Meeting #34

Laguna Beach, CA

March 16 - 19, 2016

Wednesday, March 16, 2016 through Saturday, March 19, 2016
Surf and Sand Hotel, Laguna Beach, CA

Present at the meeting were senior scholars Kelly Barth, Sarah Pedersen, Paola Pedrelli, Martin Plawecki, Joseph Schacht, and Priscila Dib Goncalves (she is actually in between a first- and second-year role, as Priscila began her work with us mid year). Also present at the meeting were first-year scholars Dorian Lamis, Leslie Lundahl, Daryl Shorter, and Randi Schuster. Marc Schuckit, Director, led the meeting, with the help of Marianne Guschwan (Associate Director) and Marcy Gregg, Administrator.

I. Wednesday, March 16, 2016
The group met in the lobby of the Surf and Sand Hotel in the late afternoon, and reconvened at 6:45 pm for the welcoming get-together and discussing the goals and schedule for the meeting. Conversations continued over a working dinner, with plans made to reconvene the next day at 8:00 am in the Seahorse Room. Dinner that evening was at Splashes Restaurant in the hotel.

II. Thursday, March 17, 2016
The meeting began with informal networking and refinement of the schedule of presentations and reports by junior and senior scholars.

The majority of the morning was a review of how to tell one’s story by Marc Schuckit. This year Marc used a different approach by asking both groups of scholars to work with him on an assignment where they would establish an outline for telling a story. The goal was to have reviewed all of the major lessons learned in Marc’s lecture in the first meeting of this group, as well as to have the opportunity for scholars to ask questions and make suggestions about how the process of optimally teaching alcohol and drug-related issues should be carried out. The target audience was group of a well educated, nonscientist retirees who want to learn how a research career develops, as well as how complex genetically-influenced disorders operate. Consistent with the AMSP approach, the group began by establishing four major points to be made in that 45 minute presentation (actually, this was a real informal lecture to be given by Marc on Sunday, March 20th). The next step was to develop an outline of a logical series of major points (roman numerals in an outline) the lecture might follow. Suggestions for specific topics and where they might fit in were made by AMSP scholars, and for each Marc showed where the topic might (or might not) fit into the lecture, and discussed pros and cons of how the additional topic might add or detract from the four basic points. At the end of the process, Marc then reviewed how the morning’s activities highlighted the major issues involved in organizing information in a logical manner as part of a written communication or a verbal lecture. As an aside, the outline was used on the evening of March 20 by Marc, speaking to an audience similar to that mentioned above, and it was found to work quite well.

The next presentation was delivery of a lecture by first-year scholar Dorian Lamis regarding alcohol and suicide. Among the items discussed following this excellent 40-minute lecture were how well Dorian monitored the time and was able to end at almost exactly 40 minutes; the excellent transition between subject areas of the lecture with a good summary of what had been presented to that point; the benefits of numbering the slides so that anyone in the audience was able to point to a specific issue related to a specific slide; use of a specific patient example (along with suggestions of how “Jane” might be tied into the lecture even more fully); how slides are most effective when any information and title is limited to one line that can be easily assimilated by the audience by a process close to speed reading; and related issues that summarized many of the points made by Marc in the initial meeting for the group six months previously.

Following the lecture the group was served lunch in the meeting room, during which discussion of issues related to academic development. The topics included questions relating to how different departments have different rules regarding seeing private patients; the temptations of expanding the number of patients seen at the cost of less time for teaching and research, along with ideas of how to keep a balance among those three; items related to the assets and liabilities of collaborations in research (assets include: learning additional approaches to research; being part of more papers as multiple people have access to the collaborative data; observing additional potential research lines that might be followed; and abilities to have part of one’s salary paid from grants for such collaborations, while liabilities include: the possibility of being drawn away from one’s own research line; the slowed tempo of research when decision-making involves multiple people at multiple universities; one’s personal preference regarding whether the greater enjoyment comes from working specifically on a small project or being a small part of a larger project). The discussion went on to the guidelines regarding mentoring and what at some times may be “tough love” where one sets limits on developments of the mentee, and helps the mentee to focus more closely on what they are doing.

The afternoon began with a fine lecture by first-year scholar Leslie Lundahl from Wayne State University. The lecture style was excellent and placed the audience at ease; the flow of logic exemplary; and slides/illustrations were very useful. The group had suggestions regarding documentation of some statements, the excellent definition of jargon used during the lecture, and some specific items regarding the topic.

The meeting adjourned at 3:00 pm with each of the scholars on their own for dinner. The group was reminded of the joint dinner to be held on Friday evening, and the schedule for the remaining lectures and reports was reviewed.

III. Friday, March 18, 2016
The AMSP scholars reassembled at 8:00 am in the Seahorse Room. The morning began with delivery of the lecture by the first-year scholar, Randi Schuster, from the Harvard Service at Massachusetts General Hospital regarding the topic of the effects of cannabis on cognition in adolescents. The presentation was excellent, as were the slides, and the material was close to ready for loading onto the AMSP website. The educational level of the material presented was appropriate for the audience and the style presentation very clear. Specific suggestions were made about several of the slides, some questions were asked about the documentation for some of the material, but there was little left for Randi to do to make a fine lecture even better.

Joe Schacht, second-year scholar from the Medical University of South Carolina (MUSC), then presented his accomplishments since the last AMSP meeting. Dr. Schacht has continued many of his preexisting educational commitments at MUSC during this time, including lecturing to second-year psychiatry residents on the neurobiology of addiction and assisting with the first-year medical student brain dissection labs. He has also continued to serve on the Department of Psychiatry and Behavioral Science’s Grand Rounds Committee, under the auspices of which he has invited experts in addiction research to present in the psychiatry Grand Rounds series, and the Addiction Sciences Division’s Media and Outreach Committee. As part of his membership on the latter committee, Dr. Schacht recently presented a lecture that focused on the contributions of neuroimaging to understanding drug and alcohol effects on the brain and on recovery from addiction to patients engaged in a relapse prevention group in an intensive outpatient program for substance abuse. Dr. Schacht used the AMSP presentation principles to create the slides for this lecture. Finally, Dr. Schacht was recently invited to serve as a mentor for two NIDA-funded training grants at MUSC, one of which focuses on Ph.D. student training in addiction sciences and the other of which focuses on research training for psychiatry residents interested in a career in addiction research.

Second-year scholar, Paola Pedrelli, from Massachusetts General Hospital, then demonstrated her ability to use about an hour of work to modify her original AMSP lecture as delivered six months earlier into a 30-minute lecture presenting the relationship between alcoholism and depressive symptoms, but this time as if presented to a different audience (psychiatric residents who are already fairly knowledgeable about depressive disorders). As is traditional in AMSP, the purpose of having been told only the day before that a lecture needs to be modified for a different audience and the restriction of spending only about an hour of time to modify the lecture demonstrates how to focus on a different audience, and how the same or similar material (with some modest change in slides and the limitation of using only 10-15 slides) can be done. The new lecture was excellent and effective. The group had several suggestions and questions, and many compliments about the manner in which the original lecture could be changed without much time allowed for preparation.

The next exercise involved asking one of the senior scholars to use the lecture outline and slides developed by another of the senior scholars to demonstrate how the AMSP lectures can be delivered by individuals other than the person who originally developed it. In this case, second-year scholar Joe Schacht from South Carolina used the materials and presented the lecture originally developed by second-year scholar Sarah Pedersen from the University of Pittsburgh on the topic of alcohol use and problems in African Americans. This was a beautiful delivery of an excellent lecture with some small modifications in slides. Joe spent less than two hours in preparation, which went as smoothly as if he had developed the original lecture for himself.

Martin Plawecki, second-year scholar from Indiana University, next presented his report of progress regarding enhancing alcohol and drug education for medical students, psychiatric residents and fellows, and psychology trainees at his medical school and for undergraduate and graduate students at the affiliated Indiana University – Purdue University Indianapolis campus. At the medical student level, he continues to engage with the departmental and section liaisons for the medical student education reform process, with implementation scheduled in the next 1-2 academic years. At the undergraduate level, his research group was informed of an ongoing mandatory survey of matriculating undergraduates. The larger Indiana Alcohol Research Center Outreach component has begun discussing how to use this data scientifically and potentially as a medium for internet-delivered education. Martin continues to serve on the Child and Adolescent Psychiatry Resident Education Committee. His activity in the education of psychiatric fellows has increased and Martin continues to use the AMSP methodology within lectures provided to the group. Martin has commenced active participation on the admissions committee of the Indiana University Medical Scientist Training Program steering committee, encouraging students to consider research into alcohol and substance abuse.

Daryl Shorter, first-year scholar from Baylor College of Medicine (BCM) next discussed his recent educational activities geared toward the advancement of alcohol and drug education at his medical school. In his role as course director for the Introduction to Addictions Treatment lecture series for post-graduate year 1 (PGY-1) General Psychiatry residents, Dr. Shorter updated the curriculum to focus more specifically on diagnosis and treatment of substance use disorders rather than organizing each talk by substance of abuse. He also delivered a talk for the series titled, "Neurobiology of Addictive Disorders," which drew upon the principles taught in AMSP. Additionally, Dr. Shorter utilized AMSP techniques for lecture outline and slide construction while presenting on medical marijuana at the Texas Medical Association's Physician Health and Wellness Annual Meeting. Finally, Dr. Shorter presented AMSP's "How to Tell Your Story" lecture to the BCM Department of Psychiatry - Clinician Educator Track, a specialized program within the residency devoted to the development of teaching excellence among trainees.

Leslie Lundahl, first-year scholar from Wayne State University in Detroit, next presented the developments in alcohol and drug education to which she contributed at her university. She has continued her involvement on the Core Competencies Committee for the Psychiatry Residency, where she lobbied for increased training opportunities in substance use. These efforts, in addition to a meeting with the Vice Chair of Medical Education, resulted in the addition of a seminar on addiction-related issues and a special case conference at which residents may present substance abuse cases. Dr. Lundahl also updated her lectures based on the AMSP style and used them in the following courses she teaches: “Psychotherapy Course” (DBT, CBT, Brief Interventions) for 3rd and 4th year psychiatry residents; “Treatment Approaches for Substance Use Disorders in Adolescents” to 2nd year psychiatry residents; and, “Adolescent Substance Abuse” for the Child and Adolescent Psychiatry Fellows. These were very well-received. Recently Dr. Lundahl agreed to serve as mentor to two PGY4 residents who elected to do a research rotation with her in substance abuse. Dr. Lundahl will present “How to Tell Your Story” (Dr. Schuckit’s lecture) at Grand Rounds this year. Finally, Dr. Lundahl was invited to present to a community taskforce on understanding adolescent SUD needs in area middle/high schools. Her new skills from AMSP aided her in developing a lecture to appeal to a very wide audience, including school administrators, community health agencies, law enforcement, clergy, drug courts, parents, and local mental health providers.

Lunch was then served in the meeting room and the group turned to a discussion of additional academic development issues. The issues included suggestions about how to develop a budget and how to monitor that budget during the course of the grant or clinical activity; selecting among data one has regarding which papers might be written first (the answer of which related to prioritizing papers that will help with any subsequent grant on a similar topic); the importance of structuring grant (including K awards) so that some data are available within the first year to contribute to papers so that in the next stage of research one can demonstrate productivity from the prior work; and issues related to various approaches to biosketches that need to be submitted as part of grant applications.

In the afternoon and to continue the reverse side of Joe Schacht’s having delivered her lecture, Sarah Pedersen next demonstrated how she could use the outline and slides (with minor modifications) originally developed by Joe Schacht to give his lecture he developed on pharmacogenetics. This, too, was an excellent lecture. The goal here was to underscore to both first and second-year scholars how the work they have put into the development of their lectures for the AMSP website produces educational material on alcohol and allied topics that can be used by graduate students, other lecturers at their university, as well as universities elsewhere.

Continuing the demonstration of how 40-minute lectures originally for medical students can be modified for a different audience with a minimal amount of time, Kelly Barth, second-year scholar from South Carolina modified her original lecture on the use and problems associated with opioid drugs originally aimed at dental students, but now as a 20-30 minute lecture with a maximum of 15 slides, but as appropriate for judges in drug courts. These were well done and very appropriate for the new audience. The group appreciated the information and the excellent delivery, as well as the content demonstrated how each member of AMSP may borrow from lectures already posted on our website, in this case to address the exceptionally important topic of over-prescription of opioids by physicians in practice.

Dorian Lamis, first-year scholar from Emory University School of Medicine in Atlanta next presented his activities for expanding alcohol and drug education. Dr. Lamis organized a workshop entitled "Innovative models of care for adolescent and adult substance use disorders", which was well attended by faculty, postdoctoral fellows, psychology interns, medical students and residents in the department of psychiatry. This workshop provided an update on the state-of-the-science with regard to substance abuse treatments for youth and adults. He also met with the director of medical school education, and is presenting a lecture on assessing and treating alcohol use and suicidal behaviors to PGY3 residents every 6 weeks. Dorian used AMSP principles to revise his lecture on this topic from treating college students to clinical patients. Given that Dr. Lamis is on the Emory Faculty Development Committee that develops the Grand Rounds schedule, he will suggest in the upcoming FDC June meeting that a nationally recognized expert in substance use/addiction be brought in to speak to the department. Finally, Dr. Lamis is planning to enhance his role as a mentor next academic year. Specifically, he has hired 3 postdoctoral fellows who will begin in July and be mentored in research and clinical work incorporating substance use prevention strategies.

Paola Pedrelli, second-year scholar, from Massachusetts General Hospital presented her progress regarding enhancing alcohol and drug education. Paola continues to ensure that the transitional age youth program for PGY-III at HMS includes training on the assessment and treatment of alcohol and drug use among young adults. Dr. Pedrelli will give a lecture June 1, 2016 to MGH Addiction fellows outlining the resources available on the AMSP website and will present the “How to Tell Your Story” lecture. Since the last AMSP meeting, Paola has given one presentation on heavy drinking at a conference organized by MGH on substance use disorders. The audience included psychiatrists, social workers and psychologists. For her presentation, she included slides from the AMSP webpage and applied AMSP principles. On April 27th she will deliver a lecture on depression and heavy drinking at a conference on teen mental health that will be attended by peer counselors, high school administrators and school psychologists. She will deliver the lecture together with a post-doctoral fellow from the Depression Clinical Research Program and will teach him the principles illustrated in the “How to Tell Your Story” lecture from AMSP. She continues to organize career development weekly meetings at the Center for Addiction Medicine at MGH where she encourages people to disseminate education on alcohol and drugs at HMS and in the community.

Kelly Barth, second-year scholar from MUSC, provided an update on her AMSP-related activities at MUSC. These included an inter-professional education project, where she is training students from nursing, pharmacy and medicine on the safe management of high-risk opioid patients. This team is identifying pain patients who will most likely benefit from opioid overdose prevention interventions, and providing education and medication for overdose prevention. Dr. Barth has been named course co-director for MUSC’s Drug & Alcohol Research Track, which trains psychiatry residents in addiction research. She has asked fellow AMSP scholar Dr. Schacht to present “How to Give a Lecture” as part of this educational series. Dr. Barth also authored a monograph for the South Caroline Medical Association entitled “Safe Benzodiazepine and Stimulant Prescribing.” This is distributed as a free statewide resource to all physicians, and qualifies as their 2 hours of required continuing education for license renewal. She continues to present her bi-annual lecture on opioid issues in dental medicine for 100 first-year dental students.

Finally, Sarah Pedersen, second-year scholar from the University of Pittsburgh (Pitt) School of Medicine, presented her activities related to alcohol and drug education since November 2015. Dr. Pedersen was involved in several different endeavors related to the goal of increasing addiction training at Pitt Medical School. First, delivered a talk to 1st year psychiatry residents on the screening and diagnosis of substance use disorders and utilized AMSP lecturing style. Dr. Pedersen also presented on racial identity development in AMSP style to 4th year psychiatry residents. She also lectured on adolescent substance use to child & adolescent psychiatry fellows. Dr. Pedersen also facilitated a small group didactic class to 1st year medical students on the topic of smoking cessation and relapse. Finally, Dr. Pedersen also presented her AMSP lecture on Black American drinking to undergraduate and graduate students at Carnegie Mellon University. Dr. Pedersen is also joining the faculty preceptors on an institutional graining grant at Pitt (T32) designed to train alcohol researchers. Dr. Pedersen is working on continuing to expand her teaching role at Pitt and is pursuing giving a talk on “how to tell your story” to the department of Psychiatry’s post-doctoral training seminar. Additionally, she has discussed AMSP with the Chair of the Psychiatry department and is working on helping provide direct feedback to post-docs and residents when they prepare a lecture or scientific presentation.

The activities on Friday, March 18th, ended with a working dinner at the Nirvana Grille Restaurant in Laguna Beach. With much of the work having been accomplished, and looking forward to the remaining lectures and reports to be delivered on Saturday, March 19th, this was a relaxed get-together in an excellent environment.

IV. Saturday, March 19, 2016
The morning began with the delivery of a lecture on buprenorphine developed by first-year scholar, Daryl Shorter, from Baylor University. With a superb and engaging delivery style this lecture demonstrated how effective it is to carefully define all jargon, the importance of helping the audience to refocus periodically by reminding them which section of the lecture is being delivered, the effectiveness of keeping titles to one line when possible (and the tendency of computer programs to override that preference, as well as how to go back to the original intent by the lecturer), as well as additional important information being delivered regarding both opioid detoxification and maintenance treatment.

Priscila Dib, a second-year scholar from the University of São Paulo, Brazil next presented her excellent lecture that was now modified for a 30-minute lecture on alcohol-related blackouts as delivered to an imaginary audience of young individuals at a university who had been arrested for driving while intoxicated. This was a fine lecture with an excellent delivery style, presented with a great sense of humor and engaging personality style. One of the remarkable aspects of this talk was that we were asking an individual to present a lecture in what was not their native language, demonstrating the importance of speaking slowly and using slides that present any words that are part of the delivery but that might be difficult for some members of the audience to understand when delivered with an accent (despite her superb mastery of English).

The group next discussed the date of the next meeting, to which first-year scholars will be attending as second-year scholars, but will be the first meeting for the new group of first-year individuals. This is now scheduled to begin Wednesday, October 19, 2016 and end at noon on Saturday, October 22nd. The specific location will be determined soon, although various alternatives with pros and cons were briefly discussed.

Following this discussion, Marty Plawecki, second-year scholar from the University of Indiana, presented an alteration of his original 40-minute lecture into a 20-minute lecture. The topic was alcohol monitoring devices, but this time the audience was potential investors. As is true of all the lectures at this meeting, the delivery was excellent, the slides highly appropriate, and the information quite appropriate to the new audience.

Priscila Dib from the University of São Paulo, next presented her plans for accomplishing AMSP-related activities at the University of São Paulo upon her return there in October 2016. Upon her return to the University of São Paulo in October 2016, Priscila intends to translate into Portuguese the presentation “How to Tell Your Story” and make it available to the AMSP website. Priscila also intends to give this talk at the Addiction Seminars, which is attended by six second-year psychiatry residents, six fellows from the multidisciplinary residency in Alcohol and Substance Use Disorders for non-medical professional, psychologists, clinical psychiatrists, and open to the general public. She plans to give this talk at the Psychiatric Grand Rounds that are attended by all psychiatric residents, psychiatry department faculty, and clinical staff from the Institute of Psychiatry, where she plans to raise awareness of the available lectures on the AMSP website. Moreover, Dr. Dib will work with Dr. Camila Silveira (AMSP alumni) to continue to improve alcohol education in concert with the coordinator of the Group of Studies on Alcohol and Drugs (GREA) with the hope of developing a plan to implement an AMSP in São Paulo within the next few years. Additionally, Priscila also will use her AMSP training to modify the alcohol and drug lectures she presents to trainees in neuropsychology, psychiatry residents and other mental health professionals.

Next on the agenda was a discussion by Randi Schuster, first-year scholar from the Massachusetts General Hospital (MGH) and Harvard Medical School (HMS) regarding her activities and upcoming plans to facilitate substance use disorders training at her institution. Randi discussed her plans to develop a series of lectures and presentations focused on issues pertinent to substance use assessment and treatment to be delivered to parents, faculty and students at local high schools where she is conducting ongoing research. Randi also recently started a journal club for newly accepted medical students and graduate students to foster a discussion on current, thematically-arranged issues in the field of substance use. Finally, she will be lecturing to the neuropsychological service at MGH in June on the impact of cannabis exposure on the developing brain, using slides and outline approaches developed through AMSP.

The group next discussed the AMSP website. While aspects of the website and the host for this site have changed over the years, the productivity and potential effectiveness of the site remain. During the prior year there were almost 9,000 page views for about 6,000 visits that were carried out by 4,500 new users. The website was visited by individuals from 112 countries, with most living in the United States, Canada, Brazil, India, Russia, the United Kingdom, Italy, China, and the Netherlands. The most often downloaded files included lectures on motivational interviewing, acute alcohol intoxication, how to tell your story, synthetic cannabinoids, alcohol withdrawal, college drinking, alcohol and cocaine, and pharmacogenetics.

Prior to the end of the meeting, the second-year scholars were presented with their graduation plaques. As is true every year, this was a happy occasion. Everyone expressed great appreciation to Marcy Gregg regarding her work in overseeing all of the details for preparing such a meeting, as well as an appreciation on all sides for how hard the second-year scholars have worked and how much they learned.

The meeting adjourned at 11:00 am. Everyone was given good wishes for a safe and comfortable trip home.

Layout and design by Brian Klima