With the emergence of physician-manager (PM) curricula in medical education, more effective assessment tools are needed to evaluate psychiatry trainees in this role. The aim of this study was to determine psychiatry residents', program directors', and PM educators' perceptions about PM role-assessment.
Psychiatry residents at two Canadian programs were given a survey on PM assessment and the use of portfolios to assess PM competency. Qualitative interviews of Canadian psychiatry educators and program directors were used to determine faculty perceptions on PM assessment. Authors analyzed survey data with descriptive statistics, and qualitative interviews were analyzed using a grounded theory approach.
Nearly 55% of psychiatry residents responded to the survey; 47% of residents did not want to change the way they were assessed by the PM role. Residents identified an array of assessment methods for each of the specific PM domains. Educator interview themes included supervisor and resident barriers to assessment, the need for new PM assessment approaches integrating multiple assessment methods, and a role for the use of portfolios if sufficient infrastructure was available.
The data supported a preference for a multimodal approach to assessment of the PM role. Future research should examine the implementation of the proposed PM assessment tool.
To determine Canadian psychiatry residents' perceived gaps in physician-manager competencies during their residency training.
Residents at 16 Canadian psychiatry residency programs were mailed an 11-item questionnaire (a copy is available from the authors) assessing their perceived deficiencies in selected managerial knowledge (GSk) and skill (GSs) areas as determined by gap scores (GS). GSs are defined as the difference between residents' perceived current and desired level of knowledge or skill in selected physician-manager domains. Residents' educational preferences were also elicited in the questionnaire.
Among the 494 psychiatry residents who were sent the survey, 237 residents (48%) responded. Residents reported the greatest GSk in Program Planning and the greatest GSs in Personal and Professional Self-Care. Predictors of greater total GSks included a lack of previous administrative education during medical school, higher training level, and female sex. Only sex was a significant predictor of total GSss. More than 50% of residents preferred workshops, small groups, mentoring, and didactic learning methods for furthering their knowledge and skills.
Residents report significant gaps in specific physician-manager training areas, specifically Program Planning, and Personal and Professional Self-Care. The results of this national survey can inform the development of formal physician-manager curricula. To appeal to residents, such curricula should incorporate more interactive pedagogical methods combined with mentoring opportunities.
Despite widespread consensus that additional training in administration is needed to prepare physicians for practice, little is known about how best to teach managerial competencies and how to integrate teaching into existing postgraduate curricula.
This study aimed to elicit resident perspectives on administrative curriculum development following exposure to a pilot physician manager curriculum at the University of Toronto.
The authors held five focus groups of psychiatry residents at the University of Toronto during 2008, engaging 40 trainees. Resident perspectives on barriers to teaching and learning administrative skills, preferred curriculum content and format and suggestions for integration of administrative training into the residency programme were elicited.
Identified barriers to learning include lack of physician manager role clarity, dearth of learning opportunities and multiple competing demands on residents' time. Residents value a formal administrative curriculum and propose additional opportunities for experiential learning such as elective rotations and mentorship opportunities. Suggested strategies for integrating administrative teaching into residency include faculty development, rotation-specific administrative objectives and end of rotation resident evaluations.
Our findings provide valuable learner input into an emerging educational framework aiming to address barriers to teaching administrative skills during residency and facilitate longitudinal reinforcement of learning.
The authors describe a pilot physician-manager curriculum designed to address the learning needs of psychiatric residents in administrative psychiatry and health systems.
The pilot curriculum includes a junior and a senior toolkit of four workshops each. The junior toolkit introduces postgraduate-year two (PGY-2) residents to the principles of teamwork, conflict resolution, quality improvement, and program planning and evaluation. The senior toolkit exposes PGY-4 residents to leadership and change management, organizational structures, mental health and addictions reform, and self and career development. Following curriculum implementation at the University of Toronto, residents rated the importance and clinical relevance of curriculum objectives and commented on the strengths and weaknesses of the workshops and areas needing improvement.
The pilot curriculum was successfully introduced at the University of Toronto in 2006. Residents rated the curriculum very highly and commented that interactive learning and contextually relevant topics are essential in meeting their needs.
It is possible to successfully introduce a physician-manager curriculum early during psychiatric residency training, to match the specific needs of clinical rotations. Interactive techniques and clinical illustrations may be crucial in facilitating teaching and learning the physician-manager role. The authors discuss barriers, facilitators, and critical success factors in implementing such a curriculum.