优化适合:目标住院医师精神病学咨询联络轮换到不同层次的培训

IF 3.4 Q2 Medicine
Scott R. Beach M.D. , Daniel Shalev M.D. , Steven V. Fischel M.D., Ph.D. , Robert J. Boland M.D. , Carrie L. Ernst M.D.
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引用次数: 1

摘要

背景:确定咨询联络精神病学(CLP)核心住院医师轮转的最佳时间和结构仍然是项目主管和轮转领导面临的关键挑战。以前就这些问题进行了调查,并发布了国家组织的指导方针,但各机构的做法仍然各不相同。方法:我们对与CLP轮转时间相关的文献进行了叙述性回顾,并根据我们作为项目主管、轮转领导和住院医生的经验得出了一致的建议。结果住院医师CLP培训的显性目标包括识别和治疗内科疾病的精神表现以及与基层团队的有效沟通。培训的隐性目标可能包括冲突管理、限制设置和“肮脏思维”。尽管早期的住院医师CLP轮转通常更适合总体课程,并允许对该领域产生早期兴趣,但需要大量的监督,并且咨询者可能会将主治医师视为主要顾问。相反,虽然后来的轮岗有时与其他门诊责任的结构具有挑战性,但它们允许更大的自主权,并可能更好地映射到非正式课程中。另一种方法是混合模式,将培训分散到多年,这可能会减轻将咨询联络培训限制在一年的一些缺点。将核心CLP轮转安排在研究生二年级或三年级,或者使用混合模式,可以提出令人信服的理由。无论实习安排如何,项目主管和轮岗领导都应注意根据受训者的发展阶段调整轮岗安排。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimizing Fit: Targeting a Residency Psychiatry Consultation-Liaison Rotation to Various Levels of Training

Background

Determining the optimal timing and structure for a core residency rotation in consultation-liaison psychiatry (CLP) remains a key challenge for program directors and rotation leaders. Previous surveys have been conducted regarding these questions, and guidelines from national organizations have been issued, but practices remain varied among institutions.

Methods

We conducted a narrative review of the literature related to the timing of CLP rotations and generated consensus recommendations based on our experience as program directors, rotation leaders, and residents.

Results

Explicit goals of CLP training in residency include identifying and treating psychiatric manifestation of medical illness and communicating effectively with primary teams. Implicit goals of training may includeconflict management, limit setting, and “thinking dirty.”

Discussion

Although CLP rotations earlier in residency often create a better fit within the overarching curriculum and allow for generating early interest in the field, significant amounts of supervision are required, and consultees may look to attendings as the primary consultant. Conversely, while later rotations are sometimes challenging to structure with other outpatient responsibilities, they allow for greater autonomy and may map better onto the informal curriculum. A hybrid model, with training spread across multiple years, is another approach that may mitigate some of the disadvantages of confining consultation-liaison training to a single year. Compelling arguments can be made for placing the core CLP rotation in postgraduate year 2 or 3 or using a hybrid model. Regardless of placement, program directors and rotation leaders should be mindful of tailoring the rotation to the trainees' developmental stage.

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来源期刊
Psychosomatics
Psychosomatics 医学-精神病学
CiteScore
3.20
自引率
0.00%
发文量
0
审稿时长
6-12 weeks
期刊介绍: The mission of Psychosomatics is to be the leading psychiatry journal focused on the care of patients with comorbid medical and psychiatric illnesses. The scope of Psychosomatics includes original research, review articles and clinical reports that address psychiatric aspects of medical illnesses and their management. Areas of particular interest include: the effect of co-morbid psychiatric conditions on the management of medical illness; the psychiatric management of patients with comorbid medical illness; educational content for physicians and others specializing in consultation-liaison (C-L) psychiatry; and, the provision of psychiatric services to medical populations, including integrated care.
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