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BACKGROUND AND OBJECTIVE

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  1. Service Based Teaching in Consultation-Liaison Psychiatry: Development and Results of a Novel Curriculum Kristen Brooks, MD; J. Jewel Shim, MD University of California San Francisco Departments of Psychiatry DISSEMINATION ORIGINAL CURRICULUM CONTENT BACKGROUND AND OBJECTIVE • Initial 12 week course: • Introduction to Consult-Liaison Psychiatry, PGY-2 Guided learning objectives • How to take and complete a consult – effectively working with consulting services, gathering data, evaluating the patient, and providing recommendations • Delirium: identification, differential, management, follow up • Capacity evaluations: basic principles and concepts • “My Patient Seems Sad”: Etiologies and Management of Depression in the Hospital Setting • “My Patient is Acting Weird”: Etiologies and Management of Psychosis and Mania in the Hospital Setting • Common Psychiatric Sequelae of Neurologic Illness • Cancer: The Psychiatric Ramifications of Diagnosis, Disease, and Treatment • Somatoform Disorders: Identification and Management in the Inpatient Setting • Personality Disorders on the Hospital Unit: Patient and Team Management • Brief Therapy in the Hospital Setting • Feedback • Dissemination is planned in 3 ways: • Service: Ensure sustainability • Department: Application of teaching principles and structure; collaboration within our multi-site system • National: Poster presentation in the academic psychiatry and CLP communities; publish the curriculum with both objective and subjective data Historically, teaching on the Consultation-Liaison Psychiatry (CLP) Service was case-based. As a result, second year residents (R2s) were not systematically exposed to core CLP topics. With this project we developed and implemented a formalized didactic curriculum for R2s rotating on the CLP Service. METHODS • Content derived from multiple sources: • Literature on service-based curricula in CLP • ACGME and RRC requirements in CLP • Residency Training Program core requirements • Academy of Psychosomatic Medicine training guidelines • Faculty input • Structured to facilitate learning: • Thirty minute didactic sessions facilitate high-yield, focused learning on a busy clinical service • Content begins with the most urgent topics, and moves through diagnostic categories, covering diagnosis and management issues • Teaching techniques vary to best cover a topic: • Didactics • Case-based learning • Evidence Based Medicine WHERE WE ARE NOW, AND THE FUTURE: • Based on positive feedback, we have implemented the following expansions: • 28 lectures on core topics in CLP following a similar developmental plan • 5 Evidence Based Medicine literature reviews on key topics in CLP • Feedback on the current curriculum structure is overwhelmingly positive and this rotation is amongst the most highly ranked by residents in terms of education and learning • Ongoing research: Obtain quantitative data on the curriculum’s effectiveness, including early and end of rotation evaluation of: • Resident self-evaluation of knowledge and competency in core CLP topics • Attending evaluation of residents using 2 standardized cases with a systematic scoring system.  Residents will be evaluated on their ability to demonstrate: • Application of DSM IV criteria in the medically ill • Recognition of common medication issues • Consideration of medical co-morbidities • Identification of systems issues • Appropriate use of collateral EVALUATION STRATEGIES Anonymous, end of rotation summative feedback Feedback incorporated rotation to rotation • Results: • Content adjusted • Sequence streamlined • Curriculum expanded Feedback incorporated week to week Ongoing verbal feedback FEEDBACK FROM RESIDENTS: • “Weekly didactics are well-organized and thought-out, great quality. The teaching is • thorough, engaging, up to date, and diverse” • “Teaching is outstanding, including the organization of teaching, with the time for teaching at generally the same time each morning” • “Excellent teaching! Rotation takes advantage of uneven flow with ample didactics and ad hoc teaching” • “I developed increased confidence in my clinical decision-making skills on this rotation more than any other rotation” • “Definitely one of the best educational experiences as a resident I have had thus far” • “Teaching sessions were frequent and useful” • 100% of residents agree (18%) or strongly agree (82%) that “the teaching is of high quality” and that the rotation is “an excellent overall educational experience” REFERENCES 1.ACGME Program Requirements for Graduate Medical Education in Psychiatry;Revised Common Program Requirements Effective: July 1, 2007 2. Recommended Guidelines for Consultation-Liaison Psychiatry Training in Psychiatry Residency Programs: A Report from the APM Task Force on Psychiatric Resident Training in Consultation-Liaison Psychiatry. Gitlin,et al. Supported by: UCSF Psychiatry Faculty Fellowship in Educational Scholarship