TY - JOUR
T1 - “Conversational Advice”
T2 - A mixed-methods analysis of medical residents’ experiences co-managing primary care patients with behavioral health providers
AU - Hemming, Patrick
AU - Levine, R. B.
AU - Gallo, Joseph J.
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/1
Y1 - 2018/1
N2 - Objective When integrated behavioral health clinicians (IBHCs) and residents co-manage patients, residents may learn new approaches. We aimed to understand the effect of co-management on residents’ behavioral health (BH) management learning. Methods Residents completed a web-based survey enquiring: whether co-management included a shared visit and/or face-to-face meeting with an IBHC, whether residents received feedback from the IBHC, and what they learned. Qualitative responses were coded thematically using a constant comparative method. Results Among 117 respondents (overall response rate 72%, 117/163), from five residencies recruited from 40 residencies with BH integration, residents were significantly more likely to receive feedback if they had a shared visit with the patient and an IBHC (yes 69% vs. no 33%; adjusted OR 3.0, 95% CI 1.2–7.6). Residents reported three major learning themes: interpersonal communication skills awareness, BH skills awareness, and newly adopted attitudes toward BH. Residents who received feedback were more likely to report themes of interpersonal communication skills awareness (yes 26.6% vs. no 9.4%). Conclusion BH integration promotes increased feedback for residents practicing face-to-face co-management with IBHCs, and a positive influence regarding residents’ attitudes and perceived skills. Practical implications Residency programs can meaningfully improve residents’ learning by promoting face-to-face co-management with IBHCs.
AB - Objective When integrated behavioral health clinicians (IBHCs) and residents co-manage patients, residents may learn new approaches. We aimed to understand the effect of co-management on residents’ behavioral health (BH) management learning. Methods Residents completed a web-based survey enquiring: whether co-management included a shared visit and/or face-to-face meeting with an IBHC, whether residents received feedback from the IBHC, and what they learned. Qualitative responses were coded thematically using a constant comparative method. Results Among 117 respondents (overall response rate 72%, 117/163), from five residencies recruited from 40 residencies with BH integration, residents were significantly more likely to receive feedback if they had a shared visit with the patient and an IBHC (yes 69% vs. no 33%; adjusted OR 3.0, 95% CI 1.2–7.6). Residents reported three major learning themes: interpersonal communication skills awareness, BH skills awareness, and newly adopted attitudes toward BH. Residents who received feedback were more likely to report themes of interpersonal communication skills awareness (yes 26.6% vs. no 9.4%). Conclusion BH integration promotes increased feedback for residents practicing face-to-face co-management with IBHCs, and a positive influence regarding residents’ attitudes and perceived skills. Practical implications Residency programs can meaningfully improve residents’ learning by promoting face-to-face co-management with IBHCs.
KW - Behavioral medicine
KW - Cooperative behavior
KW - Graduate medical education
KW - Mental health services
KW - Patient care team
KW - Primary care
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U2 - 10.1016/j.pec.2017.07.014
DO - 10.1016/j.pec.2017.07.014
M3 - Article
C2 - 28734557
AN - SCOPUS:85024475776
VL - 101
SP - 85
EP - 91
JO - Patient Education and Counseling
JF - Patient Education and Counseling
SN - 0738-3991
IS - 1
ER -