Improving GPs' skills and competencies in child psychiatry

GPs' and child and adolescent psychiatry specialists' experiences of joint consultations in the GP's office: a qualitative study

Background

The study is an exploration of a joint consultation model, a collaboration between general practitioners (GPs) and specialists from child and adolescent mental health services (CAMHS) in Lillehammer, Norway.

Methods

A qualitative study based on two focus group interviews, one with participating GPs and one with participating specialists from the local CAMHS. Participants were five GPs, with work experience varying from 6 months to 20 years (four of them specialists in general medicine) and two CAMHS specialists—a psychiatrist and a psychologist—both with more than 20 years of experience.

Results

The focus group discussions revealed that both GPs and CAMHS specialists saw the joint consultations as a good teaching method for improving GPs’ skills in child and adolescent psychiatry. Both groups believed that this low-threshold service benefits the patients and that the joint consultation is especially suited to sort problems and determine the level of help required.

Conclusions

The GPs and CAMHS specialists shared the impression that the collaboration model is beneficial for both patients and health care providers. Close collaboration with primary health care is recommended in the guidelines for child and adolescent psychiatry outpatient clinics. We suggest that the joint consultation model could be a good way for GPs and CAMHS specialists to collaborate.

Problem-based learning in postgraduate dental education: a qualitative evaluation of students' experience of an orthodontic problem-based postgraduate programme

INTRODUCTION

Problem based learning (PBL) has gained wide acceptance in undergraduate education, but less so in postgraduate education. Qualitative research methodologies can help us gain insight and understanding of the students' experience in undertaking such programmes.

AIM

To evaluate the experiences of postgraduate students undertaking a PBL based postgraduate programme.

METHODS

Focus groups and semi-structured interviews were used to investigate students' experiences. The qualitative data were coded, the codes were grouped into categories and a coding framework developed. From this a construct is proposed to give insight into students' experiences. The validity of this construct was examined by reviewing the literature.

RESULTS

Students entered the programme with high expectations, but soon found they had challenges to overcome. They came to realise that they were on a journey, rather than undertaking a sequence of separate individual learning events. PBL led to significant tensions both within the individuals and the group, caused by the conflict between appreciating PBL as a 'good thing' and yet finding that ;it just doesn't seem to work'. The fear of failure in a high stakes setting only exacerbated these tensions. The literature review revealed an inconsistent approach to the use of PBL and its evaluation in a postgraduate/continuing medical education setting. However it did provide evidence of similar findings in qualitative studies, supporting the construct developed.

CONCLUSION

We have proposed a construct to help in understanding the PBL experience for students undergoing a 'high stakes' orthodontic postgraduate programme with a core of PBL.

Teaching psychiatric diagnostics to general practitioners: Educational methods and their perceived efficacy

INTRODUCTION

Psychiatric disorders are hard to detect in a primary care setting. The vocational training for general practitioners (GPs) of the University of Maastricht, the Netherlands, intends to create a new comprehensive programme on diagnosing psychiatric disorders.

AIM

We consulted the literature to obtain an answer to the question: is evidence available for the effectiveness of specific educational methods to teach GP trainees psychiatric diagnostic skills?

METHODOLOGY

We searched in four databases for studies on a variety of search terms (39) referring to primary care, psychiatry, diagnosis, education and quality. As selection criterium for outcome measure we took change in diagnostic competence.

RESULTS

From a number of 769 articles 27 methodologically sound studies remained. This article presents several of their research characteristics. No conclusive evidence has been found for the effectivity of an isolated educational method. The combination of methods seems promising. However, no specific mix of methods is a guarantee for success.

CONCLUSIONS

We made some recommendations for training psychiatric diagnostic competency. The literature endorses our own idea that education in this field should include reflection on attitude and barriers.