LAUSR

To the Editor: Traditional education is a one-way exchange of information — from active teacher to passive learner [1]. In traditional (or teacher-centered) education, the focus is on the dissemination of information to students. In focusing on the content, traditional education fails to teach students the process of inquiry, which is central to the scientific method. Learner-centered (or student-centered) education is a model where the focus is on the process of learning rather than what is being taught [2]. In this model, students’ interests and learning needs are paramount [3]. One study among pharmacy students in China suggests that learner-centered education enhances selfdirected learning, motivation, and retention [4]. When applied to graduate medical education, learner-centered education decreased the rate of errors made by residents caring for patients with diabetes at one hospital [5]. During the psychiatry clerkship at the Yale School of Medicine, students are required to deliver a presentation on a topic of their choice to their assigned clinical team. This study aims to identify the psychiatric topics of interest to medical students by examining student presentations at one clerkship site (a VA-based psychiatric emergency room) during a 6-year period. By understanding and catering to their interests and providing students with agency, there may be better facilitation of learning. As part of the psychiatry clerkship, all students are required to complete a brief (10–20 min) oral presentation on a psychiatric topic of their choice. Students were encouraged to select a topic that stimulated their interest and was clinically relevant. Students presented to the multidisciplinary psychiatry emergency room team. Students were required to provide team members with a one-page summary of their presentations. The summaries were collected for the duration of the study period (2015–2020). The presentations were categorized into those primarily related to substance use disorders (SUDs) and those primarily related to non-substance use mental health topics. A total of 108 presentation summaries were collected. One hundred three presentations were included, as five were deemed incomplete. The institutional review boards at Yale University and at the VA hospital deemed this study exempt from full review. Of the presentations, 34 focused on SUDs, while 69 focused on non-substance use mental health topics. The SUD presentations included the following: alcohol use disorder (n= 10), opioid use disorder (n= 10), cannabis use disorder (n= 5), and other SUD topics (n= 9). The other SUD topics were as follows: female veterans with SUD, epigenetics of SUD, the comprehensive addiction and recovery act of 2016, kratom, abuse deterrent formulations, new psychoactive substances, the drug abuse epidemic, 3,4-Methylenedioxymethamphetamine and heritability of SUD. The non-substance usemental health topics include the following: depression (n=11), post-traumatic stress disorder (n=10), biopsychosocial approach (n=7), borderline personality disorder (n=5), deep brain stimulation (n=5), sleep disorders (n=5), conversion disorder (n=4), suicide (n=3), psychosis (n=3), social topics (n=2), attention-deficit/hyperactivity disorder (n=2), and other topics (n=12). The other nonsubstance use mental health topics were as follows: phantom limb pain, cognitive distortions, head injury as risk factor for psychiatric disorders, migration and mental health, anti-Nmethyl D-aspartate receptors encephalitis, mistreatment of vulnerable populations and mandatory reporting, trauma injury and surgical care, electroconvulsive therapy, contingency management, cardiovascular disease in psychiatric patients, refeeding syndrome and military sexual trauma. There are interesting findings in these data that may be relevant to medical school educators. First, more than onethird of the students chose a topic related to SUDs. One potential explanation is that many patients in the psychiatry * Brian Fuehrlein [email protected]