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

摘要

ObjectiveThis letter to the editor describes how psychiatry residents' confidence in delivering population based care improved after working within a collaborative care system. MethodsAn anonymous online survey was delivered to 24 psychiatry residents who matriculated through Cambridge Health Alliance residency from 2012 to 2014 and participated in the collaborative care rotation. During the rotation, residents provided direct and indirect consultations, used measurement-based care (MBC) and took a population approach to patient management. Items were asked about residents' level of confidence. ResultsTwenty of 24 residents responded to the survey (83% response rate) with no questions skipped. Among respondents, 80% were confident in the stepped care model, 65% were confident using MBC, 95% were confident communicating and coordinating with primary care teams, 65% felt they were likely to initiate lab checks (such as metabolic monitoring), and 95% had confidence the rotation helped clarify their role as a consultant to primary care teams. Only 30% were confident in providing indirect consultations to primary care teams. ConclusionAfter a 6month rotation in a collaborative care model, psychiatry residents have gained confidence in multiple domains of integrated care. However, additional curriculum development and training is required to help residents improve confidence in indirect consultations.