Competency of psychiatric residents in the treatment of people with severe mental illness before and after a community psychiatry rotation.

摘要

OBJECTIVE: psychiatric rehabilitation is an evidence-based service with the goal of recovery for people with severe mental illness. Psychiatric residents should understand the services and learn the principles of psychiatric rehabilitation. This study assessed whether a 3-month rotation in a psychiatric rehabilitation center changes the competency level of second-year psychiatric residents in evidence-based treatment of severe mental illness. METHODS: the study is a prospective, case-control comparison using the validated Competency Assessment Instrument (CAI), which measures 15 provider competencies critical to recovery, rehabilitation, and empowerment for people with severe mental illness, providing a score for each competency. Participants were second-year psychiatric residents attending a 3-month rotation at the Community Reintegration Program, a psychiatric rehabilitation day program. The authors administered the CAI at the beginning and the end of the residents' 3-month rotation in order to assess change in their competency in psychiatric rehabilitation. The authors also administered the CAI to a comparison group of second-year psychiatric residents who did not rotate through the Community Reintegration Program, and therefore had no formal training in psychiatric rehabilitation. RESULTS: a 3-month rotation in psychiatric rehabilitation significantly improved residents' competency in the domains of goal functioning, client preferences, holistic approach, skills, and team value relative to nonrotating residents. CONCLUSION: a brief community psychiatry rotation in the second year of residency likely improves some skills in the treatment of people with severe mental illness. Future research should evaluate year-long electives and public psychiatry fellowships.