University of Pittsburgh School of Medicine Office of Medical Education www.omed.pitt.edu 412.648.8714 Preventing and Managing Metabolic Syndrome among the Seriously Mentally Ill Mini-Elective Spring 2010 Course Dates: February 1, 8, 15, March 8 Mondays, 1:00-4:00 PM Maximum Students: 8 Class Year: MS2 Course Director: Jason Rosenstock, MD Director, Medical Student Education Department of Psychiatry Contact Information: 412-246-6495 [email protected] Registration: Betsy Nero, Office of Medical Education [email protected] Description: This 6-week mini-elective will help students begin applying behavioral medi-cine principles and practices to help real patients improve their lives. Follow-ing a series of three expert-led didactic sessions (weight management, diabe-tes prevention, and motivational interviewing) with heavy emphasis on practi-cal skill training, students will be assigned a patient with a serious and persis-tent mental illness who is working on behavior change as a way of preventing or managing metabolic syndrome. Students will provide individualized lifestyle coaching for two sessions, with faculty supervision, collaboration with primary health providers, and assessment of outcomes. Objectives: • Appreciate the importance of comorbidity of psychiatry and general medi-cal conditions • Understand basic principles and specific techniques for fostering behavior change • Learn how to collaborate effectively with health practitioners from different disciplines • Increase self-efficacy with respect to the treatment of chronically ill pa-tients • Feel more optimistic about the role/efficacy of behavior change in medicine Requirements: • Participate actively in all course sessions • Read assignments • Complete course evaluationsCourse Outline: Preventing and Managing Metabolic Syndrome among the Seriously Mentally Ill Course Director: Jason Rosenstock, MD Assistant Professor of Psychiatry Director, Medical Student Education Western Psychiatric Institute and Clinic Participating Faculty: Melissa Kalarchian, PhD Assistant Professor of Psychiatry Bruce Rollman, MD, MPH Associate Professor of Medicine and Psychiatry Allan M. Zuckoff, PhD Assistant Professor of Psychiatry Linda Siminario, RN, PhD, CDE Assistant Professor of Medicine and Nursing Director, Diabetes Institute Course Objectives: • Appreciate the importance of comorbidity of psychiatry and general medical conditions • Understand basic principles and specific techniques for fostering behavior change • Learn how to collaborate effectively with health practitioners from different disciplines • Increase self-efficacy with respect to the treatment of chronically ill patients • Feel more optimistic about the role/efficacy of behavior change in medicine Location: All sessions Oxford Building (3501 Forbes Avenue) 6th floor conference room (Suite 650) Course Outline: Week 1: February 1, 2010 1:00p-1:15p Course Overview --Jason Rosenstock 1:15p-2:45p Introduction to Metabolic Syndrome: Diabetes Prevention and Management --Linda Siminario 2:45p-3:15p Tour of 3501 Forbes Metabolic syndrome, including obesity, type 2 diabetes, and hyperlipidemia—is commonly seen in the SPMI population, occurring with a prevalence greater than national rates. SPMI patients tend to have less knowledge about these general medical conditions and tend to receive inadequate primary care interventions to address these problems. In week 1 of this mini-elective, students will receive didactic sessions on metabolic syndrome, with a focus on diabetes prevention, emphasizing skills that the phy-sician can use to help patients with behavior change. We will also take a tour of the facility housing the programs of SRRSMI (Services and Research for the Recovery of Serious Mental Illness), orienting stu-dents to staff, resources, and space that will be useful in the coming weeks. Week 2: February 8, 2010 1:00p-2:00p Observing Group Therapy (half) Patient/Preceptor Assignments (half) 2:00p-3:30p Weight Management: Diet, Nutrition, Exercise --Melissa KalarchianIn week 2, half the students will observe a group therapy session, exploring how behavior change is at-tempted in standard programming and meeting potential clients. The other half will get patient and pre-ceptor assignments and take the initial steps to set up meetings and develop a basic “teaching plan” to organize the individual counseling sessions. All students will then train on weight management tech-niques that can be useful for patients: diet, nutrition, and exercise strategies. Students will then take part in a practicum on motivational interviewing (MI), with an emphasis on speicifc techniques and approaches geared towards a psychiatrically-ill population. After the MI work-shop, students will meet with faculty preceptors and get patient assignments. For homework, students will be asked 1) to develop a basic “teaching plan” that would be used to organize the following week’s individual counseling sessions, and 2) schedule time to meet with patients and preceptors. Week 3: February 15, 2010 1:00p-2:00p Observing Group Therapy (half) Patient/Preceptor Assignments (half) 2:00p-4:00p Behavior Change: Motivational Interviewing --Allan Zuckoff In week 3, half the students will observe a group therapy session, exploring how behavior change is at-tempted in standard programming and meeting potential clients. The other half will get patient and pre-ceptor assignments and take the initial steps to set up meetings and develop a basic “teaching plan” to organize the individual counseling sessions. All students will then take part in a practicum on motiva-tional interviewing (MI), with an emphasis on specific techniques and approaches geared towards a psy-chiatrically-ill population. Weeks 4-5 Flexible scheduling of individual coaching sessions and faculty supervision Students will do two individual sessions with each patient, 30-60 minutes each, focusing on goal-setting and then follow-through (practice, specific techniques, etc.), with supervision by faculty preceptors for about 30 minutes each week. Students will help individual patients develop appropriate treatment plans based on a review of their metabolic risk factors, using MI, materials, incentives (e.g., gift cards), and equipment (e.g.,