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Educating Residents in Behavioral Health Care and Collaboration: Comparison of Conventional and Integrated Training Models

Garfunkel, Lynn C. MD; Pisani, Anthony R. PhD; leRoux, Pieter DLitt et Phil; Siegel, David M. MD, MPH

doi: 10.1097/ACM.0b013e318204ff1d
Graduate Medical Education

Purpose To determine whether former pediatric residents trained using a model of integrated behavioral health (BH) care in their primary care continuity clinics felt more comfortable managing BH care and better prepared to collaborate with BH professionals than did peers from the same residency who trained in clinics with a conventional model of BH care.

Method University of Rochester School of Medicine and Dentistry pediatric residents were assigned to one of two continuity clinic sites. At one site, psychology fellows and faculty were integrated into the clinic teams in the mid-1990s. At the other, conventional patterns of consultation and referral continued. In 2004, the authors surveyed 245 alumni (graduated 1989–2003) about their experiences and their comfort with providing BH care and collaborating with BH providers in their current practice.

Results A total of 174 alumni (71%) responded. There were significant differences between graduates who trained in the two models. Those who trained in the integrated model were significantly more likely than others to report that they had consulted or planned treatment with a BH provider during residency and to report that their continuity clinic helped prepare them to collaborate with BH providers. They were somewhat more likely to believe that their overall residency training prepared them to manage BH issues in their current practice.

Conclusions These findings suggest that an integrated training environment, described in detail in the companion article in this issue, can enhance pediatric resident education in the management of BH problems and collaboration with BH specialists.

Dr. Garfunkel is associate professor and associate director of pediatric residency training, Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Rochester General Hospital, Rochester, New York.

Dr. Pisani is assistant professor, Departments of Psychiatry and Pediatrics, University of Rochester School of Medicine and Dentistry, and Rochester General Hospital, Rochester, New York.

Dr. leRoux is associate professor, Departments of Psychiatry and Pediatrics, University of Rochester School of Medicine and Dentistry, and Rochester General Hospital, Rochester, New York.

Dr. Siegel is professor, Departments of Pediatrics and Medicine, University of Rochester School of Medicine and Dentistry, and chief of pediatrics, Rochester General Hospital, Rochester, New York.

Correspondence should be addressed to Dr. Pisani, University of Rochester Medical Center, 301 Crittenden Blvd., Box PSYC, Rochester, NY 14642; telephone: (585) 275-3644; fax: (585) 276-2065; e-mail: anthony_pisani@urmc.rochester.edu.

First published online December 16, 2010.

© 2011 Association of American Medical Colleges