John Teshima

Peer group mentoring of junior faculty.

ObjectiveThe purpose of this article is to document and evaluate the initiation of a mentoring model for junior faculty utilizing a peer group approach rather than the traditional dyadic model.MethodsJunior faculty members in an academic department of psychiatry at Sunnybrook Hospital, University of Toronto, were invited to take part in a peer mentoring program involving evening meetings every 2 months over a 1-year period from 2004–2005. Of the 12 invitees, 10 agreed to participate in the program. The group participants developed the program agenda collectively. Learning objectives as well as a list of topics of interest were established at the inaugural meeting. A focus group was held at the end of 12 months to provide a descriptive, qualitative evaluation. The focus group leader prepared a report based on observations and notes taken during the focus group.ResultsThe report prepared by the focus group leader identified six main themes that included: program development, knowledge gains, interpersonal gains, psychological/emotional gains, process of the program and future directions. The overall response was clearly favorable with a unanimous decision to maintain the group and continue meeting into the next year.ConclusionA peer group mentoring format for junior faculty in an academic department of psychiatry can be an effective model of mentoring.

A framework for telepsychiatric training and e-health: Competency-based education, evaluation and implications

Abstract Telepsychiatry (TP; video; synchronous) is effective, well received and a standard way to practice. Best practices in TP education, but not its desired outcomes, have been published. This paper proposes competencies for trainees and clinicians, with TP situated within the broader landscape of e-mental health (e-MH) care. TP competencies are organized using the US Accreditation Council of Graduate Medical Education framework, with input from the CanMEDS framework. Teaching and assessment methods are aligned with target competencies, learning contexts, and evaluation options. Case examples help to apply concepts to clinical and institutional contexts. Competencies can be identified, measured and evaluated. Novice or advanced beginner, competent/proficient, and expert levels were outlined. Andragogical (i.e. pedagogical) methods are used in clinical care, seminar, and other educational contexts. Cross-sectional and longitudinal evaluation using quantitative and qualitative measures promotes skills development via iterative feedback from patients, trainees, and faculty staff. TP and e-MH care significantly overlap, such that institutional leaders may use a common approach for change management and an e-platform to prioritize resources. TP training and assessment methods need to be implemented and evaluated. Institutional approaches to patient care, education, faculty development, and funding also need to be studied.

Child and Youth Telepsychiatry in Rural and Remote Primary Care

Young people with psychological or psychiatric problems are managed largely by primary care practitioners, many of whom feel inadequately trained, ill equipped, and uncomfortable with this responsibility. Accessing specialist pediatric and psychological services, often located in and near large urban centers, is a particular challenge for rural and remote communities. Live interactive videoconferencing technology (telepsychiatry) presents innovative opportunities to bridge these service gaps. The TeleLink Mental Health Program at The Hospital for Sick Children in Toronto offers a comprehensive, collaborative model of enhancing local community systems of care in rural and remote Ontario using videoconferencing. With a focus on clinical consultation, collaborative care, education and training, evaluation, and research, ready access to pediatric psychiatrists and other specialist mental health service providers can effectively extend the boundaries of the medical home. Medical trainees in urban teaching centers are also expanding their knowledge of and comfort level with rural mental health issues, various complementary service models, and the potentials of videoconferencing in providing psychiatric and psychological services. Committed and enthusiastic champions, a positive attitude, creativity, and flexibility are a few of the necessary attributes ensuring viability and integration of telemental health programs.

Building eHealth and Telepsychiatry Capabilities: Three Educational Reports Across the Learning Continuum

Telepsychiatry and eHealth are evidence-based, cost-effective health care delivery methods that increase access to specialist care, particularly for rural and remote populations [1–3]. Yet, the penetrance of telepsychiatry is uneven and the health system organization to support it is generally underdeveloped [4]. Inadequate postgraduate training in telehealth and eHealth may contribute to this lag. Such training and exposure has the potential to increase interest and skills in telepsychiatry and normalize it as a modality of clinical care. Recent reviews describe the status of telepsychiatry in postgraduate training and highlight the scarcity of literature on the topic and the lack of evaluation of these training programs [ 5–7]. Building on these reviews, and a study assessing resident learning needs in telepsychiatry [8], frameworks have been proposed to delineate competencies in telepsychiatry and eHealth at different stages of training [8–10]. Although these frameworks help define learner competencies, they do not describe teaching and evaluation methods for achieving these competencies. Sunderji, Crawford, and Jovanovic [6] and Glover et al. [7] provide descriptions of programs, but predate the literature on competency development. To address these gaps, we present a pedagogical caseseries across a continuum of skills development, from novice learner to intermediate learner to continuing professional development, drawn from our recent experiences within the University of Toronto, Department of Psychiatry and its residency program, located in Toronto, Ontario, Canada. These experiences align with our Department’s efforts to respond to community needs, build capacity for improved access and quality of mental health care, and prepare future psychiatrists for a rapidly evolving health care system. Each case describes the instructional methods, the rationale and objectives for the activity, the outcomes and evaluation modalities, and considers lessons learned through the implementation process. Pertinent faculty development needs will be addressed throughout the paper given the importance of faculty trained and experienced in the delivery and teaching environment of telehealth. Our aim is to provide a concrete and feasible approach to building eHealth and telepsychiatry capabilities within the context of postgraduate psychiatric training and continuing professional development, as a complement to existing standardized competency frameworks.