Introduction: In medical education, communication is recognized as a core competency for physicians. In Canada, medical students are taught core communication abilities. The importance of communication in postgraduate training is recognized in the CanMEDS competency framework. Although robust literature exists on teaching communication abilities to medical students, research in communication abilities for psychiatry residents is lacking, despite the fact that the clinical interview is frequently the only diagnostic tool available and often a key part of patient treatment. Given the transition to competency-based education in Canadian postgraduate medical education, it is critical that the psychiatric profession gains an improved understanding of the progression of communication abilities in psychiatry training. This study seeks to understand the progression of communication skills development in psychiatry.
Methods: This study used a constructivist grounded theory approach. This study used purposive sampling and conducted semi-structured interviews with 14 faculty educators who regularly supervise psychiatry residents at two sites affiliated with one university-based residency program. Constant comparative analysis occurred concurrently with iterative data collection until thematic sufficiency was reached and all relationships between themes were determined.
Results: Five themes outlining the progressive development of communication abilities were identified. Three themes identified three foundational sets of abilities, including refining pre-existing relational abilities, developing a repertoire of specific psychiatric communication abilities, and learning to reflect upon and manage one’s own internal reactions. These competencies served as foundational pillars for the final two themes, in which residents develop the personalized art of flexible psychiatric interviewing, which then allows them to skillfully partner with their patients in co-creating care plans.
Conclusion: This research represents a first step in defining a communication competency framework for psychiatry residents. It includes defining the core abilities required for progression to unsupervised practice. Future research should explore generalizability, test the framework, and determine teaching and assessment methods. / Thesis / Master of Science (MSc) / In contemporary medical education, the ability to communicate well with patients is a fundamental competency. This set of abilities is taught in medical schools and reflected in residency training competence frameworks, such as the CanMEDS framework. In psychiatry residency training, communication is fundamental as the clinical interview is typically the only diagnostic tool available and frequently part of the treatment of psychiatric illness (e.g., psychotherapy). However, the development of psychiatric communication competency remains understudied. With the shift to competency-based education across Canadian psychiatry postgraduate residency education, understanding the development of patient communication abilities in psychiatry residents is critical for teaching and assessment. This research examines psychiatry educators’ perceptions of the developmental model of psychiatry resident competence in communication. The results of this study highlight five clear themes that emerge to explain how residents achieve the abilities to communicate with their patients at a level of competence that is compatible with independent practice. This framework brings clarity to the unique set of abilities that psychiatrists use to communicate with and help their patients. It will also serve as a foundation for developing teaching and assessment methods in psychiatry residency education and will serve as a basis for further research on the development of communication abilities in psychiatry residents.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/25378 |
| Date | January 2020 |
| Creators | Snelgrove, Natasha |
| Contributors | Sherbino, Jonathan, Health Science Education |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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