PSYU-4075 - Reproductive Psychiatry

PSYU-4075 - Reproductive Psychiatry

Elective Title: Reproductive Psychiatry
Course Number: PSYU-4075
Elective Type: career Duration/Weeks: 2 Max Enrollment: 1
Prerequisites: Successful completion of Year 2
Additional Requirements: Intended for 3rd year medical students for Clerkship purposes only. Contact Jessica Prescott (jlpresco@utmb.edu) with any questions.
Responsible Faculty Director: Kimberly Grayson, MD Periods Offered: 1AB-3AB, 5B, 6AB-9AB,10A, 12AB-13AB including holiday period 8 
Coordinator: Jessica Prescott Other Faculty:
Location to Report on First Day:
Webster Psychiatry Clinic (400 N Texas Ave, Suite A, Webster, TX 77598)

Goals
1. Students will appreciate the unique factors that influence women's mental health, including pregnancy and the post-partum period, considerations during breastfeeding, infertility, and menopause.
2. Students will understand how to conduct a full initial psychiatric interview, including how to screen for mood, anxiety, and psychotic disorders and how to conduct a mental status exam.
3. Students will be comfortable in talking with patients who are pregnant or breastfeeding about the benefits and risks of taking psychotropic medications.

Objectives
1. Students will be able to conduct a thorough psychiatric interview and integrate their knowledge of psychiatric diagnoses and medications to create a biopsychosocial assessment and plan for their patients.
2. Students will be able to apply their learning from readings and lectures to patient's they see in clinic and/or clinical vignettes to improve their management plans for pregnant and breastfeeding patients and to better counsel patients on medication use in pregnancy and breastfeeding.
3. Students will read and discuss a paper on a topic within reproductive psychiatry.
4. Students will be able to conduct a detailed mental status exam and include this in a patient write-up.
5. Students will compose a full patient write-up which includes a history of present illness, relevant history, mental status exam, biopsychosocial assessment with a differential diagnosis, and management plan.

Description of course activities
Students will attend clinic at the UTMB outpatient psychiatry clinic in Webster each Monday and Tuesday afternoon of the rotation. Students will get to experience a combination of shadowing and interviewing patients themselves. They will interview new patients and get immediate feedback on their patient interviews and presentations, with particular focus on mental status exam. Students will also join the psychiatry consult team in Galveston at Rebecca Sealy on Thursdays and will focus on seeing OB/GYN consults. Students will be assigned readings, lectures, and/or podcasts to complete on the other days of the week. They will complete a detailed write-up on one of the patients they see in clinic or on consults, which will include a biopsychosocial assessment and differential diagnosis with clinical reasoning. Students will apply knowledge learned from their readings/lectures to their chosen patient. Students will meet with faculty at the end of each week to discuss what they have learned, present cases, and to receive verbal feedback.

Type of students who would benefit from the course
Students who are interested in the intersection between psychiatry and women's health and who wish to learn more about the field of Reproductive Psychiatry would benefit from this elective. This elective would be helpful to any students wanting to become more comfortable counseling patients on medication use in pregnancy and breastfeeding. Students who want to work on their psychiatric interviewing and observational skills, and want to receive feedback on patient interviews, mental status exams, and assessments would benefit from this elective.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday 8-12 (Webster Psych Clinic) 1-5 (Webster Psych Clinic)
Tuesday 8-12 (Self Study) 1-5 (Self Study)
Wednesday 8-12 (Self Study) 1-5 (Self Study)
Thursday 8 (Rebecca Sealy Psych Consults) 5 (Rebecca Sealy Psych Consults)
Friday 8-12 (Self Study) 1-2 (online discussion/feedback)
Saturday
Sunday

 Average number of patients seen per week: 24
 Call Schedule: None

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study
Data-Collection/Analysis
Other

Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
    3 days per week
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback
Other

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Faculty Supervisor
  B. Frequency / Duration of Presentation(s)?
    Twice weekly during clinic and during supervision
  C. Format - What guidelines are set for the student's presentation?
    Standard psychiatric case presentation
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    Twice weekly
  B. Format - What guidelines are set for the student's written work?
    Students will write a standard H&P for a patient during Monday's clinic and will write a more detailed clinical assessment to be presented and reviewed for feedback during supervision at the end of each week.
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
   
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    current cases or student-selected
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
  Format
    Oral   Written multiple choice   Written essay / short answer   OSCE
Other

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    Complete readings, lectures, and podcasts to apply new knowledge to cases

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".
    None

7.  Other Modes of Evaluation
  Please explain below.
    None

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.
   
 
B.
Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.
   
 
C.
How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?
   
 
D.
What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?
   
 
E.
An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?
   
 
F.
How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?
   
 
G.
How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
   
 
H.
Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.