Assessing Integrative Psychiatry Curriculum Needs

Evaluation of Integrative Medicine in Residency-Psychiatry Curriculum

OBJECTIVE

This study describes knowledge change, self-assessed confidence in providing integrative medicine approach, and respondents' perspective on value and feasibility for the Integrative Medicine in Residency-Psychiatry (IMR-Psychiatry) curriculum, a 100-h elective offered during psychiatry training.

METHODS

Residents/fellows completed pre-post Medical Knowledge tests and self-assessment instruments tracking self-rated confidence. Participants were also interviewed for feedback about their experience using a semi-structured design after completion of the program.

RESULTS

Thirty-five of 37 (94.6%) participants completed all elective requirements. Items on the self-assessment instrument with the greatest positive pre-post change (p < 0.001) included ability to identify authoritative sources about botanicals (Cohen d = 2.15), effectively respond to patients' questions regarding the use of herbs/supplements (Cohen d = 2.67), and interpret labels on nutraceuticals (Cohen d = 2.28). Mean score on the Medical Knowledge test (n = 30) increased from 64.7% correct at pretest to 81.6% at posttest. Responses tracking self-assessed confidence in providing an IM approach to address 18 common medical and psychiatric conditions all increased significantly pre to post (p < 0.001). Qualitative interviews provided important insights into challenges and recommendations for improvement, and all participants highly recommended the curriculum and found it feasible to complete during training.

CONCLUSION

The IMR-Psychiatry curriculum provides trainees skills that promote comprehensive person-centered care; as a tool to optimize patient care and safety while enhancing physician well-being, wider-spread incorporation of the curriculum into psychiatry residency programs would be beneficial.

Training the trainers: Finding new educational opportunities in the virtual world

The COVID-19 pandemic has disrupted scientific gatherings and conferences, opening up opportunities for virtual learning platforms. Realizing the potential of online academic exchanges, the World Psychiatric Association (WPA) also developed virtual avenues and information systems for capacity building of mental health professionals across the world. Among its first such initiatives, the WPA organized a virtual Train the Trainers workshop, where 123 psychiatrists, psychiatric trainees, and educators from 45 countries participated. The innovative and interactive workshop allowed participants to get to know each other, exchange educational and professional experiences, and ask questions or receive advice from experts. Keynote speakers, including WPA President Prof. Afzal Javed and Prof. Norman Sartorius, stressed upon the importance of finding innovative solutions in psychiatry training and the need to improve teaching and training in the field of psychiatry, especially in the provision of leadership and communication skills. Online training methods can provide easy access to academics and students while reducing the organizational and logistical costs. They have the potential to improve educational equality and allow the voice of the underprivileged scientists to be heard across the globe. The devastating impact on access to mental health services during COVID-19 underscores the urgent need for online training, particularly in countries where the ratio of psychiatrists to patients is inadequate and doctors concentrate more on treatment than on research and education. Virtual educational interventions could prove incredibly useful in the future just as they are being successfully utilized in local and regional contexts during the pandemic.

The Integrative Psychiatry Curriculum: Development of an Innovative Model

The Integrative Psychiatry Curriculum (IPC) was developed to train psychiatry residents and fellows to apply an Integrative Medicine (IM) approach for patients presenting with psychiatric disorders. Launched in 2015, IPC includes interactive online courses, in-person experiential sessions, and a clinical component with supervision. Twenty-one residents and fellows have completed the curriculum. The purpose of the IPC is 2-fold: to enhance patient wellness through training residents and fellows in evidence-based whole-person care and to improve physician well-being through enhanced stress management and self-awareness utilizing the practice of mind-body skills within a supportive small group setting. Course participants are trained in a broad range of prevention and treatment options and learn about their evidence base; they then practice incorporating IM into diagnosis and treatment plans through supervised clinical experience. This article describes the development of IPC and its elements. Efforts are underway to further develop and standardize the offerings and increase the portability of the course, making it easier for Psychiatry training programs with limited faculty expertise in IM to provide the curriculum for residents and fellows. To reach the goal of disseminating such a curriculum for integrative psychiatry, further funding and collaboration with multiple residency training programs is needed.