Haghani Tehrani Poonè, Sala-Hamrick Kelsey J, Knottenbelt Sushilla, Sánchez John P, Salvador Julie G
Associate Professor, Department of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center.
Clinical Psychologist, Department of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center.
MedEdPORTAL. 2024 Dec 20;20:11468. doi: 10.15766/mep_2374-8265.11468. eCollection 2024.
Mental health and substance use disorders are common in the United States; however, only a portion of adults with these conditions receive treatment. Recent recommendations include using integrated behavioral health (IBH) models to increase patient access to care. Despite IBH's effectiveness, few psychiatry residents are trained in it. Considering the scarcity of evaluated curricula on IBH, we created a curriculum to teach different IBH models to psychiatry residents.
The curriculum was developed using the constructivism theoretical framework and aligned with the principles of competency-based medical education. The learning activities allowed learners to apply knowledge relevant to IBH models to critically appraise a clinical scenario while practicing different components of IBH, such as electronic consults. More specifically, the curriculum assignment prompted residents to examine a clinical practice, identify the model, make recommendations for changes, and discuss the advantages and barriers of the proposed changes. We employed Kirkpatrick model levels 1 and 2b to evaluate the curriculum.
Thirty-three residents participated in this curriculum. Eleven residents completed the assignment, which was qualitatively coded to evaluate their learning. Results indicated that the participants were able to compare different IBH models and critically appraise clinical practice using knowledge of those models. Twenty-two additional residents completed an anonymous retrospective pre- and postrotation survey on their perceived level of proficiency. Survey results showed improved perceived level of proficiency at rotation completion.
The developed curriculum was successful in teaching residents to acquire and apply knowledge relevant to IBH.
心理健康和物质使用障碍在美国很常见；然而，只有一部分患有这些疾病的成年人接受治疗。最近的建议包括使用综合行为健康（IBH）模式来增加患者获得护理的机会。尽管IBH有效，但很少有精神科住院医师接受过相关培训。鉴于评估IBH课程的稀缺性，我们创建了一门课程，向精神科住院医师教授不同的IBH模式。
该课程采用建构主义理论框架开发，并与基于能力的医学教育原则相一致。学习活动使学习者能够应用与IBH模式相关的知识，在实践IBH的不同组成部分（如电子咨询）时批判性地评估临床情景。更具体地说，课程作业促使住院医师审视临床实践，确定模式，提出变革建议，并讨论所提议变革的优点和障碍。我们采用柯克帕特里克模型的第1级和第2b级来评估该课程。
33名住院医师参加了该课程。11名住院医师完成了作业，对其进行定性编码以评估他们的学习情况。结果表明，参与者能够比较不同的IBH模式，并利用这些模式的知识批判性地评估临床实践。另外22名住院医师完成了一项关于他们感知到的熟练程度的匿名回顾性轮转前和轮转后调查。调查结果显示，在轮转结束时，他们感知到的熟练程度有所提高。
所开发的课程成功地教会了住院医师获取和应用与IBH相关的知识。
