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继续医学教育项目对初级保健提供者的影响——对萨斯喀彻温省儿童精神病学教育项目的分析

Impact of a continuing medical education program on primary care providers - an analysis of a child psychiatry education program in Saskatchewan.

作者信息

Clark Malin, Sarda Madhav, Alaverdashvili Mariam, Le Thuy, Teare Adrian, Barton James, Jensen Peter S, Felstrom Anna

机构信息

Department of Psychiatry, College of Medicine, University of Saskatchewan, Rm 235 Ellis Hall, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada.

Continuing Medical Education, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.

出版信息

BMC Prim Care. 2025 May 16;26(1):172. doi: 10.1186/s12875-025-02872-4.

Abstract

BACKGROUND

Treating children and youth with mental health problems in the primary care setting is challenging for many reasons. One barrier to care is a lack of physician knowledge of child psychiatry. Saskatchewan has implemented a 6-month course developed by the non-profit REACH Institute and adapted to Canada (CanREACH), focused on teaching and implementing evidence-based child psychiatric diagnostic and treatment methods into primary care. Our study focused on determining this program's impact on primary care providers (PCPs) and patients.

METHODS

To determine the impact of CanREACH, we assessed the knowledge and skills gained by PCPs and determined whether these were retained over time. To evaluate systemic impact, we examined if the pre-training and post-training referrals to an outpatient child psychiatry clinic were impacted for PCPs who had taken the course.

RESULTS

PCPs developed significant skills and comfort in assessing, diagnosing and treating various mental illnesses and retained this knowledge over time. PCPs who had taken the course had a significant reduction in referrals (0.9 per PCP) made to child psychiatry, as compared to those who had not taken the course (1.3 per PCP) (p < 0.05). This long-term retention of skills provides reassurance about the effectiveness of the CanREACH program.

CONCLUSIONS

Education improved the capacity of primary care providers to manage child and adolescent psychiatry cases, reducing the need to refer children to psychiatry subspecialists. This ultimately improved access to outpatient child psychiatry care for Saskatchewan residents.

摘要

背景

由于多种原因,在初级保健环境中治疗有心理健康问题的儿童和青少年具有挑战性。护理的一个障碍是医生缺乏儿童精神病学知识。萨斯喀彻温省实施了一个由非营利性的REACH研究所开发并改编为适合加拿大情况的为期6个月的课程(加拿大REACH课程),该课程专注于将循证儿童精神病诊断和治疗方法教授并应用于初级保健。我们的研究重点是确定该项目对初级保健提供者(PCP)和患者的影响。

方法

为了确定加拿大REACH课程的影响,我们评估了初级保健提供者获得的知识和技能,并确定这些知识和技能是否能随时间保持。为了评估系统影响,我们检查了参加该课程的初级保健提供者在培训前和培训后转诊到门诊儿童精神病诊所的情况是否受到影响。

结果

初级保健提供者在评估、诊断和治疗各种精神疾病方面培养了重要技能并增强了信心,并且随着时间推移保留了这些知识。与未参加课程的初级保健提供者(每位PCP转诊1.3例)相比,参加课程的初级保健提供者转诊到儿童精神病科的病例显著减少(每位PCP转诊0.9例)(p < 0.05)。技能的长期保持为加拿大REACH课程的有效性提供了保证。

结论

教育提高了初级保健提供者管理儿童和青少年精神病病例的能力,减少了将儿童转诊给精神病专科医生的需求。这最终改善了萨斯喀彻温省居民获得门诊儿童精神病护理的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cf7/12082973/fe2d6f48fac7/12875_2025_2872_Fig1_HTML.jpg

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