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Using Shakespeare's Lear to Deepen Formulation Skills in Geriatric Psychiatry.

Mark Rapoport1,2, Certina Ho3, Rex Kay3

  • 1Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Mark.Rapoport@sunnybrook.ca.

Academic Psychiatry : the Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry
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Summary

Shakespearean theatre improved geriatric psychiatry residents' confidence in biopsychosocial formulation and understanding health determinants. This innovative teaching method enhances skills in addressing ageism and stigma in older adults.

Keywords:
Geriatric psychiatry residencyMedical humanitiesPsychiatric educationPsychiatric formulationShakespeare

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Area of Science:

  • Geriatric Psychiatry
  • Medical Education
  • Psychotherapy Training

Background:

  • Psychiatry requires understanding biopsychosocial determinants of health.
  • Theatre offers nuanced human condition observations but lacks formal evaluation as a psychiatric teaching tool.
  • Shakespeare's works provide rich character studies relevant to clinical practice.

Purpose of the Study:

  • To explore Shakespeare's King Lear as an educational intervention.
  • To enhance formulation skills training in geriatric psychiatry residency.
  • To assess the impact on residents' understanding of health determinants and ageism.

Main Methods:

  • A half-day educational session involving seven residents and four professional actors performing scenes from King Lear.
  • Faculty debriefing sessions were conducted.
  • Pre- and post-surveys measured confidence; three-month follow-up surveys and semi-structured interviews were also performed.

Main Results:

  • Statistically significant improvements in confidence were observed in formulating biopsychosocial understanding (p=0.01).
  • Residents showed enhanced confidence in communicating social and cultural determinants of health (p=0.02).
  • Confidence increased in describing ageism and stigma in older adults with mental disorders (p=0.02).

Conclusions:

  • Live performance of Shakespearean text can benefit residents' confidence in formulation.
  • The intervention improved communication of health determinants and understanding of ageism in geriatric psychiatry.
  • The educational approach was deemed helpful and recommended for residency programs.