innovative methods in teaching psychiatry to...

Eur. J. Psychiat. Vol. 29, N.° 1, (67-78)2015

Keywords: Teaching psychiatry; Innovation; Medi -cal students; Performance; Satisfaction.

Innovative methods in teaching psychiatryto medical students

Antonio Lobo*,***,****,*****Concepción de-la-Cámara*,**,***,****,*****Ricardo Campos*,**,***,****,*****Tirso Ventura*,**,***,****,*****Carlos Marco*,**,***,*****Antonio Campayo*,**,***,****,*****Federico Dourdil†*,**,***Mari Fé Barcones*,***,****,******Pedro Saz*,***,****,*****

* Department of Medicine and Psychiatry,University of Zaragoza, Zaragoza

** Hospital Clínico Universitario, Zaragoza

*** Instituto de Investigación Sanitaria deAragón (IIS Aragón), Zaragoza

**** Centro de Investigación Biomédica enRed de Salud Mental (CIBERSAM), Madrid

***** Faculty of Medicine, Universityof Zaragoza, Zaragoza

****** Hospital Universitario Miguel Servet,Zaragoza

SPAIN

ABSTRACT – Background and Objectives: To test the conjecture that the innovativemethod to teach psychosomatic psychiatry previously reported will be confirmed as bene-ficial in the training of medical students in the field of general psychiatry.

Methods: The emphasis in this course is placed on the discussion of clinical cases, bed-side clinical teaching, and a research-oriented part. The “Innovative Teaching Plan” (ITP)is intended to train student-leaders to guide small groups (SG) of students. The results of anintensive clerkship on bedside teaching are also studied. Trainee performance was assessedby the marks in the final examination, and a reliable and valid tool, the Medical Tea chingQuality Questionnaire (MTQQ) was used to document trainee satisfaction. The results offive academic courses are presented in this report.

Results: External experts consulted assured that the content of the course was adequate.Eight hundred and thirty eight medical students have completed the learning course in thestudy period, and 418 (one of the two groups) completed the evaluation with the MTQQ.

Most items related to the students’ satisfaction were rated “high” or “very high”, in-cluding the items asking about the usefulness of the course for physicians, the quality ofthe teaching methods and the bedside teaching. In relation to innovation, the discussion of

68 ANTONIO LOBO ET AL.

Introduction

Psychiatry is a crucial discipline in thestandard teaching of psychological medicineaspects of interest for general physicians1.Furthermore, some previous reports ac-knowledge the increasing demand for im-proved skills by medical graduates in thepsychosocial aspects of medical care2. It is inthis setting that interest in novel methods ofteaching have emerged. For example, thebeneficial effects of incorporating team learn-ing into the psychiatry clerkship have beensuggested by some authors3. Other authorshave used a novel peer-peer learning activitywith medical students, encompassing a spe-cialist psychiatrist-general practitioner (GP)dyadic interchange of letters to enhance stu-dents’ appreciation of the intricacies of thediscipline4. On the other hand, several re-ports underlie the relevance of problem-solv-ing methods in this setting5.

The importance of research to improve theresults of teaching should not be underesti-mated, since it is useful, for example, to iden-tify problems in need of remedial actions. Asystematic review identified that a mix of pos-itive and negative attitudes toward psychiatry:while overall, the attitudes were considered to

be positive, psychiatry as a career choice wasrated poorly and found to be unpopular formany students6. However, research also sug-gests that attitudes towards psychiatry maybe changed. For example, there is also someevidence that psychiatric courses may changethe clinical behavior of physicians, so that thecourse would benefit their careers7.

We consider that the improvement on the at-titude of students towards psychiatry may de-pend on both the psychiatry curriculum and onthe development of innovative teaching strate-gies. While a number of reports in the interna-tional literature have approached the teachingof psychiatry in medical schools, the use ofstandardized assessment methods has not beenthe norm in most studies. The literature pro-vides a variety of educational methods to trainmedical students in general or in specific areas,but this literature has been found to be of vari-able quality, so that the provision of guidancefor development of curricula and medical ed-ucation policy is inconsistent8.

We have previously reported the use of in-novative methods to teach Psychosomaticand Liaison Psychiatry in the Medical Schoolof Zaragoza, and found that teaching results,and student satisfaction measured with a stan-dardized, original method were both posi-

clinical cases in small groups was also very satisfactory and the “enhancement of a re-searcher’s mind” was rated “high” or “very high” by 1/3rd of medical students. The utili-ty of the yearly evaluation of the quality of teaching methods was supported by resultsshowing that items scored not favourably in the initial evaluation were considerably im-proved in the follow-up evaluations, when modifications in the method were introduced.

Conclusions: Good performance and high satisfaction of medical students was docu-mented in a course on general psychiatry. Lessons may be drawn to inform about efficientand effective ways of teaching and learning this subject.

Received: 9 January 2015Revised: 15 February 2015Accepted: 20 February 2015

INNOVATIVE METHODS IN TEACHING PSYCHIATRY TO MEDICAL STUDENTS 69

tive9. In this background, the objective ofthis study is to try to test the conjecture thatthis same method will be confirmed as ben-eficial in the training of medical students inthe field of general psychiatry both, for cur-riculum results and for students’ satisfaction.

Methods

The content of this course on psychiatryfor medical students has been considered tobe adequate by external experts consulted.The course has a theoretical part, for lecture-oriented sessions; a seminar part, to potenti-ate active participation and learning in smallgroups (SG); a practical, bed-side clinicalteaching; and a research-oriented part. Thecontents of the theoretical, lecture-orientedpart follows standard material in textbooks,such as the one we now recommend10. Theteaching methodology of the full academicyear course is summarized in table 1.

A crucial innovation in the last years was theintroduction of the “Innovative Teaching Plan”for students (ITP) (http://www.unizar.es/innovacion/convocatorias2010/index.php), in-tended to educate student-leaders to stimulatebetween-students interaction and participa-tion. Over the last academic courses, a re-quirement for each SG was to design an orig-inal research project, led by the trained ITP.

Special consideration in the course hadthe bedside teaching. While the staff re-sources are limited for the number of studentsassigned each year and the heavy clinical re-sponsibilities of clinicians, the Departmentmanaged itself to provide a 4-week period ofbedside, practical supervised work for thestudents. Table 2 summarizes the main char-acteristics of this bedside teaching.

A central coordination for the program hasbeen organized, under the responsibility of amotivated, clinical professor. Then, a teachingimprovement plan was designed which in-cludes characteristics such as an active super-

Table 1Teaching methodology in the psychiatry courses.

– One full academic course per year, 9 UZ credits; 6.4 ECTS credits

– Two hours/week for classes/seminars

− 50% lectures/50% clinical cases seminars

– “Innovative Teaching Plan” for students (I.T.P.)

– Weekly session with I.T.P. student leaders

– “Small Groups” (SG) (n = 4 students) with I.T.P. leader in seminars

– One research project by SG and I.T.P. leader.

vision by tutors, with the students having on-line access; systematic meetings with students;specific supervision in taking the psychiatrichistory and one -to -one supervision by clini-cal professors throughout the clerkship.

Trainee performance has been assessed bythe marks in the final examination, and theMedical Teaching Quality Questionnaire(MTQQ)11 was used to document trainee sat-isfaction. We originally developed the MTQQ


to capture the student’s perception of salientaspects of teaching practices. It contains five-point, Likert-type items related to the subjectmatter; to the teaching method; and to theactual stimulation of research interest. Per-formance of teachers is also assessed, and aglobal satisfaction item is accessible to cap-ture to what extent the course meets the stu-dent’s expectations. The questionnaire alsoinvites the student to answer open questionsabout “the two most positive” and “the twomost negative” aspects of the course. Relia-bility of the MTQQ was considered to be“good to excellent” (Cronbach’s alfa coeffi-cient was 0.865; and test-retest kappa W was0.655 (I.C. 99% 0.562-0.748); and constructvalidity was also supported11.

All participating students completed ano -nymously the MTQQ in the last week of tea -ching. The questionnaires were then placed ina sealed envelope, under the custody of teach-ers and students’ course representatives, to beopen after the official marks were made pub-lic by the University officials. The results ofthe academic courses 2007-08 through 2011-12 with available assessments, and corres -

pon ding to one of the two groups in the class,are presented in this report.

MTQQ items were treated separately for thestatistical analysis. Scores in each item havebeen combined into three categories, positiveresults or “above average” (AA: “high” or“very high”), “average” (“middle”) and “be-low average”. Descriptive, summary statisticsare presented as frequencies and percentagesfor discrete variables, and means and stan-dard deviations for continuous variables.

Results

External psychiatric professors from dif-ferent medical schools have been consulted atdifferent points in this process. They supportthe idea that the content of the course, wasadequate. Eight hundred and thirty eightmedical students have completed the learningcourse in the study period, and 418 (one ofthe two groups) completed the evaluationwith the MTQQ.

Table 2Bedside teaching of psychiatry: the philosophy.

– Central coordination by motivated, clinical professor

– Teaching improvement plan

+ Tutor and personalized supervision (and online access)

+ Systematic meetings with students

+ Annual dossier by coordinator

+ Plan to cover incidences of teachers

+ Specific supervision of psychiatric history by tutors

Operational criteria for assessment

+ One to one supervision by clinical professors throughout the clerkship

+ Voluntary, summer clinical practices for students


Most students (85% - 92%) took the firstround of the final examination each year, and93-95%of them passed the examination. Highmarks, “outstanding” marks (9.0 or mo re,maximum 10 points) were obtained through-out this experience by 30% – 33% of medicalstudents, including among them 21 studentswith “honors”.

In relation to satisfaction, figure 1 showsthat more than three quarters the studentsscored above average (AA: “high” or “veryhigh”) the relevance of this subject for medicaltraining, its usefulness for physicians or thequality of the scientific information provided,and the usefulness of the clinical cases wasrated particularly high, with more than 90%

Figure 1. Assessment by medical students of the relevance and quality of contents in five consecutive academiccourses of psychiatry. Mean scores in Medical Teaching Quality Questionnaire MTQQ.

scoring in those categories. Medical studentsconsidered the degree of difficulty of the sub-ject was not particularly high, since only onethird of them scored in the same categories.

In relation to the quality of the teachingmethods, figure 2 shows that the technicalmastery and the preparation of lectures wererated very favourably by medical students,since both items were rated “high” or “veryhigh” (AA). “Clarity in teaching” was alsorated in those categories by more than 2/3rdsof students, but the study of bibliographicalmaterial was not so favourable, since only¼th rated “high” or “very high”.

In relation to innovative teaching methods,“enhancement of a researcher’s mind” wasrated “high” or “very high” (AA) by 1/3rd ofmedical students, and the remainder rated “mid-dle” (average). The usefulness of the continuedevaluation, with the assessment and tests per-formed in the classroom, in regular teachinghours, was rated in the high categories by morethan 2/3rds the medical students.

The utility of the yearly evaluation of thequality of teaching methods was tested by ob-serving the results in items rated not verypositive in the first evaluation. Figure 4 showsthe results of this longitudinal assessment in


relation to the “the clarity in teaching”. Itshows favorable results, since the proportionof students rating “very high” this item startsin a rather low proportion in the academiccourse 2007/08 (below 20%). With this in-formation coming from the enquiries, theteachers face somehow the situation and areable to show an improvement, so that the pro-portion of “very high” ratings increases gra -

dually to above 40% in the academic course2011/12.

Similarly, the utility of the yearly evalua-tion of the quality of teaching methods hasalso been tested in relation to the approach toenhance a researcher’s mind. Figure 5 showsthe results of this longitudinal assessment,also showing favorable results: the proportion

Figure 2. Assessment by medical students of the quality of teaching methods in five consecutive academiccourses of psychiatry. Mean scores in Medical Teaching Quality Questionnaire MTQQ.

Figure 3. Assessment by medical students of innovative teaching methods in five consecutive academiccourses of psychiatry. Mean scores in Medical Teaching Quality Questionnaire MTQQ.

Items


Figure 5. Progress in positive scores of medical students in assessing the approach to enhance a researcher’s mind.Mean scores in Medical Teaching Quality Questionnaire MTQQ.

Figure 4. Progress in positive scores of medical students in assessing the clarity in teaching.Mean scores in Medical Teaching Quality Questionnaire MTQQ.


of students rating “high” or “very high” (AA)this item starts in a low number in the acad-emic course 2007/08 (approximately 25%).Then, the teachers face somehow the situa-tion and are able to show a gradual improve-ment, so that the proportion of the same rat-ings goes up to 2/3rds of students in theacademic course 2011/12.

The MTQQ has also been used to asses thestudents’ satisfaction with the bedside teach-ing during the last academic course in thestudy period. All students (n = 198) in theclass completed this part of the study. Moststudents (87%) rated “high” or “very high”(AA) this item in the questionnaire.

Among “the two most positive” aspectsof the course, the students indicated mostfrequently the relevance of the subject and thediscussion of clinical cases in small groupsfollowed by the general discussion. Simi-larly, they had an exceptional, positive viewof the bedside teaching.

Discussion

As most previous medical education re-search, this study has focused on the assessmentof trainee performance and trainee satisfac-tion12, frequently used sources of informationentering into the academic decision-makingprocess13. Our research has found supportfor the initial conjecture that the rather orig-inal method implemented for the training ofmedical students in general psychiatry is ben-eficial for both the final results of examina-tions in this subject and for the students’ sat-isfaction.

The performance of trainees in this partic-ular course was quite positive, since the greatmajority passed the first round of the final ex-amination, and a considerable proportion wasawarded high marks. These results comparefavourably with other medical subjects in thesame academic years (information from themedical school). The fact that most students

Figure 6. Assessment of the medical students’ satisfaction with the bedside teaching.Mean scores in Medical Teaching Quality Questionnaire MTQQ.

rated the course as “no-difficult” (2/3rds)may partially explain the positive results.

In relation to the students’ satisfaction, mostitems in the sections of relevance of the cur-riculum for a general physician; quality of theteaching methods; or specific methods such asthe use of continued evaluation in the standardclasses, were all rated very positively. The en-hancement of the student-teacher interactionhas also been rated positively in the final, openquestions, and may merit special attention,since the desirability of this interaction hasbeen supported in different studies14,15.

This report further documents that the in-clusion of clinical cases in the teaching sem-inars was most favourably valued by the stu-dents. In fact, methods of teaching with casesare receiving increasing support16, and havebeen used to advance deeper learning in med-ical fields17. Our approach is quite similar inthis respect to the valued method of prob-lem-based learning (PBL)18. We believe thismethod is also quite appropriate for learningclinical reasoning, particularly when the casesare worked-out in small groups under theleadership of specially trained medical stu-dents and the maintained supervision of theprofessor19.Clinical reasoning is considered tobe a crucial aspect of medical training20.

We have also documented in this studythe positive ratings of teachers’ performanceby the medical students. This may explain inpart the student’s general satisfaction, sinceapproval by students has been documented tobe highly related to the teachers’ perfor-mance21. Other aspect considered to be pos-itive in this course is the inclusion of avail-able, voluntary summer practices in clinicalwork22. Moreover, we believe part of the stu-dents’ satisfaction may be related to our com-mitment to teach especially on the recogni-tion and treatment of those common mentaldisorders that they will have to face fre-

quently in their medical practice. This makessense to them, obviously, and has been em-phasized as one of the goals in the future ofmedical education23.

An important aspect in the course is cer-tainly the bedside teaching. In relation tothis, the appointment as coordinator of ahighly motivated, clinical professor (RC) hasbeen crucial to promote the plan; and to stim-ulate a personalized supervision. We con-sider the very positive rating in this section isquite remarkable, particularly because thetime allotment for bedside teaching, a 4-weekclerkship, is limited, and the supervisors areparticularly burdened with clinical care. Aspecial consideration in the bedside teachingwas given to the improvement in the abilityof students to collect psychiatric histories, animportant aspect of medical training18.

The positive rating in “enhancing a re-searcher’s mind” merits emphasis, since in-novation and research is certainly crucial inMedicine. It is quite remarkable that the stu-dents were able to produce original researchprotocols, with only limited training, althoughwe have previously documented similar resultsin Psychosomatic Psychiatry9. As we havepreviously suggested, an explanation to thisperformance may be related to the high qual-ity of medical students in countries such asSpain, where the acceptance in medicalschools requires very high marks (http://wzar.unizar.es/servicios/acceso/admisgrado/corte/grados11-12.pdf). However, we believe it alsorelates to the clear message sent to traineesabout the relevance of research, and the com-mitment to stimulate the initiative and the po-tential of such bright students. Research ac-tivity is not a mandatory component ofme dical education in Spain, and similarly inother countries, although some previous re-ports underlie the fact that most students areinterested in research and complain of thelack of institutional incentive24.


Contrary to the positive aspects, most stu-dents rated low initially the items related to“out of classroom” (not in-person) work withbibliography material. While this type ofstudy is valued by the teachers, particularlyaiming at continuous, post-graduate educa-tion, it seems obvious that changes in thismethodology had to be introduced shouldthe objective be to make it more attractive forthe students. On the bases of this observation,we modified the teaching method, with somepositive results. Similarly, we show in thisstudy that it was possible to improve the stu-dents’ satisfaction in relation to the “clarity”of lectures, by modifying the method in thefollowing courses once we were aware ofthe unsatisfactory results. This observationsupports the importance of this type of re-search, since weak aspects of the teachingmethod may be identified so that remedial ac-tion can be implemented.

Among the strengths of the study we in-clude the use of a reliable and valid assessmentinstrument and the longitudinal design, with afive-year evaluation. We also value the innov-ative method introduced by training I.T.P. stu-dents as leaders in the SGs, and also in the de-velopment of the original research designs.Students responses to the final, open questionsin the MTQQ support this interpretation.

Limitations in the study should also be ad-dressed. First, the results in one medicalschool, although it is rather typical in Spain,may not be generalizable, and the methodsshould be implemented elsewhere before theyhave more general acceptance. And second,it has been shown that medical students maybe only moderately consistent in the extent towhich they evaluate teachers, and the incon-sistency may vary by course and by teacherswithin the courses13. However, this potentialbias is minimized in this study, because dif-ferent academic courses were assessed andresults were consistent.

Few other subjects may be addressed,looking at the future. The teaching of specificareas of psychiatry, such as child and ado-lescent psychiatry25, competent psychophar-macology26, community psychiatry27 or sub-stance abuse8 may need a more detailedanalysis. We are particularly interested in thepotential role of trainees as clinical teachersof medical students in psychiatry28; and arealso supportive of the need to try to homog-enize the core curricula across medicalschools23. Finally, we are also convinced, asour teachers McHugh and Slavney29, thatteaching psychiatry may provide notablepleasure and lasting satisfaction30.

In conclusion, the conjectures about theadvantages of our method in teaching psy-chiatry for medical students are supported bythe results presented and discussed. In view ofthe positive assessment of this course, thisstudy also may draw lessons to inform med-ical teachers about efficient and effective waysof teaching and learning psychiatry.

Co-authors

H. Salvador-Rosés, L.Lobo-Escolar, M.J.Pérez Echevarría, M. Cortina, J. Civeira, J.L.Día, J. García Campayo, I. Irigoyen, A. PérezPoza, M.A. Quintanilla, P. Ruiz, C. Sanz, M.Velilla, M.A. Zapata.

Acknowledgements

Special recognition should be given to thefollowing medical students who did excellentwork as the leaders of small groups in the“Innovative Teaching Plan” (ITP): H. Sal-vador-Rosés, L. Lobo Escolar, E. Esparza


Isasa, L. Gil Melgosa, F. Fuentes Gorgas, A.Lambea Gil, B. Apellániz Aparicio, G. PírezMora, H. López Mendoza, M.E. Calvo Co-tado, Z. Carrillo López, M. Marco Brualla, I.Abadías Granados, H. Arasanz Esteban, I.Hernández Aragüés, J.A. Delgado Domingo,M. González Sierra, B. Gros Alcalde.

References

1. Platt L. Medical science: Master or servant? Br Med J.1967; 4(5577): 439-44.

2. Kelly B, Raphael B, Byrne G. The evaluation of teach-ing in undergraduate psychiatric education: Students’ atti-tudes to psychiatry and the evaluation of clinical compe-tency. Med Teach. 1991; 13(1): 77-87.

3. Levine RE, O’Boyle M, Haidet P, Lynn DJ, Stone MM,Wolf DV, Paniagua FA. Transforming a clinical clerkshipwith team learning. Teach Learn Med. 2004; 16(3): 270-5.

4. Castle D, Sanci L, Hamilton B, Couper J. Teaching psy -chiatry to undergraduates: Peer-peer learning using a “GPletter”. Acad Psychiatry. 2014; 38(4): 433-7.

5. Goerg D, De Saussure C, Guimón J. Objectives for theundergraduate teaching of psychiatry: Survey of doctorsand students. Med Educ. 1999; 33(9): 639-47.

6. Lyons Z. Attitudes of medical students toward psychi-atry and psychiatry as a career: A systematic review. AcadPsychiatry. 2013; 37(3): 150-7.

7. Halperin PJ. Psychiatry in Medicine: Five years of ex-perience with an innovative required fourth-year medicalschool course. Acad Psychiatry. 2006; 30(2): 120-5.

8. Kothari D, Gourevitch MN, Lee JD, Grossman E,Truncali A, Ark TK, Kalet AL. Undergraduate medical ed-ucation in substance abuse: A review of the quality of the lit-erature. Acad Med. 2011; 86(1): 98-112.

9. Lobo A, Campayo A, de-la-Cámara C, Saz P, Salva dorH, Lobo-Escolar L, López-Mendoza H, Pírez G, Calvo ME,Ventura T, Lobo E, Marco C. The teaching of liaison psy-chiatry. J Psychosom Res. 2012; 72(6): 457-9.

10. Lobo A. Manual de Psiquiatría. Editorial MédicaPanamericana. Madrid. 2013.

11. Saz P, Campayo A, Lobo E, Aguilar E, De-La-FuenteS, Lobo A. Psychometric properties of a teaching evaluationquestionnaire for an Academic Psychiatric Area. EducaciónMédica. 2007; 10(2): 121-126.

12. Prystowsky JB, Bordage G. An outcomes researchperspective on medical education: The predominance oftrainee assessment and satisfaction. Med Educ. 2001; 35(4):331-336.

13. West RF. The short-term stability of student ratings ofinstruction in medical school. Med Educ. 1988; 22(2): 104-12.

14. Young L, Orlandi A, Galichet B, Heussler H. Effec-tive teaching and learning on the wards: Easier said than do -ne. Med Educ. 2009; 43(8): 808-17.

15. Jaarsma AD, Dolmans DD, Muijtjens AM, Boer-boom TT, van Beukelen P, Scherpbier AJ. Students’ andteachers’ perceived and actual verbal interactions in seminargroups.Med Educ. 2009; 43(4): 368-76.

16. Boehrer J, Linsky M. Teaching with Cases: Learningto Question. In M.D. Svinicki (ed.). The Changing Face ofCollege Teaching. New Directions for Teaching and Learn-ing, 42. San Francisco: Jossey-Bass, 1990.

17. Zimmerman SD, Lester Short GF, Hendrix EM. Im-pact of interdisciplinary learning on critical thinking usingcase study method in allied health care graduate students. JAllied Health. 2011; 40(1): 15-8.

18. Schäfer M, Georg W, Mühlinghaus I, Fröhmel A,Rolle D, Pruskil S, Heinz A, Burger W. [Experience withnew teaching methods and testing in psychiatric training].Nervenarzt. 2007; 78(3): 283-4, 287-90, 292-3.

19. Harris A, Boyce P, Ajjawi R. Clinical reasoning ses-sions: Back to the patient. Clin Teach. 2011; 8(1): 13-6.

20. Schatte DJ, Piemonte N, Clark M. “I Started to FeelLike a ‘Real Doctor’”: Medical Students’ Reflections onTheir Psychiatry Clerkship. Acad Psychiatry. 2015.

21. Schüppel R, Gatter J, Hrabal V. Teaching psychoso-matic medicine: Predictors of students’ attitudes toward acompulsory course. J Psychosom Res. 1997; 42(5): 481-4.

22. Black ML, Curran MC, Golshan S, Daly R, Depp C,Kelly C, Jeste DV. Summer research training for medical stu-dents: Impact on research self-efficacy. Clin Transl Sci.2013; 6(6): 487-9.

23. Thomas S, Pai N, Dawes K, Wilson C, Williams V.Updating medical school psychiatry curricula to meet pro-jected mental health needs. Australas Psychiatry. 2013;21(6): 578-82.

24. De Oliveira NA, Luz MR, Saraiva RM, Alves LA.Student views of research training programmes in medicalschools. Med Educ. 2011; 45(7): 748-55.

25. Hunt J, Barrett R, Grapentine WL, Liguori G, TrivediHK. Exposure to child and adolescent psychiatry for med-ical students: Are there optimal “teaching perspectives”?Acad Psychiatry. 2008; 32(5): 357-61.



26. Gardner DM. Competent psychopharmacology. CanJ Psychiatry. 2014; 59(8): 406-11.

27. Abed R, Teodorczuk A. Danger ahead: Challenges inundergraduate psychiatry teaching and implications forcommunity psychiatry. Br J Psychiatry. 2015 Feb; 206(2):89-90.

28. Hickie C, Nash L, Kelly B. The role of trainees asclinical teachers of medical students in psychiatry. Austra -las Psychiatry. 2013; 21(6): 583-6.

29. McHugh, P.R. and Slavney, Phillip R. The Educationof Psychiatrists. In: New Oxford Textbook of Psychiatry,Gelder, M.G., Lopez-Ibor, J.J., Andreasen, N. (Eds.), OxfordUniversity Press, 41-47, 2000.

30. Yager J. Personal reflections on a life of learning andteaching psychiatry. Int Rev Psychiatry. 2013; 25(3): 357-63.

Corresponding author:Antonio LoboUniversity of ZaragozaDepartment of Medicine and PsychiatryC/ Domingo Miral s/n50009 ZaragozaSpainTel: +34976761713E-mail: [email protected]

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