TY - JOUR
KW - Canada
KW - Clinical Competence
KW - Curriculum
KW - Delivery of Health Care, Integrated
KW - Education, Medical, Undergraduate
KW - Humans
KW - Interviews as Topic
KW - Mental Health
KW - Patient-Centered Care
KW - Psychiatry
KW - Qualitative Research
KW - competency
KW - integrated care
KW - undergraduate medical education
AU - S. Sockalingam
AU - Z. K. Chaudhary
AU - R. Barnett
AU - J. Lazor
AU - M. Mylopoulos
A1 - 
AB - Phenomenon: Despite the emergence of the integrated care (IC) model, IC is variably taught and is challenged by current siloed competency domains. This study aimed to define IC competencies spanning multiple competency domains. Approach: Iterative facilitated discussions were conducted at a half-day education retreat with 25 key informants including clinician educators and education scientists. Seven one-on-one semistructured interviews were subsequently conducted with different interprofessional providers in IC settings within a Canadian context. Data collection grounded in patient cases with a physical illness and concurrent mental illness (medical psychiatry) were used to elicit identification of complex patient needs and the key medical psychiatry knowledge and skills required to address these needs. A thematic analysis of transcripts was performed using constant comparison to iteratively identify themes. Findings: Participants described 4 broad competency domains necessary for expertise in IC: (a) extensive integrated knowledge of biopsychosocial aspects of disease, systems of care, and social determinants of care; (b) skills to establish a longitudinal alliance with the patient and functional relationships with colleagues; (c) constructing a comprehensive understanding of individual patients' complex needs and how these can be met within their health and social systems; and (d) the ability to effectively meet the patient's needs using IC models. These 4 domains were linked by an overarching philosophy of care encompassing key enabling attitudes such as proactively pursuing depth to understand patient and system complexity while maintaining a patient-centered approach. Insights: The study addresses how development of IC expertise can be fostered by integration of individual IC competency domains. The findings align with previous research suggesting that competencies from existing frameworks are being enacted jointly in expert capabilities to meet the complex needs of patients, in this case with comorbid physical and mental health concerns.
AD - Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.; The Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.; MD Program, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.; MD Program, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.; The Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
BT - Teaching and learning in medicine
C5 - Education & Workforce; Healthcare Disparities
CP - 2
CY - United States
DO - 10.1080/10401334.2019.1654387
IS - 2
JF - Teaching and learning in medicine
LA - eng
M1 - Journal Article
N2 - Phenomenon: Despite the emergence of the integrated care (IC) model, IC is variably taught and is challenged by current siloed competency domains. This study aimed to define IC competencies spanning multiple competency domains. Approach: Iterative facilitated discussions were conducted at a half-day education retreat with 25 key informants including clinician educators and education scientists. Seven one-on-one semistructured interviews were subsequently conducted with different interprofessional providers in IC settings within a Canadian context. Data collection grounded in patient cases with a physical illness and concurrent mental illness (medical psychiatry) were used to elicit identification of complex patient needs and the key medical psychiatry knowledge and skills required to address these needs. A thematic analysis of transcripts was performed using constant comparison to iteratively identify themes. Findings: Participants described 4 broad competency domains necessary for expertise in IC: (a) extensive integrated knowledge of biopsychosocial aspects of disease, systems of care, and social determinants of care; (b) skills to establish a longitudinal alliance with the patient and functional relationships with colleagues; (c) constructing a comprehensive understanding of individual patients' complex needs and how these can be met within their health and social systems; and (d) the ability to effectively meet the patient's needs using IC models. These 4 domains were linked by an overarching philosophy of care encompassing key enabling attitudes such as proactively pursuing depth to understand patient and system complexity while maintaining a patient-centered approach. Insights: The study addresses how development of IC expertise can be fostered by integration of individual IC competency domains. The findings align with previous research suggesting that competencies from existing frameworks are being enacted jointly in expert capabilities to meet the complex needs of patients, in this case with comorbid physical and mental health concerns.
PP - United States
PY - 2020
SN - 1532-8015; 1040-1334
SP - 159
EP - 167
EP - 
T1 - Developing a Framework of Integrated Competencies for Adaptive Expertise in Integrated Physical and Mental Health Care
T2 - Teaching and learning in medicine
TI - Developing a Framework of Integrated Competencies for Adaptive Expertise in Integrated Physical and Mental Health Care
U1 - Education & Workforce; Healthcare Disparities
U2 - 31482737
U3 - 10.1080/10401334.2019.1654387
VL - 32
VO - 1532-8015; 1040-1334
Y1 - 2020
Y2 - Apr-May
ER -