1. Michael Scharf, MD
Assistant Professor of Psychiatry and Pediatrics
Peter Martin, MD, MPH
Child and Adolescent Psychiatry Fellow
University of Rochester

2. Disclosure Statement
 Dr. Martin and Dr. Scharf do not have any financial
disclosures related to this presentation

3. Access to Slides
 Viewable slideshow:
http://www.slideshare.net/psychiatrytech/
 Downloadable PDF:
http://sites.google.com/site/psychiatrytech/

4. Overview
 Our personal experience
 Review of learning theory
 Review of written resources
 Review of audio resources
 Demonstration of creating audio resources
 Review of shared information technologies
 Review of copyright concerns
 Discussion of implementation into real life

6. Inspiration
Source: http://www.youtube.com/watch?v=FL7yD-0pqZg

7. Inspiration

9. Howard Gardner’s
Multiple Intelligences Theory
intelligence type capability and perception
Linguistic words and language
Logical-Mathematical logic and numbers
Musical music, sound, rhythm
Bodily-Kinesthetic body movement control
Spatial-Visual images and space
Interpersonal other people's feelings
Intrapersonal self-awareness
Source: http://www.businessballs.com/howardgardnermultipleintelligences.htm

10. Learning Theory
 VARK: Visual, Aural, Read/write, Kinesthetic
 Visual: ex. Maps, charts, graphs, diagrams
 Does NOT include movies, PowerPoint
 Aural: listening as well as talking out problems
 Read/write: information as words
 Includes notes, PowerPoint
 Kinesthetic: prefer reality
 Experience, simulation
 Multimodals: prefer more than one type, or different
types in different situations
Source: http://www.vark-earn.com/english/page.asp?p=faq

11. Learning Theories
 We all learn in unique ways
 May have one style of learning that is better suited for
an individual
 Likely have maximum benefit from combining
different forms of learning

13. Evidence Based Teaching
 Sounds cool, even intuitive in 2011
 Like practicing EBM, there are significant challenges...

14. Evidence Based Teaching
 Sounds cool, even intuitive in 2011
 Like practicing EBM, there are significant challenges...
 Retraining teachers
 Defining outcomes
 Learner Satisfaction?
 Increase knowledge base?
 Change Behavior?

15. Evidence Based Teaching
 Sounds cool, even intuitive in 2011
 Like practicing EBM, there are significant challenges...
 Retraining teachers
 Defining outcomes
 Learner Satisfaction?
 Increase knowledge base?
 Change Behavior - Skills Training

16. Skills Training, But How?
“Evidence-based Teaching” Methods
 Written guidelines, CMEs, and “hit and
run” workshops and lectures are generally
ineffective
 Training needs to focus on skills (not
factual knowledge), and must address
obstacles encountered in practice
 Training must use collaborative learning
partnerships, vs. “one-down”
relationships, & use role models like those
being trained

17. Recommended methods for assisting health care
providers in adopting EBPs:
Survey of 50 national MH experts
Training Method Mean SD Median Mode
Reading 3.00 1.61 3 3
Brief video-based 4.12 2.48 4 1
training
Supervisor 4.58 2.09 5 5
consultation
Didactic workshops, 4.89 2.69 5 6
no follow-up
Consultation with 5.89 2.40 6 6
experts
Hands on workshops 8.45 1.35 9 9
with follow-up
1 = not at all recommended, 9 = highly recommended

18. Skills Training, But How?
“Evidence-based Teaching” Methods
To be effective, skills training should “keep it light,”
make frequent use of humor, and switch between
different learning modes: hands-on practice, role
plays, panels, Q&A sessions, skits, and friendly
competition among small groups, etc.

19. How to recognize the moods of an adolescent
HAPPY DEPRESSED EXCITED
ANXIOUS MANIC SUICIDAL

20. REACH Skills Training Approach
 Hands-on, with role plays and extensive practice
 Intensive training of trainers
 Essential use of PCP “role models” as trainers
 2 day’s face-to-face training with 15-30 clinicians, with
2-3 trainers, followed by:
 6-12 months of twice-monthly phone call consultation
and support, 1-1.5 hours/call
 Individual case presentations, with learning and risk-
taking shared among peers

22. RSS (Really Simple Syndication)
 Definition: a family of web font formats used to
provide subscribers with frequently updated
information. Format allows distributing contents
without the need of a navigator, by means of software
designed to read RSS (aggregator) comments
Source: http://www.en.masterbase.com/support/glossary.asp
http://www.techlifeweb.com/wp-content/themes/TLW/images/rss-feed-icon.jpg

23. RSS “Readers”
 Websites:
 Google Reader
 NewsGator
 Programs
 Windows
 Browsers (Internet Explorer, Mozilla FireFox, Google Chrome)
 NewzCrawler
 FeedDemon
 Omea Reader
 Mac
 Browsers (Safari, Mozilla FireFox, Google Chrome)
 Shrook
 NetNewsWire
 NewsFire

24. RSS
 Mobile
 Google Reader
 iOS
 Reeder
 Newsrack
 Feeddler
 Android
 gReader
 NewsRob
 FeedR

25. Google Reader
 http://google.com/reader

30. RSS Feeds – General Psychiatry
 American Journal of Psychiatry (AJP)
 http://ajp.psychiatryonline.org/rss/13.xml
 Archives of General Psychiatry
 http://archpsyc.ama-assn.org/rss/current.xml
 Annals of General Psychiatry
 http://www.annals-general-psychiatry.com/rss/
 Current Psychiatry
 http://www.currentpsychiatry.com/rssAllArticles.asp
 Psychiatry Services
 http://ps.psychiatryonline.org/rss/18.xml
 The British Journal of Psychiatry
 http://psy.psychiatryonline.org/rss/current.xml

31. RSS Feeds – Subspecialties
 Journal of the American Academy of Child and Adolescent
Psychiatry (JAACAP)
 http://www.jaacap.com/current.rss
 Psychosomatics
 http://psy.psychiatryonline.org/rss/current.xml
 Biological Psychiatry
 http://www.journals.elsevierhealth.com/periodicals/bps/curr
ent.rss
 Journal of Neuropsychiatry & Clinical Neurosciences
 http://neuro.psychiatryonline.org/rss/62.xml
 Academic Psychiatry
 http://ap.psychiatryonline.org/rss/17.xml

32. RSS Feeds - Psychology
 Annual Review of Psychology
 http://www.annualreviews.org/action/showFeed?ui=45
mu4&mi=3fndc3&ai=s1&jc=psych=etoc&feed=rss
 Psychological Bulletin
 http://content.apa.org/journals/bul.rss
 Psychological Review
 http://content.apa.org/journals/rev.rss
 Behavioral and Brain Science
 http://journals.cambridge.org/data/rss/feed_BSS_rss_2.
0.xml

33. RSS Feeds – Other Specialties
General Medicine
 Journal of the American Medical Association (JAMA)
 http://jama.ama-assn.org/rss/current.xml
 New England Journal of Medicine (NEJM)
 http://content.nejm.org/rss/current.xm
 The Lancet
 http://multimedia.thelancet.com/rss/lancet_current.xml
 Annals of Internal Medicine
 http://www.annals.org/rss/current.xm
 British Medical Journal
 http://www.bmj.com/rss/latest.xml
Pediatrics
 Pediatrics
 http://pediatrics.aappublications.org/rss/current.xml
 Archives of Pediatrics
 http://archpedi.ama-assn.org/rss/current.xml
Neurology
 Neurology
 http://www.neurology.org/rss/current.xml
 Archives of Neurology
 http://archneur.ama-assn.org/rss/current.xml
 Annals of Neurology
 http://www3.interscience.wiley.com/rss/journal/76507645
 The Lancet Neurology
 http://multimedia.thelancet.com/rss/laneur_current.xml
 Journal of Child Neurology
 http://jcn.sagepub.com/rss/current.xml

34. Lessons Learned
 Very convenient and efficient way to obtain overviews
of a large amount of information
 Some journals better than others to maximize
usefulness of feeds (i.e. amount of information
provided)
 Different readers offer varying levels of convenience
 Can be difficult to keep track of what has been read
 Need to be proactive in order to keep useful
articles/abstracts organized
 Links may change over time

36. Audio Resources
 Pre-recorded
 Podcasts
 User generated
 From text resources

37. Podcast
 Definition: “series of digital media files (either audio
or video) that are released episodically and often
downloaded through web syndication”
 All of the following are available through iTunes
 Simply search for title of podcast and can then
download through iTunes
 Also: iTunes U
Source: http://en.wikipedia.org/wiki/Podcast

38. Based on Journals
 American Journal of Psychiatry Audio
 Great summarization of each month’s articles
 The Journal of Clinical Psychiatry: Publisher’s Podcast
 The Journal of Neurology, Neurosurgery, and
Psychiatry
Source: http://ajp.psychiatryonline.org/cgi/content/full/168/5/A34/DC1

39. Podcasts
 Psychiatric Times
 Interesting highlights, but hit and miss
 Medscape Psychiatry (& Mental Health) Podcast
 Miscellaneous
 My Three Shrinks (by Shrink Rap)
 Psychiatry Today
 Psychiatric Secrets Revealed by Dr. Mike
 Power Without Pills: One Psychiatrist’s Guide to Healing and
Growth
 Psychiatrist and Physiatrist
 Institute of Psychiatry
 Shrink Zone
 Conversations about Mental Illness

40. Podcasts
 Biggest problem: most are not updated
 MedscapeCME Psychiatry (& Mental Health) Podcast
 PeerView Psychiatry CME/CNE/CPE Audio Podcast
 Also includes accompanying PDFs
 MGH Psychiatry Academy
 MUSC Mental Health Podcast
 Psychiatry Grand Rounds from the UCLA Semel Institute
 MDPU Podcast: Mood Disorders Psychopharmacology Unit –
University of Toronto
 The Centre of Excellence in Interdisciplinary Mental Health

41. Podcasts from Other Specialties
 Journal of the American Medical Association (JAMA)
 New England Journal of Medicine (NEJM)
 The Lancet
 Neurology

42. Lessons Learned
 If available, can be a useful adjunct to learn material
 But lack of/consistent availability is major concern
 Different podcasts vary GREATLY in terms of quality
and usefulness
 Different podcasts utilize different approaches, which
may appeal to different types of learners
 Some summarize all or the main articles of the current
issue
 Some take one article/theme and discuss more
thoroughly, including interviews with authors

44. Text
Paper Digital
Previously Original digital
scanned article file, editable (i.e.
Word document)
Scan
PDF without PDF with copy/paste
copy/paste functionality
functionality
Optical Character
Recognition (OCR) Software
Text To Speech (TTS) Software
Audio

45. Text To Speech (TTS)
 Definition: “The ability of the computer to convert text into spoken
words”
 Voice Databases
 AT&T Natural Voices
 Acapela
 RealSpeak
 Cepstral
 Websites
 YAKiToMe! (http://www.yakitome.com)
 From Text To Speech (http://www.fromtexttospeech.com)
 ReadTheWords.com (http://www.readthewords.com)
 Programs
 NaturalReader
 Neospeech
 TextAloud
Source: http://developer.apple.com/Mac/library/documentation/UserExperience/Conceptual/
AppleHIGuidelines/XHIGGlossary/XHIGGlossary.html&rct=j&sa=X&ei=iBbHTaKqNIrn0QGduOGYCA&ved=
0CC8QngkwAA&q=Text+to+speech&usg=AFQjCNEBi_pvhL6AlMAMs_8BZt94n61X9w

46. Voice Databases
Source: http://www.nextup.com/

48. From Text To Speech
 http://www.fromtexttospeech.com

49. Lessons Learned
 Effective way to learn straightforward information
(most journal articles)
 Not very effective for more complex articles (such as
classic readings)
 Computer-generated voice actually not bad – helps to
change speed to “fast” to make less monotonous

50. Optical Character Recognition
 Definition: “the electronic identification and digital encoding of printed or handwritten
characters by means of an optical scanner and specialized software”
 Websites
 Free Online OCR (http://free-online-ocr.com)
 NewOCR (http://www.newocr.com/)
 Free OCR (http://www.free-ocr.com/)
 OCR Terminal (http://www.ocrterminal.com/)
 Instant OCR (http://www.instantocr.com/index.php/)
 Online OCR (http://www.onlineocr.net/)
 Programs
 Microsoft OneNote 2007
 Microsoft Office Document Imaging
 Omnipage
 ABBYY FineReader
 SimpleOCR
 TopOCR
 FreeOCR
Source: http://www.thefreedictionary.com/optical+character+recognition

51. Free Online OCR
 http://free-online-ocr.com

52. Lessons Learned
 Paid-for program most likely would be more beneficial
to save time (can easily do multiple pages with less
effort/more quickly)
 Again, pay for what you get – websites can change
overnight
 Programs work surprisingly well even with poor quality
scans
 Can be useful even if not desiring audio text but want
an editable digital version of old articles/text

54. Dangers?
 No evidence from the literature of an increase in
accidents of listening to audio learning programs
 Only increase in danger if loud or unexpected
 Distractibility seems to be the key issue
 Long history of asking if radio was on/turned up after an
accident – so be cautious!
Source: http://www.drdriving.org/misc/music_strick_report.html

56. Video
 Recorded Lectures
 Webinars
 Video Conferencing
 “Produced” Video Teaching Tools

57. What is she looking at?

59. Shared Drives
 Advantages
 Administered through university/hospital system
 Convenience of having full IT support
 Disadvantages
 May not be able to access from home or other work
computers
 Can be expensive to set up and maintain
 Often very limited amount of space

60. Blackboard

61. Cloud Storage
 Definition: “provision of computational resources on
demand via a computer network”
 Advantages
 Easy access from multiple computers
 Off-site access
 Disadvantages
 Security concerns
 May not be able to access depending on company
firewalls
 Do not “own” the files
Source: http://en.wikipedia.org/wiki/Cloud_computing

62. Dropbox
http://www.dropbox.com
 Supported on multiple platforms:
 Desktop: Windows, Mac, Linux
 Mobile: iPhone, iPad, Android, Blackberry
 Also can access files through web browser
 Free registration: 2 GB storage
 Can set up both personal accounts/folders as well as
shared folders

63. Cost/Benefit
 Benefits:
 Potentially decrease paper usage
 Digitized format helps preserve and potentially organize
information
 Costs:
 Time consuming
 Shift costs to trainees?

65. Copyright
 Copyright law based on Article 8 of Constitution: gives
Congress the power to enact laws “to promote the
progress of science and useful arts, by securing for
limited times to authors and inventors the exclusive
right to their respective writings and discoveries.”
 US Copyright Act can be found in 17 United States
Code
Source: http://www.pacaoffice.org/copyrightInfo/PACAcoped.ppt

66. Protected by Copyright
 Essentially everything
 Text
 Pictures
 Music
 Video

67. Not Protected by Copyright
 Ideas
 Short phrases

68. Teaching
 “Fair Use” doctrine: allows limited copying of copyright
material for educational or research purposes (“reasonable
and limited portions”)
 Translation: Cannot copy an entire text for distribution in
class (including textbooks)
 TEACH Act (2002): allows usage of teaching materials both
in-person as well as for distance learning
 However, for distance learning, may have to pare down/limit
usage (think using clips)
 Only applies to accredited nonprofit educational institutions
 Only covers works that would be used IN CLASS (though fair
use doctrine may still apply for outside of class)
Source: http://www.utsystem.edu/ogc/intellectualproperty/teachact.htm

70. Viewable slideshow:
http://www.slideshare.net/psychiatrytech/
Downloadable PDF:
http://sites.google.com/site/psychiatrytech/
Contact Information
Michael Scharf: michael_scharf@urmc.rochester.edu
Peter Martin: peter_martin@urmc.rochester.edu