Determination and Documentation of Insight in Psychiatric Inpatients In written evaluations of psychiatric patients, many residents and attending psychiatrists include little nuance or detail on the insight component of the mental status examination. A review of initial psychiatric evaluations and progress notes shows that insight, often in a combined item listed as “Insight/Judgment,” is frequently described as “poor,” “fair,” “limited,” “improving,” etc.
Are We Training Physicians to Be Shift Workers? During residency training, young doctors learn the requisite skills, knowledge, and values essential to the practice of medicine. We will all agree that to learn, the resident must have the desire and drive to master the essential knowledge and skills of his or her specialty.
The Psychiatric ER Survival Guide The psychiatric emergency room (ER) is an intense, stressful work environment where psychiatrists must perform rapid assessments and make swift treatment decisions. During psychiatry residency training, the ER provides critical experience that helps sharpen resident’s diagnostic and interview skills, as well as enhance their overall clinical confidence.
Working With Physicians in the Emergency Department Time is a vanishing resource that shapes our collaboration with colleagues in emergency medicine.1 These colleagues evaluate more patients in less time, because the number of emergency department (ED) visits has increased an average of 20% from the early 1990s to the most recent decade, and the number of EDs has decreased by more than 10% in the same period.2,3 Our emergency medicine colleagues have also noticed that psychiatric cases constitute a growing portion of their caseload.4 This suggests that psychiatrists who consult in an ED have to do more with less among personnel who are already strained.