The Use of Health Care and Community-Based Services by People Living With Dementia and Their Caregivers During the COVID-19 Pandemic.

IntroductionPeople living with dementia have been particularly affected by the COVID-19 pandemic.MethodsA survey of dementia care professionals was conducted to assess the use of health care and community-based services by people living with dementia and their caregivers during the first year of the pandemic.ResultsThe survey indicated that most services were no longer being used or were being used less during the pandemic, with a few key exceptions.DiscussionMany barriers and few facilitators were identified to service use for people living with dementia and their caregivers. The results identify potential gaps in the dementia care service network and may inform efforts to improve dementia care during future large-scale public health emergencies in the state of Wisconsin and beyond

Growing the Psychiatry Workforce Through Expansion or Creation of Residencies and Fellowships: the Results of a Survey by the AADPRT Workforce Task Force.

ObjectiveThe USA needs to produce more psychiatrists to meet projected workforce deficits. The American Association of Directors of Psychiatric Residency Training Directors (AADPRT) sought to examine opportunities for and obstacles to expanding or creating residencies and fellowships.MethodsIn November 2019, the authors conducted a survey of residency and fellowship directors. The survey gathered information about new positions, new programs, participation in interprofessional education, and loss of residency or fellowship positions.ResultsThe survey was distributed to psychiatry residency (N=231) and fellowship (N=194) directors, with a response rate of 33.4%. One quarter of responding residencies and fellowships reported creating new programs; 24.7% of residency and 17.5% of fellowships reported expansion. The most common reason to develop or expand programs was the shortage of psychiatrists, with the local institution as the most common funding source. Fifty-seven percent reported that they had wanted to expand, but faced barriers, primarily lack of funding. Recruitment and retention of faculty are major challenges. Psychiatry departments frequently (87.5%) participate in interprofessional education, generally perceived as positive. Unfortunately, 15.7% of respondents reported loss of positions or closure of programs.ConclusionsCreating and expanding residencies and fellowships are common strategies for addressing the shortage of psychiatrists. Barriers include lack of funding and challenges recruiting/retaining faculty. The loss of residency/fellowship positions or closure of programs is a worrisome trend

Faculty Development for Teaching Faculty in Psychiatry: Where We Are and What We Need

OBJECTIVE: A Faculty Development Task Force surveyed the American Association of Directors of Psychiatric Residency Training membership to assess faculty development for graduate medical education faculty in psychiatry departments and barriers to seeking graduate medical education careers. METHODS: An anonymous Survey Monkey survey was emailed to 722 American Association of Directors of Psychiatric Residency Training members. The survey included questions about demographics, the current state of faculty development offerings within the respondent\u27s psychiatry department and institution, and potential American Association of Directors of Psychiatric Residency Training faculty development programming. Two open-response questions targeted unmet faculty development needs and barriers to seeking a career in graduate medical education. Results were analyzed as frequencies and open-ended questions were coded by two independent coders. We limited our analysis to general psychiatry program director responses for questions regarding faculty development activities in an attempt to avoid multiple responses from a single department. RESULTS: Response rates were 21.0% overall and 30.4% for general program directors. General program directors reported that the most common existing departmental faculty development activities were educational grand rounds (58.7%), teaching workshops (55.6%), and funding for external conference attendance (52.4%). Of all survey respondents, 48.1% expressed the need for more protected time, 37.5% teaching skills workshops, and 16.3% mentorship. Lack of funding (56.9%) and time (53.9%) as well as excessive clinical demands (28.4%) were identified as the main barriers to seeking a career in graduate medical education. CONCLUSIONS: Despite increasing faculty development efforts in psychiatry departments and institutions, real and significant unmet faculty development needs remain. Protected time remains a significant unmet need of teaching faculty which requires careful attention by departmental leadership

Implementation of the AAMC\u27s holistic review model for psychiatry resident recruitment

Introduction: In psychiatry, several converging factors are impacting the recruitment of residents: the increased competitiveness of the specialty, the national trend to take active steps to improve diversity and inclusion, and the decision from USMLE to change Step 1 to a pass/fail result. Methods: We developed a workshop for psychiatry residency program directors to meet these challenges and transition into using a holistic review model during recruitment. The workshop included (1) a didactic session providing background on the AAMC holistic review model; (2) a small-group exercise to determine and prioritize experiences, attributes, competencies, and metrics (EACMs) aligned with the program\u27s mission and aims; (3) a review of the rankings from the previous exercise, selection of two very important criteria for each of the four domains of the EACM model, and operationalization of these criteria based on the recruitment process; and (4) a discussion focused on application of program criteria with example applicants. Results: The holistic review workshop was conducted at the American Association of Psychiatry Residency Directors conference in 2021 with 48 self-selected attendees. Following the workshop, 74% of attendees reported a likelihood of implementing holistic applications during their next application cycle, 78% were able to leave with at least one actionable item, 100% thought that the session was interactive, and 78% felt that the session met their expectations. Discussion: Implementing a holistic review for psychiatry residency recruitment can assist programs in responding to the rapidly changing landscape and achieve aims for improving diversity and inclusion

Training professional caregivers to screen for report of cognitive changes in persons with intellectual disability

Abstract Introduction By age 60, 60% of adults with Down syndrome (DS) have dementia. Detecting dementia in persons with intellectual disability (ID) can be challenging because their underlying cognitive impairment can confound presentation of dementia symptoms and because adults with ID may have difficulty reporting symptoms. The National Task Group Early Detection Screen for Dementia (NTG‐EDSD) was developed to aid detection of report of cognitive impairment in adults with ID. We implemented an educational curriculum using the NTG‐EDSD and evaluated the impact of the intervention on professional caregivers’ self‐assessed capacity to identify persons with ID and dementia. Methods We held five in‐person training sessions for professional caregivers of persons with ID, partnering with various managed care organizations and social services agencies. We assessed knowledge and attitudes at baseline; immediately after training; and 1 week, 1 month, and 6 months after training. Results A total of 154 direct care workers, case managers, health‐care providers, and other social services staff attended the trainings. Satisfaction with the NTG‐EDSD training was high; 94% of attendees agreed or strongly agreed that they could use the NTG‐EDSD with their clients. After training, attendees reported a marked increase in confidence in their ability to track various health circumstances and detect functional decline in their clients, although some gains were not sustained over time. As a result of the training, one managed care organization made the NTG‐EDSD a standard part of its assessment of adults with DS starting at age 40. Discussion Social services and health‐care professionals can learn to document signs of cognitive decline in adults with ID using the NTG‐EDSD. Attendees were highly satisfied with the training, experienced an increase in confidence in their care of persons with ID, and found the NTG‐ EDSD feasible to use. Because not all gains were sustained over time, booster trainings may be necessary

Implementation of the AAMC's Holistic Review Model for Psychiatry Resident Recruitment

Introduction: In psychiatry, several converging factors are impacting the recruitment of residents: the increased competitiveness of the specialty, the national trend to take active steps to improve diversity and inclusion, and the decision from USMLE to change Step 1 to a pass/fail result. Methods: We developed a workshop for psychiatry residency program directors to meet these challenges and transition into using a holistic review model during recruitment. The workshop included (1) a didactic session providing background on the AAMC holistic review model; (2) a small-group exercise to determine and prioritize experiences, attributes, competencies, and metrics (EACMs) aligned with the program's mission and aims; (3) a review of the rankings from the previous exercise, selection of two "very important" criteria for each of the four domains of the EACM model, and operationalization of these criteria based on the recruitment process; and (4) a discussion focused on application of program criteria with example applicants. Results: The holistic review workshop was conducted at the American Association of Psychiatry Residency Directors conference in 2021 with 48 self-selected attendees. Following the workshop, 74% of attendees reported a likelihood of implementing holistic applications during their next application cycle, 78% were able to leave with at least one actionable item, 100% thought that the session was interactive, and 78% felt that the session met their expectations. Discussion: Implementing a holistic review for psychiatry residency recruitment can assist programs in responding to the rapidly changing landscape and achieve aims for improving diversity and inclusion

Effectively training dementia care specialists and other dementia professionals on using the DICE ApproachTM with caregivers to improve the management of behavioral and psychological symptoms of dementia

Introduction: Most persons living with dementia will exhibit at least one behavioral or psychological symptom of dementia (BPSD) (Kales, et al., 2015). As brain pathology progresses, challenging behaviors can increase in frequency and severity, causing an increase in caregiver stress and burden. Furthermore, BPSD can result in unplanned hospitalizations and unnecessary use of psychotropic medications. Non‐pharmacological management of BPSD should be the first line of treatment. The DICE (Describe, Investigate, Create, Evaluate) ApproachTM was developed by experts from the University of Michigan and John Hopkins University, to help caregivers learn how to identify and manage BPSD. This project describes a statewide implementation of the DICE approach with community‐based dementia care providers.MethodsFrom September 2017 to April 2020, we held four DICE trainings (three in‐person trainings, one web‐based training) for Dementia Care Specialists (DCSs) and other dementia care professionals who work directly with family caregivers of people with dementia in Wisconsin. We assessed trainees’ knowledge and attitudes from the Dementia Attitudes Scale (DAS) and the Knowledge about Memory Loss and Care test (KAML‐C) at baseline of training, immediately after training, and six months after training. Consultations were provided to address challenging cases.ResultsParticipants (N=136) in both in‐person and online DICE trainings experienced significant changes in knowledge, self‐efficacy and attitudes from baseline to post‐training (immediately after training) assessments (p<.01) (see Table 2 for details). Narrative feedback from trainees was generally very positive. Trainees used DICE with 165 caregivers who were primarily non‐Hispanic white (92%) females (74.4%) from an urban location (68.1%), caring for their spouse (52.7%) (Table 1).Discussion: By using the DICE approach with caregivers of persons with dementia, Wisconsin’s DCSs and other dementia professionals are uniquely positioned to help reduce risks associated with BPSD, including the use of psychotropic medications. Training satisfaction was high, knowledge about BPSD increased, and attitudes improved. The DICE trainings prepared trainees to implement this intervention with 165 family caregivers. A follow‐up survey will explore the real‐world application of DICE, including barriers to its use and modifications made in communities across the state.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/171246/1/alz049782.pd