The Current and Ideal State of Mental Health Training: Pediatric Program Director Perspectives

• Published in: Academic pediatrics Vol. 14; no. 5; pp. 526 - 532
• Main Authors: Green, Cori, MD, MS, Hampton, Elisa, MD, Ward, Mary J., PhD, Shao, Huibo, MS, Bostwick, Susan, MD, MBA
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2014
• Subjects: Adolescent Psychiatry - education; Adolescent Psychiatry - standards; Adolescent Psychiatry - statistics & numerical data; Child Psychiatry - education; Child Psychiatry - standards; Child Psychiatry - statistics & numerical data; Curriculum; Education, Medical, Graduate - standards; Education, Medical, Graduate - statistics & numerical data; Humans; Internship and Residency - standards; Internship and Residency - statistics & numerical data; mental health; Mental Health - education; Mental Health - standards; Mental Health - statistics & numerical data; Mental Health Services; Neonatal and Perinatal Medicine; pediatric program directors; pediatric residency training; Pediatrics; Pediatrics - education; Pediatrics - standards; Pediatrics - statistics & numerical data; mental health; pediatric program directors; pediatric residency training
• ISSN: 1876-2859; 1876-2867
• DOI: 10.1016/j.acap.2014.05.011

Abstract Objective To assess pediatric residency program director (PD) perceptions of the current state of mental health (MH) training, their receptivity to curricular changes, and perceptions of their residents' knowledge and skills in MH care. Methods We performed a cross-sectional study utilizing a Web-based survey of pediatric residency PDs to assess program characteristics, learning modalities PDs currently had or would implement, and their knowledge of the new American Academy of Pediatrics' MH competencies. PDs then ranked their residents' knowledge and skills for 29 MH competencies. Analyses included descriptive statistics and bivariate and multivariate analyses to assess for associations between variables, particularly MH model of care and perceived competence. Results Ninety-nine PDs (51%) responded. A total of 87% of PDs reported that MH care was taught as part of another rotation, yet PDs were receptive to curricular changes. Only 45% of PDs were aware of the 2009 American Academy of Pediatrics competencies, and PDs infrequently rated their residents' MH skills and knowledge to be above average. Attention-deficit/hyperactivity disorder (ADHD) was an exception: 64% reported above-average ADHD knowledge in diagnoses and 57% in treatment. There was an association between enhanced MH services in continuity clinics and perceived resident systems-based practice ( P  < .01) and medical knowledge ( P  = .04). Conclusions PDs acknowledged that MH training is not emphasized, leading to deficiencies in their residents' knowledge and skills in MH care. The receptivity of PDs suggests the need for targeted dissemination of national guidelines or curriculum. Integrated models of care may be one way to improve resident competencies, but this deserves further study.