MedEdPORTAL (Apr 2012)
Bipolar Disorder: A Self-Directed Learning Module
Abstract
Abstract Medical education is increasingly distributed among geographically distant sites and campuses. The patient encounters may be limited by teaching time constraints, practice setting restrictions, seasonal variation in patient availability and limited duration of clerkships. Simulation has been classically performed with standardized patients and with high fidelity integrated mannequins but these modalities become impractical for students training at clinical sites remote from the main university campus. To meet licensing bodies' requirements for medical education, the schools need to identify the types of patients or clinical conditions that students must encounter in each discipline and are encouraged to use simulated experiences to fill gaps in exposure. In addition, schools must provide comparable educational experiences and equivalent methods of assessment across all instructional sites within a given discipline. Given the factors described above, educators from various medical disciplines established national clerkship curriculum guidelines and created databases of computer based simulated cases to cover the curriculum. For example, the pediatric CLIPP cases include 31 modules and the surgery WISE MD has 15 modules, which are proprietary. Since 2010, a taskforce of educators now including representatives from the Universities of Chicago, California Davis, Nebraska Medical Center, Central Florida, Georgia Health Sciences University (GHSU) and Medical University of South Carolina have joined forces to develop a free national database of psychiatry teaching cases. The pilot modules (adolescent depression, dementia with comorbidities, psychiatric interview, somatization disorder and bipolar disorder) were developed using the ADMSEP Clinical Learning Objective Guide for Psychiatry Education of Medical Students (2007) as a framework. The taskforce developed anonymous student and faculty surveys, to ensure that periodic updates and improvements are based on consistent user feedback about the modules' content and teaching areas. So far the surveys have been IRB-approved at 2 of the participating medical schools, GHSU and University of Central Florida. The preliminary research results for the Bipolar Self-Learning Module will be presented in the Instructor's Guide. The potential advantages of utilizing a self-learning resource are its portability (it can be viewed anywhere where a computer is available), availability of repetitive viewing, and the standardized content built into the script. In addition, the resource allows revision when advances in medical knowledge and users' feedback dictate content changes. Practical implementation of the Bipolar Self-Directed Learning Module in Medical College of Georgia @ Georgia Health Sciences University curriculum: The resource became available for the use of 3rd year students in September 2011. The module is made available on the 3rd year clerkship's password-protected website along with the other modules created by CSI taskforce (Adolescent Depression, Somatization, Dementia with Co-morbidities and Psychiatric Interview). The students are encouraged to view the module to supplement their patient exposure or when the mid-rotation feedback uncovers gaps in exposure. Other potential uses: Small group teaching setting; to illustrate concepts about mood disorders or suicide risk assessment. Clinical correlation; to supplement 2nd year neuroscience modules. Nursing students - behavioral science curriculum. Family medicine and neurology residents Pilot feedback data: Since its release, the module has been revised based on informal feedback from GHSU students. In addition, we accumulated pilot feedback data from faculty and students at GHSU and University of Central Florida on our anonymous IRB-approved surveys. The faculty (N=5) rated the usefulness of the video-clips, the clarity of the content and the content consistency with its learning objectives at 6.20 on a 7-point scale (Strongly disagree, Disagree, Somewhat disagree, Neutral, Somewhat agree, Agree, Strongly agree). The faculty spent between 30 min (60%) and 45 min (40%) to go through the module. 80% would use the module to supplement patient exposure in 3rd and 4th-year medical students, 60% would use it for residents and 40% for 1st and 2nd year medical students, physician-assistant and nursing students. The faculty rated the educational value of the module between 5.5 and 6.3 on the same 7-point scale. The student feedback (N=2) on the IRB-approved survey rated the module's knowledge area from 5.50-6.50; the students thought that the module enhanced their ability to recognize symptoms of bipolar disorder, to work through the differential diagnosis and choose treatment options. The students rated the skills area between 5.5-7; they thought that the module increased their comfort in interacting with patients with bipolar disorder, gave them a framework to approach patients with bipolar disorder and increased their confidence that they can elicit symptoms of bipolar disorder. The general module feedback ranged between 4.5–7 on the same 7-point scale; the students thought that the module was valuable as an educational tool and would use it again to review the material presented. The quizzes were rated from 4.5-5.5.
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