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.

Delivering Difficult News: Simulation-Enhanced Training Improves Psychiatry Residents' Clinical Communication Skills

Background: Delivering difficult news to individuals diagnosed with mental health disorders and their family members can be challenging. The use of simulated patients (SP) is an effective teaching method to enhance clinical skills, particularly those around communication. We developed, implemented, and evaluated the effectiveness of an SP-based training module to improve psychiatric residents' clinical communication skills in delivering difficult news.Methods: We conducted 5-h workshops consisting of 3 components: (1) a high-fidelity simulation session with a professional actor; (2) a 30-min lecture; and (3) role-playing of 3 short scenarios, during which residents rotated taking on different roles (as psychiatrist, patient, or family member). We observed through a 1-way mirror and videotaped each resident's simulation session and followed it with personalized debriefing. Following the workshop, each resident received the full-length video of their simulated interview, together with a list of questions as a take-home assignment. Two months after the workshop, the residents were invited to a second SP-based session, during which 2 independent evaluators, each a board-certified psychiatrist with expertise in medical simulation, evaluated the participants' communication skills using a previously validated instrument. To avoid observation bias, the 2 evaluators rated the videotapes blind to the timing of the simulation (pre- vs. post-training). Participants completed self-report questionnaires on satisfaction and self-confidence, before, after, and 2 months following the workshop.Findings: Of the 28 psychiatric residents who participated in the training day, 24 (86%) completed the post-workshop evaluation. Mean communication score increased from 24.9 to 27.8 (paired t-test: 5.6, p < 0.001). The mean score for the self-confidence questionnaire, calculated on a 1 to 5 Likert scale, increased from 3.4 to 4.0 after the training day, and remained unchanged (4.2) 2 months later (p < 0.001).Conclusions: An SP-based training module proved useful in improving the objectively measured communication skills of psychiatric residents delivering difficult news. The training further enhanced participants' subjective sense of confidence in those clinical skills.

Comparing the attitudes and knowledge of psychiatric residents about psychotherapy before and after the psychotherapy rotation

Introduction: The evidence show that the attitudes to any specialty can be improved as a result of a skillful and interested presentation and negative attitudes toward psychiatry can be the particular target in clinical and non-clinical courses [1]. The present study aimed to compare the attitudes and knowledge of psychiatric residents about psychotherapy before and after the psychotherapy rotation. Methodology: The present study was a descriptive research using causal-comparative method. The population consisted of all psychiatric residents in the universities of Tehran in 2018-2019. The study was a census and all residents were asked to participate if they were willing to. From different universities of medical sciences including Iran, Shahid Beheshti, Tehran, Social Welfare and Rehabilitation Sciences, 27, 24, 25, and 41 subjects were included in the study, respectively. The total number of subjects was 117. The researcher-made questionnaire was used for three groups of residents to assess their psychiatric attitudes and knowledge: the residents who passed the theoretical and practical psychotherapy courses, the residents who have not yet passed the psychotherapy course, and those who were passing the theoretical course. Cronbach's alpha coefficients for internal consistency of attitude and knowledge were 0.953 and 0.985, respectively. Findings: one-way variance analysis test was used to analyze the variables. According to the results of this test, there was a significant difference among the psychiatric residents in terms of knowledge and attitude (p<0.01). Moreover, regarding the means obtained for each group, it can be said that the residents who passed the theoretical and practical courses of psychotherapy had higher mean in attitude and knowledge than the other two groups; the difference was statistically significant. Conclusion: in any educational relationship, the attitudes of educators and learners play a key role in effectiveness and success. The psychotherapy course can change the negative stereotypes about psychiatry in psychiatrists and provide an important opportunity to change their negative attitudes.

Factors influencing medical students and psychiatry residents in Ghana to consider psychiatry as a career option – a qualitative study

Background Currently, Ghana has 14 actively practicing psychiatrists and about 26 psychiatric residents for a population of over 28 million people. Previous research suggests a lack of interest by Ghanaian medical students and medical graduates in considering psychiatry as a career option. Objectives To examine the perception of medical students and psychiatry residents in Ghana about the barriers which hinder Ghanaian medical graduates from choosing careers in psychiatry and how these barriers could be overcome. Methods This was a cross-sectional qualitative study with data gathered using focus group discussion. Twenty clinical year medical students were selected through block randomization from the four public medical schools in Ghana and invited to participate in one of two focus group discussions. Also, four psychiatric residents were invited to participate in the focus group discussions. Results The main barriers identified by participants could be grouped under four main themes, namely: (a) myths and stigma surrounding mental health and patients, (b) negative perceptions of psychiatrists, (c) infrastructure and funding issues, (d) lack of exposure and education. To address the barriers presented, participants discussed potential solutions that could be categorized into five main themes, namely: (a) stigma reduction, (b) educating professionals, (c) addressing deficient infrastructure, (d) risk management, and (e) incentivizing the pursuit of psychiatry among students. Conclusion Health policy planners and medical training institutions could consider implementing proposed solutions to identify barriers as part of efforts to improve the psychiatrist to patient ratio in Ghana.