在加拿大精神病学独立医学检查中评估不良结果和学习需求
Brad D Booth1, Jeffrey C Waldman2, Jacqueline H Fortier2
1Dr. Booth is an Associate Professor, Division of Forensic Psychiatry, Department of Psychiatry, Faculty of Medicine, University of Ottawa and Forensic Psychiatrist, Integrated Forensic Program, Royal Ottawa Health Care Group Ottawa, ON. Dr. Waldman is an Assistant Professor, Department of Psychiatry, Faculty of Medicine, University of Manitoba and Medical director, Roblin Medical Forensic Group, Winnipeg, MB. Ms. Fortier is a Medical Analyst Researcher for Safe Medical Care Research, Canadian Medical Protective Association Ottawa, ON. Dr. Garber is a Professor in the Department of Medicine and the School of Public Health and Epidemiology, University of Ottawa, Ottawa, ON, a Professor in the Department of Medicine, University of Toronto, Toronto, ON, and Director of Safe Medical Care Research, Canadian Medical Protective Association. Ms. Hardy is Chief Executive Officer, Canadian Psychiatric Association. Dr. Lemay is a Medical Analyst Researcher, Safe Medical Care Research, Canadian Medical Protective Association. Mr. Liu is a Statistical Data Analyst, Safe Medical Care Research, Canadian Medical Protective Association. Dr. Tomita is a Clinical Associate Professor, University of British Columbia, Vancouver, BC. Dr. Ramshaw is an Assistant Professor, Division of Forensic Psychiatry, Department of Psychiatry, Faculty of Medicine, University of Toronto and a Forensic Psychiatrist, Forensic Service, Centre for Addiction and Mental Health (CAMH), Toronto, ON. brad.booth@theroyal.ca.
独立医疗检查 (IME) 对精神病学家带来医学法律风险,但正规培训很少. 新的指导方针旨在减轻IME评估人员面临的这些风险,并提高精神病学评估的质量.
科学领域:
- 法医精神病学 法医精神病学
- 医疗法 法律 医疗法
- 精神病学实践 精神病学实践
背景情况:
- 独立医疗检查 (IME) 非常重要,但缺乏关于评估者风险和培训需求的文献.
- 执行IME的精神病医生面临医疗法律后果,包括监管投诉.
- 现有的IME进行精神病医生的正规培训显著有限.
研究的目的:
- 调查执行IME的精神病学家的医学法律风险和学习需求.
- 确定IME实践中针对精神病学家的常见投诉和法律诉讼.
- 评估在加拿大精神病医生中进行IME的正式培训的普遍性.
主要方法:
- 几乎38,000个加拿大医疗保护协会 (CMPA) 涉及IME精神病学家的病例的回顾性图表审查.
- 由加拿大精神病学与法律学院 (CAPL) 和加拿大精神病学会 (CPA) 对306名加拿大精神病学家进行的调查.
- 分析投诉类型和报告的医疗法律后果.
主要成果:
- 108个CMPA文件揭示了常见的投诉:偏见的意见,不充分的评估和文档问题.
- 37%的进行IME的精神病医生报告了医疗法律后果.
- 只有40%的IME执行精神病医生和20%的精神病医生接受过正式的IME培训.
结论:
- 尽管面临医疗法律风险,但很大一部分从事IME的精神病医生缺乏正式培训.
- 常见的投诉突出了需要改善IME实践和报告的领域.
- 加拿大法医精神病学评估和报告撰写指南 (CAPL) 提供了一个减少风险的框架.
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