Browsing by Subject "Curriculum"

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    ItemOpen Access
    A Curriculum of Resilience: Increasing Personal Resilience through Environmental Education
    (2023-04-27) McCollum, Aurora
    As more communities feel the impacts of climate change, the field of environmental education (EE) has been incorporating climate change topics into EE curriculum. One such topic, resilience, has begun to emerge. Most EE resilience activities focus on ecological resilience rather than personal resilience, even though both of these concepts are deeply intertwined with climate change. This paper explores a case study of resilience in EE that explicitly connects personal and ecological resilience via a middle school resilience curriculum co-created by researchers, resilience practitioners, and educators in coastal North Carolina. This curriculum blends personal and ecological resilience concepts using activities including storytelling. This study examines how teachers responded to the co-created curriculum writing process and the resulting resilience curriculum. Specifically, we asked, 1. What were teachers' perspectives on the challenges and benefits of the co-creation curriculum design experience? 2. What were teachers’ perspectives on the challenges and benefits of teaching the interdisciplinary resilience curriculum? Our initial results identified four themes of teacher-identified benefits and five themes of teacher-identified challenges of resilience curriculum and curriculum design experience. Benefits include themes like meeting a distinct local need and engaging with like-minded professionals. Challenges include themes like the difficulty of navigating middle school identities when trying to be vulnerable and students knowing the right answers but having trouble applying those answers to their personal lives. We will use these preliminary findings to iterate and improve on the curriculum and design process to better serve the teachers and students in this area.
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    A Defense of the Role of History in Education Through the Analysis of the Chilean School Curriculum
    (2017-01-17) Brahm Rivas, Maria Trinidad
    In 2010, the Chilean Government tried to cut the school hours per week of social sciences in the 5th to 10th grade school curriculum in order to increase the hours of language (Spanish) and mathematics. This reform tried to follow the trend of “successful” schools and the recommendations of the OECD based on the experience of countries that have more hours of language and mathematics and higher scores in national and international quantitative standards of measurement. The example of the Chilean case represents how humanities and social sciences have been left aside since a “humanistic” approach to education is less amenable to testing. This research project develops a qualitative analysis of the contradictions between the current objectives of education and the role of the subject of history in the school curriculum. The goal of this work is to understand 1) how the benefits of history education might be recognized within the current discussion about education and its objectives, and 2) what has been the role of the history subject in the Chilean schools´ curriculum. To develop this purpose, the paper is organized in three different chapters that explain why the study of history is important during high-school years and how the Chilean government has been modifying the history school curriculum considering the political evolution of the country. The last chapter examines the tenth and eleventh grade Chilean social studies programs in order to analyze if the current way history is taught helps students to develop higher learning outcomes and abilities, such as critical thinking, analytical and creative abilities, and social consciousness. The inconsistency between the history school programs and how they are put into practice is a key element to understand the design of educational policies to develop students´ effective learning outcomes.
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    A framework for revising preservice curriculum for nonphysician clinicians: The mozambique experience.
    (Educ Health (Abingdon), 2014-09) Freistadt, Fernanda; Branigan, Erin; Pupp, Chris; Stefanutto, Marzio; Bambo, Carlos; Alexandre, Maria; Pinheiro, Sandro O; Ballweg, Ruth; Dgedge, Martinho; O'Malley, Gabrielle; de Oliveira, Justine Strand
    Mozambique, with approximately 0.4 physicians and 4.1 nurses per 10,000 people, has one of the lowest ratios of health care providers to population in the world. To rapidly scale up health care coverage, the Mozambique Ministry of Health has pushed for greater investment in training nonphysician clinicians, Tιcnicos de Medicina (TM). Based on identified gaps in TM clinical performance, the Ministry of Health requested technical assistance from the International Training and Education Center for Health (I-TECH) to revise the two-and-a-half-year preservice curriculum. A six-step process was used to revise the curriculum: (i) Conducting a task analysis, (ii) defining a new curriculum approach and selecting an integrated model of subject and competency-based education, (iii) revising and restructuring the 30-month course schedule to emphasize clinical skills, (iv) developing a detailed syllabus for each course, (v) developing content for each lesson, and (vi) evaluating implementation and integrating feedback for ongoing improvement. In May 2010, the Mozambique Minister of Health approved the revised curriculum, which is currently being implemented in 10 training institutions around the country. Key lessons learned: (i) Detailed assessment of training institutions' strengths and weaknesses should inform curriculum revision. (ii) Establishing a Technical Working Group with respected and motivated clinicians is key to promoting local buy-in and ownership. (iii) Providing ready-to-use didactic material helps to address some challenges commonly found in resource-limited settings. (iv) Comprehensive curriculum revision is an important first step toward improving the quality of training provided to health care providers in developing countries. Other aspects of implementation at training institutions and health care facilities must also be addressed to ensure that providers are adequately trained and equipped to provide quality health care services. This approach to curriculum revision and implementation teaches several key lessons, which may be applicable to preservice training programs in other less developed countries.
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    A Pharmacology-Based Enrichment Program for Undergraduates Promotes Interest in Science.
    (CBE Life Sci Educ, 2015) Godin, Elizabeth A; Wormington, Stephanie V; Perez, Tony; Barger, Michael M; Snyder, Kate E; Richman, Laura Smart; Schwartz-Bloom, Rochelle; Linnenbrink-Garcia, Lisa
    There is a strong need to increase the number of undergraduate students who pursue careers in science to provide the "fuel" that will power a science and technology-driven U.S. economy. Prior research suggests that both evidence-based teaching methods and early undergraduate research experiences may help to increase retention rates in the sciences. In this study, we examined the effect of a program that included 1) a Summer enrichment 2-wk minicourse and 2) an authentic Fall research course, both of which were designed specifically to support students' science motivation. Undergraduates who participated in the pharmacology-based enrichment program significantly improved their knowledge of basic biology and chemistry concepts; reported high levels of science motivation; and were likely to major in a biological, chemical, or biomedical field. Additionally, program participants who decided to major in biology or chemistry were significantly more likely to choose a pharmacology concentration than those majoring in biology or chemistry who did not participate in the enrichment program. Thus, by supporting students' science motivation, we can increase the number of students who are interested in science and science careers.
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    A single institution, cross-sectional study on medical student preferences for collaborators in interprofessional education.
    (BMC medical education, 2024-02) Goins, Emily C; Coates, Margaret; Gordee, Alexander; Kuchibahtla, Maragatha; Waite, Kathleen; Leiman, Erin

    Background

    While the importance of interprofessional education in medical training has been well-established, no specific framework has been used uniformly or shown to be most effective in the creation of interprofessional education (IPE) sessions. Further, prior studies have demonstrated that students have preferences for the design of these experiences. In this study, we sought to understand medical student preference for interprofessional teammates and motivations for this choice.

    Methods

    In this single-institution, cross-sectional analysis of the Duke IPE Clinic, participating students from September 2019-March 2020 completed a voluntary electronic survey that queried preferences for which health professions students (Doctor of Physical Therapy (DPT), Accelerated Bachelor of Science in Nursing (ABSN), Nurse Practitioner (NP), Pharmacy, and Physician's Associate (PA)) they would want to work with, and the motivating reason. Preferences and reasons were compared between first-year medical students (MS1s) and third- and fourth-year medical students (MS3s/MS4s).

    Results

    In total, 132 students participated. We found that MS1s most preferred interprofessional teammates with a more similar area of study (PA, NP), whereas MS3s/MS4s most preferred classmates with a less similar area of study (pharmacy, DPT, ABSN). MS1 students frequently selected their first-choice preference because the profession seemed most similar, while MS3/MS4 students often selected their first-choice preference because the profession seemed most different.

    Conclusions

    Medical students earlier in training have more interest in working with professions they view as similar whereas senior students prefer to work with professions they view as more different. This information is important for designing educational IPE opportunities.
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    Advancing Nursing Science Through Site-Based Clinical Inquiry: Designing Problem Pyramids.
    (AACN advanced critical care, 2022-06) Granger, Bradi B; Mall, Anna; Reynolds, Staci S
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    An innovative DNP post-doctorate program to improve quality improvement and implementation science skills.
    (Journal of professional nursing : official journal of the American Association of Colleges of Nursing, 2021-01) Reynolds, Staci S; Howard, Valerie; Uzarski, Diane; Granger, Bradi B; Fuchs, Mary Ann; Mason, Leslie; Broome, Marion E

    Background

    Doctor of Nursing Practice programs prepare nurse leaders for unique roles to address healthcare needs across the quality spectrum. However, additional mentoring and training in implementation science and analytical skills is needed to effectively lead system-wide quality initiatives.

    Purpose

    The purpose of this article is to describe the planning, implementation, and evaluation of an innovative post-doctoral DNP Quality Implementation Scholars Program developed through an academic-practice partnership to address this need.

    Project method

    Throughout the one year post-doctoral program, we evaluated student experiences qualitatively using focus groups and quantitatively using standardized course and instructor surveys to assess overall programmatic goals. Program outcomes were evaluated from the perspective of the academic-practice partnership planning committee through a Qualtrics© survey.

    Findings

    Strengths of the program included the in-depth mentoring by faculty and relationships built across the larger health system. Both scholars and the planning team noted that the system-wide project implemented by the scholars was relevant, timely, and quality-focused.

    Conclusions

    This innovative DNP post-doctoral program leveraged the skill-sets of DNP-prepared nurse leaders to lead system-wide quality improvement initiatives tailored specifically to healthcare organizations.
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    Consensus development of a pediatric emergency medicine clerkship curriculum.
    (West J Emerg Med, 2014-09) Askew, Kim L; Weiner, Debra; Murphy, Charles; Duong, Myto; Fox, James; Fox, Sean; O'Neill, James C; Nadkarni, Milan
    INTRODUCTION: As emergency medicine (EM) has become a more prominent feature in the clinical years of medical school training, national EM clerkship curricula have been published to address the need to standardize students' experiences in the field. However, current national student curricula in EM do not include core pediatric emergency medicine (PEM) concepts. METHODS: A workgroup was formed by the Clerkship Directors in Emergency Medicine and the Pediatric Interest Group of the Society of Academic Emergency Medicine to develop a consensus on the content to be covered in EM and PEM student courses. RESULTS: The consensus is presented with the goal of outlining principles of pediatric emergency care and prioritizing students' exposure to the most common and life-threatening illnesses and injuries. CONCLUSION: This consensus curriculum can serve as a guide to directors of PEM and EM courses to optimize PEM knowledge and skills education.
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    COVID-19 and the need for disability conscious medical education, training, and practice.
    (Journal of pediatric rehabilitation medicine, 2020-01) Doebrich, Adrienne; Quirici, Marion; Lunsford, Christopher
    The COVID-19 era exposes what was already a crisis in the medical profession: structural racism, ageism, sexism, classism, and ableism resulting in healthcare disparities for Persons with Disabilities (PWD). Early research highlights these disparities, but we do not yet know the full impact of this pandemic on PWD. Over the last 20 years, many medical schools have attempted to develop disability competency trainings, but discrimination and inequities remain, resulting in a pervasive distrust of medicine by the disability community at large. In this commentary, we suggest that disability competency is insufficient because the healthcare disparities experienced by PWD are not simply a matter of individual biases, but structural and systemic factors requiring a culture shift in the healthcare professions. Recognizing that disability is a form of diversity that is experienced alongside other systemic disadvantages like social class, race, age, sex, gender identity, and geographic location, we explore the transformative potential of disability conscious medical education, training, and practice that draws on insights from intersectional disability justice activism. Disability conscious medicine is a novel approach, which improves upon competency programs by utilizing disability studies and the principles of disability justice to guide us in the critique of norms, traditions, and institutions to more fully promote the respect, beneficence, and justice that patients deserve.
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    D.R.O.N.E.S.: Designing Real-World Outcomes for North Carolina Education in STEM
    (2019-04-22) Rienks, Keni D.
    There is a recent impetus for curriculum that enhances skills in science, technology, engineering, and mathematics (STEM) in the K-12 school system. Analysis of STEM curriculum in the US has noted gaps in national test scores compared to other developed countries and has stressed the importance of STEM education on the economic future of the US. The use of unmanned aerial vehicles (commonly known as drones) can be an effective tool in the integration of STEM-related class activities. Lessons designed with drones can provide an exciting and hands-on environment for students to gain practical experience in solving real-world problems. This paper examines current use of drones in K-12 classrooms as aligned with current state and national standards, and it provides insight on successes and disparities on the execution of an introductory course on drones. The lesson provided can serve as a framework for the development of drone curriculum in STEM classrooms that align with North Carolina and Next Generation Science Standards.
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    Design thinking teaching and learning in higher education: Experiences across four universities.
    (PloS one, 2022-01) McLaughlin, Jacqueline E; Chen, Elizabeth; Lake, Danielle; Guo, Wen; Skywark, Emily Rose; Chernik, Aria; Liu, Tsailu
    A growing body of literature highlights the increasing demand on college graduates to possess the problem finding, problem framing, and problem-solving skills necessary to address complex real-world challenges. Design thinking (DT) is an iterative, human-centered approach to problem solving that synthesizes what is desirable, equitable, technologically feasible, and sustainable. As universities expand efforts to train students with DT mindsets and skills, we must assess faculty and student DT practices and outcomes to better understand DT course experiences. Understanding how DT is taught and experienced within higher education can help schools promote student learning and align their training programs with professional, personal, and civic needs. In this study, surveys were completed by 19 faculty and 196 students from 23 courses at four universities. DT teaching and learning was characterized by three DT practices and five outcomes. Statistically significant differences were found by discipline of study and student type (i.e., graduate vs undergraduate), but not by gender or race/ethnicity. These results can be used to inform the development of classroom-based DT teaching and learning strategies across higher education institutions and disciplines.
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    Development of a curricular thread to foster medical students' critical reflection and promote action on climate change, health, and equity.
    (PloS one, 2024-01) Dalapati, Trisha; Alway, Emily J; Mantri, Sneha; Mitchell, Phillip; George, Ian A; Kaplan, Samantha; Andolsek, Kathryn M; Velkey, J Matthew; Lawson, Jennifer; Muzyk, Andrew J

    Introduction

    Due to the health consequences arising from climate change, medical students will inevitably interact with affected patients during their training and careers. Accordingly, medical schools must incorporate education on the impacts of climate change on health and equity into their curricula. We created a curricular thread called "Climate Change, Health, and Equity" in the first-year preclinical medical program to teach foundational concepts and foster self-reflection and critical consciousness.

    Methods

    The authors developed a continuum of practice including administrators, educators and faculty members, students, and community partners to plan and design curricular activities. First-year medical students at Duke University School of Medicine participated in seven mandatory foundational lectures and two experiential learning opportunities in the local community. Following completion of activities, students wrote a critical reflection essay and completed a self-directed learning exercise. Essays were evaluated using the REFLECT rubric to assess if students achieved critical reflection and for thematic analysis by Bloom's Taxonomy.

    Results

    All students (118) submitted essays. A random sample of 30 (25%) essays underwent analysis. Evaluation by the REFLECT rubric underscored that all students were reflecting or critically reflecting on thread content. Thematic analysis highlighted that all students (30/30, 100%) were adept at identifying new areas of medical knowledge and connecting concepts to individual experiences, institutional practices, and public health and policy. Most students (27/30; 90%) used emotionally laden words, expressing negative feelings like frustration and fear but also positive sentiments of solidarity and hope regarding climate change and effects on health. Many students (24/30; 80%) expressed actionable items at every level including continuing self-directed learning and conversing with patients, minimizing healthcare waste, and advocating for climate-friendly policies.

    Conclusion

    After participating in the curricular thread, most medical students reflected on cognitive, affective, and actionable aspects relating to climate change, health, and equity.
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    Development of an Interactive Global Surgery Course for Interdisciplinary Learners.
    (Annals of global health, 2021-03) Fitzgerald, Tamara N; Muma, Nyagetuba JK; Gallis, John A; Reavis, Grey; Ukachukwu, Alvan; Smith, Emily R; Ogbuoji, Osondu; Rice, Henry E

    Introduction

    Global surgical care is increasingly recognized in the global health agenda and requires multidisciplinary engagement. Despite high interest among medical students, residents and other learners, many surgical faculty and health experts remain uniformed about global surgical care.

    Methods

    We have operated an interdisciplinary graduate-level course in Global Surgical Care based on didactics and interactive group learning. Students completed a pre- and post-course survey regarding their learning experiences and results were analyzed using the Wilcoxon signed-rank test.

    Results

    Fourteen students completed the pre-course survey, and 11 completed the post-course survey. Eleven students (79%) were enrolled in a Master's degree program in global health, with eight students (57%) planning to attend medical school. The median ranking of surgery on the global health agenda was fifth at the beginning of the course and third at the conclusion (p = 0.11). Non-infectious disease priorities tended to stay the same or increase in rank from pre- to post-course. Infectious disease priorities tended to decrease in rank (HIV/AIDS, p = 0.07; malaria, p = 0.02; neglected infectious disease, p = 0.3). Students reported that their understanding of global health (p = 0.03), global surgery (p = 0.001) and challenges faced by the underserved (p = 0.03) improved during the course. When asked if surgery was an indispensable part of healthcare, before the course 64% of students strongly agreed, while after the course 91% of students strongly agreed (p = 0.3). Students reported that the interactive nature of the course strengthened their skills in collaborative problem-solving.

    Conclusions

    We describe an interdisciplinary global surgery course that integrates didactics with team-based projects. Students appeared to learn core topics and held a different view of global surgery after the course. Similar courses in global surgery can educate clinicians and other stakeholders about strategies for building healthy surgical systems worldwide.
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    Digital health competencies for primary healthcare professionals: A scoping review.
    (International journal of medical informatics, 2020-11) Jimenez, Geronimo; Spinazze, Pier; Matchar, David; Koh Choon Huat, Gerald; van der Kleij, Rianne MJJ; Chavannes, Niels H; Car, Josip

    Background

    Despite digital health providing opportunities to enhance the quality, efficiency and safety of primary healthcare, the adoption of digital tools and technologies has been slow, partly because of poor digital health literacy. For primary healthcare systems to take full advantage of these technologies, a capable, digitally literate workforce is necessary. Still, the essential digital health competencies (DHCs) for primary healthcare have not been explored. This review aims to examine the broad literature on DHCs as it applies to Primary Care (PC) settings.

    Methods

    We performed a scoping review on all types of research linking DHCs to PC. We searched all major databases including Medline, Embase, CINAHL, and Cochrane Library in November 2019. Concurrently, a thorough grey literature search was performed through OpenGrey, ResearchGate, Google Scholar, and key government and relevant professional associations' websites. Screening and selection of studies was performed in pairs, and data was analysed and presented using a narrative, descriptive approach. Thematic analysis was performed to identify key DHC domains.

    Results

    A total of 28 articles were included, most of them (54 %) published before 2005. These articles were primarily aimed at PC physicians or general practitioners, and focused on improving knowledge about information technologies and medical informatics, basic computer and information literacy, and optimal use of electronic medical records. We identified 17 DHC domains, and important knowledge gaps related to digital health education and curriculum integration, the need for evidence of the impact of services, and the importance of wider support for digital health.

    Conclusions

    Literature explicitly linking DHCs to PC was mostly published over a decade ago. There is a need for an updated and current set of DHCs for PC professionals to more consistently reap the benefits of digital technologies. This review identified key DHC domains and statements that may be used to guide on the development of a set of DHC for PC, and critical knowledge gaps and needs to be considered. Such a DHC set may be used for curricula development and for ensuring that the essential DHC for PC are met at a clinical or organizational level, and eventually improve health outcomes.
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    Exploring the impact of tablet computers on medical training at an academic medical center.
    (J Med Libr Assoc, 2013-04) Perez, Bradford A; von Isenburg, Megan A; Yu, Miao; Tuttle, Brandi D; Adams, Martha B
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    Getting under the hood: how and for whom does increasing course structure work?
    (CBE life sciences education, 2014-01) Eddy, Sarah L; Hogan, Kelly A
    At the college level, the effectiveness of active-learning interventions is typically measured at the broadest scales: the achievement or retention of all students in a course. Coarse-grained measures like these cannot inform instructors about an intervention's relative effectiveness for the different student populations in their classrooms or about the proximate factors responsible for the observed changes in student achievement. In this study, we disaggregate student data by racial/ethnic groups and first-generation status to identify whether a particular intervention-increased course structure-works better for particular populations of students. We also explore possible factors that may mediate the observed changes in student achievement. We found that a "moderate-structure" intervention increased course performance for all student populations, but worked disproportionately well for black students-halving the black-white achievement gap-and first-generation students-closing the achievement gap with continuing-generation students. We also found that students consistently reported completing the assigned readings more frequently, spending more time studying for class, and feeling an increased sense of community in the moderate-structure course. These changes imply that increased course structure improves student achievement at least partially through increasing student use of distributed learning and creating a more interdependent classroom community.
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    Global Mental Health: Five Areas for Value-Driven Training Innovation.
    (Acad Psychiatry, 2016-08) Kohrt, Brandon A; Marienfeld, Carla B; Panter-Brick, Catherine; Tsai, Alexander C; Wainberg, Milton L
    OBJECTIVE: In the field of global mental health, there is a need for identifying core values and competencies to guide training programs in professional practice as well as in academia. This paper presents the results of interdisciplinary discussions fostered during an annual meeting of the Society for the Study of Psychiatry and Culture to develop recommendations for value-driven innovation in global mental health training. METHODS: Participants (n = 48), who registered for a dedicated workshop on global mental health training advertised in conference proceedings, included both established faculty and current students engaged in learning, practice, and research. They proffered recommendations in five areas of training curriculum: values, competencies, training experiences, resources, and evaluation. RESULTS: Priority values included humility, ethical awareness of power differentials, collaborative action, and "deep accountability" when working in low-resource settings in low- and middle-income countries and high-income countries. Competencies included flexibility and tolerating ambiguity when working across diverse settings, the ability to systematically evaluate personal biases, historical and linguistic proficiency, and evaluation skills across a range of stakeholders. Training experiences included didactics, language training, self-awareness, and supervision in immersive activities related to professional or academic work. Resources included connections with diverse faculty such as social scientists and mentors in addition to medical practitioners, institutional commitment through protected time and funding, and sustainable collaborations with partners in low resource settings. Finally, evaluation skills built upon community-based participatory methods, 360-degree feedback from partners in low-resource settings, and observed structured clinical evaluations (OSCEs) with people of different cultural backgrounds. CONCLUSIONS: Global mental health training, as envisioned in this workshop, exemplifies an ethos of working through power differentials across clinical, professional, and social contexts in order to form longstanding collaborations. If incorporated into the ACGME/ABPN Psychiatry Milestone Project, such recommendations will improve training gained through international experiences as well as the everyday training of mental health professionals, global health practitioners, and social scientists.
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    Guidelines for cognitive behavioral training within doctoral psychology programs in the United States: report of the Inter-organizational Task Force on Cognitive and Behavioral Psychology Doctoral Education.
    (Behav Ther, 2012-12) Klepac, Robert K; Ronan, George F; Andrasik, Frank; Arnold, Kevin D; Belar, Cynthia D; Berry, Sharon L; Christofff, Karen A; Craighead, Linda W; Dougher, Michael J; Dowd, E Thomas; Herbert, James D; McFarr, Lynn M; Rizvi, Shireen L; Sauer, Eric M; Strauman, Timothy J; Inter-organizational Task Force on Cognitive and Behavioral Psychology Doctoral Education
    The Association for Behavioral and Cognitive Therapies initiated an interorganizational task force to develop guidelines for integrated education and training in cognitive and behavioral psychology at the doctoral level in the United States. Fifteen task force members representing 16 professional associations participated in a year-long series of conferences, and developed a consensus on optimal doctoral education and training in cognitive and behavioral psychology. The recommendations assume solid foundational training that is typical within applied psychology areas such as clinical and counseling psychology programs located in the United States. This article details the background, assumptions, and resulting recommendations specific to doctoral education and training in cognitive and behavioral psychology, including competencies expected in the areas of ethics, research, and practice.
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    History of Medicine in the Clerkships: A Novel Model for Integrating Medicine and History.
    (Journal of the history of medicine and allied sciences, 2023-03) Barr, Justin; Ingold, Rachel; Baker, Jeffrey P
    The history of medicine has only unevenly been integrated into medical education. Previous attempts to incorporate the subject have focused either on the first year, with its already over-subscribed curriculum, or the fourth year in the form of electives that reach a small minority of students. Duke University provides an alternative model for other universities to consider. At our institution we have overcome many of the curricular limitations by including history during the mandatory third year clerkships. Reaching 100% of the medical school class, these sessions align with clinical disciplines, providing students a longitudinal perspective on what they are seeing and doing on the hospital wards. They are taught in conjunction with a medical history librarian and rely heavily on the utilization and interpretation of physical artifacts and archival manuscripts. The surgery, obstetrics/gynecology, and pediatrics rotations now feature successful and popular history of medicine sessions. Describing our lesson plans and featuring a list of both physical and online resources, we provide a model others can implement to increase the use, the framing, and the accessibility of history in their medical schools.
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    Identifying core curricular components for behavioral health training in internal medicine residency: Qualitative interviews with residents, faculty, and behavioral health clinicians.
    (International journal of psychiatry in medicine, 2019-05) Hemming, Patrick; Revels, Jessica A; Tran, Anh N; Greenblatt, Lawrence H; Steinhauser, Karen E

    Objective

    Behavioral health services frequently delivered by primary care providers include care for mental health and substance abuse disorders and assistance with behavioral risk factor reduction. Internal medicine residencies in the United States lack formal expectations regarding training in behavioral health for residents. This qualitative study aimed to determine learners' and teachers' perceptions about appropriate behavioral health curricular components for internal medicine residents.

    Method

    Focus groups and interviews were conducted with the following individuals from the Duke Outpatient Clinic: residents with continuity practice (n = 27), advanced practice providers (n = 2), internal medicine attending physicians (n = 4), internal medicine/psychiatry attending physicians (n = 2), and behavioral health clinicians (n = 4). A focus group leader asked regarding residents' successes and challenges in managing behavioral health issues and about specific learning components considered necessary to understand and manage these behavioral health conditions. Transcripts were coded using an editing analysis style to identify central themes and concordance/discordance between groups.

    Results

    Regarding mental health management (Theme 1), residents emphasized a need for better care coordination with specialty mental health, while attendings and behavioral health clinicians gave priority to residents' skills in primary management of mental health. Residents, attendings, and behavioral health clinicians all emphasized advanced interviewing skills (Theme 2) with subthemes: eliciting the patient's perspective, managing time in encounters, improving patients' understanding, and patient counseling.

    Conclusions

    Internal medicine residents, attendings, and behavioral health clinicians may differ significantly in their perceptions of primary care's role in mental health care. Future internal medicine behavioral health curricula should specifically address these attitudinal differences. Curricula should also emphasize interview skills training as an essential component of behavioral health learning.