Abstract
BackgroundThe prevalence of psychiatric disorders in children and young people is high but despite this, many doctors have difficulty identifying and managing psychiatric disorders presenting in this age group. The purpose of this study was to determine appropriate curriculum content in Child and Adolescent Psychiatry (CAP) for a Graduate Entry Medicine (GEM) course. Doctors with a background in primary care who were also involved in undergraduate teaching rated how necessary they considered a number of knowledge, skills and attitudes items were for inclusion in the CAP curriculum.MethodsAn online questionnaire study was carried out using modified Delphi methodology in two rounds. The questionnaire was derived from a list of CAP learning objectives and/or curricular content obtained from a thorough review of the literature. 23 of the 24 doctors who had agreed to participate went on to complete the round one questionnaire (95.8% response rate) with 19 also completing round 2 (82.6%). Where there was high agreement (70% or more) amongst participants, items were considered as having sufficient consensus to either accept or reject them. Mean scores were then used as a way to prioritise items.ResultsAt the end of round two, there was consensus to consider including 26 of the 34 knowledge items, 16 of the 20 skills items and three of the four attitudes items in the CAP curriculum. The most highly rated knowledge, skills and attitudes items were depression/ suicide; communicating with children, young people and families; and rapport building. The majority (83.3%) of round two responders, considered that the current amount of CAP teaching time was “too little”.ConclusionsDelphi methodology proved useful for determining consensus and the priority rankings of the CAP knowledge, skills and attitudes items can now be used to help educators determine which topics to focus upon. The study findings support the need for additional CAP teaching time in the GEM curriculum and will help to shape new CAP content. Additional formal CAP teaching time has already been incorporated into the psychiatry speciality attachment, a new clinical skills session has been developed and CAP topics have been introduced into written and clinical examinations.
Highlights
The prevalence of psychiatric disorders in children and young people is high but despite this, many doctors have difficulty identifying and managing psychiatric disorders presenting in this age group
Whilst only a quarter of the Children and Young People (CYP) in that study with a psychiatric disorder had been seen in a specialist health service in the previous year, nearly a half had had contact with their General Practitioner (GP) and they were more likely than children with no disorder to present in other health settings such as Accident and Emergency or outpatient departments [1]
The aim of the study was to develop consensus among doctors with a background in primary care who were involved in undergraduate teaching as to how necessary they considered a number of knowledge, skills and attitudes items were for inclusion in the Child and Adolescent Psychiatry (CAP) curriculum
Summary
The prevalence of psychiatric disorders in children and young people is high but despite this, many doctors have difficulty identifying and managing psychiatric disorders presenting in this age group. Is has been suggested that the care of CYP with psychiatric problems could be improved by adapting undergraduate education to reflect the future needs of doctors working in primary care [6] These findings support the need for all medical students to have a foundation in Child and Adolescent Psychiatry (CAP) regardless of their future career choices [7, 8]. There is still no clear consensus on the optimum number of hours CAP teaching that medical students may require before they graduate nor which topics should be taught [17] What these studies do have in common is that many recommend that the undergraduate CAP curriculum should be made more relevant to students given the majority are not planning to become psychiatrists. Similar conclusions are made in a CAP curriculum review in a Canadian medical school [20] as well in several other studies examining which topics should be included in a CAP curriculum [6, 13, 21]
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