Associate Professor, Department of Pediatrics, Uniformed Services University of the Health Sciences F. Edward Hébert School of Medicine; Military Pediatric Residency Program Director, Wright-Patterson Medical Center.
Assistant Professor, Department of Pediatrics, Uniformed Services University of the Health Sciences F. Edward Hébert School of Medicine.
MedEdPORTAL. 2024 Apr 29;20:11400. doi: 10.15766/mep_2374-8265.11400. eCollection 2024.
Pediatric behavioral and mental health (BMH) disorders are increasingly common, but most pediatricians feel inadequately trained to manage them. We implemented a case-based, longitudinal curriculum in BMH within a pediatric residency program to prepare trainees to diagnose and manage these conditions.
The pediatric residency program at Wright State University/Wright-Patterson Medical Center implemented a new BMH curriculum in 2020-2021. The curriculum consisted of five simulated cases involving depression, anxiety, attention deficit disorder with hyperactivity (ADHD), developmental delays, behavioral concerns, and autism. To reflect follow-up within a continuity clinic, cases included initial encounters and multiple follow-up visits. Faculty facilitators led residents in monthly small-group meetings over the academic year, with each session consisting of two to three simulated patient encounters. Residents completed pre-post surveys regarding their confidence in diagnosing and managing BMH conditions and pre- and posttests to evaluate the impact of the curriculum on knowledge gains.
All 47 pediatric residents participated in the curriculum; 38 (81%) completed pre-post surveys. Upon completion of the curriculum, residents reported significantly increased confidence in managing ADHD, treating depression, creating safety plans for suicidality, recognizing autism, and counseling patients and families on special education services. Knowledge-based pre- and posttests completed by 25 residents (53%) also demonstrated significant improvement ( = 92.4, = 10.9, pre vs. = 99.3, = 6.6, post, = .009).
This case-based, longitudinal curriculum in pediatric BMH simulating patient continuity improved residents' confidence and knowledge in diagnosing and managing common BMH conditions.
儿科行为和心理健康 (BMH) 障碍越来越常见,但大多数儿科医生觉得自己在管理这些问题方面的培训不足。我们在儿科学住院医师培训计划中实施了一项基于案例的纵向 BMH 课程,以培养受训者诊断和管理这些疾病的能力。
莱特州立大学/赖特-帕特森医疗中心的儿科学住院医师培训计划在 2020-2021 年实施了一项新的 BMH 课程。该课程由五个涉及抑郁、焦虑、注意力缺陷多动障碍(ADHD)、发育迟缓、行为问题和自闭症的模拟病例组成。为了反映在连续性诊所中的后续治疗,病例包括初始就诊和多次随访就诊。在整个学年中,教师导师每月通过小型小组会议引导住院医师进行学习,每次会议由两到三个模拟患者就诊组成。住院医师完成了关于他们诊断和管理 BMH 疾病的信心的预-后调查以及评估课程对知识获取影响的预-后测试。
所有 47 名儿科住院医师都参加了该课程;38 名(81%)完成了预-后调查。在完成课程后,住院医师报告说在管理 ADHD、治疗抑郁症、制定自杀安全性计划、识别自闭症以及为患者和家属提供特殊教育服务方面的信心显著增强。完成预-后测试的 25 名住院医师(53%)的基于知识的预-后测试也显示出显著的提高( = 92.4, = 10.9,预 vs. = 99.3, = 6.6,后, =.009)。
这项基于案例的纵向儿科 BMH 课程模拟了患者的连续性,提高了住院医师诊断和管理常见 BMH 疾病的信心和知识。