Section: Module 6: Clinical Skills | Psychiatric Clerkship for Medical Students | NextGenU.org

  • This module provides the learner with a comprehensive overview of clinical skills, including history-taking, examination, medical interviewing, documentation and communication, clinical reasoning, and differential diagnosis and assessment of psychiatric emergencies.

    • Module 6: Lesson 1: History-Taking, Examination, and Medical Interviewing
       

      This lesson provides the learner with resources to effectively and successfully engage in history taking, patient evaluation, and medical interviewing in a culturally competent manner.

       
      Required Learning Resources and Activities
    • url icon
      Medical Assessment of the Patient With Mental Symptoms URL
      Students must
      View

      Read the entire page. (10 minutes)

      MSD Manuals for the Professional - 2020

    • url icon
      Drug-Induced Movement Disorders URL
      Students must
      View

      Read the entire article. (15 minutes)

      Aust Prescr. - 2019

    • url icon
      Etiology, Triggers and Neurochemical Circuits Associated With Unexpected, Expected, and Laboratory-Induced Panic Attacks URL
      Students must
      View

      Read under the headlines: (12 minutes)
      - "Section 2 – Panic Disorder and Panic Attacks: Symptoms, Signs, Diagnostic Criteria (DSM-I through V)"

      Neurosci Biobehav Rev. - 2015

    • url icon
      When Psychiatric Symptoms Reflect Medical Conditions URL
      Students must
      View

      Read the entire article. (26 minutes)

      PMC NIH - 2018

    • url icon
      What Is a Psychotropic Drug? URL
      Students must
      View

      Read the entire article. (15 minutes)

      Healthline  - 2021

    • url icon
      Medical History-Taking in Psychiatry URL
      Students must
      View

      Read the content under the heading from "If you don't ask you'll never know" until "Documentation". (12 minutes)

      Cambridge Core - 2018

    • url icon
      Religion and Spirituality in Clinical Practice URL
      Students must
      View

      Read from Clinical practice until assessments. (12 minutes)

      BJPsych - 2018

    • url icon
      The Mental Status Examination URL
      Students must
      View

      Read the entire document. (15 minutes)

      Brown. Education

    • url icon
      The Mental Status Examination URL
      Students must
      View

      Read the entire article. (20 minutes)

      American Family Physician Journal - 2016

    • url icon
      Screening Tools URL
      Students must
      View

      Read the entire article and explore embeded hyperlinks. (17 minutes)

      PSYCH-MENTAL HEALTH HUB - 2021

    • url icon
      Top Tips to Deal with Challenging Situations: Doctor–Patient Interactions URL
      Students must
      View

      Read the entire article. (27 minutes)

      PMC - 2017

    • url icon
      Development Stages and Methods of Interviewing Children URL
      Students must
      View

      Read the entire document. (21 minutes)

      Warsaw University

    • url icon
      Psychology Interviewing Skills Interviewing Skills for Psychology Undergraduate Students URL
      Students must
      View

      Read the entire article. (22 minutes)

      University of New South Wales - 2021

    • url icon
      Family Assessment Conversations as a Tool to Support Families Affected by parental mental illness: a retrospective review of electronic patient journals URL
      Students must
      View

      Read the entire article. (6 minutes)

      Georgetown University Center for Child and Human Development - 2021

    • url icon
      Interview Techniques URL
      Students must
      View

      Read the following sections: (20 minutes)
      -Issues of Concern
      -Other Issues

      StatPearls [Internet] - 2021

    • url icon
      Mental Status Examination URL
      Students must
      View

      Read the content under the headings from "Introduction" until "Enhancing Health care team outcomes". (33 minutes)

      Stat Pearls - 2021

    • url icon
      Engaging Patients to Improve Quality of Care: A Systematic Review URL
      Students must
      View

      Read the following sections: (34 minutes)
      -background
      -results
      -discussion and conclusion

      BMC Implementation Science - 2018

    • url icon
      Verbal and non-verbal communication skills including empathy during history taking of undergraduate medical students URL
      Students must
      View

      Read the following sections: (10 minutes)
      - Background
      - Discussion
      - Conclusion

      BMC Implementation Science - 2018

    • url icon
      The Use of an Interpreter During a Forensic Interview: Challenges and Considerations URL
      Students must
      View

      Read the following sections: (11 minutes)
      - Working with an Interpreter
      -Standardized intruments and an interpreter
      -conclusion

      ps.psychiatryonline.org - 2017

    • forum icon
      Activity : Self Reflection 1 (100 minutes) Forum
      Students must
      View
      Start discussions: 1

      In this learning activity, you will reflect on your experiences with patient interviews, particularly as it relates to history-taking, examination and medical interviewing. 

      Instructions:

      Step 1: Review 

      Read the required material for this lesson.

      Step 2: Reflect and Respond 

      Reflect on your experience having conducted patient interviews. With a word limit of 300-450 words, you will respond to the following key points :

      • What were some issues/challaanges you encountered when interviewing patients? You can reveiw the LRs “The Interview Research Method” and “Interview Techniques” to help identify any issues.
      • Ways of overcoming language barriers in your setting.
      • Reflect on the strengths and weaknesses of your own interviewing skills in your setting. 
      • Based on your reflection, in your own words, what do you think is the importance of having strong interviewing skills?

      Step 3: Share 

      To share your work, click on the “Add a new discussion topic” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

      Step 4: Interact

      To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner, using the items in this Rubric to guide you. Be sure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas on other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You may use the following as a guide: 

       Item A is  .…. because….  My suggestions for improvement are…. 
       Item B is  .…. because….  My suggestions for improvement are…. 
      Item C is  .…. because….  My suggestions for improvement are….
      Item D is  .…. because….  My suggestions for improvement are….

      OPTIONAL Step 5: Interact (10 minutes)

      If you would like to, you can reply to your peers' posts in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”


    • scorm icon
      Case Study 16: The Case of the challenging interview SCORM package
      Students must
      View
      Receive a grade
      In this activity, you must pass the quiz to be marked as complete, and you will have unlimited attempts to complete it.

    • Recommended Additional Readings

    • url icon
      Cultural Considerations in the Classification of Mental Disorders: Why and How in ICD-11 URL

      Read the entire article. (5 minutes)

      BMC Medicine - 2020

    • url icon
      Interviewing Techniques for Patients with Intellectual Disability URL

      Read the content from Table 2 up to Summary. (11 minutes)

      Journal of Mental Health Disorders - 2021

    • url icon
      Family Assessment Conversations as a Tool to Support Families Affected by Parental Mental Illness: a Retrospective Review of Electronic Patient Journals URL

      Read the following sections: (22 minutes)
      Background
      Discussion
      Conclusion.

      International Journal of Mental Health Systems - 2018

    • url icon
      The Interview Research Method URL

      Read the entire content. (9 minutes)

      Simply Psychology - 2021

    • url icon
      Mental State Examination and Its Procedures—Narrative Review of Brazilian Descriptive Psychopathology URL

      Read the following sections: (19 minutes)
      -Introduction
      -Discussion
      -Conclusion       

      Frontier in Psychiatry - 2019

    • url icon
      Section 6: Strategies for Improving Patient Experience with Ambulatory Care URL

      Read the entire content. (19 minutes)

      Agency for Healthcare Research and Quality - 2017

    • url icon
      Communication skills 3: non-verbal communication URL

      Read the entire content. (10 minutes)

      Nursing Times - 2018

    • Module 6: Lesson 2: Documentation and Communication
       

      This lesson provides the learner with resources to improve their written and oral communication skills by communicating clearly and concisely to other professionals, patients, and their families.

       
      Required Learning Resources and Activities
    • url icon
      How to Keep Good Clinical Records URL
      Students must
      View

      Read the entire content. (19 minutes)

      BREATHE, The respiratory professinals' source for continuing education - 2016

    • url icon
      Guideline Communication with Patients, Family, and the Health Care Team URL
      Students must
      View

      Read entire article. (15 minutes)

      Washington Medical Quality Assurance Commission - 2016

    • url icon
      Psychoeducation an Effective Tool as Treatment Modality in Mental Health URL
      Students must
      View

      Read from section Models of psychoeducation up to conclusion. (13 minutes)

      The International Journal of Indian Psychology - 2017

    • url icon
      Assessment and Management of Risk to Others URL
      Students must
      View

      Read the entire document. (13 minutes)

      Royal College of Psychiatrists - 2016

    • url icon
      Assessing and Supporting Adolescents’ Capacity for Autonomous Decision-Making in Health-Care Settings URL
      Students must
      View

      Read the content on the section "2. Use of the tool" to the final of the document on pages 4-10.  (26 minutes)

      WHO source - 2021

    • scorm icon
      Case Scenario 17: The Case of Psychoeducation SCORM package
      Students must
      View
      Receive a grade
      In this activity, you must pass the quiz to be marked as complete, and you will have unlimited attempts to complete it.

    • Recommended Additional Readings

    • url icon
      Best Practices for Communication with Patients and One Another URL

      Read the entire article. (5 minutes)

      JOHNS HOPKINS Medicine - 2021

    • url icon
      Clinical Practice Guidelines for Psychoeducation in Psychiatric Disorders General Principles of Psychoeducation URL

      Read from section
      -Various types of psychoeducation until "Conclusion."       (16 minutes)

      Indian J Psychiatry - 2020

    • url icon
      Psychoeducation on Anxiety URL

      Watch the entire video. (11 minutes)

      YouTube - 2020

    • url icon
      When Patients Choose to Live at Risk: What is an Ethical Approach to Intervention? URL

      Read from section: Evaluating and assessing risk up to Summary. (9 minutes)

      BC Medical Journal - 2018

    • Students must
      Mark as done
      Module 6: Lesson 3: Clinical Reasoning and Differential Diagnosis
       

      This lesson provides the learner with resources to become skillful at discerning signs and symptoms of psychiatric disorders and formulate reasonable diagnostic hypotheses with plans for further evaluation.

       
      Required Learning Resources and Activities
    • url icon
      Diagnosing and Classifying Abnormal Behavior URL
      Students must
      View

      Read from 3.2.1 Clinical Diagnosis and Classification Systems to 3.2.2.3 DSM 5 Disorder Categories. (12 minutes)

      ESSENTIALS OF ABNORMAL PSYCHOLOGY Washington State University - 2018

    • url icon
      DSM5 URL
      Students must
      View

      Read pages 20-23 of the manual under the headlines "Definition of a Mental Disorder" and "Elements of a Diagnosis" (4 minutes)

      American Psychiatric Association - 2013

    • url icon
      Differential Diagnosis of Mental Health Disorders URL
      Students must
      View

      Read the content from " The Process of Differential Diagnosis" until the end of the page. (9 minutes)

      The Recovery Village Webpage - 2020

    • url icon
      Clinical Assessment URL
      Students must
      View

      Read from " What is Clinical Assessment?" to " Intelligence Testing" (15 minutes)

      Essentials of Abnormal Psychology - Washington University - 2018

    • url icon
      Change In Mental Status URL
      Students must
      View

      Read the entire web page. (11 minutes)

      StatPearls - 2021

    • url icon
      Neuropsychological Evaluations in Adult URL
      Students must
      View

      Read the entire article. (21 minutes)

      American Family Physician Journal - 2019

    • scorm icon
      Case Study 18 : Developing a case-specific Differential Diagnosis SCORM package
      Students must
      View
      Receive a grade
      In this activity, you must pass the quiz to be marked as complete, and you will have unlimited attempts to complete it.

    • Recommended Additional Readings

    • url icon
      Diagnosing and Classifying Mental Disorders URL

      Read the content under the heading " until "Overview of the Major Disorder categories". (11 minutes)

      Lumen Abnormal Psychology 

    • url icon
      Diagnosis and Classification Issues: DSM-5 and More URL

      Read from pages 151 to 156.

      2019

    • url icon
      Medical Assessment of the Patient With Mental Symptoms URL

      Read the entire webpage. (10 minutes)

      MSD Manual - 2020

    • Module 6: Lesson 4: Assessment of Psychiatric Emergencies
       

      This lesson provides the learner with resources that allows one to recognize potential psychiatric emergencies, perform risk assessments, evaluate the patient, and initiate an appropriate intervention for patients with altered mental status, behavioral dyscontrol, and potential assaultive behavior.

       
      Required Learning Resources and Activities
    • url icon
      Risk Factors for Serious Suicide Attempts: Difference Between Older and Younger Attempters in the Emergency Department URL
      Students must
      View

      Read the content under the heading " Introduction" "Discussion" and "Conclusion". (15 minutes)

      Frontiers in Psychiatry - 2021

    • url icon
      Suicide Risk Assessment Toolkit URL
      Students must
      View

      Read pages 7-11 of the document. (12 minutes)

      Mental Health Commission of Canada - 2021

    • url icon
      Psychiatric Emergencies: Assessing and Managing Suicidal Ideation URL
      Students must
      View

      Read from section "Management Goals" until section "Future considerations/Summary." (31 minutes)

      HHS Public Access - 2017

    • url icon
      Risk and Protective Factors: Violence Prevention URL
      Students must
      View

      Read entire webpage. (4 minutes)

      CDC - 2020

    • url icon
      Management of the Violent Patient in the Emergency Department URL
      Students must
      View

      Read the following sections:
      -Cues
      -Evaluation and Diagnostic Studies
      -Table 2: Diagnostic Consideration.       (4 minutes)

      Emergency Medicine Reports - 2017

    • url icon
      De-escalating Violence in Health Care URL
      Students must
      View

      Read pages 39-42. (7 minutes)

      Sigma Theta Tau International Honor Society of Nursing - 2020

    • url icon
      Violent Patients URL
      Students must
      View

      Read from "Evaluation" to the end. (13 minutes)

      NCBI - 2021

    • url icon
      DSM5 URL
      Students must
      View

      Read pages 742-744 Clinician-Rated Dimensions of Psychosis Symptom Severity

      Read all the Diagnostic criteria from pages 90-118 (30 minutes)

      To access this book you must follow the instructions provided on the link below: LINK

      Important note: Take into account that at some point some of the 3 copies are not available and are in use. During this time, you will not be able to access a copy of the DSM-5, if so, please wait a moment and try to access the book later.

      American Psychiatric Association - 2013

    • url icon
      Canadian Guidelines for the Assessment and Diagnosis of Patients with Schizophrenia Spectrum and Other Psychotic Disorders URL
      Students must
      View

      Read section "Results". (18 minutes)

      Canadian Journal Psychiatry - 2017

    • url icon
      DSM5 URL
      Students must
      View

      Read all the contents on pages 593-595. (10 minutes)

      To access this book you must follow the instructions provided on the link below: LINK

      Important note: Take into account that at some point some of the 3 copies are not available and are in use. During this time, you will not be able to access a copy of the DSM-5, if so, please wait a moment and try to access the book later.

      American Psychiatric Association - 2013

    • url icon
      Twelve Tips for Assessing and Managing Mild Cognitive Impairment and Major Neurocognitive Disorder in Older People URL
      Students must
      View

      Read entire article. (22 minutes)

      BC Medical Journal - 2017

    • url icon
      Adult Acute Psychiatric Inpatient Hospitalization URL
      Students must
      View

      Read the entire article. (6 minutes)

      Community Behavior Health - 2017

    • url icon
      Psychiatric Acute Day Hospital as an Alternative to Inpatient Treatment URL
      Students must
      View

      Read the following sections: (24 minutes)
      -Introduction
      -Discussion 
      -      Conclusion.

      Front. Psychiatry - 2020

    • url icon
      Risk factors of hospitalization for any medical condition among patients with prior emergency department visits for mental health conditions URL
      Students must
      View

      Read the following sections: Abstract, Introduction, Discussion, and Conclusion. (16 minutes)

      BMC Psychiatry - 2020

    • url icon
      Physical Restraint URL
      Students must
      View

      Read pages 2-7. (15 minutes)

      Mental Health Act 2016, Australia - 2016

    • url icon
      The Pharmacological Management of Agitated and Aggressive Behaviour: A Systematic Review and Meta-Analysis URL
      Students must
      View

      Read the following sections: Introduction, Results, Discussion, and Conclusion. (21 minutes)

      European Psychiatry - 2019

    • url icon
      DSM-5 URL
      Students must
      View

      Read the following section on pages 483-486. (10 minutes)
      - Features
      - Substance Intoxication and Withdrawal

      To access this book you must follow the instructions provided on the link below: LINK

      Important note: Take into account that at some point some of the 3 copies are not available and are in use. During this time, you will not be able to access a copy of the DSM-5, if so, please wait a moment and try to access the book later.

      American Psychiatric Association - 2013

    • url icon
      Management of Common Adverse Effects of Antipsychotic Medications URL
      Students must
      View

      Read section:
      GENERAL STRATEGIES FOR MANAGING THE ADVERSE EFFECTS OF ANTIPSYCHOTICS.       (5 minutes)

      World Psychiatry Journal - 2018

    • url icon
      Six-month Follow Up of the Injured Trauma Survivor Screen (ITSS): Clinical Implications and Future Directions URL
      Students must
      View

      Read the contents from Background to Discussion section. (27 minutes)

      HHS Public Access - 2019

    • url icon
      Assessing and Treating Traumatic Stress in Crime Victims URL
      Students must
      View

      Read the following pages 12-20. (28 minutes)

      Victim Justice Network - 2017

    • forum icon
      Activity : Discussion Forum 11 (100 minutes)
      Students must
      View
      Start discussions: 1

      In this learning activity, you will outline methods of conducting a clinical assessment then, discuss recommendations for further evaluation of a trauma survivor.

      Instructions:

      Step 1: Review 

      Read the required material for this lesson.

      Step 2: Reflect and Respond 

      Reflect on your experience having conducted patient interviews. With a word limit of 250-300 words, you will respond to the following key points :

      • Highlight the most appropriate methods for conducting clinical assessment of a trauma survivor
      • Briefly describe why the methods you chose are the most appropriate
      • Propose recommendations for further evaluating trauma survivors, giving a brief rationale behind your recommendations

      Step 3: Share 

      To share your work, click on the “Add a new discussion topic” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

      Step 4: Interact

      To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner, using the items in this Rubric to guide you. Be sure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas on other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You may use the following as a guide: 

       Item A is  .…. because….  My suggestions for improvement are…. 
       Item B is  .…. because….  My suggestions for improvement are…. 
      Item C is  .…. because….  My suggestions for improvement are….
      Item D is  .…. because….  My suggestions for improvement are….

      OPTIONAL Step 5: Interact (10 minutes)

      If you would like to, you can reply to your peers' posts in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”


    • scorm icon
      Case study 19 : The case of the agitated and violent patient SCORM package
      Students must
      View
      Receive a grade
      In this activity, you must pass the quiz to be marked as complete, and you will have unlimited attempts to complete it.
    • quiz icon
      Quiz: Module 6

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the questions.

      TO PASS THIS QUIZ YOU MUST OBTAIN A SCORE OF 80%.

      Not available unless: The activity Quiz: Module 5 is marked complete
    • Recommended Additional Readings
    • url icon
      Treatment for Suicidal Ideation, Self-Harm, and Suicide Attempts Among Youths URL

      Read the following chapters: (64 minutes)
      - Chapter 3 (25mins)
      - Chapter 4 (25mins)
      - Chapter 5 (15mins).       

      SAMHSA - 2020

    • url icon
      Identifying Patients at High Risk for Violence and Self-Harm in the ED URL

      Read the following sections: (33 minutes)
      - Identifying and Risk Stratifying Patients at High Risk for Violence
      -Mitigate Patient’s Risk from Self-Directed or Interpersonal Harm
      -Sharing Patient Information 

      American College of Emergency Physicians - 2015

    • url icon
      How Can I De-escalate a Situation When Someone is Angry or Agitated? URL

      Read entire page. (2 minutes)

      NSW Government-Health - 2020

    • url icon
      Prevention and Management of Agitation in the ED URL

      Read the content under the headings from "Recommendations " until "2. Hand-offs and Documentation" on pages 4-16. (34 minutes)

      Mn Health Collaborative - 2021

    • url icon
      An Assessment of Five (PANSS, SAPS, SANS, NSA-16, CGI-SCH) Commonly used Symptoms Rating Scales in Schizophrenia and Comparison to Newer Scales (CAINS, BNSS) URL

      Read the entire article. (34 minutes)

      PMC Labs - 2017

    • url icon
      The Clinical Characterization of the Patient with Primary Psychosis Aimed at Personalization of Management URL

      Read the sections: "ONSET AND COURSE","NEUROCOGNITION", "SOCIAL COGNITION", and NEURODEVELOPMENTAL INDICATORS. (31 minutes)

      World Psychiatry Journal - 2021

    • url icon
      Assessment of Major Neurocognitive Disorders in Primary Health Care: Predictors of Individual Risk Factors URL

      Read entire article. (28 minutes)

      Frontiers - 2020

    • url icon
      Criteria, Procedures, and Future Prospects of Involuntary Treatment in Psychiatry Around the World: A Narrative Review URL

      Read the Discussion section and review tables 1, 2, and 3 of the Results section. (20 minutes)

      Frontiers in Psychiatry - 2019

    • url icon
      Psychiatric Hospitalization vs. Treatment at Home URL

      Read the entire article. (12 minutes)

      Psychology Today - 2013

    • url icon
      Clinical and Social Factors Associated with Increased Risk for Involuntary Psychiatric Hospitalisation: a Systematic Review, Meta-Analysis, and Narrative Synthesis URL

      Read the "Discussion" part. (10 minutes)

      Lancelet Psychiatry - 2019

    • url icon
      Physical Restraint in Mental Health Nursing: A Concept Analysis URL

      Read the entire article. (26 minutes)

      2019

    • url icon
      Clinical Toxicology and Overdose of Psychiatric Medications URL

      Read the entire article. (18 minutes)

      East Asian Arch Psychiatry - 2019

    • url icon
      Managing Psychotropic Medications in Complex, Real-World Patients Using Comprehensive Therapeutic Drug Monitoring URL

      Read the entire article. (10 minutes)

      American Chemical Society - 2017

    • url icon
      DSM-5 URL

      Read the following sections in pages 265-290 (45 minutes)
      -Diagnostic Criteria
      -Diagnostic Features
      -Differential Diagnosis       

      To access this book you must follow the instructions provided on the link below: LINK

      Important note: Take into account that at some point some of the 3 copies are not available and are in use. During this time, you will not be able to access a copy of the DSM-5, if so, please wait a moment and try to access the book later.

      American Psychiatric Association - 2013

    • url icon
      Torture Survivors: A Mental Health Provider’s Guide to Conducting Evaluations URL

      Read entire article. (14 minutes)

      Psycom Pro - 2021