A Survey Comparing Adult and Child Psychiatry Trainees, Faculty, and Program Directors’ Perspectives About Telepsychiatry: Implications for Clinical Care and Training

Abstract Background C.difficile Toxin Polymerase Chain Reaction (C.diff PCR) and C.difficile Toxin Enzyme Immunoassays (toxin EIA) are commonly used tests to diagnose Clostridoides difficile infection (CDI). C.diff PCR cannot differentiate between colonization and infection, leading to a higher false-positive diagnosis of CDI. Toxin EIA has low sensitivity leading to a missed diagnosis of CDI. In patients with C.diff PCR positive(+) and Toxin EIA negative(-), clinical judgment is often needed regarding the decision to treat or not to treat. C.diff cytotoxic assay (CCA), is a more sensitive method to detect the toxin but is time-consuming and not readily available. Methods Between 6/2019 and 12/2019, 83 patients who were admitted to the hospital, met our inclusion criteria (C.diff PCR+/EIA-). Clinicians who cared for these patients were contacted and surveyed with a predesigned questionnaire evaluating the rationale of treatment. Also, a simultaneous medical records review was done to ensure consistency. Along with this C.diff PCR+/EIA- stool samples were sent to ARUP laboratories for CCA. The CCA results were not available for clinicians and did not impact clinical care. Average cost for a CCA assay was $29 Results Demographics of the clinicians were variable (Table 1). Several parameters were considered when making decisions regarding treatment and GI/ID were frequently involved (figure 1). Among the 83 patients, 41(49%) were CCA (+) and 42(51%) were CCA (-). 48 of 83 (58%) patients received treatment for CDI. 25 of 48 (52%) patients who were treated were CCA positive while 23 of 48 (48%) patients were CCA negative. Among the untreated patients, 16/35 (46%) were CCA+ while 19/35(54%) were CCA-. There was no statistically significant correlation between clinical judgment and CCA assay results (p: 0.56 on the Chi test). Demographics of the clinicians Clinician survey responses CDI Treatment and by CCA positivity Conclusion Clinicians regardless of their background and training face challenges with the treatment of C.diff PCR+/EIA- patients. Patient outcomes based on the incorporation of CCA assay into an algorithm for C.diff PCR+/EIA- patients, need to be evaluated. But it has a potential role in stopping unnecessary CDI treatment as well as avoidance of missed treatment opportunities while possibly also being cost-effective. Disclosures Ank E. Nijhawan, MD, MPH, Gilead (Grant/Research Support, Scientific Research Study Investigator, Research Grant or Support)

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Perceived ethical misconduct: a survey of neuropsychology professionals in Mexico

International journal of psychological research ◽

10.21500/20112084.2101 ◽

2016 ◽

Vol 9 (1) ◽

pp. 64-71 ◽

Cited By ~ 2

Author(s):

Paola Fonseca ◽

Laiene Olabarrieta Landa ◽

Ivan Panyavin ◽

Xóchitl Angélica Ortiz Jiménez ◽

Adriana Aguayo Arelis ◽

...

Keyword(s):

Professional Practice ◽

High Frequency ◽

Professional Training ◽

Clinical Care ◽

Professional Relationships ◽

Ethical Misconduct ◽

And Training ◽

Do So

Objective: To evaluate the frequency of perceived ethical misconduct in the practice of neuropsychology in Mexico. Method: One hundred fourteen psychologists answered a survey which assessed perceptions of ethical misconduct in four areas of professional practice in the field of neuropsychology.Results: The area of professional training contained the highest percentage of perception of ethical misconduct, followed by research and publications, clinical care, and professional relationships. Conclusion: The high frequency of ethical misconduct perceived by neuropsychology professionals in Mexico is a cause for concern. The results suggest the need to create and implement a system to make sure that professionals follow the ethics standards required by the profession, and to provide consequences for those who fail to do so. The profession of neuropsychology and training of professionals in the field must be regularized in the country, to reduce the frequency of future ethical misconducts.

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Child Psychiatry and Pediatrics: The State of the Relationship

PEDIATRICS ◽

10.1542/peds.60.4.616 ◽

1977 ◽

Vol 60 (4) ◽

pp. 616-620

Author(s):

Thomas F. Anders

Keyword(s):

Child Psychiatry ◽

The State ◽

Review Of The Literature ◽

Strong Ties ◽

Current State ◽

Pediatric Inpatient ◽

The Relationship ◽

Inpatient Units ◽

And Training

A great deal of attention has been focused on the notion that child psychiatry and pediatrics should develop strong ties. Yet, a review of the literature suggests that, in spite of exhortations to the contrary, little true collaboration has developed between the two disciplines. This study surveys the major pediatric teaching and training centers throughout the country in an attempt to assess the current state of the relationship between child psychiatry and pediatrics. Of the 82 centers surveyed, 68% responded. Although enthusiasm and desire for closer collaboration were expressed repeatedly, actual successful efforts remain minimal. Psychiatric consultations on pediatric inpatient units continue to be the predominant child psychiatry service provided. A method for achieving closer relationships between the two disciplines is proposed.

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myTIPreport and Training for Independent Practice: A Tool for Real-Time Workplace Feedback for Milestones and Procedural Skills

Journal of Graduate Medical Education ◽

10.4300/jgme-d-17-00137.1 ◽

2018 ◽

Vol 10 (1) ◽

pp. 70-77 ◽

Cited By ~ 6

Author(s):

AnnaMarie Connolly ◽

Alice Goepfert ◽

Anita Blanchard ◽

Elizabeth Buys ◽

Nicole Donnellan ◽

...

Keyword(s):

Medical Education ◽

Real Time ◽

Program Directors ◽

Obstetrics And Gynecology ◽

Independent Practice ◽

Clinical Environment ◽

Procedural Skills ◽

Web Based ◽

Female Pelvic Medicine ◽

And Training

ABSTRACT Background Few tools currently exist for effective, accessible delivery of real-time, workplace feedback in the clinical setting. Objective We developed and implemented a real-time, web-based tool for performance-based feedback in the clinical environment. Methods The tool (myTIPreport) was designed for performance-based feedback to learners on the Accreditation Council for Graduate Medical Education (ACGME) Milestones and procedural skills. “TIP” stands for “Training for Independent Practice.” We implemented myTIPreport in obstetrics and gynecology (Ob-Gyn) and female pelvic medicine and reconstructive surgery (FPMRS) programs between November 2014 and May 2015. Residents, fellows, teachers, and program directors completed preimplementation and postimplementation surveys on their perceptions of feedback. Results Preimplementation surveys were completed by 656 participants of a total of 980 learners and teachers in 19 programs (12 Ob-Gyn and 7 FPMRS). This represented 72% (273 of 378) of learners and 64% (383 of 602) of teachers. Seventy percent of participants (381 of 546) reported having their own individual processes for real-time feedback; the majority (79%, 340 of 430) described these processes as informal discussions. Over 6 months, one-third of teachers and two-thirds of learners used the myTIPreport tool a total of 4311 times. Milestone feedback was recorded 944 times, and procedural feedback was recorded 3367 times. Feedback addressed all ACGME Milestones and procedures programmed into myTIPreport. Most program directors reported that tool implementation was successful. Conclusions The majority of learners successfully received workplace feedback using myTIPreport. This web-based tool, incorporating procedures and ACGME Milestones, may be an important transition from other feedback formats.

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A Survey of Child Psychiatry Teaching in Canada

The Canadian Journal of Psychiatry ◽

10.1177/070674378803300617 ◽

1988 ◽

Vol 33 (6) ◽

pp. 539-545 ◽

Cited By ~ 2

Author(s):

R.J. Macleod

Keyword(s):

Family Medicine ◽

Child Psychiatry ◽

Training Programs ◽

Education And Training ◽

Psychiatry Training ◽

General Psychiatry ◽

Special Groups ◽

Teaching Programs ◽

And Training ◽

Family Medicine Residents

This article describes the findings of a survey of Child Psychiatry Training Programs conducted by the Education and Training Committee of the Canadian Academy of Child Psychiatry. The objectives of the Committee are identified to include teaching programs for career trainees, residents in general psychiatry, and special groups such as pediatric and family medicine residents. Information obtained on available programs for each group is outlined.

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FAMILY THERAPY AND TRAINING IN CHILD PSYCHIATRY

Journal of the American Academy of Child Psychiatry ◽

10.1016/s0002-7138(09)61256-5 ◽

1973 ◽

Vol 12 (3) ◽

pp. 461-472 ◽

Cited By ~ 8

Author(s):

Frederick M. Ehrlich

Keyword(s):

Family Therapy ◽

Child Psychiatry ◽

And Training

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The teaching and training of psychiatry in Thailand

International Psychiatry ◽

10.1192/s1749367600001788 ◽

2007 ◽

Vol 4 (2) ◽

pp. 41-42 ◽

Cited By ~ 2

Author(s):

Pichet Udomratn

Keyword(s):

Residency Training ◽

Child Psychiatry ◽

Adolescent Psychiatry ◽

Medical Schools ◽

Child And Adolescent ◽

Child And Adolescent Psychiatry ◽

The Other ◽

Adult Psychiatry ◽

And Training

In Thailand, we have only two programmes for residency training in psychiatry: one is general or adult psychiatry, which takes 3 years to complete; the other is child and adolescent psychiatry, which takes 4 years. There are nine institutes that offer residency training but only three medical schools have the capacity to offer training in both general and child psychiatry (Table 1).

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Treatment of a Fellow Doctor in a Public Sector Hospital: Ethnographic Study of Collegial Professionalism

Annals of King Edward Medical University ◽

10.21649/akemu.v23i2.1558 ◽

2017 ◽

Vol 23 (2) ◽

Author(s):

EHSANULLAH TARIN

Keyword(s):

Blood Pressure ◽

Public Sector ◽

Medical Profession ◽

Clinical Care ◽

Ethnographic Study ◽

Doctor Who ◽

Public Sector Hospital ◽

Medical Education And Training ◽

The Status ◽

And Training

Ethics and collegiality in medical profession requires a doctor to treat fellow professional as brother and sister. Ethnography was employed to study the status of collegiality in public sector hospital, where an ailing doc-tor sought clinical care from a physician. The former, on account of the latter’s cold reception and behaviour, reacted with his blood pressure shooting-up. The communication gap led the ailing doctor, who com-plied by coming to the laboratory, was perturbed, making him firstly unfit and later decided not to undergo the prescribed test. While Pakistan Medical and Dental Council have the responsibility to oversee, the under-graduate medical education and training should also lay greater emphasis on ethics in medical practice and healthy collegiality in the medical profession.

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A Survey of Residents/Fellows, Program Directors, and Faculty About Telepsychiatry: Clinical Experience, Interest, and Views/Concerns

Journal of Technology in Behavioral Science ◽

10.1007/s41347-020-00164-5 ◽

2021 ◽

Author(s):

Cesar Cruz ◽

Kali Orchard ◽

Erica Z. Shoemaker ◽

Donald M. Hilty

Keyword(s):

Clinical Experience ◽

Clinical Care ◽

Clinical Effectiveness ◽

Program Directors ◽

The United States ◽

Fellowship Training ◽

Residency Programs ◽

Core Curricula ◽

Curricular Interventions ◽

Positive Effect

AbstractThe effectiveness of telepsychiatry video for clinical care is well established, and clinician and psychiatry resident interest in it is growing—particularly in light of the COVID-19 impact. Still, few residency programs in the United States have core curricula, rotations/electives available, and competencies, and many faculty have no experience. A survey was sent via national organization listserves for residents, fellows, faculty, and program directors to complete. The survey queried demographics, clinical experience and interest, and views/concerns, using Likert-like and yes/no questions. Descriptive statistics and other analyses compared the groups to assess impact of clinical experience on interest and views/concerns. Respondents (N = 270) have limited clinical experience with telepsychiatry (46% none), with trainees having less than others, and yet, most were very interested or interested in it (68%). Trainees (N = 123) have concerns about being prepared for future practice. Clinical experience with video in the range of 6–20 h appears to dramatically increase interest and reduce concerns, though less time has a positive effect. Respondents have concerns about connectivity, medico-legal issues, and clinical effectiveness (e.g., diverse populations, psychosis, and emergencies) with telepsychiatry. More research is needed to assess current clinical and curricular experience, interest, and concerns. Additional curricular interventions during residency and fellowship training could build skills and confidence, if this is feasible, and the benefits outweigh the costs.

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Collaborating with low- and middle-income countries: Experience from two of the United Kingdom’s comprehensive cancer centers.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e23014 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e23014-e23014

Author(s):

Emma Foreman ◽

Isla Leslie ◽

Hannah Lyons ◽

Katherine Piddock ◽

Anguraj Sadanandam ◽

...

Keyword(s):

Global Health ◽

Clinical Care ◽

Education And Training ◽

Middle Income ◽

Research Education ◽

Care Research ◽

Middle Income Countries ◽

Wide Range ◽

And Training ◽

Low And Middle Income

e23014 Background: The number of annual global cancer deaths is rising and the majority of this burden, for a multitude of reasons, falls in low- and middle- income countries (LMICs). With the United Nations’ 3rd and 17th Sustainable Development Goals in mind (which include by 2030 “reduce by one third premature mortality from non-communicable diseases” and “partnership for the goals”) a survey was undertaken at the UK’s two largest comprehensive cancer centres to scope individual and team endeavours to work with colleagues in less well-resourced countries. Methods: Employees at the Royal Marsden Foundation Trust (RM) and Institute of Cancer Research (ICR) in London and Surrey, UK and The Christie NHS Foundation Trust (Christie), Manchester were invited to complete a survey to capture collaborative clinical care, research, education and training. Results: Responses were received from 520 multidisciplinary individuals across the 2 centres to two similar questionnaires. A large number had experience of working in some capacity in, or in collaboration with an LMIC. At the RM 14.62% of respondees were currently working with colleagues in LMICs. At The Christie 13.22% of staff had experience of working in LMICs in a supportive capacity. Those currently collaborating with colleagues in LMICs were working in a wide range of countries across Asia, Africa and South America in a range of initiatives spanning clinical care, research, education and training. Of those who answered the survey 64% at The Christie said they’d like to hear more about opportunities to be involved in supporting global health care, and 89% at RM/ICR said they’d be interested in joining a collaborative group working on global oncology initiatives at the institutions. Conclusions: This survey highlights the body of willing, interested individuals keen to work with colleagues in LMICs to improve cancer outcomes. The launch of the UK Global Cancer Network in 2020 will build upon these two surveys with a planned national survey of global health and cancer work undertaken by individuals in 2021.

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