Understanding the dynamics of change and the impact on psychiatric education.

Academic departments of psychiatry are experiencing unprecedented changes that are difficult and challenging for faculty and administrators. This article examines the factors that influence change and the barriers to effective change. The author reviewed the business literature on change in organizations and examined the psychodynamic factors that mediate individual and organizational response to change.

Problem-oriented instruction as a predictor of success in early psychiatric interviewing.

Of 77 second-year medical students, the 27 who were randomly assigned to problem-oriented instruction (POI) in interviewing skills rated themselves as better prepared and more successful in interviews of psychiatric patients, compared with students receiving lecture only or no classroom instruction in interviewing skills. POI-trained students also rated themselves as better in focusing on nonverbal aspects, effective questioning, and exploring feelings. The POI involved hierarchically organized, skills-focused role-plays in which students rotated through the roles of "doctor," "patient," and "observer.