To generate hypotheses regarding factors that influence senior psychiatric residents, to consider treating geriatric patients in their future practices.
Using the Delphi technique, designed to generate ideas and consensus, we asked psychiatry residents at the University of Toronto who had completed, or were completing, their geriatric rotation about the factors they thought might influence residents in devoting some of their practice to geriatric patients. Residents then rated the degree of influence of these factors which had been synthesized into a questionnaire.
Twenty-six items were rated according to their degree of influence. The most influential item was positive clinical experiences with seniors. This was followed closely by supervisor characteristics such as enthusiasm, role modeling, competence, and mentoring. Interest in and comfort with the medical psychiatric and neuropsychiatric nature of the field were also felt to be influential.
The factors that influence senior psychiatry resident interest in the practice of geriatric psychiatry are primarily educational and result from exposure to the field under optimal educational circumstances (positive clinical experiences and excellent supervisors). The medical and neuropsychiatric nature of the field also likely exerts a unique influence and should be considered in stimulating interest in this population.
Comment In: Can J Psychiatry. 2001 May;46(4):373-411387801
To present experiences with teams in a university hospital and various community settings that promote the learning of collaboration among different professionals.
Research in developmental psychopathology has increasingly linked childhood vulnerabilities and risk factors to adolescent and adult disorders. In this context the multidisciplinary teams can be seen as the expression of the expanding knowledge and expertise of the medical and allied health professionals, which can be directed toward promotion of health as well as prevention and cure of illness.
Collaboration reflects the application of biopsychosocial principles to consultation and research both in the community and in hospital, and the general trend in medicine to move from solo to team practice.
Psychiatrists have the obligation to promote, develop and maintain the psychosocial and personal dimension in the teaching and practice of medicine.
The Ontario Child Health Study (OCHS) described in the companion paper (1) confirms the fact that psychiatric disorders among children and adolescents are prevalent, that comorbidity and associated impairements are common and that only a minority of children are seen by any definite mental health or social service. The current assessment and treatment methods and the present service system leave the majority of children unserved. Children and their families suffer a good deal before they are adequately diagnosed and treated, and treatment service delivered on a one-by-one basis are expensive. The OCHS data, has, it follows, important implications for clinical work, for mental health service planning, for further research and for training in child and adolescent psychiatry. This paper does not address all the implications of the OCHS in these areas but does attempt to address those which follow from the summary of the OCHS data described in (1).