Frydman Ruth
Department of Psychiatry, Maine Medical Center, Portland, Maine.
J Maine Med Cent. 2023 Summer;5(2). doi: 10.46804/2641-2225.1143. Epub 2023 Jul 12.
There is a shortage of psychiatric providers trained to work in community settings with people with serious mental illness (SMI) and associated comorbidities. We designed an innovative psychiatry rotation and curriculum for psychiatry residents and other learners.
The rotation incorporates working with our Assertive Community Treatment team and includes home visits, assertive outreach, and visits in other community settings. It was designed to improve learners' confidence in their understanding and skill set for working with and treating people with SMI in the community on an interprofessional (IP) team. This pilot quality improvement project evaluated psychiatry resident responses to the rotation using a standard evaluation form (residents) and post-rotation debriefing (all learners and IP staff).
Preliminary responses to the evaluation form indicated that the rotation improved residents' confidence in their knowledge of underlying approaches, social determinants of mental health, and community resources. The rotation also improved their skills in working collaboratively with people with SMI, IP teams, and people with serious substance use disorders. Debriefing sessions revealed that the rotation was rated highly by learners and IP staff.
Preliminary results suggest that the rotation (1) was well received by learners and IP staff and (2) increased residents' confidence in their understanding and skill set for working in community psychiatry on an IP team.
Using an IP team model, this rotation provides an opportunity for improving learners' confidence in their expertise, skills, and understanding of how to work with patients with SMI and comorbidities who are marginalized and difficult to engage.
目前缺乏受过培训、能够在社区环境中为患有严重精神疾病(SMI)及相关合并症患者提供服务的精神科医疗人员。我们为精神科住院医师和其他学习者设计了一种创新的精神科轮转培训及课程。
该轮转培训包括与我们的积极社区治疗团队合作,内容涵盖家访、积极外展服务以及在其他社区环境中的探访。其目的是提高学习者在跨专业(IP)团队中,针对社区中患有严重精神疾病患者的理解能力和技能水平的信心。这个试点质量改进项目使用标准评估表(针对住院医师)和轮转后汇报(针对所有学习者和跨专业工作人员)来评估精神科住院医师对该轮转培训的反应。
评估表的初步反馈表明,该轮转培训提高了住院医师对潜在治疗方法、心理健康的社会决定因素以及社区资源知识的信心。轮转培训还提升了他们与患有严重精神疾病患者、跨专业团队以及患有严重物质使用障碍患者协作的技能。汇报会议显示,学习者和跨专业工作人员对该轮转培训评价很高。
初步结果表明,该轮转培训(1)受到学习者和跨专业工作人员的好评,(2)增强了住院医师在跨专业团队中从事社区精神科工作的理解能力和技能水平的信心。
通过跨专业团队模式,这种轮转培训为提高学习者在专业知识、技能以及如何与被边缘化且难以接触的患有严重精神疾病及合并症患者合作方面的信心提供了一个机会。