Biomedical subjects

Anna Chur-Hansen

Publications and source records attributed to Anna Chur-Hansen.

11 recordsLinked to original sources

PubMed2006

'Let's fix the chemical imbalance first, and then we can work on the problems second': an exploration of ethical implications of prescribing an SSRI for 'depression'.

The creation of pharmacotherapies, such as Selective Serotonin Reuptake Inhibitors (SSRIs), for the treatment of depression was hailed as a great breakthrough in mental health care. However, since that time, serious questions have arisen as to their safety and the way they are prescribed without full information being provided to patients about a range of important issues, including the possible aetiologies of depression, and the efficacy and potential side-effects of medication. These issues have been especially important in the care and treatment of young people, as there is evidence that SSRIs may be implicated in increased suicidal behaviour. In this article, we examine the experiences of five individuals who were prescribed an SSRI in their late teens or early twenties, and discuss some of the ethical issues that arise from their accounts.

Adolescent↗

PubMed2006

On being a supervisor: the importance of feedback and how to give it.

OBJECTIVE: We outline some of the dominant opinions regarding the provision of formative feedback, as expressed by both trainees and their supervisors. METHODS: Trainee psychiatrists and their supervisors were interviewed and asked to identify 'good' as opposed to 'poor' supervision. RESULTS: A recurrent theme in interview data was that of formative feedback. Trainees expressed a desire to receive it, but some supervisors discussed misgivings and a lack of skill in providing such feedback. CONCLUSIONS: Formative feedback is an essential part of the supervisor's role. We describe the principles of how to best deliver feedback, in order to increase supervisors' confidence and ability in utilizing this learning and teaching skill.

Clinical Competence↗

PubMed2006

An interdisciplinary course for trainee psychiatrists: feedback and implications.

OBJECTIVE: To describe a course for trainee psychiatrists, designed to encourage critical thinking within an interdisciplinary framework. Trainees' responses to the course, and the implications of these for teaching, learning and clinical practice, are considered. METHOD: Trainees were interviewed, and their responses subjected to content analysis. RESULTS: To some extent, the course appears to have met its objectives. However, some trainees found parts of the course content threatening, and reported negative perceptions of teaching staff and the process of critical appraisal. CONCLUSIONS: Challenging taken for granted beliefs in psychiatry is a fundamental skill, which should be fostered in trainee psychiatrists if the profession is to move forwards as an intellectual and clinical discipline. The lessons learned from the course we describe may be useful to others who wish to pursue integrated, interdisciplinary teaching methods.

Attitude of Health Personnel↗

PubMed2005

Is psychiatry an art or a science? The views of psychiatrists and trainees.

OBJECTIVE: It is generally considered by many practitioners that psychiatry is an art, that is, one of the humanities, as well as being a science. We systematically collected the views of practitioners and trainee psychiatrists regarding the question 'Is psychiatry an art or a science?' METHOD: Eleven supervisors and nine trainees were interviewed and their responses analysed, using a qualitative method, the modified framework approach. RESULTS: Several themes emerged from the data: that 'art' and 'science' are different; psychiatry as a discipline is difficult to define; psychiatry demands a broader range of skills than other medical specialties; the relationship of psychology to psychiatry; supervisor cynicism to the 'science' of psychiatry; and the 'art' and 'science' of the assessment process. CONCLUSIONS: The tension that exists within the profession's identity as a discipline has important implications for teaching, learning, and clinical and research practices.

Art↗

PubMed2005

Formative feedback in teaching undergraduate psychiatry.

OBJECTIVE: This paper describes the introduction of formative feedback into a psychiatry attachment at an Australian university and evaluates students' responses to that initiative. METHOD: Students were provided with formative feedback sessions employing a standardized instrument, also used at the end of the attachment for summative assessment. They were asked to both define formative feedback and rate its usefulness on a questionnaire, providing open-ended written comments where appropriate. RESULTS: The concept and purpose of formative feedback were understood by 91.9% of the students who completed a questionnaire. The vast majority considered it to be useful, but some identified the need for constructive criticism and structured feedback as important characteristics of formative sessions. CONCLUSIONS: Rigorous research is needed to establish whether formative feedback impacts summative assessments. However, it is clear that such feedback is desirable, in that it increases student confidence and direction. We encourage our colleagues to consider introducing and evaluating formative feedback into psychiatry curricula.

Attitude↗

PubMed2004

The patient's voice in a problem-based learning case.

OBJECTIVE: Problem-based learning (PBL) relies upon trigger material, often a paper case, to stimulate self-directed enquiry and group discussion. We describe the process of writing a PBL case based upon a patient's narrative account of her experiences of psychiatric illness, and the possible benefits of that collaboration for the patient, as well as for student learning. CONCLUSION: Real patients are under-utilized in teaching, as are their narratives, and both are believed to be resources worthy of further attention.

Cooperative Behavior↗

PubMed2004

Returning home to work: Malaysian students who studied medicine overseas.

International students' medical training often includes an elective placement in their home country to prepare them for practice on graduation. Seven Malaysian students in their final year of medicine were interviewed pre- and post-graduation and asked to reflect on whether they felt adequately prepared for working in Malaysia. These seven international students, who studied medicine in Australia, all returned to Malaysia for six weeks for their elective, and the interviews canvassed their perceptions of this experience, along with their thoughts on how well their training in Australia had prepared them for working in their country of origin. The interview data were qualitatively analysed, and case studies were constructed. Main themes were identified and tabulated. Students voiced similar concerns about how ready they were for working at home. These included a lack of practical skills relative to their Malaysian-trained counterparts, language difficulties, medical communication skill incompatibilities across cultures, expectations to perform complex or unfamiliar tasks with minimal supervision and substantial burdens of responsibility with long working hours. These students did not feel greatly prepared for their return home to practise medicine. The elective placement was not well utilized by the majority of students in this study.

Education, Medical↗

PubMed2004

Description and evaluation of an up-skilling workshop for rural and remote mental health practitioners in South Australia.

OBJECTIVE: In response to the identified need for up-skilling in psychiatry for rural and remote general practitioners, a series of workshops has been designed and delivered to medical and nursing staff in South Australia. In this paper one such workshop is described, dealing with acute psychiatric care. Quantitative and qualitative evaluations of the workshop are reported on, and recommendations are made for future training programmes. CONCLUSIONS: The workshop was well received and increased participants' knowledge about the management of acute psychiatric presentations. Qualitative data indicate that the pharmacological management and neurobiology of psychiatric illness was interesting but difficult for some participants, and further training in these areas may be appropriate in future workshops. Inclusion of all professional stakeholders in future training is recommended, including students, to promote interest in working in rural and remote health. Participants considered networking with colleagues as an important benefit of the workshop. Targeted training in psychiatry may be needed for overseas-trained doctors. Further, rigorous research is needed to evaluate the long-term benefits of up-skilling workshops, and to inform funding bodies as to where resources might be most effectively channelled.

Australia↗

PubMed2003

The subjective experience of patients who received electroconvulsive therapy.

OBJECTIVE: Despite the vast amount of scientific literature available on electroconvulsive therapy (ECT), there is little qualitative focus upon the patients' subjective experience of this procedure. Using an exploratory descriptive methodology, this study aims to provide a more unique insight into what certain patients actually think of ECT. METHOD: Semistructured interviews were conducted to explore eight patients' opinions and experiences of ECT. Interviews were subjected to analysis by a five-step framework approach that identified prominent themes in relation to five broad questions and in conjunction with issues raised by the subjects themselves. RESULTS: Eleven major themes were identified. Four of these were chosen for discussion, not only as the most prevalent themes (in terms of how frequently they were mentioned by the subjects), but also as the most striking (in regards to the intensity of emotions evoked, or their influence on their perception of ECT as a future treatment option). The four themes are fear of ECT, attribution of cognitive decline and memory loss to ECT, positive ECT experiences, and patients' suggestions. CONCLUSIONS: Using such a qualitative approach, the depth of the information obtained has revealed new perspectives on how patients perceive the experience of ECT. Fears reported by patients present an opportunity to address specific areas of the procedure that generate the most angst. These were closely associated with recommendations that many patients proposed throughout the interviews. Patients' perceptions of the cognitive effects of ECT do not necessarily correspond with those commonly reported in the literature on ECT. Positive experiences with ECT were more complex than simply its efficacy. There is a need for future research in order to explore and address patients' experiences of ECT.

Adult↗

PubMed2002

Preferences for female and male nurses: the role of age, gender and previous experience --year 2000 compared with 1984.

BACKGROUND: The situations in which patients prefer a male or female nurse are not clear, as the literature reports differing relationships between gender and preference. Furthermore, most research has focused on female preferences. METHODS: This questionnaire study investigated the preferences of both males and females for a male or female nurse, depending on four clinical situations. The role of age and previous experience with a male nurse was also taken into account. Gender, age and experience were further examined in relation to attitudes towards professional nursing practice. To determine whether preferences and attitudes have changed over time, the study was replicated in 2000, having been first conducted in 1984. Data were collected from the same general practice waiting room on each occasion. RESULTS: Consistent with previous research, the degree of intimacy in a clinical situation was found to be predictive of same-gender preferences. Younger females may prefer female nurses more than older females. Experience with male nurses was limited in both samples, but was not predictive of preferences or attitudes. CONCLUSIONS: Generally speaking, results from 1984 and 2000 were not significantly different. As a quantitative study, this research contributes to an understanding of patient preferences. However, in-depth, qualitative research is recommended to understand better the reasons for preferences and attitudes, for both male and female patients.

Adolescent↗

PubMed2002

Introducing psychosocial and psychiatric concepts to first year medical students using an integrated, biopsychosocial framework.

OBJECTIVE: The main objective of the problem-based teaching unit reported in this paper was to introduce psychosocial and psychiatric concepts to first year medical students using an integrated approach. METHOD: A total of 131 undergraduate students studied a case of delirium. Students were encouraged to understand the problem from a number of perspectives and approaches. In particular, the patient's view was emphasised. This was partially achieved by employing a standardised patient, who answered students' questions about what it was like to be unwell and hospitalised. Both quantitative and qualitative evaluations of the teaching project were conducted. RESULTS: Overall, the teaching project was well received. However, as an introduction to a complex and unfamiliar area, students were concerned that material was difficult to grasp. CONCLUSIONS: As a foundation for future teaching in psychiatry, the case and our methods appear appropriate. However, this initial teaching should be reinforced and expanded upon in all years of the medical curriculum.

Journal Article↗