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Published on: June 12, 2020
Implementing the Behavioral and Mental Health Entrustable Professional Activity: Insights for a Path Forward
Victoria Wurster Ovalle1, Abigail Martini1, Shelby Tanguay2
1Department of Pediatrics (V Wurster Ovalle, A Martini, S Tanguay, and DJ Schumacher), Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, Ohio; Division of Emergency Medicine (V Wurster Ovalle, A Martini, and DJ Schumacher), CCHMC, Cincinnati, Ohio.
Objective:
Mental health problems in children are growing exponentially. General pediatricians, while in a unique position to address these issues as they arise, report they lack adequate training in assessing and managing behavioral/mental health (B/MH) problems. Underscoring the importance of this area, the American Board of Pediatrics has defined B/MH as one of only 17 foundational entrustable professional activities (EPAs) for general pediatric practice. Our goal was to explore the facilitators and barriers associated with implementing and assessing the B/MH EPA among pediatric residency programs in order to identify best practices and potential solutions to common barriers.
Methods:
In this qualitative study, 18 key faculty members from 4 residency programs with 3 years' experience implementing and assessing their residents on the B/MH EPA were purposively sampled. Semistructured interviews were conducted with each participant, and interviews were analyzed utilizing a thematic analysis.
Results:
Five themes were defined in the thematic analysis 1) B/MH training: who's responsible? 2) local context can serve as a barrier or facilitator, 3) B/MH may require longitudinal, integrated, and multidisciplinary training, 4) B/MH specialists: indispensable, yet a hurdle?, and 5) resident and faculty confidence and skill impact B/MH training.
Conclusions:
The need for robust training to prepare pediatric residency graduates to meet the needs of patients with B/MH problems has never been greater. This study provides important insights about gaps in B/MH training. These should inform future directions focused on addressing this need.
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