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The Effect of Administering a Boundary Course to Third-Year Medical Students During Their Psychiatry Clerkship

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Abstract

Objectives

Due to lack of experience, third-year medical students (MS3) may be vulnerable to boundary violations. Investigators aimed to increase awareness regarding boundary issues among MS3s and assess the effect of using videotaped scenarios and case-based discussion on medical students’ comfort in managing boundary issues.

Methods

A nine-question pre-course survey was administered to MS3s enrolled at Cooper Medical School of Rowan University that asked students to rate their comfort in managing various boundary challenges. MS3s then viewed seven pre-recorded boundary-related cases followed by a 10–15-min discussion after each case. A post-course survey reassessed comfort in managing boundary challenges using the same nine questions, with three additional questions assessing satisfaction with the course. Change in pre- and post-course scores were analyzed using paired t tests and effect sizes. Internal consistency was assessed using Cronbach’s alpha.

Results

There was a significant difference between pre- and post-course total scores as well as seven of the nine individual scores. Effect sizes were large (d > .08). These findings indicate that students became more comfortable managing boundary issues following the course. In addition, satisfaction ratings were high indicating the course was perceived favorably.

Conclusion

Medical students perceived the course to be beneficial and reported that it increased their awareness of boundary issues. A boundary course at the beginning of the psychiatry clerkship can improve MS3s’ comfort in managing boundary challenges. With increased comfort in managing boundary, students can better focus on other aspects of their psychiatry education and on building therapeutic alliances with their patients.

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Acknowledgements

The authors wish to thank Dr. Amanda Bunden, the director of the simulation lab at the medical school for her direction. In addition, we thank Aileen Zoneni the Standardized Patient Program Coordinator for her help with the case write-ups, recordings, and editing of the simulated cases.

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Authors and Affiliations

  1. Cooper University Hospital, Camden, NJ, USA

    Sindhura Kunaparaju & Karim Sedky

  2. Cooper Medical School of Rowan University, Camden, NJ, USA

    Michael Sposito Hidalgo

  3. Drexel University, Philadelphia, PA, USA

    David S. Bennett

Authors
  1. Sindhura Kunaparaju
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  2. Michael Sposito Hidalgo
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  3. David S. Bennett
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  4. Karim Sedky
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Corresponding author

Correspondence to Karim Sedky.

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Ethical Considerations

All research ethics were evaluated and approved by the Rowan University IRB with standards as set forth in the Belmont Report. Rowan University IRB has reviewed and approved the consent and/or assent process, waiver and/or alteration described in this protocol as required by 45 CFR 46 and 21 CFR 50, 56 (if FDA regulated research) (Rowan University IRB number 16-024EX).

Disclosures

On behalf of all authors, the corresponding author confirms that there are no disclosures or conflict of interest. This research received no grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Kunaparaju, S., Hidalgo, M.S., Bennett, D.S. et al. The Effect of Administering a Boundary Course to Third-Year Medical Students During Their Psychiatry Clerkship. Acad Psychiatry 42, 371–375 (2018). https://doi.org/10.1007/s40596-018-0904-8

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  • DOI: https://doi.org/10.1007/s40596-018-0904-8

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