A Survey of Residents/Fellows, Program Directors, and Faculty About Telepsychiatry: Clinical Experience, Interest, and Views/Concerns

Abstract

The effectiveness of telepsychiatry video for clinical care is well established, and clinician and psychiatry resident interest in it is growing—particularly in light of the COVID-19 impact. Still, few residency programs in the United States have core curricula, rotations/electives available, and competencies, and many faculty have no experience. A survey was sent via national organization listserves for residents, fellows, faculty, and program directors to complete. The survey queried demographics, clinical experience and interest, and views/concerns, using Likert-like and yes/no questions. Descriptive statistics and other analyses compared the groups to assess impact of clinical experience on interest and views/concerns. Respondents (N = 270) have limited clinical experience with telepsychiatry (46% none), with trainees having less than others, and yet, most were very interested or interested in it (68%). Trainees (N = 123) have concerns about being prepared for future practice. Clinical experience with video in the range of 6–20 h appears to dramatically increase interest and reduce concerns, though less time has a positive effect. Respondents have concerns about connectivity, medico-legal issues, and clinical effectiveness (e.g., diverse populations, psychosis, and emergencies) with telepsychiatry. More research is needed to assess current clinical and curricular experience, interest, and concerns. Additional curricular interventions during residency and fellowship training could build skills and confidence, if this is feasible, and the benefits outweigh the costs.

A Preliminary Italian Cross-Sectional Study on the Level of Digital Psychiatry Training, Knowledge, Beliefs and Experiences among Medical Students, Psychiatry Trainees and Professionals

“…Moreover, data revealed a general concern about achieving a good therapeutic alliance through digital tools. These results are consistent with existing literature [ 11 , 30 , 34 , 35 , 39 ], and in contrast with the evidence that patients treated via videoconferencing tend to consider the therapeutic alliance valid [ 42 ]. Other perplexities were related to data and privacy protection and the appropriateness of using DP during the first psychiatric visit rather than just in follow-up visits in already stable patients.…”

“…Overall, the present findings of the inadequate DP training in Italy are in line with data collected in other European countries, such as France [ 23 ], and in non-European countries, such as India [ 24 ], Sri Lanka [ 25 ] and Asia-Pacific Regions [ 26 ]. Similarly, the overall interest in implementing the field of DP is consistent with past findings in samples of medical students and psychiatry trainees [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. Conversely, different data emerge from U.S. studies conducted in the last decade.…”

“…In particular, the perplexities concerned the effectiveness of digital interventions compared to in-person ones, despite the evidence proving that the two modes are equally effective in terms of outcomes, treatment adherence, and symptomatology improvement [ 37 ]. Only a tiny percentage of the sample declared that digital interventions are as effective as in-person ones, following data emerging from existing literature [ 30 , 38 , 39 ].…”

Telepsychiatry services during COVID‐19: A cross‐sectional survey on the experiences and perspectives of young adults with first‐episode psychosis

“…Such research is needed given service providers' concerns of using telepsychiatry for patients with symptoms of psychosis (e.g. paranoia) (Cruz et al, 2021 ).…”

Column on Telebehavioral Health Education, Training, and Competency Development: Current and Future Impact of the COVID-19 Pandemic

“…Since many behavioral health practitioners typically had minimal or no telehealth education and training experience in their professional development prior to the pandemic (Cruz et al, 2021;Sunderji et al, 2015;Gluekauf et al, 2018;Hertlein et al, 2021;Hoffman & Kane, 2014;Perry et al, 2020;Pierce et al, 2020;Sammons et al, 2020), providing and obtaining basic telehealth education to quickly transition to telehealth services were typical responses after COVID-19 by service organizations and practitioners.…”