Early clinical informatics (CI) education provides an introduction to CI methodologies for resident physicians to apply within their boarded specialties. A specialty notably absent from the effort to train residents in CI is psychiatry. We present a novel means of integrating CI exposure into a structured educational track within a psychiatry residency training program. The clinical informatics track at the University of North Carolina Department of Psychiatry is a 3-year, longitudinal experience open to residents starting in postgraduate year 2. To our knowledge, this is the first track of its kind within a psychiatry residency training program.
Psychiatry has experienced a rapid expansion in providing behavioral health services using virtual means; however, little is known regarding clinicians’ experience in managing patient emergencies during virtual encounters. We present survey data from a large academic psychiatry department designed to better understand safety planning while delivering ambulatory tele-behavioral health services during the COVID-19 pandemic. Clinical faculty in the department were sent an anonymous electronic survey developed and distributed using the Qualtrics™ software. Departmental leadership provided a list of clinicians who performed ambulatory care. SAS 9.4 was used to conduct statistical analysis for associations between variables. Approximately one quarter (23.3%) of respondents engaged in proactive safety planning for most of their outpatient virtual visits, while a little over half (53.2%) of clinicians implemented emergent safety planning between just one to five visits. Clinicians who more frequently implemented emergency protocols were more likely to engage in proactive safety planning prior to emergencies (p = 0.0115). 10.8% of participants petitioned for civil commitment, though those that did identified numerous challenges. Our results reinforce the importance in appropriate training regarding best practices while providing tele-behavioral health care, with increased awareness for conducting safety planning and implementing emergent protocols. Furthermore, while petitioning for civil commitment is a relatively low base rate event in a large outpatient practice, these data and narrative feedback help to outline challenges and potential measures to improve this process for all parties. Increased attention to protocols and procedures are key as the utilization of virtual care within psychiatry continues.
Supplementary Information
The online version contains supplementary material available at 10.1007/s11126-022-10000-z.
In COVID’s immediate wake, the 2020 death toll from a different enemy of the public’s health — gun violence — ticked up by 15 percent in the United States from the previous year. Meanwhile, the U.S. Supreme Court issued an opinion in Caniglia v. Strom that will allow people who have recently threatened suicide — with a gun — to keep unsecured guns in their home unless police take time to obtain a search warrant to remove them.
UNSTRUCTURED
This manuscript is intended to serve as a tutorial for programs seeking to create and implement a didactic curriculum in the field of Digital Psychiatry. To accomplish this task, this work includes a narrative description of a Digital Psychiatry Interest Group as well as the components of the developed didactic curriculum. This curriculum was taught to separate psychiatry residency training classes, with solicited feedback through surveys. The survey data is further discussed on trainee response to this new residency curriculum. Our hope is that other psychiatry programs can use this tutorial as a template to further trainees’ knowledge in this growing field.
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