Psychiatric Education Research Articles

American emergency room wait times for psychiatric conditions from 2019 to 2021

Use of Emergency Departments (EDs) for psychiatric complaints has increased significantly in past decades. The onset of the COVID-19 pandemic saw large shifts in ED usage, with a relative increase in mental health complaints in EDs. This paper will investigate the difference in ED wait times for psychiatric and non-psychiatric complaints over this period. Utilized National Hospital Ambulatory Medical Care Survey (NHAMCS), from 2019 to 2021, for average wait times for psychiatric versus non-psychiatric complaints. Compared the average wait times for psychiatric complaints by region, triage status, and ICD-10 F code. There was no significant difference in the average wait times overall between these conditions (P = 0.57). People with schizophrenia or psychosis had a significantly higher wait time (P = 0.03) compared to mental health symptoms secondary to physiologic conditions. Northeastern American EDs also had prolonged wait times for psychiatric conditions (P < 0.01) Research into factors of prolonged wait times can advise quality improvements such as the implementation of evidence-based triage and workup tools, and directed psychiatric education.

Humanoid patient robot for diagnostic training in medical and psychiatric education.

Simulation-based learning is an integral part of hands-on learning and is often done through role-playing games or patients simulated by professional actors. In this article, we present the use of a humanoid robot as a simulation patient for the presentation of disease symptoms in the setting of medical education. In a study, 12 participants watched both the patient simulation by the robotic patient and the video with the actor patient. We asked participants about their subjective impressions of the robotic patient simulation compared to the video with the human actor patient using a self-developed questionnaire. In addition, we used the Affinity for Technology Interaction Scale. The evaluation of the questionnaire provided insights into whether the robot was able to realistically represent the patient which features still need to be improved, and whether the robot patient simulation was accepted by the participants as a learning method. Sixty-seven percent of the participants indicated that they would use the robot as a training opportunity in addition to the videos with acting patients. The majority of participants indicated that they found it very beneficial to have the robot repeat the case studies at their own pace.

LGBT - A GLOBAL ISSUE: SOCIAL IMPACT PREVENTIVE SOLUTION FROM QURANIC PERSPECTIVE (STUDY OF QURANIC CHAPTER AL-A‘RAF [7]: 80-81)

The LGBT Problem is a hotly vulnerable discussion in 2021-2024. This is marked by the emergence of many movements from activists and sympathizers of LGBT supporters who ask for their rights in public spaces, such as the rights of society in general. The presence of a movement that advocates equality for LGBT people has a close relationship with the people of Prophet Lut (‘Alaih As-Salam), who have a different sexual orientation from humans in general, which in Arabic, is called liwatat (sodomy). The campaign effort was then carried out openly in the public. This study aims to analyze the practice of LGBT from an Islamic perspective based on the Quranic chapter Al-A‘raf verses 80-81. The results showed that the emergence of LGBT movements and campaigns today are an inseparable part of the story of Prophet Lut’s society, which has an unusual sexual orientation. The condition is caused by environmental, psychological, and theological factors. The rise of efforts to voice the equality of Human Rights openly has an impact on society in various aspects, including in the elements of health, society, education, and security. Thus, preventive solutions are needed to fend off the LGBT behaviour such as through education of faith and Islamic SharÊ‘ah, besides moral, psychiatric, social and sexual education.

Psychedelic medicine in psychiatry residency training: a survey of psychiatric residency program directors

Objective The growth of psychedelic medicine creates new challenges in psychiatric education as physicians may soon be responsible for prescribing a number of psychedelic interventions. Despite this growing need for educated providers, very little is known about the training psychiatry residents receive in psychedelic medicine. We conducted a survey to determine the current educational opportunities as well as the priorities and concerns held by training directors about this emerging field. Methods We emailed an online survey to US psychiatry residency training directors. Respondents answered questions about current offerings in psychedelic medicine, as well as their interest, priorities, and concerns about curricular materials and their delivery. Results Sixty-one programs responded to our survey. The majority of respondents (64%) favored devoting additional time to psychedelic education, but many endorsed concerns about the dearth of educational materials (54%) and limited availability of faculty to deliver content (46%). The majority of programs (94%) expressed some interest in implementing a standardized curriculum in psychedelic medicine. Conclusion Training directors recognized that their current curricular materials are limited, and they appeared interested in additional support to meet the upcoming demand in psychedelic education. Further research can inform curriculum development and implementation of psychedelic education in residency training.

The Ultimate Guide for Using Movies in Psychiatric Education

The Ultimate Guide for Using Movies in Psychiatric Education

Looking Back to Advance Equity in Psychiatric Nursing: Strategies for the Classroom and for Practice.

With deep historical roots in psychiatry, structural racism persists in psychiatric nursing today. Psychiatric nurses may hold implicit biases and stereotypical beliefs that influence how they perceive, assess, and interact with people from different racial backgrounds, leading to discrimination, poor treatment, and misdiagnosis. To eliminate discrimination in clinical care and diversify the workforce, there is an urgent need to integrate teaching and learning strategies that address influences of racism and racial identity in psychiatric nursing education. This article explores the historical context and proposes antiracist psychiatric nursing teaching and practice interventions to reduce the harms of racism.

Concept analysis of psychiatric nursing competency in psychiatric nursing

This concept analysis study identified attributes and defined psychiatric nursing competency among psychiatric nurses. The approach of Walker and Avant was used for concept analysis, and a literature review was completed including eight steps. The concept of psychiatric nursing competency was identified as five attributes: professional assessment, situation coping skills, communication, cooperation, and self-management. Antecedents of the concept were psychiatric nursing education and experience, and the consequences were patient outcomes, patient safety, and efficiency of care. Psychiatric nursing competency was defined as the comprehensive ability to care for psychiatric patients appropriately and effectively in the nursing situation. This study is meaningful in that it clarified psychiatric nursing competency among psychiatric nurses, and the attributes and empirical referents of this study will be the basis for development to a psychiatric nursing competency measurement tool.

Assessment of psychiatrists' preparedness in managing disaster-related psychiatric disorders: a survey in Taiwan from post-graduate medical education perspective.

Disaster-related psychiatric disorders (DRPD) present a significant challenge to mental health professionals, yet there is a notable lack of emphasis on the preparedness of psychiatrists in managing these conditions within post-graduate medical education. This study utilized a questionnaire to collect data from psychiatrists, focusing on their prior involvement in managing DRPD, perceived competence, medication preferences, and factors influencing their experiences in handling such disorders. Analysis included distribution and ranking of variables, alongside cross-analysis examining associations between demographic factors (age, gender, hospital levels, years of practice, board certification) and treatment experiences, as well as readiness for in-hospital or outside-hospital mobilization in DRPD management. One hundred and three Taiwanese psychiatrists participated in the study, with the majority reporting involvement in managing DRPD (71.8%), particularly in post-traumatic stress disorder (PTSD) and depression. Antidepressants, specifically serotonin selective reuptake inhibitors, were commonly preferred for DRPD treatment, including PTSD and depression. Psychiatrists aged over 40, with more than 10 years of practice, and hold the board-certified status, showed greater experiences for outside- or inside- the hospital mobilization in DRPD management. Findings suggest that within post-graduate medical education, Taiwanese psychiatrists demonstrate significant experience, willingness, and capacity to effectively manage DRPD. However, there is a need to integrate comprehensive training on disaster psychiatry into post-graduate psychiatric education programs to further enhance preparedness and optimize outcomes in managing these challenging conditions.

Evaluation of the Effectiveness of Standardized Patient Simulation as a Teaching Method in Psychiatric and Mental Health Nursing.

Background: The use of standardized patient simulation in psychiatric nursing education addresses the unique challenges presented by mental healthcare settings. Students' attitudes toward clinical simulation remain predominantly favorable, with many expressing enthusiasm for the opportunities it provides in terms of embracing challenges, enhancing realism, and promoting critical thinking through problem solving, decision-making, and adaptability. Methods: This quantitative study used a cross-sectional, descriptive, correlation design to investigate the effectiveness of standardized patient simulation as a teaching method in the Psychiatric and Mental Health nursing course in a university setting. A total of 84 nursing students were recruited for the convenience sample. Data were collected using a three-part questionnaire survey which included the following: a demographic data sheet, the Student Satisfaction and Self-confidence in Learning Scale, and a narrative open-ended question asking the participants to write the advantages and disadvantages of their simulation experience. Data were analyzed using the statistical software JMP pro17. Results: The total satisfaction with learning subscale score ranged between 5 and 25 with a mean score of 19.36 ± 6.32. The total self-confidence subscale score ranged between 8 and 40 with a mean score of 30.87 ± 9.1. Pearson's correlation coefficient r revealed a statistically significant positive relationship between the participants' satisfaction with the learning experience and their self-confidence (t = 0.923, p < 0.0001). Approximately 91.7% of the students recommended using simulation. The results confirmed the students' recommendations of simulation use in teaching psychiatric and mental health courses; furthermore, the results showed a statistically significant positive correlation with the total SSLS (p = 0.01) and satisfaction with learning subscale (0.003). Participants reported that authentic, practical, comfortable, and safe learning environments contributed to an enriched learning experience. Additionally, factors such as timesaving, access to information, cost-effectiveness, standardized teaching, varied exposure, skill development, and immediate feedback also enhanced the learning experience through patient simulation in psychiatric and mental health nursing. Conclusion: Simulations can contribute efficiently and positively to psychiatric and mental health nursing education in a manner that optimizes the learning experience while ensuring the consistency of student learning in a safe learning environment.

Teaching psychiatric nursing with films during the COVID-19 pandemic: A qualitative study.

Interactive learning environments are known to be among the most effective methods used in education. Some of the interactive methods used in psychiatric nursing education are simulations, group discussions, case studies and video and film presentations. In psychiatric nursing education, cinematic films are among the online methods used. It is known that films used in psychiatric nursing education are useful for understanding mental disorders, the nurse-patient relationship, the roles of the nurse and the therapeutic environment. The COVID-19 pandemic deeply affected nursing education, and the difficulties faced gave rise to many new perspectives. After this period, it is of prime importance to update the nursing curriculum and develop new strategies in clinical practice. Teaching with films can help students to understand people's feelings, make sense of them and empathize. This method can have an emotional impact on student nurses and take learning to a deeper level beyond simple theoretical understanding. The findings of the study suggest that teaching through film is an effective method that can be used practically in psychiatric nursing education. Standardizing these practices may be an effective strategy for developing students' professional identity as nurses. This study is focused on undergraduate students, but has implications for nurses in continuing education and professional development of nurses in developing a positive perspective towards psychiatric patients, increasing self-awareness and reducing prejudices. INTRODUCTION: The COVID-19 pandemic affected many areas of life and had a negative effect on education. This study investigated the impacts of using film as a method of education in students who were taking Psychiatric Nursing class during the COVID-19 pandemic, examining how this method contributed to theoretical and clinical practices of the students, their personal development and their viewpoint on psychiatric patients. This study adopted a qualitative research design. The study data were collected from 15 nursing students in June 2022. Interviews were conducted, audiotaped and transcribed verbatim. The method of education via film made contributions such as better theoretical understanding of the subjects taught, acquisition of analytical thinking skills and greater awareness of professional nursing skills and care practices. The students developed their professional perspectives, and their motivation increased. Using film is effective and practical when used in psychiatric nursing education. Standardizing these practices may be an effective strategy for developing students' sense of their identity as professional nurses. This study relates directly to undergraduate students and also has implications for nurses undergoing continuing education and professional development.

Clozapine Proficiency as a Milestone in Psychiatric Training

This Viewpoint advocates for the addition of clozapine prescribing as a milestone in psychiatric education.

ACP's Award for Creativity in Psychiatric Education

ACP's Award for Creativity in Psychiatric Education

Psychiatric nurse and educator perspectives on professional boundaries in nursing education: An interpretive description study

BackgroundPsychiatric nurses are responsible for maintaining professional boundaries. However, professional boundaries are as described as unclear and psychiatric nursing students are at risk of crossing these boundaries. Educational instruction regarding professional boundaries within psychiatric nursing often lacks foundational structure placing students at risk of transgressions. PurposeThe purpose of the study was to describe boundaries in psychiatric nursing practice, identify strategies effective in teaching professional boundaries, and inform curriculum development in psychiatric nursing education. MethodInterpretive description was utilized to answer: How do psychiatric nurse educators interpret and explain professional boundaries in psychiatric nursing undergraduate education? Psychiatric nurse educators and psychiatric nurses were recruited from an academic institution in western Canada. Twenty participants engaged in semi-structured interviews. Eight of those participants also attended a focus group. ResultParticipants reported that ‘textbook’ definitions of boundaries were insufficient in illustrating the complexities of the construct. Rather, relational forms of learning such as educators sharing clinical stories, role play activities, clinical supervision, and clinical debriefing were described as helpful strategies. ConclusionFoundational knowledge regarding professional boundaries in psychiatric nursing practice appears to be incorporated in the formal curriculum. However, learning is enhanced through the informal and hidden curriculum.

Conceptual competence in psychiatric training: building a culture of conceptual inquiry.

Building a culture of conceptual inquiry in psychiatric training requires the development of conceptual competence: the ability to identify and examine assumptions that constitute the philosophical foundations of clinical care and scientific investigation in psychiatry. In this article, we argue for the importance of such competence and illustrate approaches to instilling it through examples drawn from our collective experiences as psychiatric educators.

The Performance of ChatGPT on Short-answer Questions in a Psychiatry Examination: A Pilot Study

Abstract Objectives: We compared ChatGPT’s performance to medical students’ on psychiatry examinations and investigated whether raters could distinguish answers between them. Methods: We used a copy of short-answer questions from a psychiatry examination to compare the performance of three randomized groups – ChatGPT, student, and hybrid (student-modified ChatGPT responses). Furthermore, we investigated raters’ ability to identify response origins. Results: ChatGPT-assisted answers, both ChatGPT alone (p &lt; 0.001) and hybrid (p &lt; 0.001), had significantly better examination performance than did independent students work. Raters showed high accuracy in identifying the origin of the responses, correctly identifying 92% of both students’ and ChatGPT-assisted responses. But raters were only 61% accurate in making the distinction between ChatGPT and hybrid answers. Conclusion: ChatGPT showed superior performance in a psychiatry examination compared to students’ work, but raters showed high accuracy in distinguishing them. Further investigation is warranted to optimize the advantages and mitigate the drawbacks of incorporating such technology into psychiatric education and health care.

“Nobody puts Grammy in the Corner”: Impacts of Ageism Across Cultures and in Psychiatric Education

Across culture, identity, positionality, and geography, ageist beliefs and acts influence the clinical outcomes and lived experience of patients and providers alike. Ageism profoundly impacts the health care of geriatric patients. This presentation will promote awareness of ageism's negative impacts through discussing its global reach and pervasive presence across cultures as well as present possible solutions from current research and education projects. Through evaluating current WHO statistics on ageism towards older adults, participants will consider the consequences of poorer physical and mental health outcomes associated with ageism. Drawing attention to the unique interplay between ageism and culture, the impact of ageist perceptions and beliefs will be explored in diverse cultures. Efforts to change ageist patterns will be considered as presenters discuss curriculum developed and research designed to educate and investigate ageism's influence. Participants will learn about ageism in medical students and of one proposed intervention to challenge ageist beliefs in undergraduate medical education. In graduate medical education, presenters will detail the challenges and successes from a recent initiative to integrate teaching ageism curriculum within a general psychiatry residency.

The Making of Psychiatrists in Japan

Abstract Background: Like in most countries in the world, Japan has its own system of how a medical graduate becomes a psychiatrist. Methods: The authors, young Japanese psychiatrists, describe what they have personally been through the education and training before becoming full-fledged psychiatrists who can treat patients with psychiatric diseases. All those personal experiences are validated with related documents. Results: In Japan, the pathway to become psychiatrists involves a rigorous process starting with a competitive entrance to medical school, followed by a six-year educational curriculum influenced by international accreditation standards. After graduating from medical schools, physicians receive a two-year junior residency training, which briefly introduces them to psychiatry, influencing some to specialize in the field. Specialization requires further training and certification, facilitated by the Japanese Society of Psychiatry and Neurology (JSPN) and the Ministry of Health, Labor, and Welfare, encompassing various psychiatric settings and disorders. Beyond initial certification, there are continuous professional development opportunities, including advanced specializations and educational programs supported by professional societies such as the JSPN and the Japan Young Psychiatrists Organization. Conclusion: This system ensures a comprehensive and structured approach to psychiatric education and specialization in Japan, offering a wide range of opportunities for aspiring psychiatrists.

A multi-ancestry genetic study of pain intensity in 598,339 veterans.

Chronic pain is a common problem, with more than one-fifth of adult Americans reporting pain daily or on most days. It adversely affects the quality of life and imposes substantial personal and economic costs. Efforts to treat chronic pain using opioids had a central role in precipitating the opioid crisis. Despite an estimated heritability of 25-50%, the genetic architecture of chronic pain is not well-characterized, in part because studies have largely been limited to samples of European ancestry. To help address this knowledge gap, we conducted a cross-ancestry meta-analysis of pain intensity in 598,339 participants in the Million Veteran Program, which identified 126 independent genetic loci, 69 of which are new. Pain intensity was genetically correlated with other pain phenotypes, level of substance use and substance use disorders, other psychiatric traits, education level and cognitive traits. Integration of the genome-wide association studies findings with functional genomics data shows enrichment for putatively causal genes (n = 142) and proteins (n = 14) expressed in brain tissues, specifically in GABAergic neurons. Drug repurposing analysis identified anticonvulsants, β-blockers and calcium-channel blockers, among other drug groups, as having potential analgesic effects. Our results provide insights into key molecular contributors to the experience of pain and highlight attractive drug targets.

Distributed Medical Education (DME) in psychiatry: perspectives on facilitators, obstacles, and factors affecting psychiatrists' willingness to engage in teaching activities

BackgroundDistributed Medical Education (DME), a decentralized model focused on smaller cities and communities, has been implemented worldwide to bridge the gap in psychiatric education. Faculty engagement in teaching activities such as clinical teaching, supervision, and examinations is a crucial aspect of DME sites. Implementing or expanding DME sites requires careful consideration to identify enablers that contribute to success and barriers that need to be addressed. This study aims to examine enablers, barriers, and factors influencing psychiatrists' willingness to start or continue participating in teaching activities within Dalhousie University's Faculty of Medicine DME sites in two provinces in Atlantic Canada.MethodologyThis cross-sectional study was conducted as part of an environmental scan of Dalhousie Faculty of Medicine’s DME programs in Nova Scotia (NS) and New Brunswick (NB), Canada. In February 2023, psychiatrists from seven administrative health zones in these provinces anonymously participated in an online survey. The survey, created with OPINIO, collected data on sociodemographic factors, practice-related characteristics, medical education, and barriers to teaching activities. Five key outcomes were assessed, which included psychiatrists' willingness to engage in (i) clinical training and supervision, (ii) lectures or skills-based teaching, (iii) skills-based examinations, (iv) training and supervision of Canadian-trained psychiatrists, and (v) training and supervision of internationally trained psychiatrists. The study employed various statistical analyses, including descriptive analysis, chi-square tests, and logistic regression, to identify potential predictors associated with each outcome variable.ResultsThe study involved 60 psychiatrists, primarily male (69%), practicing in NS (53.3%), with international medical education (69%), mainly working in outpatient services (41%). Notably, 60.3% lacked formal medical education training, yet they did not perceive the lack of training as a significant barrier, but lack of protected time as the main one. Despite this, there was a strong willingness to engage in teaching activities, with an average positive response rate of 81.98%. The lack of protected time for teaching/training was a major barrier reported by study participants. Availability to take the Royal College of Physicians and Surgeons of Canada Competency by Design training was the main factor associated with psychiatrists' willingness to participate in the five teaching activities investigated in this study: willingness to participate in clinical training and supervision of psychiatry residents (p = .01); provision of lectures or skills-based teaching for psychiatry residents (p < .01); skills-based examinations of psychiatry residents (p < .001); training/supervision of Canadian-trained psychiatrists (p < .01); and training and supervision of internationally trained psychiatrists (p < .01).ConclusionThe study reveals a nuanced picture regarding psychiatrists' engagement in teaching activities at DME sites. Despite a significant association between interest in formal medical education training and willingness to participate in teaching activities, clinicians do not consider the lack of formal training as a barrier. Addressing this complexity requires thoughtful strategies, potentially involving resource allocation, policy modifications, and adjustments to incentive structures by relevant institutions.

Descriptive Analysis of Student Diagnostic and Documentation Skill Development in a low Fidelity Simulation in Psychiatric Nurse Practitioner Education.

Nursing educators face challenges in helping registered nurses prepare to be psychiatric nurse practitioners. Nursing educators must consider the variation of students' skill sets, experience levels, and the shortage of preceptors. Simulations can help overcome limited clinical sites and standardize skill acquisition. High-fidelity simulations can be helpful but are labor-intensive and expensive. Low-fidelity simulations are adaptable to fit the learning needs of psychiatric nurse practitioner students but little research has evaluated these simulations. This paper evaluates a series of low-fidelity interventions used to help students learn diagnostic criteria, treatment decisions, and documentation. A retrospective descriptive analysis was performed on the results of all students in five cohorts in a psychiatric nurse practitioner course (n=68) on 45 low-fidelity online simulations over five years during the course on advanced psychiatric nursing of adults. Diagnostic notes were graded on four criteria by a psychologist or a psychiatric nurse practitioner. A representative sample of grades on eight notes were analyzed for this manuscript. Survey responses from the students in one cohort were obtained to evaluate their confidence levels and perceptions of simulation utility and responses were analyzed using descriptive and qualitative methods. The overall mean of description, detail, completeness, and professionalism increased from 7.6 (out of 10) to 9 over the semester with statistically significant improvements in all four areas. The strongest correlation was between detail and completeness and the weakest correlation was between professionalism and description. Students reported that they found significant value in the low-fidelity simulation exercises. This analysis demonstrates one of the first efforts to analyze low-fidelity simulations for psychiatric nurse practitioner students. The data indicate these simulations can help students improve their confidence and skills in several areas.