A Novel Model for Continuing Medical Education Delivery to Community-Based Providers: Community-Based Integrated Care...

Collaborative Care is a key strategy to improve population mental health by leveraging the expertise of psychiatric providers to support team-based treatment in primary care settings. Novel continuing education models can support psychiatric workforce development in this emerging area.

Describe the design, implementation, and outcomes of an interprofessional continuing education program for community-based psychiatrists and advanced practice psychiatric providers in practice across Washington State.

The part-time fellowship consists of the following four components: online didactics, live skills workshops, a quality improvement learning collaborative, and individual mentorship. The rationale and design of each component is described. Principles of adult learning were incorporated throughout, emphasizing active learning approaches. Evaluation included application data, fellows' attendance and session evaluations, and fellow surveys at baseline, end of fellowship, and 6 months postfellowship. Descriptive statistics and paired t-tests were used.

In the first 5 years, 60 individuals graduated, with 72% from a designated mental health professional shortage area. They supported care delivered by 186 care managers and 696 primary care providers. Attendance was strong (79-90%) and fellows rated didactic quality and relevance highly (mean 4.5 out of 5 [standard deviation 0.30] and 4.5 [standard deviation 0.41], n = 1355 evaluations [85% response]). Relative to baseline, at graduation, fellows had significantly higher confidence in 49 of 53 clinical, systems-based, and quality improvement skills assessed (68-95% response); however, attitudes were unchanged (77-87% response). At baseline, 76% of fellows never reviewed aggregate patient data, whereas upon graduation, 48% did so at least quarterly (83% response). Graduates launched at least 8 new Collaborative Care programs in rural practices.

The Community-based Integrated Care Fellowship exemplifies an innovative model that meets the lifelong learning needs of practicing psychiatric providers. Graduates increased their skills and embarked on practice change. Continuing education can be delivered through flexible, employment-friendly modalities at larger scale than traditional full-time clinical fellowships. This program demonstrates how active learning strategies can be utilized to stimulate clinical practice change. Moreover, its structure serves as a model for other psychiatric subspecialties, such as geriatrics or addictions, where workforce development targeting providers in practice may be particularly valuable.