Winter 2016 Issue
PSV 2016 Fall Meeting Poster Winner
Left to right: Lance Irons, M-2; Steven Cunningham, MD, EVMS MD ’05, EVMS Residency ‘09; Jordan Ramero, MD, EVMS Residency ‘16; Robert Busch, MD, EVMS PGY-3; Lisa Fore-Arcand, EdD – Associate Professor; Doug Chessen, MD – former EVMS Community Faculty; Brian Wood, MD – EVMS Residency ‘93
The Psychiatric Society of Virginia (PSV) met in Roanoke, Virginia October 7-8 at the historic Hotel Roanoke and EVMS was well represented. Robert Busch, MD PGY-3 presented a poster entitled ‘PTSD Treated with a Combination of Prolonged Imaginal Exposure and TMS Targeting the Dorsolateral Prefrontal Cortex and the Supplemental Motor Cortex: A Case Report.’ Lance Irons, M-2 and President of the EVMS Psych Interest Group presented a poster entitled ‘No Hit Zone: Corporal Punishment Prohibition in an Urban Academic Pediatric Practice,’ based on the work he completed in the EVMS/CHKD summer scholars program. Lance was awarded second place in the best poster competition, a wonderful accomplishment for this young rising star student.
Alumni, current residents and medical students, faculty, and community faculty came together to network and learn about ‘Controversies in Psychiatric Diagnosis and Treatment,’ the theme of this fall meeting.
Second Place Poster Award Presented to Lance Irons
By Lance Irons
The research that I presented at the Psychiatric Society of Virginia Fall Meeting was titled “No Hit Zone: Corporal Punishment Prohibition in an Urban Academic Pediatric Practice.” The purpose of this research was to collect base line data from the caregivers of patients who had well child appointments at the Children’s Hospital of The King’s Daughters (CHKD) General Academic Pediatrics Clinic. This pre-data set will be used to compare a before and after No Hit Zone policy at this clinic in 2017. The questions that were presented to these participants included their perceptions, usage, and personal thoughts on the disciplinary techniques that they have used to manage their children’s behavior. The research also asked questions about child behaviors, demographic information, thoughts on corporal punishment, the perceived effectiveness of corporal punishment, and their interest in physicians providing them with advice and information on evidence based behavioral management strategies.
There were a few significant correlations in the data that was collected. We found that caregivers were ten times more likely to use corporal punishment if they themselves were spanked by their parents compared to caregivers who used other behavior strategies. It was also found that respondents who have used corporal punishment with their children were 2.78 times more likely to express frustration when their child does not initially obey them and 3.19 times more likely to express frustration when their child repeatedly disobeyed them compared with parents who expressed that they have never spanked their children before. Probably the most readily modifiable finding was that about fifty six percent of caregivers say that they have not received any behavioral strategy advice from a physician or couldn’t remember. This is highlighted further by the reported forty seven percent of respondents saying that they were interested in receiving advice from their physicians on behavioral management techniques. This finding demonstrates a gap in services that patients want their physicians to provide and the advice they are currently getting.
This research has provided the starting point for our No Hit Zone policy at the General Academic Pediatrics Clinic at CHKD. The “No Hit Zone” trains staff to help address corporal punishment that they witness and provides an expectation similar to a no smoking policy. The enactment of this policy will include No Hit Zone signage information pamphlets, and de-escalation training for staff members. Training will also include fostering discussion about discipline and provide opportunities for residents and physicians to provide advice on disciplinary techniques during appointments. The ultimate goal of this pilot study is to measure the benefits of implementing a No Hit Zone in one department and then use this evidence approach to provide system-wide change in all of our 28 practice sites and 208 bed hospital. This will ultimately provide community expectations and hopefully translate into improved public health outcomes in the community.
March 17-18, 2017
The Hilton Short Pump
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