Residency Programs Research Articles

Education Research: Utilization of Simulation in Residency Programs

Education Research: Utilization of Simulation in Residency Programs

Developing CLOUT: A Longitudinal, Cross-Program Chief Resident Curriculum to Increase Psychological Safety in the Clinical Learning Environment.

Psychological safety in the clinical learning environment is essential for learning and thriving. The authors aimed to leverage the leadership position and influence that chief residents hold and invited them to participate in a longitudinal professional development curriculum designed to provide them with the tools to promote psychological safety. A total of 66 chief residents from 25 residency programs, along with 18 faculty allies, participated in 5 workshops, which were designed to increase their understanding of and effective responses to workplace mistreatment or bias directed toward trainees. These skills-based workshops focused on effective coaching, conflict management, and self-regulation of emotions for themselves and their trainees. There was a significant improvement in self-reported efficacy in these domains at the completion of the curriculum and evidence of behavior change as assessed by baseline and final case scenario responses. Additionally, the relationship building that resulted by bringing all chief residents together further enhanced the curriculum's impact as assessed qualitatively. Providing chief residents with skills and resources to become change agents through a longitudinal curriculum in a cohort model improves individual self-efficacy and responses to exemplar cases. Assessment of the overall impact on individual programs and institutional climate is planned.

Chutes and Ladders: Using Knowles to Guide Nurse Residents up the Benner Ladder Through Facilitation of Nurse Resident Ownership.

This article discusses the collaborative efforts of two nurse residency program coordinators to increase engagement and improve outcomes within their respective programs. Inspired by the theories of Patricia Benner and Malcolm Knowles, the authors promoted self-directed learning by introducing resident-led committees. Implementing these committees helped improve program evaluation scores, build camaraderie, and provide personalized experiences for each cohort. [J Contin Educ Nurs. 2024;55(12):560-562.].

Estimating Cognitive Workload Using Task-Related Pupillary Responses in Simulated Drilling in Cochlear Implantation.

Training of temporal bone drilling requires more than mastering technical skills with the drill. Skills such as visual imagery, bimanual dexterity, and stress management need to be mastered along with precise knowledge of anatomy. In otorhinolaryngology, these psychomotor skills underlie performance in the drilling of the temporal bone for access to the inner ear in cochlear implant surgery. However, little is known about how psychomotor skills and workload management impact the practitioners' continuous and overall performance. To understand how the practitioner's workload and performance unfolds over time, we examine task-evoked pupillary responses (TEPR) of 22 medical students who performed transmastoid-posterior tympanotomy (TMPT) and removal of the bony overhang of the round window niche in a 3D-printed model of the temporal bone. We investigate how students' TEPR metrics (Average Pupil Size [APS], Index of Pupil Activity [IPA], and Low/High Index of Pupillary Activity [LHIPA]) and time spent in drilling phases correspond to the performance in key drilling phases. All TEPR measures revealed significant differences between key drilling phases that corresponded to the anticipated workload. Enlarging the facial recess lasted significantly longer than other phases. IPA captured significant increase of workload in thinning of the posterior canal wall, while APS revealed increased workload during the drilling of the bony overhang. Our findings contribute to the contemporary competency-based medical residency programs where objective and continuous monitoring of participants' progress allows to track progress in expertise acquisition. Laryngoscope, 134:5087-5095, 2024.

Implementing an Interactive Self-screening Psychological Distress Tool for Residents and Fellows.

Physicians have equivalent rates of depression and higher rates of suicide than other professions. While death by suicide is relatively rare, it is the leading cause of death in male resident physicians and the second leading cause of death in female resident physicians. Physicians who die by suicide are less likely to receive mental health treatment than non-physicians. The authors implemented a confidential, online, interactive screening program to help residents and fellow physicians gain awareness of their mental health, with the goal of reducing physician suicide. The authors implemented the American Foundation for Suicide Prevention's Interactive Screening Program (ISP). During the first 2years of ISP implementation (May 1, 2021-April 30, 2023), all trainees in 155 Accreditation Council for Graduate Medical Education-accredited residency and fellowship programs were invited to participate in the screening program. Of 1900 residents and fellows, 200 (10.5%) completed the self-screening tool. Of those who completed the screening, 197 (98.5%) were experiencing at least a moderate amount of distress (i.e., depressive symptoms, problems related to alcohol, drug use or eating behaviors, or indication that their symptoms made it somewhat difficult to function). The majority (161/200, 80.5%) logged back into the system to review their results and personalized recommendations. Physicians with psychological distress often suffer in silence. The ISP is a tool to help self-identify residents and fellows in distress and connect them to mental health resources with the goal of improving physician well-being.

Strengthening an OR Nurse Residency Program: Enhancing Education and Achieving Accreditation.

This article discusses the implementation and enhancement of an OR nurse residency program at a health care system in North Carolina. Recognizing the unique challenges and skills required in perioperative nursing, program coordinators aimed to support new nurses transitioning into the OR setting. Key enhancements included incorporating AORN's Periop 101: A Core Curriculum to provide consistent, evidence-based perioperative education and pursuing accreditation through the Commission on Collegiate Nursing Education to ensure the highest standards of excellence. The program also emphasizes simulation training, preceptor guidance, and continuous feedback to increase residents' proficiency and confidence. The integration of Periop 101 has led to successful outcomes, including high pass rates on comprehensive exams and residents achieving the Certified Foundational Perioperative Nurse credential offered by the Competency & Credentialing Institute. This article highlights the importance of structured education, leadership involvement, and continuous improvement to develop competent and skilled OR nurses.

Medicine for a Changing Planet: Online Clinical Cases in Planetary Health and Infectious Diseases

Abstract Planetary health and One Health have become key concepts in public health, scientific, and veterinary training, yet these concepts remain incompletely integrated into clinical medical education. Recognizing this gap, we created a free online curriculum called “Medicine for a Changing Planet,” geared towards training the next generation of health professionals in clinical skills to detect and manage the impacts of global and local environmental change on their patients. Using a case conference-style format familiar to medical trainees, we created 11 clinical case studies teaching both planetary health concepts and clinical competencies, leveraging Bloom’s Taxonomy. Here we describe the creation of these clinical cases, highlighting those centered on emerging infectious diseases that teach clinical skills related to the human-animal interface, globalization, and climate change. The online cases have been visited by over 4,000 unique users from 99 countries, piloted with residency and medical school programs, and made available for CME credit.

The Scarred Womb

Ruchika Wason Singh is a visual artist, art educator and independent researcher based in Delhi, India. In 2016, Ruchika founded A.M.M.A.A. -The Archive for Mapping Mother Artists in Asia, a project fostering the mapping, visibility and mobility of mothers/artists of Asian origin through documentation, workshops and artist residency programs. The Scarred Womb series, shared here, aims to create a visual resonance with the emotional value of the trauma of loss. Through forms created with pencil, ink and paint, followed by scraping, etching, and digging into the paper's surface, these works explore embodied experiences of the trauma of communal violence.

Effects of Aligning Residency Note Templates with CMS Evaluation and Management Documentation Requirements.

Background The Centers for Medicare & Medicaid Services (CMS) introduced changes in outpatient and inpatient evaluation and management (E/M) current procedural terminology (CPT) codes in 2021 and 2023, which were intended to streamline providers' clinical documentation. Objectives To study the effects of aligning inpatient and outpatient note templates with updated CMS guidelines on character length and documentation time per note at an internal medicine residency program in the southeastern United States. Methods In April 2023, the Atrium Health Wake Forest Baptist Internal Medicine Residency Program's inpatient and outpatient note templates were updated according to the most recent CMS guidelines. A pre-post analysis of resident documentation time and length was conducted comparing notes written with the residency note templates from May 1, 2022 to August 31, 2022 (6439 notes) to notes written with the residency note templates from May 1, 2023 to August 31, 2023 (8828 notes). Interns were surveyed regarding their perceptions of the updated note templates. Results After the note template updates, when adjusted for differing percentages of note types in the pre- and post-periods and accounting for multiple notes written by each resident, notes written with the residency note templates decreased by a mean character length of -882 characters (95% CI: -953, -811, p<.0001), while time spent writing notes did not significantly decrease. 17/17 respondents had favorable perceptions of the note templates. Conclusions The internal medicine residency inpatient and outpatient note templates were updated to align with the most recent CMS E/M documentation requirement changes. These note template changes were associated with a meaningful decrease in documentation length but no overall significant reduction in mean documentation time when adjusted for differing percentages of note types in the pre- and post-periods and multiple notes written by the same author. The interns perceived the note template changes positively.

Practice Patterns of Graduates of a Rural Emergency Medicine Training Program

Introduction: Rural communities continue to face a shortage of emergency physicians despite the growing number of emergency medicine (EM) residencies. In rural areas, emergency physicians tend to be older, male, and White, and are less likely to have completed EM residency training or have board certification. There is also currently a higher rate of rural physicians leaving clinical practice than in urban emergency departments (ED). In this cross-sectional study we sought to identify the work environments of graduates of a rural EM residency program, and the strengths and weaknesses of such a program. Methods: We conducted a survey among 29 graduates of a community-based EM program to evaluate the effectiveness of a residency program in training physicians who will work in rural areas. The survey assessed the graduates’ perceptions of their level of preparedness, further training, and practice location after completing the program. Results are reported using descriptive statistics. Results: Twenty respondents completed the survey (69%). Most of them identified as male (60%), White (70%), and non-Hispanic or -Latino (80%). Seventy-five percent of the graduates work in counties with fewer than 1,000,000 inhabitants, and 70% work in community hospitals and EDs caring for fewer than 100,000 patients/year. Four (20%) declared to work in critical access hospitals. Overall, respondents felt confident in their residency training. Conclusion: A community-based EM training program may be an effective strategy for producing emergency physicians who go on to work in rural and smaller communities.

Teaching Airway Management Using Virtual Reality: A Scoping Review

(Anesth Analg. 2024;138(4):782–793. doi: 10.1213/ANE.0000000000006611) Airway management is a term that refers to the safe and effective increase in oxygen provided by ventilation or oxygenation in individuals that are sedated or unconscious, and the procedure is performed only by trained professionals. Training for this skill set is often done on the job, during a residency program for anesthesia or acute care. Recent advances in training environments have allowed for safer skill acquisition through simulations that allow for practice without any possibility of harming a patient, blending the need for supervision from experienced faculty with relevant situations that present no risk. These programs are expensive and labor intensive to implement and maintain; one potential solution to this is virtual reality (VR), which could blend all of the advantages of simulation education without the disadvantages of required faculty presence at all times. The immersive technology can also be implemented to simulate more diverse situations with less effort and allows for assessment of skill and training. This article is a review that evaluates VR as an effective tool for simulation education for both routine and emergency airway management.

The humanities in palliative medicine training: perspectives of academic palliative medicine physicians and trainees

BackgroundThe humanities can aid in the development of important skills for trainee physicians. Because of the nature of their work, palliative medicine residents are expected to apply humanities-based skills frequently in their clinical work and are also likely to use humanities-based skills to support their own self-care. Our project explored the role of the humanities in palliative medicine residency programs across Canada.MethodsEach priority topic or objective of the current palliative medicine residency training standards in Canada was reviewed to determine whether they relate to the humanities. A cross-sectional survey was subsequently created using Qualtrics, with the target study population being current palliative medicine residents and palliative medicine staff physicians at academic centers in Canada.ResultsMultiple humanities objectives exist in Canadian palliative medicine training standards, primarily in the ethical, cultural, and spiritual domains. Eighty-seven people completed the cross-sectional survey, for a 17.4% response rate and 94.6% completion rate. The vast majority (90%) of survey participants felt that the humanities had an important role in medical training at the undergraduate and postgraduate levels, and more than 70% of participants felt that the humanities had an important role in palliative medicine residency training. In some areas, the humanities participants felt that their programs would most benefit from ethics, philosophy, and culture. Over 65% agreed or strongly agreed that their own palliative medicine program would benefit from more humanities content.ConclusionCanadian palliative medicine training standards require residents to demonstrate humanities-based skills. Most survey participants state that the humanities have an important role in medical training at the undergraduate and postgraduate levels, and that their own palliative medicine residency program would benefit from more humanities content. These results may guide future studies to better understand why and how more humanities content can be added to palliative medicine residency programs to optimize residents’ learning experiences and better prepare them for careers in palliative medicine.

Decreasing Perceived Moral Distress in Pediatrics Residents: A Pilot Study.

Pediatric residents experience ethical dilemmas and moral distress during training. Few studies have identified meaningful methods in reducing moral distress in pediatric trainees. The authors aimed to determine how residents perceive ethics case discussions, whether such a program affects trainee ethics knowledge and perceived moral distress, and if residents' perceived moral distress changes before, during, and after a discussion series. Participants included pediatric residents in a single residency program. Five separate 1-hour sessions were presented over a 5-month period. Each session consisted of a case presentation by a resident developed under the guidance of an ethicist. Multidisciplinary services and content experts were present during sessions. Baseline, postsession, and final surveys were distributed to resident attendees. Open-ended responses were recorded. When comparing baseline and final responses, the only significance was increased preparedness to navigate ethical decisions (p = 0.004). A 10.2% decline was observed in perceived moral distress. An increase in ethics knowledge was observed. Residents favored case-based, multidisciplinary discussions. Residents desire more sessions, time for small-group discussions, and legal insight. Satisfaction was high with 90.7% of respondents feeling better prepared to address ethical concerns. Pediatric trainees desire case-based ethics training that incorporates small-group discussions and insight from multidisciplinary topic experts.

Clinical team debriefing post-critical events: perceptions, benefits, and barriers among learners

BackgroundClinical team debriefings (TD) following critical events are pivotal in promoting team learning and enhancing patient outcomes. Despite their importance, perceptions and practices surrounding these debriefings remain under-researched. The purpose of this study was to explore learners’ perceptions and experiences regarding debriefing practices, investigate correlations or discrepancies within those perceptions and experiences, and identify recommendations and potential practice improvements for clinical educators.MethodsThis was a cross-sectional anonymous survey of healthcare professionals, including medical students, medical residents, nursing students, and respiratory therapy students. The survey was sent to respiratory therapy programs, nursing programs, internal and emergency medicine and pediatric residency programs in southern California and Michigan. The variables surveyed included demographics, team debriefing experience, code experience, TD perceptions, emotional status, cognitive load, and the benefits and barriers of conducting post-code TD. Emotional status and cognitive load were assessed using validated surveys by Paas et al. and Barrett and Russell.ResultsOf the 184 participants, 56% (n = 104) were female. The mean cognitive load was 6.14 ± 1.6. A notable negative correlation was found between mental effort in recent real code experiences and emotional scales: “tense: calm” (r = −0.210; p = 0.018), “nervous: relaxed” (r = −0.234; p = 0.008), and “stressed: serene” (r = −0.258; p = 0.004). While 68.5% had attended a cardiopulmonary arrest event, only 34.9 had TD after their most recent code, and only 48.4% reported ever having a post-code TD. Notably, nurses (75.4%) and attending physicians (73.8%) predominated these debriefings. Debriefings averaged 9.30 min (SD = 7.30) with a median of 6 min. The most recognized benefits were identifying areas of systems/process improvement and promoting teamwork and solidarity within the code team participants. The most commonly recognized barriers were lack of time and wanting a more senior person to initiate TD.ConclusionThe results of this study show a relatively low TD occurrence despite the high value learners attribute to TD. Addressing this inconsistency requires structured approaches, dedicated time, and an understanding of barriers. Recognizing the significant cognitive and emotional loads on learners further accentuates the need for structured post-event debriefings. Addressing these challenges with multi-disciplinary participation can enhance debriefing outcomes.

Self-perceived preparedness for practice among graduating physical medicine & rehabilitation residents.

There is little research regarding the self-perceived preparedness of residents to enter independent practice after training. Given the vast breadth of physical medicine & rehabilitation (PM&R) and the increasingly complex and wide-ranging responsibilities and roles of physiatrists, this study is necessary to evaluate residents' perspectives of how programs are preparing them in the face of the changing practice environment. To identify how graduating PM&R residents perceived their training to prepare them for future practice. The researchers assessed perceived preparedness in six domains: (1) evaluation and management of conditions, (2) settings and responsibilities of practice, (3) familiarity with administrative processes, (4) physiatric-specific prescriptions, (5) performing procedures, and (6) interpretation of diagnostic studies. Survey. Virtual. Graduating PM&R residents in their final year of training in the United States were invited to complete the survey. Of 415 graduating residents, 54 accessed the survey, and 40 (9.6%) fully completed questions relating to preparation by residency. Not applicable. Self-perceived preparedness for practice among graduating residents across 70 subdomains of practice. Mean preparedness was highest in the domain of physiatric prescription (3.45/5), and preparedness for administrative processes was significantly lower than all other domains (mean 2.25/5, p < .001). Across subdomains, the highest preparedness was in performing electromyography (4.48/5). Medical skills rated less than 2.50/5 included interpreting urodynamics (1.93/5), performing osteopathic manipulative therapy (1.57/5), and performing unguided peripheral nerve injections (2.25/5). Ultimately, residency programs should increase administrative training and identify internal strengths and weaknesses by polling their residents.

Substantial Variation Exists in Clinical Exposure to Chief Complaints Among Residents Within an Emergency Medicine Training Program

Introduction: While many aspects of emergency medicine (EM) residency training are standardized among residents within a single residency program, there is no standard for the distribution of chief complaints (CC) that residents should see over the course of residency. This could result in substantial variability in each resident’s clinical exposure. Our objective in this study was to explore EM residents’ clinical exposure to CCs to determine whether substantial variation exists. If such variation exists, this could suggest the need for curricular reform to address gaps in resident clinical exposure during training. Methods: This was a retrospective observational study of EM residents who graduated in the years 2016–2021 at a single, university-affiliated emergency department (ED) in the midwestern United States. All patient encounters where a CC was logged were included and categorized into 1 of 20 clinical domains based on the 2016 American Board of Emergency Medicine Model of Clinical Practice. We calculated descriptive statistics for the top 10 most encountered domains for comparison among residents. Results: We included a total of 228,916 patient encounters from 69 residents in the analysis. Residents were involved in an average of 3,323 distinct patient encounters during the study period. The overall interquartile range for patient encounters was 523. The three CC domains with the broadest interquartile variation were abdominal and gastrointestinal disorders (116), musculoskeletal disorders (nontraumatic)(93), and traumatic disorders (86). Conclusion: Within a single, three-year academic EM program, substantial variation existed among residents with regard to the variety of patient CCs seen during their residency training.

Assessment of an oocyte retrieval simulation training program for residents: From training to clinical practice

AbstractObjectiveTo assess the impact of an oocyte retrieval simulation training program (ORSTP) on the clinical performance of residents.MethodsWe performed a prospective comparative study. The Simulation (S) group included oocyte retrieval (OR) performed by residents who had undergone an ORSTP before performing them on patients (n = 422 OR), and the control (C) group included OR performed by residents who had not received prior simulation training (n = 329 OR). Our main outcome measure was the OR rate (ORR) (number of oocytes collected/number of follicles aspirated) during the first 3 months of the rotation.ResultsIn the S group, six residents aspirated 657 ovaries, while in the C group, five residents aspirated 508 ovaries. The mean ORR during the first 3 months of rotation were comparable between the S and C groups (59% vs. 58%, P = 0.68). ORR during the first and second month, and at the end of the rotation were also comparable between the S and C groups (54% vs. 63% [P = 0.13], 58% vs. 59% [P = 0.82], and 58% vs. 58% [P = 0.90], respectively). There was no significant difference in the rate of failed OR (ORR = 0%) (3.3% vs. 1.8%, P = 0.13) between the S and C groups. Finally, 16% of residents in the S group reported being stressed before their first OR compared to 40% in the C group (P = 0.85), and 83% of residents in the S group felt confident about the results of their retrievals compared to 20% in the C group (P = 0.13).ConclusionThe ORSTP does not improve the residents' clinical performance, but it could decrease their stress and improve their confidence in clinical practice.

RACISM IN FOOTBALL: CONTRADICTIONS AND POSSIBILITIES FROM THE REGENCY IN THE PEDAGOGICAL RESIDENCE PROGRAM

This abstract exposes racism in football in a discriminatory way, with its implications in conscious or unconscious practices (Almeida, 2019). The topic was addressed in the training of students through Physical Education (PE) classes, in the Pedagogical Residency Program (PRP), of the Federal University of Alagoas - Arapiraca Campus, at the Aurino Maciel Field School, of the state network, in the city of Arapiraca-AL. General objective: to work on racism in football, with a view to overcoming racial discrimination in the social sphere. Specific objectives: to combat the different forms of prejudice existing in football practices; to identify stereotypes and position oneself critically in the face of prejudiced behavior; to respect the diversity of gender, ethnicity, among others. Methodology: approach of Critical-Overcoming PE (Coletivo de Autores, 2012) and method of social praxis of Historical-Critical Pedagogy (Saviani, 2021). Taking social practice as a starting and finishing point, starting from everyday practice and equipping students, aiming for catharsis (incorporation of the constituent elements of sports practice). Activities developed: seminars, guided study, individual and group work, and practical classes with simulations of racist acts. Conclusions: racism was and still is very present in our society, and this becomes contradictory due to the existing measures to criminalize this behavior. People still insist on committing acts of racial discrimination, through gestures towards athletes. Finally, we conclude that soccer was developed within a historical context marked by racial prejudice.

Dermoscopy Training Course Improves Ophthalmologists' Accuracy in Diagnosing Atypical Pigmented Periorbital Skin Lesions.

Facial pigmented skin lesions are extremely common, starting from the fourth to fifth decades, especially in South-European countries, often located in the periorbital region. These include malignant forms, Lentigo maligna (LM) and lentigo maligna melanoma (LMM), characterized by growing incidence, and a series of benign simulators, including solar lentigo (SL), pigmented actinic keratosis (PAK), seborrheic keratosis (SK) and lichen planus-like keratosis (LPK). The clinical differential diagnosis of atypical pigmented skin lesions (aPFLs) can be difficult, even for dermatologists, leading to inappropriate skin biopsies with consequent aesthetic impacts. Dermoscopy of the facial area is a specific dermoscopic field that requires dedicated training and proved to increase diagnostic accuracy in dermatologists. Since these lesions are often seen by ophthalmologists at first, we aimed to evaluate the effect of a focused dermoscopy training course on a group of ophthalmologists naïve to the use of a dermatoscope. A set of 80 periorbital pigmented skin lesions with both clinical and dermoscopic images was selected and evaluated by six ophthalmologists before and after a one-day intensive dermoscopic training course. They were required to evaluate 80 periorbital lesions one month before and after a one-day intensive dermoscopic training course, illustrating second-level diagnostic options such as reflectance confocal microscopy (RCM), obtaining a total of 480 evaluations. Specifically, they had to provide, for each case, a punctual diagnosis and a management option among dermoscopic follow-up/skin biopsy/RCM/LC-OCT. Descriptive statistics were carried out, and the accuracy (ACC), sensitivity (SE), and specificity (SP), with their 95% confidence interval (95% CI), were estimated. In the pre-course test, ophthalmologists achieved 84.0% SP, 33.3% SE and 63.7% ACC, while after the course, SE increased by +9% (i.e., 41.7%), SP decreased by 4%, and ACC remained comparable, i.e., 64.6%. In the management study, the percentage of benign lesions for which a close dermoscopic follow-up was suggested significantly decreased (51.6% versus 22.2%), in parallel with an increase in the number of lesions referred for RCM. As for malignant cases, the reduction in responses "close dermoscopic follow-up" decreased from 37.0% to 9.9%, (-27%), in favor of RCM (+15%) and skin biopsy (+12%). The ophthalmologists proved to be very receptive in quickly metabolizing and putting into practice the concepts learned during the one-day intensive dermoscopy training course. Indeed, after only a one-day lesson, they were able to increase their SE by 9% and to improve their management strategy. The present findings highlight the importance of providing training ophthalmologists in dermoscopy during residency programs, in terms of benefits for the correct patient care.

Evaluation of Integrative Medicine in Residency-Psychiatry Curriculum.

This study describes knowledge change, self-assessed confidence in providing integrative medicine approach, and respondents' perspective on value and feasibility for the Integrative Medicine in Residency-Psychiatry (IMR-Psychiatry) curriculum, a 100-h elective offered during psychiatry training. Residents/fellows completed pre-post Medical Knowledge tests and self-assessment instruments tracking self-rated confidence. Participants were also interviewed for feedback about their experience using a semi-structured design after completion of the program. Thirty-five of 37 (94.6%) participants completed all elective requirements. Items on the self-assessment instrument with the greatest positive pre-post change (p < 0.001) included ability to identify authoritative sources about botanicals (Cohen d = 2.15), effectively respond to patients' questions regarding the use of herbs/supplements (Cohen d = 2.67), and interpret labels on nutraceuticals (Cohen d = 2.28). Mean score on the Medical Knowledge test (n = 30) increased from 64.7% correct at pretest to 81.6% at posttest. Responses tracking self-assessed confidence in providing an IM approach to address 18 common medical and psychiatric conditions all increased significantly pre to post (p < 0.001). Qualitative interviews provided important insights into challenges and recommendations for improvement, and all participants highly recommended the curriculum and found it feasible to complete during training. The IMR-Psychiatry curriculum provides trainees skills that promote comprehensive person-centered care; as a tool to optimize patient care and safety while enhancing physician well-being, wider-spread incorporation of the curriculum into psychiatry residency programs would be beneficial.