Training the Doctors: A Scoping Review of Interprofessional Education in Primary Care Behavioral Health (PCBH)

Landoll, Ryan R.; Maggio, Lauren A.; Cervero, Ronald M.; Quinlan, Jeffrey D.

doi:10.1007/s10880-018-9582-7

Cited by 16 publications

(20 citation statements)

References 46 publications

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“…Users consider that professionals resort to medicalization due to the lack of other resources that can cover the needs for psychosocial problems, either due to lack of training, lack of specialized personnel or lack of time in the consultation rooms. Similar perceptions have been observed in previous studies ( 36 , 52 ). It has also been indicated that this same idea is shared by professionals, pointing out the need to provide care focused on the user in a comprehensive manner, through a multi-causal approach, with a biopsychosocial perspective, and paying attention to their family conditions ( 23 ).…”

Section: Discussionsupporting

confidence: 92%

“…These results provide evidence of situations that the user is able to identify and perceive that could act as triggers for user-professional aggression in Primary Care. Some of the focal points identified seem to be in line with recent studies carried out within Primary Care from both the user's perspective ( 23 , 24 , 35 ) and the professionals' perspective ( 6 , 36 , 37 ). It should be noted that some of these sources of conflict do not seem to be specific to Primary Care, being present in other fields of health care ( 11 , 20 , 38 , 39 ).…”

Section: Discussionsupporting

confidence: 83%

See 1 more Smart Citation

Users' Perception of Violence and Conflicts With Professionals in Primary Care Centers Before and During COVID-19. A Qualitative Study

Pina

López-Ros

Luna

et al. 2021

Front. Public Health

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Background: Workplace violence is a social problem of special interest in both intervention and research. Among the sectors that most perceive this type of violence, health care professionals stand out. The most common type of violence for this professional group is the one perpetrated by the users or patients themselves. It has been reported that one out of every four acts of violence in the workplace occurs in the healthcare setting. Within the health sector, the Mental Health, Emergency and Primary Care services have been widely reported as being among the most vulnerable, with Primary Care being the least addressed of the three. Although the available literature is extensive, there are hardly any studies that explore from a qualitative perspective what are the sources of conflict in this sector from the perspective of the users, the most common being to work with professionals.Objective: The aim of this study is to examine those aspects derived from the organization, the professionals or the users of Primary Care that, from the users' point of view, cause violent situations and how they think these could be avoided.Method: The sample consisted of 80 users of the Primary Care services of the Health Service of Murcia. For data collection, a qualitative study was conducted through 10 focus groups and a subsequent thematic analysis of the data.Results: The results have allowed us to identify that, from an organizational point of view, the uncertainty in waiting times, the need to adapt the telematic or telephone appointment to the different types of users, or the management of emergencies in Primary Care are the aspects that cause most conflicts between users and professionals. In this sense, suggested improvements are aimed at providing information in the mobile application updated on the opening hours or maintaining the telephone appointment for those who need or request it, among many others. As for the professionals, users point out that the medical staff is perceived as distant and sometimes does not provide enough information on the health status of users. Another professional group widely addressed in the focus groups was the administrative staff, being described as lacking in communication skills, assertiveness, or empathy. Users recognize the existence of a demanding/aggressive profile among users, who makes instrumental use of violence to achieve privileges over users in general. We have also identified the profile of the user who makes use of Primary Care as a way of socializing or managing conflicts of a socioemotional nature. As proposals for this thematic block, users suggest group therapies, the use of audiovisual material complementary to the information provided by professionals or community interventions in psychoeducation.Conclusion: This study allows to explore conflicts between users and professionals from the Primary Care patients' perspective. Our results are complementary to the available evidence that has used the professional's approach to study the phenomenon of workplace violence. The identification of sources of conflict and the assessment and contribution of users on possible ways of improvement can serve as a basis for the design of prevention and intervention plans to improve the work environment in Primary Care centers.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 83%

Users' Perception of Violence and Conflicts With Professionals in Primary Care Centers Before and During COVID-19. A Qualitative Study

Pina

López-Ros

Luna

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…Although the Accreditation Council for Graduate Medical Education (ACGME) Milestones recognize the critical role behavioral health plays in family medicine, and behavioral faculty are a mainstay of residency training programs, 12 there is little systematic understanding of training in integrated behavioral health service delivery models. 11,13 A recent scoping review identified that while a large number of training programs in family medicine, internal medicine, and pediatrics include interprofessional training in behavioral health, there is little formal identification of service delivery models or intentional curriculum on health care team integration. 13 This is a critical gap, as education and shared goals are key aspects of building successful health care teams.…”

Section: Methodsmentioning

confidence: 99%

“…11,13 A recent scoping review identified that while a large number of training programs in family medicine, internal medicine, and pediatrics include interprofessional training in behavioral health, there is little formal identification of service delivery models or intentional curriculum on health care team integration. 13 This is a critical gap, as education and shared goals are key aspects of building successful health care teams. 14 A more robust understanding of educational processes could address some of the known challenges with behavioral health provider attrition in PCBH practice 15 and improve physician burnout, as high-functioning interprofessional teams have been seen as a protective factor in physician well-being.…”

Section: Methodsmentioning

confidence: 99%

“…The authors selected this model by the authors following a recent scoping review in this area that utilized the 3P model as a framework. 13 The 3P model focuses on three components that represent the context, educational ORIGINAL ARTICLES milieu, and outcomes, labeled as presage, process, and product factors. 19 Presage factors focus on the preconditions of training (eg, what previous attitudes do learners come in with, or what faculty development has been given).…”

Section: Data Analysis and Orienting Frameworkmentioning

confidence: 99%

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Primary Care Behavioral Health Training in Family Medicine Residencies:

Landoll

Cervero

Quinlan

et al. 2020

Fam Med

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Background and Objectives: Primary care behavioral health (PCBH) is a service delivery model of integrated care linked to a wide variety of positive patient and system outcomes. However, considerable challenges with provider training and attrition exist. While training for nonphysician behavioral scientists is well established, little is known about how to train physicians to work efficiently within integrated teams. Methods: We conducted a case study analysis of family medicine residencies in the military health system using a series of 30 to 45-minute semistructured interviews. We conducted qualitative template analysis of these cases to chart programs’ current educational processes related to PCBH. Thirteen individuals consisting of program directors, behavioral and nonbehavioral faculty, and residents across five programs participated in the study. Results: Current educational processes included a variety of content on PCBH (eg, treatment for depression, clinical referral pathways, patient-centered communication), primarily using a mix of didactic and practice-based placements. Resource allocation was seen as a critical contributor to quality. There was variability in the degree to which integrated behavioral health providers were incorporated as residency faculty, such that programs where these specialists were more incorporated reported more intentional curriculum development and health care systems-level content. Conclusions: While behavioral health content was well represented in family medicine residency curriculum, the depth and integration of content was inconsistent. More intentional and integrated curriculum accompanied faculty development and integration of behavioral health faculty. Future research should evaluate if faculty development programs and faculty status of behavioral scientists results in different educational or health care outcomes.

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“We want to be heard”: A qualitative study of mental health care access among patients of an urban federally qualified health center

So,

Makofane,

Hernandez

2023

Mental Health Science

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Although depression is common in primary care, challenges to timely intervention exist, particularly for communities of color and lower socioeconomic status. Our objective was to understand barriers and facilitators to mental healthcare access among a sample of patients receiving care at a federally qualified health center (FQHC) in Minnesota, United States. We qualitatively interviewed 34 patients of an urban FQHC, purposively sampled on race/ethnicity, insurance status, language, and depression symptom status (based on Patient Health Questionnaire‐9 responses). We inductively and deductively analyzed interview data, leveraging theory in both the codebook development and analysis processes. Participants, who were predominantly English‐speaking, female, not privately insured, and people of color, shared numerous barriers and facilitators to accessing mental healthcare. Prominent barriers primarily concerned healthcare providers, including perceived dismissal of mental health concerns and challenges with provider continuity. Additional barriers included the costs of mental health care, communication breakdowns, the patient portal, and community‐specific perceptions of mental health. Prominent facilitators included clinic organizational factors (internal and external) and staff friendliness and warmth. Other factors including consideration of patients' financial situation, integrated management of behavioral and physical health conditions, language concordant staff, the telehealth visit modality, and the clinic's social mission were also raised as facilitating access. Patient voices from a single FQHC illustrate the challenges and possibilities of providing mental healthcare in safety net settings. Clinical, strategy, and policy solutions can be tailored to minimize barriers and optimize facilitators documented herein.

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Training the Doctors: A Scoping Review of Interprofessional Education in Primary Care Behavioral Health (PCBH)

Cited by 16 publications

References 46 publications

Users' Perception of Violence and Conflicts With Professionals in Primary Care Centers Before and During COVID-19. A Qualitative Study

Users' Perception of Violence and Conflicts With Professionals in Primary Care Centers Before and During COVID-19. A Qualitative Study

Primary Care Behavioral Health Training in Family Medicine Residencies:

“We want to be heard”: A qualitative study of mental health care access among patients of an urban federally qualified health center

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