"Teaching as a Competency": competencies for medical educators.

Most medical faculty receive little or no training about how to be effective teachers, even when they assume major educational leadership roles. To identify the competencies required of an effective teacher in medical education, the authors developed a comprehensive conceptual model. After conducting a literature search, the authors met at a two-day conference (2006) with 16 medical and nonmedical educators from 10 different U.

Preventive medical services use among community mental health patients with severe mental illness:the influence of gender and insurance coverage.

Introduction: This study examines predictors of reduced preventive health service use in patients with severe mental illness by examining psychiatric diagnoses and demographic factors.

Method: Of 387 patients approached in 4 community mental health clinics regarding their preventive health services use from January 2005 to May 2007, 234 (60.5%) were interviewed.

General-medical hospital admissions from a public inpatient psychiatric health facility: a review of medical complications over 30 months.

Background: Medical comorbidity and mortality disproportionately affect adults with serious mental illness, as compared with the general population.

Objective: This study examined the medical diagnoses of patients transferred from a psychiatric health facility to general-medical hospitals.

Method: The authors retrospectively reviewed the charts of 81 adult patients admitted to an inpatient psychiatric facility who were subsequently transferred to local general-medical hospitals from January 2005 to June 2007.

A progress report on a department of psychiatry faculty practice plan designed to reward educational and research productivity.

Objective: The authors provide a progress report on a faculty practice plan that assigns a monetary value to administrative duties, teaching, scholarship, community service, and research.

Methods: Modifications to the original plan are described and quantifiable results in the areas of scholarship and research are summarized.

Results: During a 4-year period reported, the total direct costs of all grants increased 40% and the total number of publications increased 108% during this same time frame.

The chief resident in psychiatry: roles and responsibilities.

Objective: Psychiatric residency programs have had chief residents for many years, and several articles previously published describe the chief residents' unique role as both faculty and resident. This article describes chief resident roles and responsibilities and explores trends in academic psychiatry departments from 1995 to 2006.

Methods: The authors mailed a survey about the roles and responsibilities of chief resident positions to psychiatric residency training directors using the American Association of Directors of Psychiatric Residency Training (AADPRT) mailing list in 1995 and e-mailed the AADPRT e-mail list in 2006.

Diversity initiatives in academic psychiatry: applying cultural competence.

Objective: This article describes the process of change in an academic department of psychiatry that has led to the development of a diversity initiative in teaching, research, recruitment, and services.

Methods: The authors performed a literature review of diversity initiatives using PubMed. The authors then wrote a case study of the development of a diversity initiative at UC Davis.

Use of cancer-screening services among persons with serious mental illness in Sacramento County.

Objective: This study examined the use of breast, cervical, colorectal, and prostate cancer-screening services by persons with serious mental illness enrolled in the Sacramento County Mental Health clinics.

Methods: Of 387 outpatients approached from January 2005 to May 2007, 229 were interviewed.

Results: Whereas 97% of the women had received cervical cancer screening at least once in their lifetime, more than 50% of eligible persons over age 50 had never received colorectal cancer screening.

Practical strategies for becoming a successful medical book author.

Objective: The authors, all senior editors in the Books Division of American Psychiatric Publishing, Inc., provide practical advice to authors who may be considering writing or editing a medical book.

Methods: The authors summarize strategies for developing a book proposal and outline an approach to developing a focus for a book.

Rural versus suburban primary care needs, utilization, and satisfaction with telepsychiatric consultation.

Context And Purpose: Rural and suburban populations remain underserved in terms of psychiatric services but have not been compared directly in terms of using telepsychiatry.

Methods: Patient demographics, reasons for consultation, diagnosis, and alternatives to telepsychiatric consultation were collected for 200 consecutive, first-time telepsychiatric consultations at rural and suburban clinics.

Findings: Rural patients were more likely than suburban patients to be younger than 18 years, using Medicaid, and needing treatment planning (lest they be referred out of the community).

Cognitive-disorder diagnoses in inpatient psychosomatic-medicine consultations: associations with age and length of stay.

Authors reviewed consecutive charts of 155 cognitive-disorder patients from a psychosomatic medicine service in 2001, analyzing factors of age, cognitive-disorder diagnosis, and length of stay. Mean length of stay for this cohort exceeded the typical hospital length of stay, and decreased with age. Increased age was associated with a decreased probability of a delirium-only diagnosis, and was strongly associated with an increased probability of a dementia diagnosis.

A review of bipolar disorder in adults.

Objective: This article reviews the epidemiology, etiology, assessment, and management of bipolar disorder. Special attention is paid to factors that complicate treatment, including nonadherence, comorbid disorders, mixed mania, and depression.

Methods: A Medline search was conducted from January of 1990 through December of 2005 using key terms of bipolar disorder, diagnosis, and treatment.

A qualitative needs assessment for development of a cultural consultation service.

Cross-cultural mental health services were assessed using qualitative interviews and focus groups of 43 mental health clinicians and program directors in one of the most ethnically integrated cities in the U.S. The commonly used strategy of ethnic matching between clinician and patient was found to be difficult to effectively apply to an ethnically diverse and highly integrated patient population.

The impact of psychiatric diagnosis on length of stay in a university medical center in the managed care era.

Inpatient use data were examined for fiscal years 1999-2001. Patients with and without psychiatric diagnoses were compared for length of hospital stay and complexity of illness. Patients with psychiatric disorders represented 33%-35% of total cases.

A department of psychiatry faculty practice plan designed to reward educational and research productivity.

Objective: The authors describe a faculty practice plan that assigns a monetary value to various educational and research activities.

Methods: Four years experience in the implementation of the plan are reported.

Results: During this four-year period, the total dollar value of grants increased 319.

Psychiatric diagnoses of 901 inpatients seen by consultation-liaison psychiatrists at an academic medical center in a managed care environment.

The authors reviewed the diagnoses from all inpatient psychiatric consultations conducted by faculty psychiatrists during calendar year 2001 (N = 901) at an academic medical center In about 25% of the consultations, multiple psychiatric diagnoses were made. The most frequent diagnosis groups were mood (40.7%), cognitive (32.

Mission-based reporting in academic psychiatry.

Objective: This article describes a data entry and analysis system called Mission-Based Reporting (MBR) that is used to measure faculty and department activities related to specific academic missions and objectives. The purpose of MBR is to provide a reporting tool useful in evaluating faculty effort and in helping chairs 1) to better assess their department's performance in relation to other departments and their school as a whole, 2) to plan for the future, and 3) to reward individual faculty members.

Methods: Mission-Based Reporting summaries, generated for each faculty member and each department, illustrate contributions to each of four missions: research, teaching, clinical service, and administrative/public service.

Cost issues with telepsychiatry in the United States.

Videoconferencing has increased patient access to psychiatric care by linking specialists at academic or regional health centres with primary health care professionals in shortage areas (Hilty , 1999, 2002). Preliminary studies have demonstrated positive outcomes and user satisfaction (Hilty , 2002). Information is still being sought regarding costs because of a paucity of clinical outcome studies, cost data and randomised trials.

Expansion of the consultation-liaison psychiatry paradigm at a university medical center: integration of diversified clinical and funding models.

The perspective of the contemporary Consultation-Liason Service (CLS) psychiatrist is increasingly one of consultant to medical and surgical colleagues in models other than inpatient medical and surgical units. Simultaneously, the need for a clinically and educationally robust inpatient CLS persists despite funding pressures. The University of California, Davis Medical Center Department of Psychiatry has made use of creative organizational and financial models to accomplish the inpatient CLS clinical and educational missions in a fiscally responsible manner.

Cost savings with nefazodone in treating depression.

Pharmacoeconomic analysis of antidepressant therapy is an important tool for ensuring the most cost-cognizant approach to treat a particular mental disorder. As the number of effective antidepressant compounds continues to grow, the drug selection process must consider not only the cost of the drug itself, but also costs associated with treatment failure and management of untoward and unexpected side effects. In economic studies conducted in North America and England using a decision analysis model and a direct annual cost model, nefazodone has been shown to have an impact on costs associated with depression when compared with imipramine and fluoxetine.