Asad Ghiasuddin1, Selene Luk2, Earl Hishinuma1, Himal Shrestha1, Allison Lawler3. 1. Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Hawaii, USA. 2. Staff Psychiatrist, State of California, Division of Juvenile Justice, Sacramento, California, USA. 3. Medical Student, Chicago Medical School, North Chicago, Illinois, USA. E-mail: ghiasuddina@dop.hawaii.edu.
Sir,A perennial goal of medical educators worldwide is to be able to capture the interest and enthusiasm of their trainees while at the same time imparting valuable clinical lessons. To this end, film has been used in psychiatric training for many years to demonstrate psychopathology in a memorable fashion.[1] More recently, problem-based learning (PBL) has gained momentum in medical curricula as a way to encourage active learning and to foster the application of concepts to clinical situations.[23]Here, we describe a small prospective pilot study, which combined the use of film with PBL, as a teaching innovation in child psychiatry training. Our hypothesis was that the film would generate lively and educational discussion related to child development, social welfare, and cross-cultural psychiatry.[4]The sample consisted of all available Child and Adolescent Psychiatry fellows (n = 5) from University of Hawaii, Department of Psychiatry (“fellows” are physicians who have already completed medical school and general psychiatry residency, and are in their final 2 years of subspecialty training).The documentary “Marathon Boy” (the story of a 4-year-old boy rescued from the slum who becomes a long distance running sensation, and his adoptive father, an operator of an orphanage for slum children in Orissa) was used as “case” material. The documentary follows the child through various stages of development till age 10 years, illustrating a variety of clinical material along the way.The instructional format for PBL was: Group discussion of pertinent facts from the “case,” formulating and refining hypotheses about diagnoses and treatments, and generating learning issues.An anonymous evaluation form was given to all trainees after the sessions, assessing the quality of the discussion, comparison to other teaching methods, and overall engagement.The fellows uniformly felt the instructional format stimulated good discussion related to social issues in child development, the impact of competition and athletics in youth and cross-cultural child psychiatry. In addition, the fellows felt that the experience was enjoyable, as well as comparable to a written PBL case.Open-ended responses from the trainees emphasized that the compelling nature of the documentary enhanced the learning experience. Suggestions for future sessions included having more time for discussion, and using the film earlier in their training.Limitations of the study include: (1) Small sample size, (2) no direct comparison of the film to a written case, (3) lack of a formal evaluation tool, and (4) no direct measure of material learned (i.e., pre- and post-testing of the fellows knowledge).Despite limitations, this small pilot study demonstrates the feasibility of utilizing film in a PBL format for childpsychiatric training. Future directions may include having one group of trainees view the film while another group reads a paper case and compare experiences.Given the wide range of topics covered in the movie, this film and format could be duplicated in training programs around the world. It could also be shown to medical students to increase interest in the field of child psychiatry.