Paulson Deirdre, Hidaka Brandon, Pavey Thomas
Mayo Clinic Family Medicine Residency, Eau Claire, WI, USA.
Mayo Clinic Health System, Eau Claire, WI, USA.
J Prim Care Community Health. 2025 Jan-Dec;16:21501319251371510. doi: 10.1177/21501319251371510. Epub 2025 Sep 15.
There are few trainings for primary care physicians (PCPs) on how to navigate a psychiatric crisis (such as suicidal ideation, homicidal ideation, psychosis, and/or intoxication that impairs decision making capacity) in the outpatient setting. We previously published an approach to fill this gap and now report the results of our efforts to improve the curriculum and assess if confidence was maintained over time.
Four, 1-h didactic sessions on screening and logistically managing patients in need of inpatient or outpatient psychiatric care were created. Objectives were based on the complexities of state law, institutional policy, and expert opinion. All 15 residents in a family residency program participated in the didactic series. Resident confidence to complete all aspects of these scenarios was measured by questionnaire before (Time 1), immediately after (Time 2), and 5 months after completion of the didactic series (Time 3).
From Time 1 to Time 3, resident confidence significantly increased for 10/17 (58%) aspects of assessing and managing psychiatric crises (all < .017). There was no evidence that confidence for any measure decreased from Time 2 to Time 3.
The revised curriculum increased family medicine resident confidence to assess and manage outpatient psychiatric crises 5 months after the training was completed.
针对初级保健医生（PCP）在门诊环境中应对精神科危机（如自杀意念、杀人意念、精神病和/或损害决策能力的中毒情况）的培训较少。我们之前发表了一种填补这一空白的方法，现在报告我们改进课程的努力结果，并评估信心是否随时间得以维持。
开展了四次时长为1小时的教学课程，内容涉及对需要住院或门诊精神科护理的患者进行筛查和后勤管理。目标基于州法律、机构政策和专家意见的复杂性。一个家庭住院医师项目中的所有15名住院医师都参加了该教学系列课程。通过问卷在教学系列课程开始前（时间1）、结束后立即（时间2）以及结束后5个月（时间3）测量住院医师完成这些场景所有方面的信心。
从时间1到时间3，住院医师在评估和管理精神科危机的17个方面中的10个（58%）方面的信心显著提高（所有P ＜.017）。没有证据表明从时间2到时间3任何一项测量的信心有所下降。
修订后的课程提高了家庭医学住院医师在培训完成5个月后评估和管理门诊精神科危机的信心。
