Curtin Michelle, Downs Jennifer, Hunt Amber, Coleman Emily R, Enneking Brett A, McNally Keehn Rebecca
Division of Child Development, Department of Pediatrics, Riley Child Development Center, Indiana University School of Medicine, Indianapolis, IN, United States.
Division of Child and Adolescent Psychiatry, Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States.
Front Psychiatry. 2021 Jun 23;12:671442. doi: 10.3389/fpsyt.2021.671442. eCollection 2021.
Internationally, pediatric depression and suicide are significant issues. Additionally, in the context of the COVID-19 pandemic, pediatric mental health needs are rising astronomically. In light of Child & Adolescent Psychiatrist (CAP) subspecialist shortages in the United States (US), there is an increasing call for primary care physicians in Family Medicine and Pediatrics to address an increasingly broad variety of patient needs. Here we report on the development and preliminary evaluation of medical student and resident perceptions on the "INteractive Virtual Expert-led Skills Training" (INVEST) medical education curriculum, a virtual synchronous CAP curriculum employing active learning strategies, including expert-led discussion and video modeling, and discussion designed to meet those priorities. In a standardized 60-min training format, our curriculum leverages audience response system polling, video modeling of key clinical skills, and interactive discussion with an expert subspecialist, over a virtual video conferencing platform. The primary educational strategy relies on use of video modeling to demonstrate best practice with CAP led group discussion to solidify and explain important concepts. Five waves of medical students and residents (N = 149) participated in the INVEST curriculum and completed pre- and post-training surveys regarding knowledge and comfort in the management of pediatric patients with depression and suicidality. Trainee participants reported significant positive gains in perceived likelihood of encountering pediatric suicidality as well as knowledge/comfort with depression screening and suicidality assessment in a primary care setting. Across some competency areas, there was an effect of medical learner level. Learners at lower levels generally reported the highest benefit. Medical students reported significant increases in their comfort interpreting and discussing positive depression screens and evidenced the greatest relative benefit in comfort with discussing suicidality. To our knowledge, INVEST is the first fully virtual, multimodal curriculum led by expert CAP subspecialists. Our findings suggest that INVEST shows promise for equipping medical learners with baseline knowledge for caring for patients with pediatric depression and suicidality. This synchronous, virtually delivered curriculum allows for critical training delivered to diverse medical learners regardless of geographic location, a particular benefit during the current COVID-19 pandemic.
在国际上，儿童抑郁症和自杀是重大问题。此外，在新冠疫情背景下，儿童心理健康需求正急剧上升。鉴于美国儿童与青少年精神科医生（CAP）专科医生短缺，越来越多的人呼吁家庭医学和儿科学领域的初级保健医生满足日益广泛的患者需求。在此，我们报告医学生和住院医师对“交互式虚拟专家主导技能培训”（INVEST）医学教育课程的看法的发展情况及初步评估，这是一个采用主动学习策略的虚拟同步CAP课程，包括专家主导的讨论和视频示范，以及旨在满足这些优先事项的讨论。在标准化的60分钟培训模式下，我们的课程通过虚拟视频会议平台，利用观众反应系统投票、关键临床技能的视频示范以及与专家专科医生的互动讨论。主要教育策略依赖于使用视频示范来展示CAP主导的小组讨论中的最佳实践，以巩固和解释重要概念。五批医学生和住院医师（N = 149）参加了INVEST课程，并完成了关于管理患有抑郁症和自杀倾向的儿科患者的知识和舒适度的培训前和培训后调查。学员参与者报告称，在初级保健环境中遇到儿科自杀倾向的感知可能性以及抑郁症筛查和自杀倾向评估的知识/舒适度方面有显著的积极收获。在一些能力领域，存在医学学习者水平的影响。较低水平的学习者通常报告受益最大。医学生报告称，他们在解读和讨论阳性抑郁症筛查结果方面的舒适度有显著提高，并且在讨论自杀倾向方面的舒适度相对受益最大。据我们所知，INVEST是首个由专家CAP专科医生主导的全虚拟、多模式课程。我们的研究结果表明，INVEST有望为医学学习者提供护理患有儿科抑郁症和自杀倾向患者的基础知识。这种同步的、虚拟授课的课程能够为不同的医学学习者提供关键培训，无论其地理位置如何，在当前新冠疫情期间这是一项特别的优势。
