbuckle MR, Ross DA. Crowdsourcing medical education. MEDICAL EDUCATION 2016; 50:576. [PMID: 27072463 PMCID: PMC5372201 DOI: 10.1111/medu.13010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Rego MD. Counterpoint: clinical neuroscience is not ready for clinical use. Br J Psychiatry 2016; 208:312-3. [PMID: 27036693 DOI: 10.1192/bjp.bp.115.170878] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 09/30/2015] [Indexed: 11/23/2022]
Abstract
Radical proposals are being made to change the practice, teaching and research basis of psychiatry to that of clinical neuroscience. Such changes would affect practice via what is studied, published, recommended as standard treatment and what is decided in medico-legal forums. These proposed changes are very premature and misguided. Here, I refute these proposals.
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Affiliation(s)
- Mark D Rego
- Mark D. Rego, MD, Yale University School of Medicine, 63 Lookout Hill Road, Milford, CT 06461, USA.
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Jesulola E, Sharpley CF, Bitsika V, Agnew LL, Wilson P. Frontal alpha asymmetry as a pathway to behavioural withdrawal in depression: Research findings and issues. Behav Brain Res 2015; 292:56-67. [DOI: 10.1016/j.bbr.2015.05.058] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 05/21/2015] [Accepted: 05/23/2015] [Indexed: 12/28/2022]
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Tandon R, Rankupalli B, Suryadevara U, Thornton J. Psychiatry is a clinical neuroscience, but how do we move the field? Asian J Psychiatr 2015; 17:135-7. [PMID: 26419193 DOI: 10.1016/j.ajp.2015.08.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 08/28/2015] [Indexed: 12/21/2022]
Affiliation(s)
- Rajiv Tandon
- Psychiatry Service, North Florida/South Georgia Veterans Healthcare System, Department of Psychiatry, University of Florida College of Medicine, 1149 Newell Drive, L4-100, Gainesville, FL 32611, USA.
| | - Babu Rankupalli
- Psychiatry Service, North Florida/South Georgia Veterans Healthcare System, Department of Psychiatry, University of Florida College of Medicine, 1149 Newell Drive, L4-100, Gainesville, FL 32611, USA.
| | - Uma Suryadevara
- Psychiatry Service, North Florida/South Georgia Veterans Healthcare System, Department of Psychiatry, University of Florida College of Medicine, 1149 Newell Drive, L4-100, Gainesville, FL 32611, USA.
| | - Joseph Thornton
- Psychiatry Service, North Florida/South Georgia Veterans Healthcare System, Department of Psychiatry, University of Florida College of Medicine, 1149 Newell Drive, L4-100, Gainesville, FL 32611, USA.
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"The time is now": Integrating neuroscience into psychiatry training. Asian J Psychiatr 2015; 17:126-7. [PMID: 26456208 PMCID: PMC5347978 DOI: 10.1016/j.ajp.2015.08.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 08/28/2015] [Indexed: 11/21/2022]
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Freudenreich O, Kontos N, Querques J. Remembering psychiatry's core strengths while incorporating neuroscience. Asian J Psychiatr 2015; 17:124-5. [PMID: 26456209 DOI: 10.1016/j.ajp.2015.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 08/28/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Oliver Freudenreich
- Schizophrenia Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
| | - Nicholas Kontos
- Division of Psychiatry and Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - John Querques
- Division of Psychiatry and Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
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Cortese S. Here/In This Issue and There/Abstract Thinking: Neurosciences and (Child) Psychiatry. J Am Acad Child Adolesc Psychiatry 2015. [PMID: 26210326 DOI: 10.1016/j.jaac.2015.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Samuele Cortese
- Developmental Brain-Behaviour Laboratory, University of Southampton, UK; New York University Child Study Center, New York.
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