The relationship between attitudinal and behavioral change in pediatric residents in a psychiatric liaison teaching...

Two behavioral measures--chart audits and requests for psychiatric consultations--and two attitudinal measures--case conference comments and a case management questionnaire--were used to assess changes in pediatric residents' approaches to psychosocial issues over the course of liaison training. Both attitudinal measures showed changes in the residents' approaches, including an increased attention to patients' and families' feelings and an expanded awareness of the options available in dealing with psychosocial problems. These changes in attitude, however, did not result in increases in the amount of psychosocial data recorded in the charts or increases in resident-initiated consultation requests. The authors use their observations on the wards and in case conferences and interviews with pediatric residents to explain why chart contents and psychiatric consultation practices are resistant to change. Their findings indicate a gap between attitudinal and behavioral change that requires further research on how pediatric residents identify psychosocial problems, and how liaison training is integrated with the needs and expectations of nonpsychiatric physicians.