Peer Consultation Research Articles

Evaluation of a Psychotherapy Skills Training Program with Family Practice and Psychiatry Residents

This article was migrated. The article was marked as recommended. Many individuals with mental health issues first discuss them with their family physicians, who provide initial assessment and may also be the primary resource for treatment. Nevertheless, physicians-in-training may find it challenging to address these needs within the confines of a busy practice and without training specific to addressing psychological issues with patients. It is, therefore, vital that residency programs equip trainees to examine psychological aspects of current and future practice. At Memorial University, psychology faculty at the Student Wellness and Counselling Centre provide a weekly interpersonal process recall seminar (IPR) to first-year medical residents. This inter-professional training includes three components 1) peer consultation discussion, including difficult and/or interesting patients, 2) didactic psychotherapy component, on topics such as motivational interviewing, diversity and stages of change and, 3) video review of standardized and real patient encounters, during which residents are provided with detailed feedback on their interactions with patients. During IPR, participants develop knowledge, confidence and competence to work effectively with a variety of patients from a psychological perspective. The opportunity to develop inter-professional relationships is a noteworthy additional benefit. This paper will provide a description of the IPR training program and student feedback regarding the experience. Residents were asked to complete a 48-item questionnaire that assessed residents' attitudes to three distinct components of the 11-week course. The purpose of this research was to understand what aspects of the psychotherapy training were evaluated most highly by residents and why these specific aspects were valued.

Can higher-proficiency L2 learners benefit from working with lower-proficiency partners in peer feedback?

ABSTRACTInformed by Vygotsky’s conceptualization of the Zone of Proximal Development, this case study investigated the benefits of peer feedback on second language (L2) writing for students with high L2 proficiency and the factors that may influence their learning in peer feedback in the Chinese English-as-a-foreign-language context. Specifically, the study examined whether, what, and how higher-proficiency (HP) English learners can learn when they collaborate with their lower-proficiency counterparts. Analyses of multiple sources of data – video-recordings of peer feedback sessions, interviews, stimulated recalls, and drafts of student texts – revealed that while group peer feedback in the writing classroom can provide learning opportunities for HP students, their learning can be influenced by several factors, including their beliefs about peer feedback, motives and goals for peer feedback, and medium of group discussion. Implications are drawn from these findings for peer feedback practice and research in L2 writing.

Youth as Interviewers: Methods and Findings of Participatory Peer Interviews in a Youth Garden Project

The process of conducting peer interviews has not been widely reported on as a participatory method. Youth gardens are known to support individual and community health and well-being. Producing for the Future utilized the principles of community-based participatory research within a gardening and microenterprise program for low-income youth. In addition to several mixed-methods data collection techniques, a process was implemented in which youth participants designed, conducted, and debriefed peer interviews in order to address their own questions about program impacts. Participants in the peer interview process observed four emergent themes, which were not identified elsewhere in the data, focusing on individual outcomes and the successes and challenges of implementation within unique community settings. A methodological discussion of the process of peer interviewing within a participatory research project is presented. Researchers found that the benefits of the peer interview process included high levels of youth engagement in research, shared learning and new ideas generated by youth, and building youth capacity for critical social awareness. Researchers present lessons learned from the peer interviewing process, as well as implications for using peer interviewing in future participatory research and evaluation projects.

Reflective Peer Consultation as an Intervention for Staff Support in the NICU

Professional staff members in a neonatal intensive care unit (NICU) implementing the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) expressed the need for enhancement of their well-being. The Neurorelational Framework (Lillas and Turnbull, 2009) served as a guide for supporting staff education about the science of brain development and function and the provision of trauma-informed care. This paper describes an innovative pilot project implementing a reflective peer consultation group (RPC) facilitated by an infant psychiatrist. The RPC group provided opportunities for education about stress and triggers to stressful responses, and promoted staff reflection as well as strategies to promote stress recovery. Staff reported improved physical and emotional well-being after participating in RPC groups. Additionally, group members implemented changes to their clinical practices with infants and their parents in the NICU to facilitate recovery from stress in intensive care units.

Peer interviewers in mental health services research

Purpose Inclusion of members of the target population in research is an increasing priority in the social sciences; however, relatively few studies employ approaches that involve persons with lived experience of the mental health system in mental health services research, particularly in the USA. The purpose of this paper is to describe one such approach, the employment of peer interviewers in the evaluation of a peer respite program. Design/methodology/approach The paper describes how peer interviewers were recruited, hired, trained, and supervised. The authors discuss some benefits and challenges associated with the approach. Findings Peer interviewer benefits and challenges: the shared lived experience between the peer interviewers and study participants contributed to increased comfort and a high response rate overall. The study opened up professional opportunities for peers, but inconsistent work hours were a challenge and resulted in turnover and difficulty filling vacant positions. The lead evaluator and supervisors worked closely with peer interviewers to ensure conflict of interest was mitigated to reduce bias. Originality/value This paper adds to the limited literature describing peer representation in research, outlining one avenue for partnering with peers to align research with the values of the intervention under study without compromising – and perhaps increasing – scientific rigor. The authors expect that even more peer involvement in the oversight, analysis, and interpretation of results would have improved the overall quality of the evaluation. Future efforts should build upon and incorporate the approach alongside more comprehensive efforts to partner with service users.

Enriching qualitative research by engaging peer interviewers: a case study

Engaging peer-interviewers in qualitative inquiry is becoming more popular. Yet, there are differing opinions as to whether this practice improves the research process or is prohibitively challenging. Benefits noted in the literature are improved awareness/acceptance of disenfranchised groups, improved quality of research, and increased comfort of participants in the research process. Challenges include larger investment in time and money to hire, train, and support peer-interviewers, and the potential to disrupt peer recovery. We illustrate, through case study, how to engage peer-interviewers, meet potential challenges, and the benefits of such engagement. We draw upon our experience from a qualitative study designed to understand men’s experiences of problem gambling and housing instability. We hired three peers to conduct semi-structured qualitative interviews with 30 men from a community-based organization. We contend, that with appropriate and adequate resources (time, financial investment), peer-interviewing produces a positive, capacity building experience for peer-interviewers, participants and researchers.

Experience of the Time to Change programme in England as predictor of mental health service users' stigma coping strategies.

In the field of stigma research, an area of interest is the coping strategies that mental health service users can use in response to discriminatory experiences. As a part of the evaluation of the Time to Change (TTC) anti-stigma programme, the Viewpoint telephone survey was run annually in order to assess service users' reported levels of discrimination and selected coping strategies. The study aim is to test the extent to which experience of TTC programme is a positive predictor of selected coping strategies. Telephone interview surveys carried out by peer interviewers were conducted annually. 'Educating others' and 'challenging' coping strategies were assessed alongside anticipated and experienced discrimination. During 2011-2014, 3903 mental health service users were interviewed. Participants more often adopted the 'educating others' strategy (2.31 ± 0.01) than the 'challenging' strategy (2.15 ± 0.02) (p < 0.001). On the other hand, those who participated in campaign activities endorsed 'challenging' more frequently than people who were not aware of TTC (2.78 ± 1.23 v. 2.09 ± 1.08, p < 0.001). According to the multi-variate linear regression model, we found that being actively involved in TTC activities (OR = 0.74, CI: 0.29-1.19; p < 0.05), having a diagnosis of a depressive disorder (OR = 0.20, CI: 0.04-0.36; p < 0.05) or personality disorder (OR = 0.23, CI: 0.04-0.43; p < 0.05) were good predictors of endorsing a 'challenging' strategy even after adjusted for confounding variables. A positive relationship between participating in the TTC programme and using the 'challenging' strategy was found. There is still a need to disentangle the complex association between these two coping strategies and the role of anti-stigma campaigns, promoting further local activities led by service users and carers' as well as all others stakeholders' associations.

YouTube is the Most Frequently Used Educational Video Source for Surgical Preparation

The purpose of this study was to evaluate surgical preparation methods of medical students, residents, and faculty with special attention to video usage. Following Institutional Review Board approval, anonymous surveys were distributed to participants. Information collected included demographics and surgical preparation methods, focusing on video usage. Participants were questioned regarding frequency and helpfulness of videos, video sources used, and preferred methods between videos, reading, and peer consultation. Statistical analysis was performed using SAS. Surveys were distributed to participants in the Department of Surgery at the University of Iowa Hospitals and Clinics, a tertiary care center in Iowa City, Iowa. Survey participants included fourth-year medical students pursuing general surgery, general surgery residents, and faculty surgeons in the Department of Surgery. A total of 86 surveys were distributed, and 78 surveys were completed. This included 42 learners (33 residents, 9 fourth-year medical students) and 36 faculty. The overall response rate was 91%; 90% of respondents reported using videos for surgical preparation (learners = 95%, faculty = 83%, p = NS). Regarding surgical preparation methods overall, most learners and faculty selected reading (90% versus 78%, p = NS), and fewer respondents reported preferring videos (64% versus 44%, p = NS). Faculty more often use peer consultation (31% versus 50%, p < 0.02). Among respondents who use videos (N = 70), the most used source was YouTube (86%). Learners and faculty use different video sources. Learners use YouTube and Surgical Council on Resident Education (SCORE) Portal more than faculty (YouTube: 95% versus 73%, p < 0.02; SCORE: 25% versus 7%, p < 0.05). Faculty more often use society web pages and commercial videos (society: 67% versus 38%, p < 0.03; commercial: 27% versus 5%, p < 0.02). Most respondents reported using videos to prepare for surgery. YouTube was the preferred source. Posting surgical videos to YouTube may allow for maximal access to learners who are preparing for surgical cases.

Music in Dementia Assessment Scales (MiDAS): clinical relevance, cultural adaptation and its contribution to psychosocial research in dementia

Background: Music in Dementia Assessment Scales (MiDAS) is a validated outcome measure for music therapy with people with dementia. In preparation for multi-centre studies, there was a need to develop a systematic procedure for translating and adapting music therapy outcome measures. Investigation of the clinical relevance of MiDAS and its value and limitations in the wider context of psychosocial research in dementia was also necessary.Methods: Cultural adaptation and translation procedures were developed through literature review, expert and peer consultations and field-testing. Feedback from music therapists in Denmark, Norway and the UK was obtained. Expert opinions on MiDAS were sought from INTERDEM researchers involved in recommendation of outcome measures for dementia psychosocial research across Europe.Results: Danish and Norwegian MiDAS were produced. A guideline on translation and adaptation procedures for music therapy outcome measures was published.Conclusions: MiDAS is a reliable tool to eval...

Exposure to Violence in the Community Predicts Friendships with Academically Disengaged Peers During Middle Adolescence.

Adolescents who have been exposed to violence in the community often experience subsequent difficulties with academic achievement. Because competence in the classroom is a salient developmental task during the adolescent years, outcomes in this critical context can then have broader implications for social and psychological functioning. In the current study, we tested a hypothesized progression in which the association between violence exposure and deficient achievement is presumed to potentiate friendships with academically disengaged peers. We followed 415 urban adolescents (53% girls; average age of 14.6years) for a one-year period, with two annual assessment of psychosocial functioning. Exposure to violence in the community and academic engagement were assessed with a self-report inventory; reciprocated friendships were assessed with a peer interview; and achievement was indexed based on a review of school records. Consistent with our hypotheses, neighborhood violence was associated with deficient classroom achievement. Poor achievement, in turn, mediated associations between community violence exposure and low academic engagement among friends. Our findings highlight pathways though which exposure to community violence potentially predicts later dysfunction.

(493) Pediatric pain assessment methods and interventions used by mental health providers: a survey by the Pain Special Interest Group of the Society of Pediatric Psychology

Much is known about pain assessment for youth, however, little is known about what assessment tools and treatments actually are being used in clinical settings. Similarly, we know little about how clinical providers make decisions regarding what assessment tools to use and what interventions to implement with a particular patient. The objective of the current survey study was to explore the assessment methods and interventions currently being used by pediatric psychologists and other mental health providers. The Pain Special Interest Group of the Society of Pediatric Psychology formed a committee comprised of members with particular expertise in pain assessment and/or treatment. They then created a survey that asked about pain assessment tools and interventions being utilized by clinicians. Other questions focused on familiarity with research literature and barriers and facilitators that influenced the clinicians’ decisions. The committee utilized the Redcap data capture system and psychologists who work with pediatric pain were specifically recruited. 55 psychologists completed the online survey. The majority were faculty in an academic health center (65.5%). The biopsychosocial model was most often used to conceptualize and treat patients with pain. Self-report questionnaires are widely used (78.2%). Most (62%) use measures that are published and well-validated. Common measures data was collected. Psychoeducation, cognitive restructuring, supportive therapy, Motivational Interviewing, and coping and relaxation skills were interventions more commonly used. Roughly 30-40% reported being “mostly” or “very” familiar with the literature. Barriers to using interventions included time limitations and logistical challenges. Resources utilized included professional journals (90.9%), peer consultation (70.9%), continuing education workshops (50.9%), and books (58.2%). Additional data, clinical implications, and future directions will be presented. Of specific focus will be the factors influencing how clinicians are making decisions regarding assessment and treatment of pediatric pain, and the extent to which these decisions are based on the empirical evidence.

Using optimal combination of teaching-learning methods (open book assignment and group tutorials) as revision exercises to improve learning outcome in low achievers in biochemistry.

Graduate medical students of India are taught Biochemistry by didactic lectures and they hardly get any opportunity to clarify their doubts and reinforce the concepts which they learn in these lectures. We used a combination of teaching-learning (T-L) methods (open book assignment followed by group tutorials) to study their efficacy in improving the learning outcome. About 143 graduate medical students were classified into low (<50%: group 1, n = 23), medium (50-75%: group 2, n = 74), and high (>75%: group 3, n = 46) achievers, based on their internal assessment marks. After the regular teaching module on the topics "Vitamins and Enzymology", all the students attempted an open book assignment without peer consultation. Then all the students participated in group tutorials. The effects on the groups were evaluated by pre and posttests at the end of each phase, with the same set of MCQs. Gain from group tutorials and overall gain was significantly higher in the low achievers, compared to other groups. High and medium achievers obtained more gain from open book assignment, than group tutorials. The overall gain was significantly higher than the gain obtained from open book assignment or group tutorials, in all three groups. All the three groups retained the gain even after 1 week of the exercise. Hence, optimal use of novel T-L methods (open book assignment followed by group tutorials) as revision exercises help in strengthening concepts in Biochemistry in this oft neglected group of low achievers in graduate medical education. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(4):321-325, 2016.

Peer interviews: A hiring best practice.

Peer interviews: A hiring best practice.

An Ethical Framework for Allocating Scarce Life-Saving Chemotherapy and Supportive Care Drugs for Childhood Cancer.

Shortages of life-saving chemotherapy and supportive care agents for children with cancer are frequent. These shortages directly affect patients' lives, compromise both standard of care therapies and clinical research, and create substantial ethical challenges. Efforts to prevent drug shortages have yet to gain traction, and existing prioritization frameworks lack concrete guidance clinicians need when faced with difficult prioritization decisions among equally deserving children with cancer. The ethical framework proposed in this Commentary is based upon multidisciplinary expert opinion, further strengthened by an independent panel of peer consultants. The two-step allocation process includes strategies to mitigate existing shortages by minimizing waste and addresses actual prioritization across and within diseases according to a modified utilitarian model that maximizes total benefit while respecting limited constraints on differential treatment of individuals. The framework provides reasoning for explicit decision-making in the face of an actual drug shortage. Moreover, it minimizes bias that might occur when individual clinicians or institutions are forced to make bedside rationing and prioritization decisions and addresses the challenge that individual clinicians face when confronted with bedside decisions regarding allocation. Whenever possible, allocation decisions should be supported by evidence-based recommendations. "Curability," prognosis, and the incremental importance of a particular drug to a given patient's outcome are the critical factors to consider when deciding how to allocate scarce life-saving cancer drugs.

MIAP – Web-based platform for the computer analysis of microscopic images to support the pathological diagnosis

The aim of the project is to design and to implement a web-based platform for the computer analysis of microscopic images which support the pathological diagnosis. The use of the platform will be free of charge. It offers: quantitative analysis of staining tissue sample’ images, archiving microscopic images, peer consultation, and join work independently from distance between scientific collaborating centers to registered doctors, scientists and students. The use of proposed platform allows: (i) to save pathologists’ time spend on quantitative analysis, (ii) to reduce consulting costs by replacing sending of the physical preparations by placing their images (mostly virtual slide) on the platform server, (iii) to increase reproducibility, comparability and objectivity of quantitative evaluations. These effects have a direct impact on improving the effectiveness and decreasing the costs of patients’ treatment. This paper presents the main ideas of the project which deliver web-based system working as multi-functional, integrated, modular and scalable computer system. The details of hardware solutions, concept of the workflow in the platform, the programming language and interpreters, the specific tools and algorithms, and the user interfaces are described below. The practical solutions for web-based services in the area of medical image analysis, storage and retrieval are also presented and discussed.

“If It’s Wednesday It must be Group Night”: A Case for Peer Consultation -Countertransference Groups throughout the Professional Life Span of the Psychologist

“If It’s Wednesday It must be Group Night”: A Case for Peer Consultation -Countertransference Groups throughout the Professional Life Span of the Psychologist

The Behavior Therapy Training Institute for OCD: A preliminary report

Despite decades of research demonstrating the efficacy of Cognitive Behavioral Therapy (CBT) for obsessive compulsive disorder (OCD), many clinicians have not adopted it into their practice. In an effort to increase the number of trained clinicians, the International OCD Foundation (IOCDF) developed a nationwide intensive training program, the Behavior Therapy Training Institute (BTTI). We report the first data on the BTTI. We emailed a 30-item online survey to all clinicians (N=350) who attended one of twelve BTTI workshops between 2008 and 2011. One hundred and sixty one individuals (53%) responded. Participants reported more than moderate use of all BTTI skills. Expert phone consultation and peer consultation after the training were associated with greater skills use. The most commonly reported barrier to skill use was difficulty integrating the techniques into their practice because of time or an inability to leave the office. The majority of participants also reported an increase in OCD-related referrals after the BTTI. Limitations of this work, suggestions for improvement, and the implications of our findings for broader dissemination efforts are discussed.

Evidence-based clinical guidelines in Kyrgyz Republic.

Evidence-based clinical guidelines in Kyrgyz Republic.

Editor's Note

Editor's Note

Peer interviewing in medical education research: experiences and perceptions of student interviewers and interviewees.

BackgroundInterviewing is one of the main methods used for data collection in qualitative research. This paper explores the use of semi-structured interviews that were conducted by students with other students in a research study looking at cultural diversity in an international medical school. Specifically this paper documents and gives ‘voice’ to the opinions and experiences of interviewees and interviewers (the peers and the communities) on the value of peer interviewing in the study and outlines (1) the preparation made to address some of the foreseen challenges, (2) the challenges still faced, and (3) the benefits of using peer interviews with respect to the research study, the individual and the institution.MethodsPeer interviewing was used as part of a two-year phased-study, 2012–2013, which explored and then measured the impact of cultural diversity on undergraduate students in a medical higher education institution in Ireland. In phase one 16 peer interviewers were recruited to conduct 29 semi-structured interviews with fellow students. In order to evaluate the peer interviewing process two focus group discussions were he ld and an online survey conducted.ResultsKey findings were that substantial preparations in relation to training, informed consent processes and addressing positionality are needed if peer-interviewing is to be used. Challenges still faced included were related to power, familiarity, trust and practical problems. However many benefits accrued to the research, the individual interviewer and to the university.ConclusionsA more nuanced approach to peer interviewing, that recognises commonalities and differences across a range of attributes, is needed. While peer interviewing has many benefits and can help reduce power differentials it does not eliminate all challenges. As part of a larger research project and as a way in which to get ‘buy-in’ from the student body and improve a collaborative research partnership peer interviewing was extremely useful.