Crawford Allison, Sunderji Nadiya, López Jenna, Soklaridis Sophie
Department of Psychiatry, University of Toronto, CAMH, Room 825, 250 College St., Toronto, Ontario, M5T 1R8, Canada.
Outreach and Telepsychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
BMC Med Educ. 2016 Jan 26;16:28. doi: 10.1186/s12909-016-0529-0.
A foundational assessment of learning needs is missing from previous reports of telepsychiatry curricula. We used an in-depth needs assessment to identify specific skills required for the practice of effective telepsychiatry, and provide an evidence base to guide the development of telepsychiatry curricula in postgraduate psychiatry training. Many of these skills set telepsychiatry apart from practice in traditional face-to-face clinical settings, or result from adaptations to clinical practice to meet the needs of a telepsychiatry interface in patient care.
We used a qualitative, modified grounded theory approach to gain insight into areas of importance for telepsychiatry training in postgraduate psychiatry residency. 16 interviews of faculty and residents (9 and 7 interviews, respectively), allowed participants to reflect on their experiences in telepsychiatry. Data were then thematically analyzed.
Interview respondents identified important aspects of the context for telepsychiatry training; the skills required to competently practice telepsychiatry; and the desired teaching and learning methods for acquiring these skills. Specific domains of competency were identified: technical skills; assessment skills; relational skills and communication; collaborative and interprofessional skills; administrative skills; medico-legal skills; community psychiatry and community-specific knowledge; cultural psychiatry skills, including knowledge of Indigenous cultures; and, knowledge of health systems. The skills identified in this study map well to competency- based medical education frameworks.
Telepsychiatry is increasingly being adopted as a solution to health systems problems such as regional disparities in access to care, and it requires explicit competency development. Ensuring adequate and quality exposure to telepsychiatry during residency training could positively impact our health systems and health equity.
以往远程精神病学课程报告中缺少对学习需求的基础评估。我们通过深入的需求评估来确定有效开展远程精神病学实践所需的特定技能，并提供证据基础以指导研究生精神病学培训中远程精神病学课程的开发。其中许多技能使远程精神病学有别于传统面对面临床环境中的实践，或者是为满足患者护理中远程精神病学界面的需求而对临床实践进行调整的结果。
我们采用定性的、改良的扎根理论方法，以深入了解研究生精神病学住院医师培训中远程精神病学培训的重要领域。对教员和住院医师进行了16次访谈（分别为9次和7次访谈），让参与者反思他们在远程精神病学方面的经历。然后对数据进行主题分析。
访谈受访者确定了远程精神病学培训背景的重要方面；胜任远程精神病学实践所需的技能；以及获取这些技能所需的理想教学方法。确定了具体的胜任领域：技术技能；评估技能；关系技能与沟通；协作和跨专业技能；管理技能；医学法律技能；社区精神病学和特定社区知识；文化精神病学技能，包括对本土文化的了解；以及卫生系统知识。本研究中确定的技能与基于胜任力的医学教育框架非常契合。
远程精神病学越来越多地被用作解决卫生系统问题的方案，如医疗服务获取方面的地区差异，并且它需要明确的胜任力发展。在住院医师培训期间确保充分且高质量地接触远程精神病学，可能会对我们的卫生系统和卫生公平产生积极影响。
