Cruz Cesar, Orchard Kali, Shoemaker Erica Z, Hilty Donald M
Child and Adolescent Psychiatry, USC Institute of Psychiatry & Law, Los Angeles, CA USA.
Yellowknife Adult and Child Psychiatry, Yellowknife, Canada.
J Technol Behav Sci. 2021;6(2):327-337. doi: 10.1007/s41347-020-00164-5. Epub 2021 Feb 9.
The effectiveness of telepsychiatry video for clinical care is well established, and clinician and psychiatry resident interest in it is growing-particularly in light of the COVID-19 impact. Still, few residency programs in the United States have core curricula, rotations/electives available, and competencies, and many faculty have no experience. A survey was sent via national organization listserves for residents, fellows, faculty, and program directors to complete. The survey queried demographics, clinical experience and interest, and views/concerns, using Likert-like and yes/no questions. Descriptive statistics and other analyses compared the groups to assess impact of clinical experience on interest and views/concerns. Respondents ( = 270) have limited clinical experience with telepsychiatry (46% none), with trainees having less than others, and yet, most were very interested or interested in it (68%). Trainees ( = 123) have concerns about being prepared for future practice. Clinical experience with video in the range of 6-20 h appears to dramatically increase interest and reduce concerns, though less time has a positive effect. Respondents have concerns about connectivity, medico-legal issues, and clinical effectiveness (e.g., diverse populations, psychosis, and emergencies) with telepsychiatry. More research is needed to assess current clinical and curricular experience, interest, and concerns. Additional curricular interventions during residency and fellowship training could build skills and confidence, if this is feasible, and the benefits outweigh the costs.
远程精神病学视频在临床护理中的有效性已得到充分证实，临床医生和精神病学住院医师对其的兴趣也在不断增加，尤其是考虑到新冠疫情的影响。尽管如此，美国很少有住院医师培训项目设有核心课程、提供轮转/选修课程以及具备相应能力，而且许多教员也没有相关经验。通过全国性组织的邮件列表向住院医师、研究员、教员和项目主任发送了一份调查问卷，以供他们填写。该调查使用类似李克特量表的问题以及是/否问题，询问了人口统计学信息、临床经验和兴趣，以及观点/担忧。描述性统计和其他分析对各群体进行了比较，以评估临床经验对兴趣和观点/担忧的影响。受访者（n = 270）在远程精神病学方面的临床经验有限（46%没有经验），实习生的经验比其他人更少，然而，大多数人对其非常感兴趣或感兴趣（68%）。实习生（n = 123）担心自己没有为未来的实践做好准备。6至20小时的视频临床经验似乎能显著提高兴趣并减少担忧，尽管时间较短也有积极影响。受访者对远程精神病学的连接性、医疗法律问题和临床有效性（如不同人群、精神病和紧急情况）存在担忧。需要更多研究来评估当前的临床和课程经验、兴趣以及担忧。如果可行且益处大于成本，在住院医师和研究员培训期间增加课程干预可以培养技能和信心。
