Practice Based Learning and Improvement
Outcome
By graduation, the residents will demonstrate the knowledge, attitude, and skills
necessary to initiate self-directed and independent learning to keep abreast of current
information and practices relevant to child and adolescent psychiatry, to correct
any areas of information or skills gaps, and to improve patient care practices. Residents
are expected to exhibit progressive improvement in their level of knowledge and skill
throughout their training. Methods of demonstration may include the care of patients/
families, participation in didactics and clinical conferences, presentations, or exams.
Knowledge
Definition
Residents must demonstrate the ability to
- investigate, evaluate, and improve their patient care practices
- analyze, assimilate, and utilize the scientific literature and other data sources
to acquire relevant information to improve patient care and clinical skills
- identify gaps in their existing knowledge base and relevance of data from various
areas of research and clinical practice. Suggested topics (not inclusive) include:
- Development
- Biological and Clinical Sciences
- Psychopathology/ Classification/ Differential Diagnosis
- Assessment Procedures
- Treatment Modalities (biological, psychological, and social)
- Prevention
- Consultation in clinical and community settings
- Issues in practice not specified under other topics
- Spiritual
- Cultural
- Ethics
- Forensic/ Legal
- Advocacy
Expectations
Residents will learn and utilize
- a systematic approach for investigating, evaluating, and improving their fund of knowledge
and clinical practices relevant to child and adolescent psychiatry
- the basic techniques necessary to analyze and evaluate their own practices, the literature,
and data from other sources to modify and enhance their clinical practices and fund
of knowledge
Attitudes
Definition
Residents must demonstrate
- behaviors and demeanor consistent with the recognition that learning and monitoring
their clinical practices are lifelong endeavors requiring the use of a variety of
educational forums such as scientific literature, electronic data bases, supervision,
and continuing educational conferences
- a consistent interest in and self-examination of their clinical practices, skills,
and knowledge with active attempts to improve their fund of knowledge and abilities
- an ongoing interest in the demographic, social, cultural, and other relevant characteristics
of patient populations
Expectations
Residents will
- participate actively in didactic and clinical situations with the ability to acquire
knowledge, apply information to improve clinical care and didactic learning, and promote
the education of others
- present (formally or informally) in didactic and clinical situations using information
acquired from independent, self directed study
Skills
Definition
Residents will
- analyze practice experience and perform practice based improvement activities using
a systematic methodology
- locate, appraise, and assimilate evidence from scientific studies related to their
patients' psychiatric problems
- obtain and use information about their own population of patients and the larger population
from which their patients are drawn
- apply knowledge of study designs and statistical methods to the appraisal of clinical
studies and other information on diagnostic and therapeutic use information technology
to manage information, access on-line information, and support their own education
- facilitate the learning of students and other health care professionals thorough formal
or informal presentations on patient care or other topics relevant to child and adolescent
psychiatry
- utilize information technology to enhance patient management and self-education as
evidenced by the use of health system information systems to acquire and communicate
patient information and the library and internet systems to acquire relevant medical
and psychiatric information
- be able to effectively teach others on issues relevant to the psychiatric care of
children, adolescents, and families
Expectations
Residents will
- evaluate systemically their own clinical practices as well as the practices of others
through periodic evaluation of patient progress and acquisition of new knowledge from
the observation of others, supervision, group discussions, readings, and other sources
of information
- acquire knowledge on the characteristics of patient populations
- analyze critically the literature and other sources of data to keep abreast of current
child and adolescent psychiatry theories and practices in general and as relevant
for particular patients
- utilize information technology such as computers, data bases, and data systems to
enhance the management and acquisition of information for patient care and educational
activities
- teach others about particular cases and issues relevant to child and adolescent psychiatry
Assessment/ Measurement
Objective Measures
- Regular documentation by clinical and teaching faculty of participation in didactic
modules, case conferences, and other teaching sessions
- Completion of CHILD PRITE annually with review of individual scores with the training
director
Supervision
- Regular documentation of resident performance in areas relevant to practice based
learning by supervising outpatient and on-rotation faculty
Clinical Skill Evaluation
- Direct observation of the individual resident's clinical and didactic activities by
identified faculty
- Observation and evaluation of videotaped patient interactions by supervisors and/
or teaching faculty on a regular basis
- Annual clinical examination of “mock board” type
- Biannual review of performance with training director
Independent Learning
- Demonstration of self-initiated as well as directed study through leadership of discussions
in both didactic and clinical activities and through presentations to the residency
program in various formats (e.g. required papers; seminars; grand rounds; etc)
Deficiency Remediation
- Regular review for each individual resident with the training director of the various
measures of performance and competence with the
- identification of any specific deficits
- documentation of all identified areas requiring remediation or additional concentration
- development of specific remediation plans based on the particular deficiencies identified
- planning for further assessment with the outcome being determined by a method of assessment
similar to the one used to identify the original deficiency (e.g. relative deficits
identified on the CHILD PRITE might be subsequently reassessed by later performance
on the CHILD PRITE or another written examination; deficits identified through the
supervisory process might be reassessed by subsequent supervisory reports specifically
targeted at assessing and remediating the identified deficits; etc)
