The McMaster Advanced Communication Competencies Model for Psychiatry (MACC Model).

Abstract

Communication is a core competency for all physicians in training. In Canada, the importance of communication during residency is recognized through the CanMEDS framework. Although literature exists around teaching communication skills to residents, research in psychiatry residents is lacking. The purpose of this study was to explore how faculty members conceptualize the development of communication skills in psychiatry residents and develop a model reflecting this. The authors used a constructivist grounded theory approach. Purposive sampling was used to select 14 faculty educators who regularly supervise psychiatry residents in a single university-based residency training program. Semi-structured interviews were conducted to explore educators' perceptions of how communication skills develop during residency. Constant comparative analysis occurred concurrently with data collection until thematic theoretical sufficiency was reached and relationships between themes determined. Five themes underlie the McMaster Advanced Communication Competencies model, describing the progressive development of communication abilities in residents. Three themes identify foundational sets of abilities including: refining common foundational relational abilities, developing foundational specific psychiatric communication abilities, and learning to reflect upon and manage internal reactions. These foundational pillars then allow residents to develop a personalized art of flexible psychiatric interviewing, and skillfully partner with patients in co-creating care plans. This research describes a preliminary communication competency model for teaching and assessing psychiatry residents. It defines the core communication abilities required for residents to progress to independent practice. Future research could explore and test the model's validity and transferability.