Psychiatry

Course #: 810J

Title:  Consultation Liaison Psychiatry

Selective Director(s):  Christine Pelic , M.D.

Maximum Number of students per block: 2

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Recognize common presentations of and develop treatment plans for major mood disorders such as Major Depression or Bipolar Disorder in the medically ill.
2. Recognize the role of a Consult Liaison Psychiatrist and develop an understanding of conditions that warrant a psychiatric consultation on a medical service.
3. Understand common presentations of delirium and management strategies.
4. Understand appropriate use of psychotropic medications in medically ill patients.
5. Recognize substance intoxication, abuse, dependence, and withdrawal and the potential medical complications of these conditions.
6. Recognize how multiple disciplines interact to provide complete care for a patient and the various roles different members of the treatment team plan play.
7. Demonstrate effective written and oral communications skills in interdisciplinary settings.
8. Understand differential diagnosis of patients with somatoform disorders and factitious disorders.
9. Assess patients for decision making capacity.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Direct patient care observed by the attending psychiatrist and resident.
2. Observation of the attending psychiatrist and resident performing psychiatric evaluations.
3. Attendance at “mini-lectures” presented by the attending psychiatrist and resident throughout the selective on various topics.
4. Completion of assigned readings on various topics throughout the selective.
5. Completion of a self-directed learning project that consists of a 10 minute presentation to team on a topic of relevant interest to the student.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 2 patients with delirium
2. 2 patients with substance related disorders
3. 2 patients with an anxiety disorder
4. 2 patients with a major mood disorder (Either Major depression or Bipolar Disorder)
5. Assess 2 patients for decision making capacity

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Direct observation of patient care skills by the attending psychiatrist.
2. Direct observation of patient care skills by the psychiatry residents. Resident input will be included in the student’s overall evaluation.
3. Self-directed learning project graded by the selective director.

Please outline when and how the learners will receive feedback on their performance:
After the first week and a half, students will receive verbal feedback about their performance as well as a midpoint evaluation card highlighting important points. At the end of the rotation, they will again receive verbal feedback about their performance.

Course #: 811J

Title:  Child and Adolescent Psychiatry

Selective Director(s):  Mark Wagner , M.D.

Maximum Number of students per block: 2

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1.Diagnose various childhood psychiatric disorders in an acute care setting and describe methods used to stabilize these patients.
2. Interact effectively with families, children, and members of the treatment team.
3. Understand various treatment methods used in childhood psychiatric disorders including psychopharmacology, group therapy, and family therapy.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Participation on treatment team rounds.
2. Attendance at departmental grand rounds and service case conferences.
3. Participation in individual treatment sessions under the supervision of an attending physician and resident.
4. Participation in family therapy sessions under the supervision of an attending physician and resident.
5. Completion of a self-directed learning project that consists of a brief presentation on a topic of the student’s choice within the area of childhood/adolescent psychiatry.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 1 patient diagnosed with attention deficit hyperactivity disorder
2. 1 patient diagnosed with oppositional defiant disorder/conduct disorder
3. 1 patient diagnosed with mood disorder
4. 1 patient diagnosed with anxiety disorder

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Direct observation of patient care skills by the attending psychiatrist.
2. Self-directed learning project graded by the selective director.

Please outline when and how the learners will receive feedback on their performance:
Students will receive verbal feedback about their performance following rounds and treatment sessions, as well as at the end of the rotation.

Course #: 812J

Title:  Geriatric Psychiatry

Selective Director(s):  Edgar J. Weiss , M.D.

Maximum Number of students per block: 1

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Perform psychiatric work-up of an elderly person with dementia, affective illness, or
delirium.
2. Perform clinical evaluation of cognitive capacity of an elderly person.
3. Assess activities of daily living in an elderly person.
4. Select appropriate psychopharmacological treatments and tailor treatment to a geriatric
patient.
5. Understand and apply the use of the milieu and interpersonal techniques in treatment of a geriatric patient.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Accurately conduct and record psychiatric and medical work-up of a geriatric patient.
2. Attend rounds daily; report findings and contribute to clinical discussion regarding diagnosis, treatment, prognosis.
3. Assess clinical status of patient daily and write progress note.
4. Establish a supportive and therapeutic relationship with patients.
5. Attend Geriatric Psychiatry Journal Club or read a paper in the Journal of the American Geriatric Association or the American Association of Geriatric Psychiatry and discuss finding with team.
6. Complete a self-directed learning project that consists of a 10 minute presentation to the team on a topic of relevant interest to the student.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 2 patients with dementia
2. 2 patients with depression
3. 2 patients with delirium

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Observation of student during performance of a psychiatric examination by a 2nd year resident, fellow, and/or attending.
2. Review of student’s written medical records by a 2nd year resident, fellow, and/or attending.
3. Observation of student discussing in depth history and physical examination findings, diagnosis, and treatment plan during rounds by a 2nd year resident, fellow, and/or attending.
4. Completion of self-directed learning project graded by selective director.

Please outline when and how the learners will receive feedback on their performance:
Students will receive daily feedback following rounds and clinical activities with patients from residents, fellows and/or attendings. Students will also receive feedback following completion of their self-directed learning project. At the end of the rotation, students will again receive verbal feedback about their performance.

Course #: 813J

Title:  Substance Abuse Treatment Clinic

Selective Director(s):  Jeffrey Cluver, M.D.

Maximum Number of students per block: 1

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Perform an appropriate psychiatric evaluation for a patient with substance use disorder(s) with or without co-morbid psychiatric illness(es).
2. Describe treatment options for detoxification and rehabilitation for the following substances: Alcohol/benzodiazepines, opioids, cocaine, marijuana, nicotine.
3. Differentiate between a substance induced mood/psychotic disorder and a primary mood/psychotic disorder.
4. Describe the pharmacologic options for treating substance use disorders, including alcohol dependence, opioid withdrawal and dependence, and nicotine dependence.
5. Describe the medical complications that can occur with heavy alcohol, nicotine, opioid, and cocaine use.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Evaluating patients with substance use disorders in the outpatient clinic and discussing the patient with the resident and/or attending on the service.
2. Evaluating patients with substance use disorders in consultation to the inpatient psychiatric, medicine, and surgical services at the VAMC.
3. Presenting and writing their patient encounters as described above.
4. Attending and participating in rotation specific didactics.
5. Conducting a brief presentation on a topic of their choice within the area of substance abuse.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 2 alcohol dependent patients
2. 2 cocaine dependent patients
3. 2 nicotine dependent patients
4. 1 patient with co-morbid substance use disorder and anxiety, depression, psychosis, mania
5. 1 patient with opioid, marijuana, or other substance abuse or dependence

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Individual supervision for each patient encounter by the selective director.
2. Additional supervision for charting/documentation and interviewing skills by the selective director and resident.
3. Participation in didactics and presentations by selective director.
4. Student’s presentation on the topic of as graded by selective director.

Please outline when and how the learners will receive feedback on their performance:
The selective director will provide feedback to student at the end of each week.

Course #: 815J

Title:  Forensic Psychiatry - Lieber Correctional Institution

Selective Director(s):  John Cusack, DO, Thomas Cobb , M.D.

Maximum Number of students per block: 3

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Recognize common presentations of mental illness in a correctional setting.
2. Recognize the interface between psychiatric illnesses and criminal behavior in incarcerated individuals.
3. Recognize malingering in a correctional setting.
4. Recognize differences in mental health issues among various prison populations.
5. Work in a team environment with different disciplines to provide care for inmates.
6. Assess risk factors associated with violence and suicide.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Direct patient care observation of attending providing care. Students may also work with forensic psychiatry fellows.
2. Observation of rounds on death row.
3. Discussion of patient issues and issues unique to the correctional setting.
4. Interaction with inmates supervised by attendings to gain insight into the correctional experience.
5. Completion of a brief presentation on a topic of their choice within the area of forensics.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 2 patients with delirium
2. 2 patients with substance related disorders
3. 2 patients with an anxiety disorder
4. 2 patients with a major mood disorder (Either Major depression or Bipolar Disorder)
5. Assess 2 patients for decision making capacity

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Direct observation of student’s patient care skills and knowledge by attending psychiatrist.
2. Direct observation of student’s patient care skills and knowledge by forensic psychiatry fellows.
3. Presentation on the topic of their choice graded by the selective director.

Please outline when and how the learners will receive feedback on their performance:
After the first week and a half, students will receive verbal feedback about their performance as well as a midpoint evaluation card highlighting important points. At the end of the rotation, they will again receive verbal feedback about their performance.