Program Director, National Capital Consortium Psychiatry Residency Program.
psychiatry resident at Walter Reed National Military Medical Center.
Med J (Ft Sam Houst Tex). 2021 Jan-Mar(PB 8-21-01/02/03):3-7.
There is inconsistency in the training of military medical providers on the regulations and procedures outlining US Army-specific psychiatric readiness related competencies. These competencies are necessary to ensure the appropriate categorization of a soldier's psychiatric readiness. There exists a need for a formal, comprehensive training curriculum accessible to all providers that is time- and cost-effective. Due to the COVID-19 pandemic, there is are additional barriers of social distancing, remote virtual healthcare delivery, and geographic dispersion of healthcare personnel. To address these concerns, we developed a curriculum to target these competencies and deliver them virtually. The curriculum was developed and executed based on Kern's six-step approach to curriculum development, and the objective was to train military behavioral health providers on temporary duty limitations, administrative separations, and medical board referrals based on current US Army policies and procedures. The training was implemented virtually and conducted over the course of 3-hour training sessions to two separate groups. Evaluation of training objectives was conducted via a survey of paired before and after questions, analyzing the change in perceived confidence among learners. Among the 58 respondents, training resulted in statistically significant improvement in confidence in recognizing when a US Army soldier needs a temporary profile, writing a temporary e-profile, deciding when it is critical to contact a US Army soldier's commander, executing administrative separation, deciding when a US Army soldier is at medical retention determination point (MRDP), and in referring a US Army soldier to medical board. Results show the feasibility of virtual training to enhance medical readiness-related competencies of healthcare providers at the enterprise-level to help improve medical readiness. Limitations included immediate and subjective aspects of our results. It is unclear whether our training or similar training sessions resulted in changes in behaviors such as increased profiling or medical board referrals.
在规定和程序方面，军事医疗提供者对美国陆军特定的精神准备相关能力的培训存在不一致性。这些能力对于确保对士兵的精神准备进行适当分类是必要的。需要有一个面向所有提供者的正式、全面的培训课程，该课程要具有时间和成本效益。由于 COVID-19 大流行，存在社交距离、远程虚拟医疗保健提供以及医疗人员地域分散等额外障碍。为了解决这些问题，我们开发了一个针对这些能力的课程，并通过虚拟方式提供。该课程是根据 Kern 的六步课程开发方法开发和执行的，目的是根据当前的美国陆军政策和程序，对军事行为健康提供者进行临时任务限制、行政分离和医疗委员会转介方面的培训。培训是通过虚拟方式进行的，并在 3 小时的培训课程中对两个不同的小组进行。通过对前后配对问题的调查来评估培训目标，分析学习者感知信心的变化。在 58 名受访者中，培训导致对识别美国陆军士兵何时需要临时档案、编写临时电子档案、决定何时与美国陆军士兵的指挥官联系至关重要、执行行政分离、决定美国陆军士兵是否处于医疗保留决定点 (MRDP) 以及向医疗委员会转介美国陆军士兵方面的信心有了统计学上的显著提高。结果表明，虚拟培训对于增强医疗保健提供者与企业级相关的医疗准备能力是可行的，有助于提高医疗准备水平。局限性包括我们结果的即时性和主观性。尚不清楚我们的培训或类似的培训课程是否导致行为发生变化，例如增加档案编制或医疗委员会转介。
