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Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry
BACKGROUND: Patients with complex care needs have multiple concurrent conditions (medical, psychiatric, social vulnerability or functional impairment), interfering with achieving desired health outcomes. Their care often requires coordination and integration of services across hospital and community...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116745/ https://www.ncbi.nlm.nih.gov/pubmed/37081455 http://dx.doi.org/10.1186/s12909-023-04233-0 |
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author | Chaukos, Deanna Genus, Sandalia Maunder, Robert Mylopoulos, Maria |
author_facet | Chaukos, Deanna Genus, Sandalia Maunder, Robert Mylopoulos, Maria |
author_sort | Chaukos, Deanna |
collection | PubMed |
description | BACKGROUND: Patients with complex care needs have multiple concurrent conditions (medical, psychiatric, social vulnerability or functional impairment), interfering with achieving desired health outcomes. Their care often requires coordination and integration of services across hospital and community settings. Physicians feel ill-equipped and unsupported to navigate uncertainty and ambiguity caused by multiple problems. A HIV Psychiatry resident elective was designed to support acquisition of integrated competencies to navigate uncertainty and disjointed systems of care – necessary for complex patient care. METHODS: Through qualitative thematic analysis of pre- and post-interviews with 12 participants – residents and clinic staff – from December 2019 to September 2022, we explored experiences of this elective. RESULTS: This educational experience helped trainees expand their understanding of what makes patients complex. Teachers and trainees emphasize the importance of an approach to “not knowing” and utilizing integrative competencies for navigating uncertainty. Through perspective exchange and collaboration, trainees showed evidence of adaptive expertise: the ability to improvise while drawing on past knowledge. CONCLUSIONS: Postgraduate training experiences should be designed to facilitate skills for caring for complex patients. These skills help residents fill in practice gaps, improvise when standardization fails, and develop adaptive expertise. Going forward, findings will be used to inform this ongoing elective. |
format | Online Article Text |
id | pubmed-10116745 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-101167452023-04-21 Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry Chaukos, Deanna Genus, Sandalia Maunder, Robert Mylopoulos, Maria BMC Med Educ Research BACKGROUND: Patients with complex care needs have multiple concurrent conditions (medical, psychiatric, social vulnerability or functional impairment), interfering with achieving desired health outcomes. Their care often requires coordination and integration of services across hospital and community settings. Physicians feel ill-equipped and unsupported to navigate uncertainty and ambiguity caused by multiple problems. A HIV Psychiatry resident elective was designed to support acquisition of integrated competencies to navigate uncertainty and disjointed systems of care – necessary for complex patient care. METHODS: Through qualitative thematic analysis of pre- and post-interviews with 12 participants – residents and clinic staff – from December 2019 to September 2022, we explored experiences of this elective. RESULTS: This educational experience helped trainees expand their understanding of what makes patients complex. Teachers and trainees emphasize the importance of an approach to “not knowing” and utilizing integrative competencies for navigating uncertainty. Through perspective exchange and collaboration, trainees showed evidence of adaptive expertise: the ability to improvise while drawing on past knowledge. CONCLUSIONS: Postgraduate training experiences should be designed to facilitate skills for caring for complex patients. These skills help residents fill in practice gaps, improvise when standardization fails, and develop adaptive expertise. Going forward, findings will be used to inform this ongoing elective. BioMed Central 2023-04-20 /pmc/articles/PMC10116745/ /pubmed/37081455 http://dx.doi.org/10.1186/s12909-023-04233-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Chaukos, Deanna Genus, Sandalia Maunder, Robert Mylopoulos, Maria Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry |
title | Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry |
title_full | Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry |
title_fullStr | Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry |
title_full_unstemmed | Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry |
title_short | Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry |
title_sort | preparing future physicians for complexity: a post-graduate elective in hiv psychiatry |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116745/ https://www.ncbi.nlm.nih.gov/pubmed/37081455 http://dx.doi.org/10.1186/s12909-023-04233-0 |
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