Implementing the Behavioral and Mental Health Entrustable Professional Activity: Insights for a Path Forward

Area of Science:

• Pediatric education and mental health training.
• Child and adolescent behavioral health.
• Medical education research.

Background:

• Childhood mental health issues are increasing significantly.
• Pediatricians report insufficient training in behavioral/mental health (B/MH) assessment and management.
• The American Board of Pediatrics designates B/MH as a foundational entrustable professional activity (EPA) for pediatric practice.

Purpose of the Study:

• To explore facilitators and barriers in implementing and assessing the B/MH EPA in pediatric residency programs.
• To identify best practices for B/MH training in pediatrics.
• To propose solutions for common challenges in pediatric mental health education.

Main Methods:

• Qualitative study involving 18 key faculty members from 4 residency programs.
• Programs had 3 years of experience with the B/MH EPA.
• Semistructured interviews analyzed using thematic analysis.

Main Results:

• Five key themes emerged: responsibility for B/MH training, the role of local context, the need for longitudinal/integrated/multidisciplinary training, challenges with B/MH specialists, and the impact of resident/faculty confidence and skills.
• Local context can be both a barrier and a facilitator.
• Integrated and multidisciplinary approaches are suggested for B/MH training.

Conclusions:

• There is a critical need for enhanced training to prepare pediatric residents for addressing child mental health needs.
• The study highlights significant gaps in current B/MH training.
• Findings should guide future efforts to improve pediatric mental health education and practice.