Spaced learning using emails to integrate psychiatry into general medical curriculum: Keep psychiatry in mind

Abstract

Objectives: Traditionally, medical students on clinical rotations receive instruction on principles of mental health only during the psychiatry clerkship. We used emails to insert teaching of psychiatric concepts beyond the psychiatry clerkship into other rotations using the method of spaced learning, the delivery of brief morsels of information repeated over time intervals. We predicted that the intervention would improve attitudes and confidence towards the integration of psychiatry and knowledge retention.

Methods: We developed and distributed a series of emails relating key psychiatric concepts targeted to the other core clerkships.

Results: In a cluster-randomized trial over one academic year (intervention group n = 71, control group n = 61), scores on the Attitudes and Confidence in the Integration of Psychiatry scale and on the knowledge quiz did not differ significantly. Students who actively engaged with the emails demonstrated significantly higher scores on the knowledge test. Email users valued the timing, format of delivery and application of psychiatric principles outside the psychiatric setting. Participants recommended simplifying the format and previewing the benefits of spaced learning to increase utilization.

Conclusion: Delivering spaced learning through emails, within a curriculum designed to foster engagement, may provide an efficient means of addressing the widely-recognized but elusive goal of integrating teaching across medical disciplines.

Glossary

Spaced learning: Also known as distributed practice, refers to delivery of brief morsels of information repeated over time intervals, in contrast to massed learning, a bolus of information delivered all at once without breaks.

Xue G, Mei L, Chen C, Lu ZL, Poldrack R, Dong Q. 2011. Spaced learning enhances subsequent recognition memory by reducing neural repetition suppression. J Cognit Neurosci. 23:1624–1633.

Acknowledgements

The authors would like to acknowledge Danny Quirk for the artwork entitled, “Veronica: Piece of Mind,” Janet Kavanagh for design of the email, Claire Stano for coordination and delivery of the emails, and the medical school clerkship directors who supported this study.

Disclosure statement

On behalf of all authors, the corresponding author states that there is no declaration of interest.

Funding information

This study was supported by the Investigating Student Learning and Faculty Development Fund grants, funded by the University of Michigan Office of the Provost and the Center for Research on Learning and Teaching.

Ethical approval

The University of Michigan Health Sciences and Behavioral Sciences Institutional Review Board deemed this project to be exempt from ongoing human subjects review.

Notes on contributors

Mary C. Blazek, MD, MEHP, is a Clinical Assistant Professor of Geriatric Psychiatry at the University of Michigan Medical School. This study comprises the capstone project for completion of the Master of Education in Health Profession at the Johns Hopkins University School of Education.

Bezalel Dantz, MD, is an Assistant Professor of Internal Medicine and Psychiatry at Rush University Medical Center in Chicago, where he is Director of Medical Student Education in Psychiatry.

Mary C. Wright, PHD, is Director of Assessment and an Associate Research Scientist at the Center for Research on Learning and Teaching (CRLT), University of Michigan.

Jess G. Fiedorowicz, MD, PHD, is an Associate Professor in Psychiatry, Epidemiology, and Internal Medicine at the University of Iowa, where he serves as the Associate Psychiatry Clerkship Director and Director of the Psychiatry Electives. He researches the primary causes of excess mortality in those with mood and related disorders.