Hilty Donald M, Crawford Allison, Teshima John, Chan Steven, Sunderji Nadiya, Yellowlees Peter M, Kramer Greg, O'neill Patrick, Fore Chris, Luo John, Li Su-Ting
a Department of Psychiatry & Behavioral Sciences , Keck School of Medicine at USC and LAC + USC Medical Center , Los Angeles , California.
b Department of Psychiatry , University of Toronto , Ontario , Canada.
Int Rev Psychiatry. 2015;27(6):569-92. doi: 10.3109/09540261.2015.1091292. Epub 2015 Nov 5.
Telepsychiatry (TP; video; synchronous) is effective, well received and a standard way to practice. Best practices in TP education, but not its desired outcomes, have been published. This paper proposes competencies for trainees and clinicians, with TP situated within the broader landscape of e-mental health (e-MH) care. TP competencies are organized using the US Accreditation Council of Graduate Medical Education framework, with input from the CanMEDS framework. Teaching and assessment methods are aligned with target competencies, learning contexts, and evaluation options. Case examples help to apply concepts to clinical and institutional contexts. Competencies can be identified, measured and evaluated. Novice or advanced beginner, competent/proficient, and expert levels were outlined. Andragogical (i.e. pedagogical) methods are used in clinical care, seminar, and other educational contexts. Cross-sectional and longitudinal evaluation using quantitative and qualitative measures promotes skills development via iterative feedback from patients, trainees, and faculty staff. TP and e-MH care significantly overlap, such that institutional leaders may use a common approach for change management and an e-platform to prioritize resources. TP training and assessment methods need to be implemented and evaluated. Institutional approaches to patient care, education, faculty development, and funding also need to be studied.
远程精神病学（TP；视频；同步）是一种有效的、广受欢迎的标准执业方式。关于TP教育的最佳实践已发表，但尚未涉及预期成果。本文提出了针对学员和临床医生的能力要求，并将TP置于更广泛的电子心理健康（e-MH）护理背景中。TP能力要求是根据美国研究生医学教育认证委员会的框架，并参考加拿大医学教育认证委员会（CanMEDS）的框架组织制定的。教学和评估方法与目标能力、学习环境及评估选项保持一致。案例有助于将这些概念应用于临床和机构环境。能力要求可以被识别、衡量和评估。文中概述了新手或初级新手、胜任/熟练以及专家水平的能力要求。在临床护理、研讨会及其他教育环境中采用成人教学法（即教学法）。运用定量和定性方法进行的横断面和纵向评估，通过患者、学员和教职员工的迭代反馈促进技能发展。TP与e-MH护理有显著重叠，因此机构领导者可以采用共同的变革管理方法和电子平台来优化资源配置。需要实施和评估TP培训及评估方法。还需要研究机构在患者护理、教育、教师发展和资金方面的方法。
