Efficacy of a one-month training block in psychosocial medicine for residents
A controlled study
Cite this article as: Smith, R.C., Osborn, G., Hoppe, R.B. et al. J Gen Intern Med (1991) 6: 535. doi:10.1007/BF02598223 Abstract
To determine the efficacy of a comprehensive, one-month psychosocial training program for first-year medical residents.
Nonrandomized, controlled study with immediate pre/post evaluation. Limited evaluation of some residents was also conducted an average of 15 months after teaching.
Community-based, primary care-oriented residency program at Michigan State University (MSU).
All 28 interns from the single-track MSU residency program during 1986/87–88/89 participated in this required rotation; there was no dropout or instance of noncompliance with the study. In the follow-up study in 1989, all 13 available trainees participated. Of 20 untrained, volunteer controls, ten were second/third-year residents in the same program during 1986/87 and ten were interns from a similar MSU program in Kalamazoo, MI, during 1988/89.
An experiential, skill-oriented, and learner-centered rotation with competency-based objects focused on communication and relationship-building skills and on the diagnosis and management of psychologically disturbed medical patients.
Measurements and main results:
The two subsets of the control group were combined because residents and training programs were similar and because means and standard deviations for the subsets were similar on all measures. By two-way analyses of variance (group×gender), the trainee group showed significantly greater gains (p<0.001) on questionnaires addressing knowledge, self-assessment, and attitudes; a mean of 15 months following training, there was no significant deterioration of attitude scores. All trainees were also able to identify previously unrecognized, potentially deleterious personal responses using a systematic rating procedure. Residents’ acceptance of the program was high.
Intensive, comprehensive psychosocial training was well accepted by residents. It improved their knowledge, self-awareness, self-assessment, and attitudes, the latter improvement persisting well beyond training. Key words psychosocial teaching medical interviewing residency training education evaluation resident attitudes physician-patient relationship
Received from the Departments of Medicine, Psychiatry, Psychology, and Communications, and the Office of Medical Education, Research, and Development, Michigan State University College of Human Medicine, East Lansing, Michigan.
Presented at the Task Force on the Medical Interview (Society of General Internal Medicine) 1989 meeting, the Fifth Biennial Symposium for Teaching Internal Medicine, the American Association of Medical Colleges 28th Annual Research in Medical Education Conference, the Fourth Annual National Institute of Mental Health International Conference on the Classification and Treatment of Mental Disorders in General Medical Settings, the 20th Annual Meeting of the Association for the Behavioral Sciences and Medical Education, and the 1991 Association of Program Directors of Internal Medicine Annual Meeting.
Supported in part by the College of Human Medicine, the Department of Internal Medicine, and the Department of Psychiatry, Michigan State University, and by The Fetzer Institute, Kalamazoo, Michigan.
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