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2024年美国联络-会诊精神病学住院医师培训指南

2024 ACLP Recommendations for Training Residents in Consultation-Liaison Psychiatry.

作者信息

Beach Scott R, Ernst Carrie L, Fipps David C, Soeprono Thomas M, Lavakumar Mallika, Greenstein Samuel P, Heinrich Thomas W, Schwartz Ann C

机构信息

Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA.

Departments of Psychiatry and Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY.

出版信息

J Acad Consult Liaison Psychiatry. 2025 Jan-Feb;66(1):80-89. doi: 10.1016/j.jaclp.2024.11.001. Epub 2024 Nov 10.

Abstract

BACKGROUND

Despite rapid shifts in consultation-liaison psychiatry (CLP) training in residency, including increasing general residency training requirements from the Accreditation Council for Graduate Medical Education, greater utilization of advanced practice providers, and effects of the coronavirus-2019 pandemic, the Academy of Consultation-Liaison Psychiatry has not updated recommendations for residency training in CLP since 2014. A national survey of residency program directors in 2021 suggested many changes to the structure of CLP rotations at individual programs over the past decade.

OBJECTIVE

These recommendations are intended to guide residency program directors toward optimizing CLP training for all residents, including those who will eventually pursue CLP fellowship.

METHODS

We convened a workgroup of 8 Academy of Consultation-Liaison Psychiatry members holding leadership positions in residency and fellowship education on local and national levels. The project was approved by the Academy of Consultation-Liaison Psychiatry Executive Council and conducted via a three-stage iterative process.

RESULTS

Consensus was reached on 34 recommendations across four domains, including structural issues, faculty supervision, formal curriculum and evaluations, and elective experiences. Residents must spend sufficient time on CLP rotations to achieve relevant milestones. Given that consultants are expected to offer unique insight, the ideal placement of core CLP rotations comes at a time in residency where residents are able to provide expert opinion and lead teams. Faculty expertise in CLP and availability to provide direct supervision and oversight to trainees are essential. A separate and formal CLP didactic curriculum should exist, and elective opportunities should be offered to supplement training.

CONCLUSIONS

Establishing a strong CLP foundation for all residents is essential for ensuring competency in providing psychiatric care for medically complex patients and collaborating with our colleagues in other specialties, as well as fostering trainee interest in pursuing a career in CLP.

摘要

背景

尽管住院医师培训中会诊-联络精神病学(CLP)培训发生了迅速变化,包括毕业后医学教育认证委员会提高了一般住院医师培训要求、更多地利用高级实践提供者以及2019冠状病毒病大流行的影响,但会诊-联络精神病学学会自2014年以来一直未更新CLP住院医师培训建议。2021年对住院医师培训项目主任的全国性调查表明,在过去十年中,各个项目的CLP轮转结构发生了许多变化。

目的

这些建议旨在指导住院医师培训项目主任为所有住院医师优化CLP培训,包括那些最终将攻读CLP奖学金的住院医师。

方法

我们召集了一个由8名会诊-联络精神病学学会成员组成的工作组,他们在地方和国家层面的住院医师培训和奖学金教育中担任领导职务。该项目得到了会诊-联络精神病学学会执行委员会的批准,并通过三个阶段的迭代过程进行。

结果

就四个领域的34项建议达成了共识,包括结构问题、教员监督、正式课程和评估以及选修经历。住院医师必须在CLP轮转上花费足够的时间以实现相关的里程碑。鉴于会诊医师预计会提供独特的见解,核心CLP轮转的理想安排是在住院医师能够提供专家意见并领导团队的时候。教员在CLP方面的专业知识以及为学员提供直接监督和指导的可用性至关重要。应该有一个单独的正式CLP教学课程,并且应该提供选修机会以补充培训。

结论

为所有住院医师建立强大的CLP基础对于确保为患有复杂医学疾病的患者提供精神科护理的能力、与其他专科的同事合作以及培养学员对从事CLP职业的兴趣至关重要。

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