Department of Pediatrics (V Wurster Ovalle, A Martini, S Tanguay, and DJ Schumacher), Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, Ohio; Division of Emergency Medicine (V Wurster Ovalle, A Martini, and DJ Schumacher), CCHMC, Cincinnati, Ohio.
Department of Pediatrics (V Wurster Ovalle, A Martini, S Tanguay, and DJ Schumacher), Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, Ohio; Division of Emergency Medicine (V Wurster Ovalle, A Martini, and DJ Schumacher), CCHMC, Cincinnati, Ohio.
Acad Pediatr. 2021 Jan-Feb;21(1):178-184. doi: 10.1016/j.acap.2020.07.002. Epub 2020 Jul 7.
Mental health problems in children are growing exponentially. General pediatricians, while in a unique position to address these issues as they arise, report they lack adequate training in assessing and managing behavioral/mental health (B/MH) problems. Underscoring the importance of this area, the American Board of Pediatrics has defined B/MH as one of only 17 foundational entrustable professional activities (EPAs) for general pediatric practice. Our goal was to explore the facilitators and barriers associated with implementing and assessing the B/MH EPA among pediatric residency programs in order to identify best practices and potential solutions to common barriers.
In this qualitative study, 18 key faculty members from 4 residency programs with 3 years' experience implementing and assessing their residents on the B/MH EPA were purposively sampled. Semistructured interviews were conducted with each participant, and interviews were analyzed utilizing a thematic analysis.
Five themes were defined in the thematic analysis 1) B/MH training: who's responsible? 2) local context can serve as a barrier or facilitator, 3) B/MH may require longitudinal, integrated, and multidisciplinary training, 4) B/MH specialists: indispensable, yet a hurdle?, and 5) resident and faculty confidence and skill impact B/MH training.
The need for robust training to prepare pediatric residency graduates to meet the needs of patients with B/MH problems has never been greater. This study provides important insights about gaps in B/MH training. These should inform future directions focused on addressing this need.
儿童心理健康问题呈指数级增长。普通儿科医生虽然处于能够及时解决这些问题的独特位置，但他们报告称，在评估和管理行为/心理健康 (B/MH) 问题方面缺乏足够的培训。为强调这一领域的重要性，美国儿科学会已将 B/MH 确定为普通儿科实践中仅有的 17 项基础可委托专业活动 (EPA) 之一。我们的目标是探讨在儿科住院医师培训计划中实施和评估 B/MH EPA 相关的促进因素和障碍，以确定最佳实践和常见障碍的潜在解决方案。
在这项定性研究中，从 4 个具有 3 年实施和评估居民 B/MH EPA 经验的住院医师培训计划中，有针对性地选择了 18 名主要教员。对每位参与者进行半结构化访谈，对访谈进行主题分析。
主题分析中确定了 5 个主题：1）B/MH 培训：谁负责？2）当地情况可能是障碍也可能是促进因素，3）B/MH 可能需要纵向、综合和多学科培训，4）B/MH 专家：不可或缺，但也是一个障碍？5）住院医师和教师的信心和技能影响 B/MH 培训。
为了培养儿科住院医师毕业生满足 B/MH 问题患者的需求，需要进行强有力的培训。这项研究提供了有关 B/MH 培训差距的重要见解。这些见解应指导未来专注于满足这一需求的方向。
