Want to create a review course? Here’s how this physician did it.

When I told my colleagues that I was going to try to create the first psychiatry review course at the University of Toronto, I received the same two responses: “It’s about time somebody did that!” and “What is wrong with you?” — sometimes from the same person!

The first reaction taps into the excellence of our department. With approximately 1,000 faculty with diverse expertise and the largest residency program in Canada, it is surprising that we made it until 2019 without establishing a review course curriculum.

Here’s what is wrong with me: I am passionate about my role as a consultation-liaison psychiatrist. Not only do I get to collaborate with my two beloved mentors, but I am also fortunate to supervise medical students, junior and senior residents. I also happen to be the PGY1 coordinator for our department, a kind of maternal figure to our most junior physician trainees. My first cohort completed their residency in 2018 (sniff)! I recently took on a role to help recruit and select the brightest future psychiatrists. I also have two young children. My daughter is five, and my son just turned two. Did I need to take on a project the size of planning five weddings? No. Could I resist trying? Also no.

I created Psych Refresh, U of T’s first ever review course in psychiatry. This was a week-long event that covered key areas in psychiatry with large group and small group interactive sessions. Sixty-three physicians from across Canada came together to learn, network, and (hopefully) have fun.

Here is what I learned:

1. Windows matter. Any giant undertaking in education should start with a needs assessment. So I ran some focus groups with residents and practicing physicians trying to get a sense of the type of course that would be most desirable. I was prepared to hear about high-yield content, online versus print materials, and the duration of different teaching sessions. I heard some of that. What I didn’t expect was the unanimous desire for windows that provide natural light. Regardless of level of experience, every focus group participant mentioned how crucial it was to learn in a naturally well-lit space. So began the search for venues with this attribute — surprisingly hard to find in the world of hotel conference rooms and hospital classrooms. I found myself in the historic buildings of U of T. It turns out that beautiful windows that let in sunshine carry the downside of being beautiful windows that let in sunshine. At some times of day, the sun added too much heat to the historic space with radiator heat. At other times, it was too bright and made it hard to see the presentation on the screen. When it hid behind a cloud, and the shades were down, it was too dark, too much like a lecture hall. The solution? To become an expert in adjusting the window shades at different times of day! I will never take curtains or blinds for granted again.

2. Age is just a number. These same focus groups made it clear that they were not looking to hear from cutting-edge researchers in subspecialized niche areas of psychiatry. They were looking to hear from dynamic speakers who could summarize relevant diagnostic considerations and treatment guidelines in an interactive, engaging way. Many of the specific speaker requests fell into the category of “great educator” rather than “world expert.” In reviewing the feedback, some of the highest rated sessions were taught by new faculty. Which brings me to…

3. Everyone has feedback, and nobody likes to fill out forms. Creating a new course is a huge risk and comprehensive feedback is the key to knowing whether it should happen again. The trouble is, even when people have constructive things to say, they don’t want to spend time on paper evaluations. Educational events that rely on paper are lucky to get a 30 percent response rate which captures those that loved (or hated) the event, or those conscientious few that follow all the rules even when they would rather go home. Psych Refresh took a chance on an online evaluation tool which allowed participants to give feedback for each session right away from their smartphones or computers. This gave a response rate of close to 70 percent. The instant and anonymous feedback allowed adjustments to be made from session to session. This online tool could be used to poll the audience for sample questions within a presentation. Residents figured it out pretty fast. The practicing physicians struggled a bit more. Like any technology, sometimes we had to shut it down and restart. It compiled useful final feedback, which solidified the course as a success and reminded me of a little known educational principle:

4. Tuna salad is polarizing! A shockingly large amount of feedback was about the food. Psych Refresh was a fully catered event with breakfast, coffee, and snacks mid-morning and mid-afternoon with a full lunch. To keep registration costs reasonable, we had hot lunches for three days and sandwiches and salads for two days. Some of the sandwiches had tuna. Some people love tuna. Some people think tuna is disgusting. Food really does matter.

5. Social media is a powerful tool. Registration for Psych Refresh was full with a waitlist shortly after it opened. This might be because of advertising on a popular Facebook group for psychiatrists. This was also where discussion about the course occurred during the event with unsolicited positive feedback at the end. And a good opportunity to find out how much people look like their profile pictures.

6. I might have enough energy to do it all again. Turning this course from an idea into reality was super rewarding. So it was about time that somebody did it. The jury remains out on what is wrong with me.

If you are planning your own course, I hope you are sitting by a large window with a delicious sandwich.

Mary Preisman is a consultation liaison psychiatrist at Mount Sinai Hospital and a faculty member at the University of Toronto. Her clinical interests include critical care and perinatal psychiatry, and she serves as the physician lead for the hospital’s code white response team.

Dr. Preisman is dedicated to interdisciplinary education and regularly teaches across specialties and health care disciplines. Her academic work focuses on health care worker support and resilience during crises. She is a co-author of “Providers’ perspectives on implementing resilience coaching for health care workers during the COVID-19 pandemic” and “Resilience coaching for health care workers: Experiences of receiving collegial support during the COVID-19 pandemic.”