1.Presentation of current gold standard model curriculum for ED psychiatry residency training: “Residency Training in Emergency Psychiatry: A Model Curriculum Developed by the Education Committee of the American Association for Emergency Psychiatry” by Brasch et al.1 The strengths of this structure are reviewed. The question is then posed, how can this general approach be adapted to the unique aspects of any residency training program? 2.An alternative approach to the ED Resident Curriculum is then suggested. In this model, the most common psychiatric diagnosis in the ED is identified. For our ED, the most commonly occurring presenting diagnosis in our ED is F15.259, Amphetamine-induced Psychotic Disorder, which constitutes almost 30% of all cases.3.The curriculum is then rebuilt around this diagnosis. This approach allows resident education, reaction, and disposition to become streamlined by emphasizing its prevalence. As this is the most prominent diagnosis, the residents become most familiar with the presentation, diagnosis, management, and disposition.4.Familiarity and elevated competence in the most prevalent diagnosis allow more efficient evaluation and care, allowing residents more time to spend on less prevalent ED presentations. This diagnosis-centered approach can be applied to any ED at any site, using its own unique pattern of diagnostic prevalence to shape the curriculum. For our program, it led to additional educational and quality improvement efforts. For example, a grand rounds was prepared to orient the residents to this approach, entitled “F15.259.” The walls of the ED cubicle were decorated with the diagnostic nomenclature “F15.259.” A quality improvement project involving the quality metric of the ED, length of stay, was implemented, using best pharmacologic practices from the ED literature to manage agitation from F15.259. As the residents developed more expertise in this realm, they were able to spend more time on cases that fell outside this diagnosis. Methods of determining educational effectiveness of this model are discussed in conclusion.
Learning Objectives:- List the 7 training objectives of a traditional Psychiatric Residency ED training curriculum.
- List 3 advantages of a diagnosis-based Psychiatric residency ED training curriculum.
- List 2 parameters of educational effectiveness for your model curriculum.