Psychiatry residents' confidence in integrated care skills on a collaborative care rotation at a safety net health care system

The Educational Value of Outpatient Consultation-Liaison Rotations: A White Paper From the Academy of Consultation-Liaison Psychiatry Residency Education Subcommittee

“…Overall, the literature describing educational models for outpatient CL experiences is limited, with only 17 articles meeting the search criteria (Table 3). 18,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] We found 10 articles describing individual integrated care programs 18,28,31,32,34,36,38,39,42 and 2 articles providing guidelines on core competencies for integrated care for trainees. 30,40 As shown in Table 2, the educational opportunities for integrated psychiatric care ranged from colocated services and collaborative care to dedicated outpatient psychiatric clinics for the medically ill. Only 3 of the articles describe training opportunities for advanced psychiatric trainees including 2 for CL fellows and one for child and adolescent fellows.…”

“…30 Overall, residents responded positively to the various integrated care experiences and viewed them as effective and relevant in preparing them for their future careers 34 and enhancing their learning on how to assess and manage complex medical-psychiatric patients. 35,36 Additional benefits of colocated and collaborative care models include increased primary care physician comfort with medication management, increased capacity to care for patients presenting with psychiatric problems, and improved interprofessional communication and education. 18,29,30,35,36 The limited literature regarding advanced psychiatric trainees is consistent with that of the resident experience.…”

“…35,36 Additional benefits of colocated and collaborative care models include increased primary care physician comfort with medication management, increased capacity to care for patients presenting with psychiatric problems, and improved interprofessional communication and education. 18,29,30,35,36 The limited literature regarding advanced psychiatric trainees is consistent with that of the resident experience. 27,38,39 Similar to the psychiatry residents, primary care and family medicine residents who receive training for mental health in an integrated or collaborative care model find that their training is enhanced.…”

Best Practices for Systematic Case Review in Collaborative Care

“…Thus, increasing indirect care may further enhance outcomes within CoCM, although workforce development is required (6). In one of the few residency programs offering a CoCM rotation, indirect care was the only area in which most trainees (70%) lacked confidence (7). Two reports briefly summarize indirect care (1,2), yet psychiatric educators have dubbed such care "difficult to describe" (8).…”