• A study of a structured exercise program with members of an ICCD Certified Clubhouse: program design, benefits, and implications for feasibility

      Pelletier, John R.; Nguyen, Meeta; Bradley, Kevin; Johnsen, Matthew; McKay, Colleen E. (2005-11-05)
      Individuals with serious mental illness (SMI) have significantly greater risk of comorbid health problems and premature death, and there is need for interventions that can improve physical fitness and overall health. Accordingly, a study was conducted which evaluated the effectiveness of a structured physical exercise program that was developed as part of a wellness project in an ICCD Certified Clubhouse. Seventeen clubhouse members completed a 16-week program with evidence of significant improvement in aerobic capacity and perceived mental health as well as positive trends in perceived improvements in physical and social functioning. Qualitative data indicated satisfaction with the program by all participants, especially the value of group support, while also highlighting the need for greater attention to nutrition as part of a future program. Moreover, the study found that a structured exercise program can be successfully provided to members of an ICCD Certified Clubhouse.
    • Adapting services to engage young adults in ICCD clubhouses

      McKay, Colleen E.; Osterman, Ruth; Shaffer, Joseph; Sawyer, Emily; Gerrard, Evan; Olivera, Nelson (2012-01-13)
      TOPIC: This article describes efforts to develop and offer supports for young adults within two clubhouse programs affiliated with the International Center for Clubhouse Development (ICCD). PURPOSE: In response to a need to address service gaps and create supports to engage young adults transitioning to the adult mental health system, the authors describe the background, development, and adaptations of services and supports for young adults within their respective clubhouse programs. The authors highlight details and challenges associated with program adaptation and success stories of transition aged youth actively engaged in their clubhouses. Sources Used: Published literature, personal observation, and member feedback. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: These clubhouse programs share successful strategies used to engage young adults including outreach efforts led by young adults, developing supports and linkages with local educational institutions, addressing housing issues specific to young adults, and using current technologies that young adults find appealing. These strategies may prove useful to other service models that serve this population. Clubhouses affiliated with the ICCD show promise in expanding their approach and services to engage and support young adults.
    • Development and pilot testing of a parent education intervention for type 1 diabetes: parent education through simulation-diabetes

      Sullivan-Bolyai, Susan L; Bova, Carol Ann; Lee, Mary M.; Johnson, Kimberley (2012-01-05)
      PURPOSE: To purpose of the pilot study was to evaluate the use of a pediatric human patient simulator (HPS) to teach parents diabetes management for their children newly diagnosed with type 1 diabetes, referred to as Parent Education Through Simulation-Diabetes. METHODS: A focus group study and 2 pilot studies (1-group study and a randomized 2-group study) were used to develop and test a teaching intervention. Parents were recruited from the Pediatric Diabetes Clinic at UMass Memorial Medical Center. A brainstorming group (n = 6) discussed the simulator concept and what modifications would be necessary to enhance parent teaching; the authors also developed the initial hypoglycemia and hyperglycemia teaching vignettes. Two focus groups (n = 13) discussed the acceptance of using a simulator and the timing and content of the teaching sessions. Based on their recommendations, a 1-group pretest-posttest pilot was conducted with parents (n = 10) receiving hypoglycemia education enhanced with the HPS, followed by a randomized 2-group pilot study (n = 16). FINDINGS: The focus group participants enthusiastically supported the use of the pediatric HPS after diagnosis and made recommendations for the timing and content of the teaching sessions. Major findings from the pilot work included (1) successful recruitment of 16 participants from only 1 site within 6 weeks, (2) instrument reliability demonstrated for all scales, and (3) mean change from baseline in the predicted direction for all measures. CONCLUSIONS: The HPS has the potential of providing parents an innovative means of learning diabetes management through visualization during the early months after diagnosis and so warrants a powered study to determine its efficacy.
    • Enhancing medical students' communication skills: development and evaluation of an undergraduate training program

      Hausberg, Maria C.; herert, Anika; Kroger, Corinna; Bullinger, Monika; Rose, Matthias S. F.; Andreas, Sylke (2012-03-24)
      BACKGROUND: There is a relative lack of current research on the effects of specific communication training offered at the beginning of the medical degree program. The newly developed communication training "Basics and Practice in Communication Skills" was pilot tested in 2008 and expanded in the following year at the University Medical Centre Hamburg-Eppendorf in Germany. The goal was to promote and improve the communicative skills of participants and show the usefulness of an early offered intervention on patient-physician communication within the medical curriculum. METHODS: The students participating in the project and a comparison group of students from the standard degree program were surveyed at the beginning and end of the courses. The survey consisted of a self-assessment of their skills as well as a standardised expert rating and an evaluation of the modules by means of a questionnaire. RESULTS: Students who attended the communication skills course exhibited a considerable increase of communication skills in this newly developed training. It was also observed that students in the intervention group had a greater degree of self-assessed competence following training than the medical students in the comparison group. This finding is also reflected in the results from a standardised objective measure. CONCLUSIONS: The empirical results of the study showed that the training enabled students to acquire specialised competence in communication through the course of a newly developed training program. These findings will be used to establish new communication training at the University Medical Centre Hamburg-Eppendorf.
    • Promoting self-directed learning skills in residency: a case study in program development

      Nothnagle, Melissa; Goldman, Roberta; Quirk, Mark E.; Reis, Shmuel (2010-12-01)
      Self-directed learning (SDL) skills are essential for the formation and ongoing competence of today's physicians who work in the context of expanding scientific knowledge and changing health care systems. In 2007-2008, the authors developed a program to promote SDL in the Brown University Family Medicine Residency. Through an iterative process, the project team juggled learning theories (i.e., Knowles' SDL model, Collins' cognitive apprenticeship model, and Quirk's expertise development model) with curricular goals, instructional options, and local constraints to design a practical and theoretically robust intervention.The intervention that emerged from this process features a faculty physician serving as a learning coach who meets individually each month with all second-year residents to assist them in generating learning goals, reflecting on their learning experiences, and practicing evidence-based medicine (EBM) skills. An electronic portfolio serves as a documentation tool that supports reflection; residents record their goals and reflections in the portfolio, which also contains their formative assessments, procedure logs, and special projects. To address the hidden curriculum, the program designers took special care to avoid increasing faculty and resident workload and created a forum for discussion and group reflection. Program evaluation combines qualitative and quantitative methods, such as surveys of and interviews with residents and faculty, to assess changes in residents' SDL and EBM skills and in the program's educational culture. The authors use Kern and colleagues' six-step model for curriculum development to describe both the unfolding of this complex project and the choices that resulted in the current program design.
    • Psychopharmacology curriculum field test

      Zisook, Sidney; Balon, Richard; Benjamin, Sheldon; Beresin, Eugene; Goldberg, David J.; Jibson, Michael D.; Thrall, Grace (2009-10-16)
      OBJECTIVE: As part of an effort to improve psychopharmacology training in psychiatric residency programs, a committee of residency training directors and associate directors adapted an introductory schizophrenia presentation from the American Society of Clinical Psychopharmacology's Model Psychopharmacology Curriculum to develop a multimodal, interactive training module. This article describes the module, its development, and the results of a field trial to test its feasibility and usefulness. METHODS: Nineteen residency programs volunteered to use the module during the first half of the 2007-2008 academic year. Evaluation consisted of a structured phone interview with the training director or teaching faculty of participating programs during February and early March 2008, asking whether and how they used the curriculum, which components they found most useful, and how it was received by faculty and residents. RESULTS: Of the 19 programs, 14 used the module and 13 participated in the evaluation. The most commonly used components were the pre- and postmodule questions, video-enhanced presentation, standard presentation, problem- or team-based teaching module, and other problem-based teaching modules. No two programs used the module in the same fashion, but it was well received by instructors and residents regardless of use. CONCLUSION: The results of this field trial suggest that a dynamic, adult-centered curriculum that is exciting, innovative, and informative enough for a wide variety of programs can be developed; however, the development and programmatic barriers require considerable time and effort to overcome.
    • The video-based test of communication skills: description, development, and preliminary findings

      Mazor, Kathleen M.; Haley, Heather-Lyn; Sullivan, Kate; Quirk, Mark E. (2007-06-15)
      BACKGROUND: The importance of assessing physician-patient communication skills is widely recognized, but assessment methods are limited. Objective structured clinical examinations are time-consuming and resource intensive. For practicing physicians, patient surveys may be useful, but these also require substantial resources. Clearly, it would be advantageous to develop alternative or supplemental methods for assessing communication skills of medical students, residents, and physicians. DESCRIPTION: The Video-based Test of Communication Skills (VTCS) is an innovative, computer-administered test, consisting of 20 very short video vignettes. In each vignette, a patient makes a statement or asks a question. The examinee responds verbally, as if it was a real encounter and he or she were the physician. Responses are recorded for later scoring. Test administration takes approximately 1 h. EVALUATION: Generalizability studies were conducted, and scores for two groups of physicians predicted to differ in their communication skills were compared. Preliminary results are encouraging; the estimated g coefficient for the communication score for 20-vignette test (scored by five raters) is 0.79; g for the personal/affective score under the same conditions is 0.62. Differences between physicians were in the predicted direction, with physicians considered "at risk" for communication difficulties scoring lower than those not so identified. CONCLUSIONS: The VTCS is a short, portable test of communication skills. Results reported here suggest that scores reflect differences in skill levels and are generalizable. However, these findings are based on very small sample sizes and must be considered preliminary. Additional work is required before it will be possible to argue confidently that this test in particular, and this approach to testing communication skills in general, is valuable and likely to make a substantial contribution to assessment in medical education.