Alexander Moxam, MD, traveled to Yale on July 27 to talk to psychiatry residents and psychiatrists about the neuroscience of addiction and doughnuts. He began, not by outlining learning objectives, but with an anecdote. One morning, Moxam woke up, saw it was a beautiful sunny day, got on his bike, and soon found himself dismounting in front of his favorite doughnut shop, instead of at work where he was supposed to be. “I grew to need this place,” said Moxam, to laughter from the audience.
As a psychiatry resident, he quickly realized he had conditioned himself to associate nice weather with the rewards of buying doughnuts. “This is also the process thought to drive drug-seeking behavior,” he said. People with a diagnosis of substance use disorder end up repeatedly using because they succumb to forces of habit and emotional drives.
Five other speakers gave similarly structured presentations as participants in Yale’s fourth annual session of This ‘Stuff’ Is Really Cool talks, or TSIRCs, as David A. Ross, MD ’05, PhD ’04, associate professor of psychiatry, calls them. Devised as part of the National Neuroscience Curriculum Initiative (NNCI) to improve education among psychiatry residents, TSIRCs usually last around seven minutes and serve as an alternative to time-consuming, traditional lectures.
“We’re not good at remembering facts but we’re great at remembering stories,” says Ross. With the TSIRC technique, he says, “I think there’s a reasonable chance that people will remember Alex’s doughnut fiasco,” and from there recall his lesson on the neuroscience of addiction.
TSIRCs came about because of a need to incorporate neuroscience into the psychiatry residency curriculum. While neuroscience, the biology of the brain, underlies all psychiatric illnesses, the clinical practice of psychiatry developed independent of the younger discipline. “The field of psychiatry is more than a hundred years old,” says Ross. “For most of that time we didn’t have sophisticated tools for understanding the brain.” As a result, psychiatry curricula have yet to fully integrate neuroscience.
According to Ross, many psychiatry departments have neither faculty who feel comfortable teaching neuroscience nor space to fit the content into an already crowded curriculum. Ross, associate director of Yale’s psychiatry residency program, along with Melissa Arbuckle, MD, PhD, of Columbia University, and Michael Travis, MD, of the University of Pittsburgh, both directors of psychiatry residency education at their respective schools, created the NNCI to fix this.
We’re not good at remembering facts but we’re great at remembering stories.
David Ross
Since it began in 2014, the NNCI has grown into a resource for professional development, neuroscience communication, and patient outreach.
In 2017, Ross began collaborating with Liz Neeley, executive director of The Story Collider and now a lecturer at Yale. They began incorporating professional storytelling techniques into TSIRCs and other NNCI resources. “Our idea behind the This ‘Stuff’ Is Really Cool format is to take the typical order of education and flip it on its head,” says Neeley, “[and] use what is most fascinating as a means to get to what is most important instead of starting with dry but important facts.”
Ross says he believes that people will be able to learn just as much information from seven-minute talks as from longer lectures, if not more, without sacrificing time.
The approach seems to be working. “TSIRC talks are one of the most popular resources,” he says. “At least 60 psychiatry residency programs now use the TSIRC videos as core teaching resources.”
As NNCI grows, it is expanding its outreach beyond the professional sphere. Ross and his team discovered that some psychiatric patient support groups use the NNCI resources to understand their conditions. Now, the NNCI is creating partnerships with some of these groups to learn how they can better help and educate patients. “I think ultimately,” says Ross, “that may be the most powerful impact we can have with the NNCI.”