Resident Training Curriculum in Adolescent Depression and Suicide Screening

Abstract

Introduction: Routine screening of adolescents for depression and suicide risk is now considered best clinical practice. However, due to a lack of training, many physicians do not engage in screening. The goal of this curriculum is to improve learner knowledge of and comfort in adolescent depression and suicide risk assessment and management. Methods: The didactic session typically takes 60-90 minutes to complete. In addition to a teaching PowerPoint that provides instruction in both the assessment and management of adolescent depression and suicide risk, the curriculum also includes a suicide assessment and management protocol. This protocol outlines an algorithm that assists in distinguishing between individuals at high and low risk of suicide. The algorithm enables clinicians to determine the most appropriate management plan based on the assessed level of suicide risk. Results: Outcome measures indicate that the majority of residents improved their self-perceived knowledge and comfort in assessing and managing depression and suicide risk, with an average of 61.7% of residents moving from the novice to the proficient group at the conclusion of the rotation. These results reflect learners obtaining 4 weeks of supervised clinical experience after the didactic session. Discussion: This curriculum was designed for use with pediatric and internal medicine-pediatric residents during their adolescent medicine rotation but could easily be adapted for use with other learners in different settings.

Suicide Symposium: A Multidisciplinary Approach to Risk Assessment and the Emotional Aftermath of Patient Suicide

“…Curriculum creation was inspired by data suggesting that the loss of a patient to suicide is a common and emotionally impactful experience among mental health practitioners, 1 as well as literature indicating that formal education on this topic within residency programs is lacking. 2,3 While there have been published efforts to enhance residency training in screening for depressive symptoms, including suicidality, and suicide risk assessment, 5–7 we believe the unique value of our curriculum involves the significant focus on the emotional experience of patient loss. The body of literature published on the topic of patient suicide indicates that it is the emotional aftermath of loss that appears to negatively affect mental health practitioners, especially younger, more inexperienced practitioners.…”

“…5 Our goal in creating a more formalized symposium curriculum was to provide a structured, safe environment where mental health trainees and practitioners of various specialties could obtain collegial support and education to reduce the stigma and potential isolation surrounding patient suicide. This curriculum builds upon prior work in the area, including MedEdPORTAL publications of a team-based learning suicide risk assessment module 6 and a resident training curriculum in adolescent depression and suicide screening, 7 by not only providing instruction related to suicide risk factors, risk assessment, and safety planning but also focusing significantly on the emotional experience of patient loss. It is this aspect of the symposium that fills an identified need for an effective curriculum to prepare learners for the eventual loss of a patient to suicide.…”

A Case-Based, Longitudinal Curriculum in Pediatric Behavioral and Mental Health

“…Several online lectures or modules on pediatric BMH topics have been published online, 17 – 20 and specifically in MedEdPORTAL, a longitudinal curriculum in pediatric BMH has been described within a continuity clinic with integrated mental health care capabilities, 20 in addition to specific modules on preschool behavioral concerns 18 and adolescent depression. 19 …”

Be ExPeRT (Behavioral Health Expansion in Pediatric Residency Training): A Case-Based Seminar

“… 14 The third resource directly targets residents; however, it was published in 2016 and is now outdated in relation to epidemiological data and validated screening tools. 15 With regard to other common pediatric B/MH conditions, Mian and colleagues described a video-based training for pediatric residents to improve identification and treatment of anxiety disorders in primary care settings. 16 There are also several MedEdPORTAL publications on trauma-informed care directed towards pediatric primary care health professionals as well as a resident curriculum on primary care of gender and sexual minority patients.…”