Categorical Psychiatry and Predoctoral Psychology Interns’ Perceptions of Professional Identity and Practice: Results of a Survey at the Start and Completion of a Year of Interprofessional Education

Abstract

To the Editor: In academic medicine, a basic tenet of interprofessional education (IPE) is that educational experiences can be more valuable when learners are brought together from more than one health profession. IPE is widely used in both graduate and undergraduate medical education and is associated with a number of benefits, including improved patient outcome [1]. A survey study of US residency program directors reported that more than half used some type of IPE, most commonly by creating multi-professional classrooms and clinical teamcentered instruction [2]. Regarding the study of these varied endeavors, one area of active research involves students’ perceptions of other learners, rather than of the IPE activity itself. For example, one study showed that nursing students, after completing a course with students “shadowing” interprofessional team members while they performed other duties, were better able to describe the scope of practice of their student teammates’ profession [3]. An IPE program involving psychology and psychiatry interns involves learners more dissimilar than their titles suggest. Psychiatry interns have received their graduate medical degree and are in their first year of 4–5 years of postgraduate training. By contrast, psychology interns have yet to graduate and are in their final, predoctoral year of study. Furthermore, every psychology intern has already completed 3–4 years of behavioral health training, including clinical practicum and, among PhD students, original research. These learners may work within similar settings, interacting with similar, if not the same, patients. As of 2020, the Association of American Medical Colleges recognized 266 adult psychiatry residency programs [4] and the American Psychological Association, 765 internships [5]. Co-located psychology-psychiatry internships are therefore a potentially rich source for IPE development and study. We describe one aspect of such an IPE program, the mutual perceptions of psychology and psychiatry interns’ professional development on a 60-bed general psychiatric inpatient service where both groups work together over the course of a 12month academic year. Key features include joint patient treatment with psychotherapy, psychological testing, and medication management; shared development of performance improvement programs; and interns’ attendance at the morning rounds and group psychotherapies that are a primary focus of each group. To accomplish this, we used two complementary and anonymous surveys to determine each group of interns’ perceptions of the professional training and scope of practice of the other intern group. Each survey consisted of 10 seven-point Likert scale questions in three domains: knowledge of clinical abilities, clinical education, and professional practice. All four psychology interns received a questionnaire about the psychiatry interns; the 12 psychiatry interns’ survey, identical in every other way, asked about psychology. Surveys were completed at the beginning (T1) and end (T2) of interns’ respective rotations. IRB approval was obtained prior to administering the surveys, which were either completed by hand and returned anonymously or emailed to a department employee, who printed them without identifiers. Regarding psychiatry interns’ responses, the following four items showed significant change T1 to T2: Q1, “I can describe the clinical training a psychology intern receives,” from 2.9 to 4.7 (t = 2.167, df = 22, p < 0.01); Q2, “I have a good understanding of a psychology interns’ clinical abilities,” from 3.5 to 5.25 (t = 7.68, df = 21, p < 0.001); Q8, “I have a good understanding of how psychiatrists spend their day,” from 3.5 to 4.5 (t = 1.8, df = 21, p < 0.05), and Q10, “I consider myself a peer of the psychiatry interns,” from 5 to 5.9 (t = 3.83, df = * Mark H. Townsend [email protected]