MENTAL HEALTH CURRICULUM IN CANADIAN PAEDIATRIC TRAINING PROGRAMS: CURRENT TRAINING AND PROGRAM DIRECTOR PERSPECTIVES

Abstract

BACKGROUND: Canadian paediatricians play an important role in caring for and managing children with mental health (MH) problems, yet they consistently identify child and adolescent psychiatry as an area in which they feel less than adequately trained. The Royal College of Physicians and Surgeons of Canada (RCPSC) Objectives for Training Requirements (OTR) presently includes a comprehensive set of child and adolescent MH objectives, intended to better define the knowledge and skills required for paediatricians in practice. However, paediatric training programs across Canada struggle to adequately teach these MH objectives in residency. As an initial step toward improving MH curriculum implementation, an environmental scan of current MH educational strategies and input from paediatric postgraduate Program Directors (PDs) is needed. OBJECTIVE(S): Primary: To assess and describe current MH training practices in Canadian paediatric residency programs. Secondary: To determine PDs' perspectives regarding how well the OTR in MH are presently covered. DESIGN/METHOD: Pediatric postgraduate PDs at 17 Canadian academic centres described the MH curriculum in their training programs using an online survey. RESULT(S): Fifteen of 17 PDs completed the survey. Ten programs (66.7%) reported having an explicit MH curriculum, which included MH rotations, academic half day lectures, and/or problem-based learning sessions. Thirteen programs (86.7%) had a MH rotation at least 4 weeks in length, of which 10 (76.9%) were mandatory. Twelve of the 13 rotations were supervised by psychiatrists and 1 rotation was supervised by adolescent medicine specialists. Ten PDs (66.7%) reported that their programs covered the MH OTR "well", with 6 (60%) of those PDs reporting that their graduating trainees felt "somewhat comfortable" managing pediatric MH problems. CONCLUSION(S): To our knowledge, this is the first study of the MH curriculum and PD perspectives regarding implementation of the RCPSC MH OTR in Canada. Despite MH curriculums, mandatory rotations and adequately covered MH OTR, most PDs note that their graduating trainees feel only somewhat comfortable with MH problems. As an initial insight into the challenges of MH training, pediatric residents' perceptions as well as objective indicators of competence in the MH OTR are needed, to further understand how and where changes to the MH curriculum in Canadian pediatrics training programs should occur. With the national implementation of Competency Based Medical Education in Canada, educators now have the opportunity to craft clinical experiences which will meet explicitly defined competencies in this important area.