Integrated Behavioral Health: A Curriculum for Residents in Rural and Community Psychiatry

Mental health and substance use disorders are common in the United States; however, only a portion of adults with these conditions receive treatment. Recent recommendations include using integrated behavioral health (IBH) models to increase patient access to care. Despite IBH's effectiveness, few psychiatry residents are trained in it. Considering the scarcity of evaluated curricula on IBH, we created a curriculum to teach different IBH models to psychiatry residents.

The curriculum was developed using the constructivism theoretical framework and aligned with the principles of competency-based medical education. The learning activities allowed learners to apply knowledge relevant to IBH models to critically appraise a clinical scenario while practicing different components of IBH, such as electronic consults. More specifically, the curriculum assignment prompted residents to examine a clinical practice, identify the model, make recommendations for changes, and discuss the advantages and barriers of the proposed changes. We employed Kirkpatrick model levels 1 and 2b to evaluate the curriculum.

Thirty-three residents participated in this curriculum. Eleven residents completed the assignment, which was qualitatively coded to evaluate their learning. Results indicated that the participants were able to compare different IBH models and critically appraise clinical practice using knowledge of those models. Twenty-two additional residents completed an anonymous retrospective pre- and postrotation survey on their perceived level of proficiency. Survey results showed improved perceived level of proficiency at rotation completion.

The developed curriculum was successful in teaching residents to acquire and apply knowledge relevant to IBH.