Meeting #40 - Hawaii

Mauna Kea Beach Resort, Kohala Coast, HI

October 3 - 6, 2018

Minutes of the AMSP Meeting – Kona Hawaii, October 3-6, 2018

Present at the meeting were Marc Schuckit (Director), Marianne Guschwan (Assistant Director), MaryAnn Klima (Administrator), First year scholars: Brooke Arterberry from Iowa State University, Elizabeth Aston from Brown University, Kathleen Broad from Western University, Christopher Hammond from Johns Hopkins, and Jose Vito from New York University. Also present were second year scholars: Kara Bagot from UCSD Medical School, Jennifer Merrill from Brown University, and J. David Stiffler from New York University.

I. Wednesday, October 3, 2018
The meeting began with a get together in the lobby of the Mauna Kea Resort. The group had the opportunity of introducing each other and to give each other’s backgrounds, (this is the first meeting for first year scholars). We reviewed the agenda for the meeting, discussed the goals of what is to be accomplished during these three days, and then moved the meeting to the Manta Restaurant for continued discussion and networking.

II. Thursday, October 4, 2018
The session began at 8:00am. The first item was an in-depth discussion of the history of AMSP and a review of the current goals of the meeting. Each scholar introduced themselves in more detail and gave a brief background.
The remainder of the morning involved Marc presenting the information on “How to Tell Your Story”. This was the basis for developing lectures, papers, posters, and grant applications. Second year scholars offered their suggestions on additional information that might be helpful to first year participants;, there was plenty of opportunity for questions and answers regarding application of this information to one’s own career; and thoughts were shared about the application of these guidelines to the development of the project for all first year scholars aimed at practicing what was taught during the meeting.

The group then had a working lunch. One issue was discussing how to optimize happiness and success in an academic environment. Other topics included the balance between clinical obligations and personal development and research, how and when to say no when asked to take on a project, and balancing time between home and work.

The next item of business was a return to issues related to telling one’s story. Covered was how to handle questions that arise during presentations, as well as issues related to delivery of lectures. Special attention was paid to how to modify the information for posters.

Jennifer Merrill, second year scholar from Brown University, then presented her lecture on alcohol related black-outs. This was a fine lecture and Marc pointed out some especially good slides as well as the organization of the flow of information during the talk. Jennifer, working with the group, then created an exercise where the same lecture was to be delivered in 20 minutes (rather and 40 minutes), with the use of 20 slides (rather than 40 slides for the full lecture). This was done by focusing on a limited number (two or three) of the original four points. Slides could be modified, it would be possible to add an additional slide if needed, but the process began by determining which slides can be taken out of the lecture once it is shortened.

The meeting adjourned with a discussion of topics for the next day, and questions about dinner for that evening (all scholars were on their own).

III. Friday, October 5, 2018
The day began with delivery of a lecture by Kara Bagot, second year scholar from UCSD, regarding marijuana. The lecture was excellent and was then used for a similar discussion of how to modify an existing lecture based on the audience and time allotted. This process was carried out by Marc, Kara, and the full group. The first goal was to cut the lecture from 40 minutes to 20 minutes and only using 20 slides; followed by how that lecture could then be cut to 10 minutes/10 slides by focusing on only one of the major points.

The next order of business was for the first year scholars to present tentative plans regarding their project that will be used to practice the major lessons delivered in the “How to Give a Lecture” presentation. In this process, Chris Hammond, from Johns Hopkins University, selected modification of a fMRI presentation developed by Claire Wilcox regarding craving; Elizabeth Aston, of Brown University, decided to develop a lecture from scratch regarding bonified uses of medical marijuana; Brook Arterberry, from Iowa State University, selected the lecture on drinking in college settings by Gail Bosch for modification; Kathleen Broad from Western University in Toronto, Canada, decided on developing a new, full lecture based on a paper published by Marc Schuckit in The Lancet, a lecture that Kathleen can use regarding alcohol use disorders both in her own university as well as her work in the Northwest Territories; Jose Vito, from NYU, opted to update the lecture on spice by Shelly Holmes.

The next goal was for each second-year scholar to present their accomplishments regarding enhancing alcohol and drug education at their medical schools:

1. David Stiffler, from NYU, continues to serve as the Associate Editor of the American Academy of Addiction Psychiatry (AAAP) Newsletter and wrote two articles since the last meeting, including one on trauma and substance use disorders and another on ayahuasca. Dr. Stiffler continues to be active in medical education at NYU, where he serves on the Residency Selection Committee and is the faculty advisor to the Medical Student Psychiatry Interest Group, which recently hosted an event for medical students to learn from substance abuse experts on the most effective ways to interview patients who use substances in different medical settings. Dr. Stiffler also continues to lecture to psychiatry residents, giving talks to first year residents on the neurobiology of trauma and resilience and to fourth year residents on trauma and substance use disorders. He participated in two case conferences involving patients with substance use disorders on inpatient resident training units, one at Bellevue Hospital and another at the Manhattan VA Hospital. In the Steven A. Cohen Military Family Clinic, where David is the medical director, he supervises psychology externs and has lectured on psychopharmacologic treatments for substance use disorders. He also was interviewed about benzodiazepines on Doctor Radio, which is programmed by the NYU Langone Medical Center radio station and aired nationally on Sirius XM Radio. Finally, Dr. Stiffler was a speaker on a panel at the National Council for Behavioral Health annual conference (NatCon18) where he spoke about the opioid epidemic.

2. Kara Bagot, second year scholar from UC San Diego Department of Psychiatry, has continued to develop and expand child and adolescent psychiatry fellowship substance use didactics, using the AMSP format in delivering lectures to the child psychiatry fellows. These didactics are in conjunction with field education in community adolescent substance use rotation for fellows. She has also adapted previous lectures for medical students and adult psychiatry residents to the AMSP format to improve understanding of the concepts discussed. Further, in collaboration with Dr. Carla Marienfeld, an associate professor at UC San Diego, and a graduated scholar, Kara will co-direct didactics for the addiction psychiatry fellowship. Kara also mentors undergraduates, graduate and medical students, postdoctoral fellows and child and adolescent psychiatry fellows on substance use education and research. Further, she has given Pediatric Grand Rounds at Rady Children’s Hospital on adolescent substance use disorders to education pediatric residents and faculty. Kara is also a member of the Opiate Use Task Force at Rady Children’s Hospital to influence opioid prescribing practices among physicians, ad increase parent education on opiate safety, administration and disposal. She is also increasing substance use education among allied health professionals, by providing rounds to nurses in community adolescent substance use centers regarding consequences and treatment of various substance of use. As co-chair of the Addiction Special Interest Group in the Department of Psychiatry, Kara serves as the co-chair of the Training and Education committee helping to increase substance use education among medical students and psychiatry residents and fellows. Finally, on a national level, Kara was recently interviewed by Anderson Cooper for a segment on 60 Minutes educating the general public on cannabis use disorders and other potential compulsive behaviors of concern among adolescents.

3. Jennifer Merrill, from Brown University, continued to be involved in the Alcohol and Other Drug Committee at Brown University, where she is co-chairing a subcommittee focused on enhancing faculty and staff abilities to recognize and address substance use issues among students. She helped conduct a survey-based needs assessment, which included assessment of faculty/staff willingness to attend a lecture on substance misuse topics. Jennifer began to revise some of her lectures for her Summer at Brown course, using AMSP principles. (3) Jennifer is chair of the Rounds Committee at CAAS. She invited former scholar Paola Pedrelli to give a task as a part of this series. Dr Merrill has spread the word about the AMSP program, including the availability of lectures on the website. (5) Jennifer was interviewed for a podcast episode on alcohol with the goal of educating medical providers on important issues related to substance use. The primary audience of the podcasts will be infectious disease physicians, nurses, social workers, medical assistants, substance use counselors, therapists, etc. In the future, if there is interest among Brown faculty and staff, Jennifer will develop and deliver an AMSP style lecture on identifying and addressing substance use problems among students. Next, she will look into who is in charge of alcohol education for Clinical Psychology Trainees and Medical Students, in order to survey the department on what kinds of education is currently provided and give additional suggestions. In her role as chair of the CAAS Rounds Committee, she will look for opportunities to provide weekly speakers of that series, and/or postdoctoral fellows, with suggestions for using the guidelines put forth in the “How to Tell your Story” AMSP lecture. Jennifer will assist her PhD and Master’s students in using AMSP principles as they develop and deliver research presentations. She will continue to practice outlining and modifying existing lectures (to be delivered to a Summer at Brown Introduction to Psychology class) using the AMSP principles, with an ultimate goal of redoing all lectures for that course using these principles. (6) Finally, Jennifer is co-chairing the 2019 Collaborative Perspectives on Addiction conference, and advocated for this conference to be held in Providence, RI so that Brown University students and residents will be able to benefit from further education on alcohol and drugs. She will advertise and encourage Brown students and residents to attend.

The group then discussed the lessons exemplified by those second year lectures. We also discussed reassembling at 7:00pm in the lobby of the hotel for a working dinner at Sansei Restaurant where we continued discussion of the assignments of first year scholars and began the work to select appropriate mentors for that process.

IV. Saturday, October 6, 2018
The group reconvened at 8:00am with the presentation by David Stiffler from NYU of his full lecture as developed when he was a first-year scholar. The topic was post traumatic stress disorder. Once again, this was a fine lecture with superb slides. The group next turned to this information might be useful as the first year scholars begin their projects. David Stiffler and Marc and the full group followed the approach of changing both the audience and the timeframe in order to modify the lecture.

The next order of business was assignment of first-year scholars to mentors. The results were:

1. Chris Hammond will work with Marc Schuckit.
2. Elizabeth Aston will work with Kara Bagot.
3. Brooke Arterberry will work with Jennifer Merrill.
4. Kathleen Broad will work with Marianne Guschwan.
5. Jose Vito will work with David Stiffler.

The group then turned to potential date for the spring meeting. After detailed discussion the group decided on March 20-23, 2019. Potential locations for the meeting occurring in March probably preclude most east coast venues (with the possible exception of Charleston, South Carolina). Locations under consideration include Napa, Monterey/Carmel Santa Monica, and San Diego.
The first year scholars were asked to present their thoughts on projects that they might do to enhance alcohol and drug education at their institutions. The results were the following:

1. Kathleen Broad, from Western University, presented her plans for how to improve alcohol and drug education at her institution. She plans to give Grand Rounds at Stratford General Hospital on alcohol use disorders (AUDs). She plans to give "Doc Talks" to nurses at Stratford General Hospital on AUDs. She plans to contact the psychiatry undergraduate and postgraduate education coordinators at Western University to determine and explore needs for improving alcohol and drug medical education for medical students and psychiatry residents. In her role as consultant for the Northern Psychiatric Outreach Program at CAMH, she plans to give a lecture on AUDs to nurses at the Qikiqtarjuaq Health Centre in Nunavut Canada, and will supervise a senior psychiatry resident to give a lecture on AUDs to nurses at Pangnirtung Health Centre in Nunavut Canada.

2. Brooke Arterberry, from Iowa State University, plans to continue to serve on the Curriculum Committee for the Counseling Psychology area, which focuses on enhancing the courses taught in the Counseling Psychology program. She intends to develop a seminar focused on Alcohol and Other Drug Use as a course offering for graduate students in the Department of Psychology. Additionally, she is assisting in the implementation of the BASICS program at the university. This will also provide Dr. Arterberry with the opportunity to provide education regarding alcohol and other drugs to university staff working in Student Wellness, Student Conduct, and Residence Life, as well as Counseling Psychology graduate assistants who will be interacting with students mandated to the BASICS program. Dr. Arterberry also plans to deliver the “How to Tell Your Story” lecture to graduate students in Psychology.

3. Jose Vito, junior scholar from NYU Langone School of Medicine, gave his report of future activities. Currently as a Clinical Assistant Professor and as a member of the Educational Committee of trainees at NYU, he plans to adapt his current lectures for the medical students and adult psychiatry residents to the AMSP format including his current project of updating the Synthetic Cannabinoid AMSP lecture. As the Director of the Medical Education and Training at the Outpatient Clinic of Manhattan Psychiatric Center, this will be a great venue to teach medical students, residents, and nurse practitioners on substance use education and research. He is also on the Addiction Committee of the New York County Psychiatric Society, a District Branch of the American Psychiatric Association. One of his initiatives it to create an AMSP-inspired talks and podcasts to educate substance use disorders to APA members and the general public. He is also co-authoring a chapter to a book about adolescents and substance use disorder.

4. Elizabeth Aston, from Brown University, will develop and deliver an AMSP style lecture on the behavioral economics of marijuana to postdoctoral students in the Center for Alcohol and Addiction Studies (CAAS) as part of their Etiology of Substance Use Disorders course. She also plans to modify the AMSP slides regarding how to give a lecture and present this as part of a monthly postdoctoral writing group, of which she is the group coordinator. Elizabeth will plan to deliver her in-progress AMSP lecture on Medical Marijuana to the “Alcohol and Other Drug Use” group, a group comprised of faculty and students focused on learning more about substance use and intervention at Brown University. Dr Ashton will modify existing course lectures using the AMSP principals and guidelines (to be delivered to a Summer@Brown Introduction to Neuroscience course). She is also part of the 2019 Collaborative Perspectives on Addiction conference planning committee, and as part of this commitment, will encourage Brown University medical residents and students to participate and attend the meeting, wherein much research will focus on assessment, prevention, and intervention for alcohol and other substance use. Elizabeth will plan to present on her current research during CAAS Rounds, implementing AMSP guidelines and principles. Finally, Elizabeth will look for other opportunities to present on use of marijuana for both medical and recreational purposes at national meetings, including at conferences and as part of invited talks, using the AMSP guidelines.

5. Christopher Hammond, first-year scholar at Johns Hopkins, next presented some thoughts on how he might improve alcohol and drug education at his medical school. His background in child and adolescent psychiatry and addiction research, and collaborative network that bridges pediatrics, adolescent medicine, general psychiatry, child and adolescent psychiatry, and addiction medicine, place him in an excellent position to play a key role in alcohol and drug education programming within the Johns Hopkins University School of Medicine. Chris plans to develop and refine alcohol and drug educational curriculum for residents and fellows in the JHU general psychiatry and child and adolescent psychiatry training programs. He has developed an adolescent substance use disorder research elective for JHU child psychiatry fellows and plans to refine this elective and expand it to also include general psychiatry and pediatric residents, medical students, and pre-medical undergraduate and post-baccalaureate students at JHU. Chris also plans to provide clinical in-services on diagnosis and treatment of co-occurring substance use and psychiatric disorders in adolescent and young adults to clinical staff at JHU-affiliate institutions and programs including the Kennedy Krieger Institute and the JHU Community Psychiatry Program. To optimize the impact of the proposed educational initiatives, he plans to coordinate efforts with the JHU training directors for fellowship and residency programs.

The group then turned to a more detailed description of what might be done in each of the first year projects. Marc reviewed each project and made suggestions, with additional suggestions from other scholars.

The meeting adjourned at 11:30am in order for individuals who were leaving that day to be able to check-out and make their flights home. Everybody was wished a safe flight, and Marc also took a moment to thank MaryAnn Klima for all of her work in organizing the meeting.

Meeting then adjourned.

Minutes by Marc Schuckit

Layout and design by Brian Klima