Educational Objectives
WSU - BSOM Psychiatry Clerkship

I. Knowledge and Life-Long Learning

By the end of the psychiatry clerkship, the student will demonstrate the ability to:

• organize clinical data from psychiatric interviews and mental status exams to hypothesize reasonable psychiatric diagnoses on all fives axes, with attention to gender and cultural differences
• develop thorough psychiatric differential diagnoses based upon patients' data
• recognize these psychiatric illnesses:
  -Major Depression
  -Bipolar Disorder
  -Dysthymia
  -Panic Disorder
  -Generalized Anxiety Disorder
  -PTSD
  -OCD
  -Schizophrenia
  -Schizoaffective Disorder
  -Personality Disorders
  -Substance Use Disorders
  -Cognitive Disorders
  -Somatoform Disorders
  -ADHD
• describe first line medication treatments and psychotherapy treatments for each of the above disorders
  By the end of psychiatry clerkship, the student will demonstrate understanding of the mechanisms of action, common side effects, potentially catastrophic side effects, and contra-indications for the following psychotropic classes of medication:
• antidepressants
• mood stabilizers
• anxiolytics
• antipsychotics
• sleep agents
• cognitive enhancers
• stimulants
  

By the end of psychiatry clerkship, the student will be able to describe both intoxication and withdrawal syndromes for the following categories if substances of abuse:

• alcohol and other central nervous system depressants
• opioids
• sympathomimetics
• cannabinoids
• psychadelics
• dissociate anesthetics
• steroids
• nicotine
• miscellaneous prescription medications

By tho general appearance and activity

-levels of consciousness
-speech characteristics
-orientation
-concentration
-memory
-fund of information
-mood and affect
-perceptual abilities/disturbances
-hallucinations/illusions
-depersonalization/derealization
-thought processes
-obsessions/compulsions
-delusions
-suicidal and homicidal thoughts
-self mutilation thoughts
-abstract thinking
-judgment
-insight
-reality

• perform acceptable general medical physical examinations
• perform common screening exams for common psychiatric disorders, i.e., CAGE, MMSE

By the end of the psychiatry clerkship, the student will recognize the indications for lab data, and will demonstrate the ability to:

• determine which laboratory tests are medically indicated based upon patients' psychiatric presentations
• recognize when psychiatric laboratory data are pathological
• determine when laboratory test are indicated to check patients' compliance and responses to psychiatric medications
• inform patients of risks and benefits of obtaining psychiatric laboratory tests.

By the end of the psychiatry clerkship, the student will demonstrate the ability to develop psychiatric formulation and present plausible theories about the etiologies and courses of patients' psychiatric illnesses in regard to:

• biological factors
• psychological factors
• social factors
• cultural factors
• spiritual factors
• patients' strengths
• patients' weaknesses

By the end of the psychiatry clerkship, the student will demonstrate the ability to:

• recognize psychiatric emergencies among general medical patients, including:
  - suicidal thinking
  -homicidal thinking
  -signs of mental decompensation
  -impulsivity
  -dangerously poor judgment
  -lethal side effects to medications
• neuroleptic malignant syndrome
• neurotoxic or cardiotoxic responses
• overdosage
• demonstrate knowledge about medical and medical-legal interventions
  -psychiatric referrals
  -involuntary commitment
  -judgments of medical incompetence
• recognize potential risks in general medical patients who have psychiatric disorders

II. Interpersonal and Communication

By the end of the psychiatry clerkship, the student will demonstrate the ability to conduct a psychiatric interview, including:

• establish rapport with patients by properly introducing self and defining the role the interview will have in patients' care
• be empathic with patients, showing genuine concern for patients' moods, dilemmas, viewpoints, and conflicts through tone of voice, style of speaking, facial expressions and gestures
• facilitate interviews with helpful blends of open and closed questions, supportive remarks, uses of silences, and therapeutic interruptions
• use language neutral to gender, age, race, sexual orientation, culture and religion
• conclude interviews with proper timing and respect

By the end of the psychiatry clerkship, the student will demonstrate the ability to elicit data for a complete psychiatric history, including:

• chief complaints in patients' own words
• details for thorough histories of present psychiatric illness:
  -onset of symptoms
  -duration of symptoms
  -time lines of exacerbations and decreases of symptoms
  -actions patients have taken to cope with symptoms
  -impacts of symptoms on patients
  -patients' thoughts about causes for and meanings of symptoms
  -patients' expectations for prognosis
  
• details for past general medical histories and psychiatric histories
  
• details for psychiatric reviews of systems
  
• details for family and social histories
  
• details for developmental histories
  
• details for substance use histories

By the end of the psychiatry clerkship, the student will demonstrate the ability to develop psychiatric treatment plan with attention to cultural and gender influences, including:

• indications for treatments for patients with psychiatric disorders
  -types of psychotherapies
  -- individual: psychodynamic, cognitive, behavioral, supportive, interpersonal
  --marital, family, groups
  -medications
  -somatic therapies
  -social interventions
  -economic interventions
  -legal interventions
  --recognize contraindications for specific psychiatric treatments in specific patients
  --inform patients about risks and benefits of psychiatric treatments
  --collect data about compliance with treatments

By the end of the psychiatry clerkship, the student will demonstrate the ability to present coherent, thoughtful presentations of psychiatric patients in both oral and written forms:

• patients' psychiatric histories
• mental status examinations data
• physical examination data
• lab data
• five axes of diagnoses
• differential diagnoses
• psychiatric formulations
• treatment plans
  By the end of the psychiatry clerkship, the student will demonstrate the capacity to respond appropriately to constructive feedback given throughout the rotation and, specifically, at mid-rotation evaluations and in the observed interviews.

III. Professionalism

The student will demonstrate professionalism through the ability to:

• be punctual and attend required events
• complete patient notes in a timely fashion with legible writing
• maintain professional boundaries (physical, sexual, financial, and emotional) with patients
• be truthful about medical data
• be courteous to patients, patients' families, staff, colleagues, and other health professionals
• maintain confidentiality regarding patient care
• demonstrate respect, empathy, responsiveness, and concern regardless of the patient's problems, personal characteristics, or cultural background
• demonstrate sensitivity to medical student-patient similarities and differences in gender, ethnic background, sexual orientation, socioeconomic status, educational level, political views, and
• personality traits.
• demonstrate integrity, responsibility and accountability in the care of assigned patients
• demonstrate scholarship in the form of contributing to a positive learning environment, collaborating with colleagues, and performing self-assessment and self-directed learning
• to assess one's strengths, weaknesses and health (physical and emotional), and be willing to seek and accept supervision and constructive feedback

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