Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry
Abstract Background Patients with complex care needs have multiple concurrent conditions (medical, psychiatric, social vulnerability or functional impairment), interfering with achieving desired health outcomes. Their care often requires coordination and integration of services across hospital and c...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12909-023-04233-0 |
| _version_ | 1827961308055601152 |
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| author | Deanna Chaukos Sandalia Genus Robert Maunder Maria Mylopoulos |
| author_facet | Deanna Chaukos Sandalia Genus Robert Maunder Maria Mylopoulos |
| author_sort | Deanna Chaukos |
| collection | DOAJ |
| description | Abstract Background Patients with complex care needs have multiple concurrent conditions (medical, psychiatric, social vulnerability or functional impairment), interfering with achieving desired health outcomes. Their care often requires coordination and integration of services across hospital and community settings. Physicians feel ill-equipped and unsupported to navigate uncertainty and ambiguity caused by multiple problems. A HIV Psychiatry resident elective was designed to support acquisition of integrated competencies to navigate uncertainty and disjointed systems of care – necessary for complex patient care. Methods Through qualitative thematic analysis of pre- and post-interviews with 12 participants – residents and clinic staff – from December 2019 to September 2022, we explored experiences of this elective. Results This educational experience helped trainees expand their understanding of what makes patients complex. Teachers and trainees emphasize the importance of an approach to “not knowing” and utilizing integrative competencies for navigating uncertainty. Through perspective exchange and collaboration, trainees showed evidence of adaptive expertise: the ability to improvise while drawing on past knowledge. Conclusions Postgraduate training experiences should be designed to facilitate skills for caring for complex patients. These skills help residents fill in practice gaps, improvise when standardization fails, and develop adaptive expertise. Going forward, findings will be used to inform this ongoing elective. |
| first_indexed | 2024-04-09T16:23:27Z |
| format | Article |
| id | doaj.art-f79e4aa67d3b46909a747f65d712e5c6 |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-04-09T16:23:27Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-f79e4aa67d3b46909a747f65d712e5c62023-04-23T11:20:57ZengBMCBMC Medical Education1472-69202023-04-012311810.1186/s12909-023-04233-0Preparing future physicians for complexity: a post-graduate elective in HIV psychiatryDeanna Chaukos0Sandalia Genus1Robert Maunder2Maria Mylopoulos3Department of Psychiatry, Temerty Faculty of Medicine, University of TorontoDepartment of Psychiatry, Sinai Health SystemDepartment of Psychiatry, Temerty Faculty of Medicine, University of TorontoDepartment of Pediatrics, Temerty Faculty of Medicine, University of TorontoAbstract Background Patients with complex care needs have multiple concurrent conditions (medical, psychiatric, social vulnerability or functional impairment), interfering with achieving desired health outcomes. Their care often requires coordination and integration of services across hospital and community settings. Physicians feel ill-equipped and unsupported to navigate uncertainty and ambiguity caused by multiple problems. A HIV Psychiatry resident elective was designed to support acquisition of integrated competencies to navigate uncertainty and disjointed systems of care – necessary for complex patient care. Methods Through qualitative thematic analysis of pre- and post-interviews with 12 participants – residents and clinic staff – from December 2019 to September 2022, we explored experiences of this elective. Results This educational experience helped trainees expand their understanding of what makes patients complex. Teachers and trainees emphasize the importance of an approach to “not knowing” and utilizing integrative competencies for navigating uncertainty. Through perspective exchange and collaboration, trainees showed evidence of adaptive expertise: the ability to improvise while drawing on past knowledge. Conclusions Postgraduate training experiences should be designed to facilitate skills for caring for complex patients. These skills help residents fill in practice gaps, improvise when standardization fails, and develop adaptive expertise. Going forward, findings will be used to inform this ongoing elective.https://doi.org/10.1186/s12909-023-04233-0Resident educationPsychiatryComplexityCollaborative and team-based careInterprofessional learningAdaptive expertise |
| spellingShingle | Deanna Chaukos Sandalia Genus Robert Maunder Maria Mylopoulos Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry BMC Medical Education Resident education Psychiatry Complexity Collaborative and team-based care Interprofessional learning Adaptive expertise |
| title | Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry |
| title_full | Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry |
| title_fullStr | Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry |
| title_full_unstemmed | Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry |
| title_short | Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry |
| title_sort | preparing future physicians for complexity a post graduate elective in hiv psychiatry |
| topic | Resident education Psychiatry Complexity Collaborative and team-based care Interprofessional learning Adaptive expertise |
| url | https://doi.org/10.1186/s12909-023-04233-0 |
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