Co- Authors: Dan Udrea MD, Yevgeniy Suvorov MD, Gary Swanson MD

1. Teaching a psychopharmacology course during residency Perceived changes in teachers and students Co- Authors: Dan Udrea MD, Yevgeniy Suvorov MD, Gary Swanson MD Department of Psychiatry, Allegheny General Hospital, Pittsburgh, PA Background • psychotherapy. This was done by openly encouraging input and discussion. • The pre test asked questions we wished to explore and we followed up with reviewing studies like STAR-D, CATIE, MECA, MTA, TADS and POTS. We further discussed cases that were pertinent. types of questions which were answered by group, the largest improvement was noted in Research Studies between pre and post test (25% - 88%), then in Pharmacokinetics/ Chart 1 Chart 2 Developing teaching skills presents an excellent opportunity to facilitate communication skills and learning in residency. However, residents face multiple challenges during their teaching time with medical students. Most of the time, teaching is limited to a single lecture. Medical student rotations often lead to diffusion of teaching responsibility and can result in residents not being fully responsible for how much students actually remember. In this research project, we reflect on our experience of teaching a full course of psychopharmacology to Psy.D students at Carlow University and we try to give practical advice for residents presented with an opportunity to teach more extensive courses. Preparing the new course was challenging and requires a different mind frame and amount of effort. There is an increase in responsibility in terms of the outcome of your teaching. Development of skills is necessary to present the material and facilitate a productive learning environment while tailoring it to individual students in order to help them use their own experience. This article will explore how teaching an entire course in psychopharmacology changed us as psychiatric residents; how it affected our teaching styles and our own knowledge base; and how it influenced the knowledge and views of the students we taught. Discussion (What We Learned) • Keep it as simple as you can - The subject of Psychopharmacology is extensive and condensing it can be difficult. • Teaching a full course requires mastery of the subject - and required understanding on how to tie material together; how to build knowledge in students from simple principles to complex concepts; how to use the individual strengths of each student and their clinical experience; and how to create an environment where students can share their knowledge and teach each other. • Preparing a full course is time consuming 8-10 hours preparation per hour of lecture • Tailor your lecture to the audience– Our interest was in mechanisms of action and the biological basis of disease, Emphasizing these subjects was not required in this class. • Use a pretest - it will let your audience know which subjects are important. • The first session was essential- It laid the groundwork for two way communication by encouraging discussion, and expressing our own views on psychotherapy and psychopharmacology. • Keep it varied – It pays to use multiple different teaching techniques and styles. Case presentations keep it real, using videos, pictures and graphs keep it easy to remember, and using Jeopardy style questions to review keeps it fun. • Keep students, active listeners – Ask relevant questions that can tie subjects together and repeat, repeat, repeat. • Teaching a course together allowed us to learn from each other. • Set clear expectations of the material that needs to be learned in order to facilitate discussion. • How much responsibility for learning students have themselves and how much teachers are responsible for the final outcome. As new teachers we assumed 80-90% of the responsibility for assimilation of the material we presented. By the end of the course we realized that learning in large part depends on the amount of effort put forth on the part of the student and accordingly decreased the responsibility we took to 60%. • How to deal with students who were making limited progress and are resistant. • How to make students think about psychopharmacology as part of comprehensive care for patients and not to be intimidated by the specific knowledge they do not understand. • How to grade students fairly. • Thought provoking feedback we received: • “It felt like we were in the medical school” (via facebook) Pharmacodynamics (37% - 79%), Treatment of Disorders (52% -85%), and Side Effects (59% - 73%) (Chart 2). The raw scores of the Opinions section changed as well. The largest changes in opinion were noted in knowledge that psychiatrists have of psychotherapy and the role they play in it. Their views also changed on whether psychiatric disorders were over diagnosed. Chart 3 Methods Pre- and post-test measures were administered to eight Psychology Doctoral level students in their last year. The test consisted of two sections, a knowledge section and an opinion section. The knowledge section consisted of 30 multiple choice questions. These questions could further be broken down into 4 different areas: Treatment of Disorders (6) Side Effects (11) Pharmacokinetics / Pharmacodynamics (11) Research Studies (2) The second part of the pre and post test was based on a 7 point Likert Scale which asked about opinions on different subjects including their views of psychiatrists, the roles of therapists and psychiatrists in medication and therapy decisions, the importance of the course material and views on psychopharmacology. To judge our performance as teachers, written feedback was solicited at the end of the class. During the class multiple different teaching styles were tried including PowerPoint presentations, video material, case presentations, oral presentations by students, and using Jeopardy and case analysis to review the material. Dialogue with the class about which teaching style they found most useful was encouraged. Once the class was finished we reflected on the perceived changes we underwent. Discussion (What we are still learning) Discussion (What They Learned) • They learned Pharmacotherapy, shown by the fact that there was significant improvement between pre and post test. • The distribution of scores was skewed with 2 scores above one standard deviation and only one score significantly below one standard deviation. The widening of the standard deviation in the post test can be accounted for by differences in effort, little interest in learning the subject or lack of good of fit with our teaching style. • Subjects best learned were in the areas of Research Studies, Pharmacokinetics / Pharmacodynamics, and Treatment of Disorders. The smallest improvement was noted in Side Effects. Despite this, students were able to identify and suggest appropriate interventions successfully after recognizing Depakote toxicity and serotonin syndrome in patients that they were treating. • Many of the students changed their opinion about psychiatrists from: not being approachable, or open for discussion, to being able to play a bigger role in Results The doctoral students had significantly improved scores on the knowledge portion of the post test with respect to the pre test (t=-5.50 df = 29 p<0.0001). Students scored 13.25 out of 30 (44%) on the pre test and 22 of 30 (73%) on the post test (chart 1). Standard deviations varied significantly as well, with the pre test having a standard deviation of 2.60 and the post test having a standard deviation of 4.17. In looking at the different Referrences: Upon request. Contact information:danmudrea@yahoo.com, 747737@gmail.com