A Pilot Study of Psychiatry Resident Psychotherapy Competency: The Impact of Resident Attitude and Demographics
Coon, Kim A., Yates, William R., Touchet, Bryan K., Lund, Brian, American Journal of Psychotherapy
Objective: In psychiatry education, psychotherapy knowledge, skills, and attitudes are new competency objectives.
Methods: Two faculty members independently ranked psychiatry residents for psychotherapy competency. A rank of 1 indicated the most competency and a rank of 15 indicated the least competency for the resident psychotherapist. Several demographic and attitudinal variables of the residents were examined for relationships with psychotherapy competence.
Results: When the competency rankings of the two faculty members were compared, they demonstrated a high level of agreement (spearman r = 0.74, p = 0.0016). Of the variables studied, resident age (r = .61, p = .015) and personal attitude toward psychotherapy (S = 29, p = .026) were significantly associated with psychotherapy competency. Both variables remained independently significant after statistical adjustment.
Conclusions: Our study indicates that psychiatry resident attitude and age may influence psychotherapy competency. These markers for psychotherapy competency may assist training programs with resident selection parameters and may enhance psychotherapy educational strategies for residents predicted to require assistance in achieving competency.
The assessment of competency for residents has changed dramatically as a result of implementation of the Accreditation Counsel for Graduate Medical Education (ACGME) Outcome Project (Beresin & Mellman, 2002). The impact of the Project has particularly affected the training of psychiatry residents. Psychotherapy competency evaluation is new to psychiatry resident training and has yet to be standardized across psychiatry training programs (Weerasekera, Antony, & Bellissimo, 2003). Thus, to remain accredited, individual training programs are left to teach, assess, and document the competency of their residents because, at present, no gold-standard assessment tools and guidelines have been established as markers of psychiatry resident psychotherapy competency.
The cost to implement new assessments and documentation guidelines for resident competency may have a marked impact on the financial resources of a training program (Magen & Banazak, 2000). Moreover, additional costs to assess and document psychotherapy competency may strain the limited resources of psychiatry training programs' for standard resident training in general competency elements. secondary to the past trend of downsizing psychiatry residency training programs, an improved ability to choose residents based upon a prediction of competency may be beneficial in maintaining viable psychiatry education programs (Rao, 2003). Predictors can be useful tools for training programs in the selection, recruitment, and retention of competent residents, to ensure their successful completion of training requirements and the future of the training program (Veloski & Callahan, 2000). Furthermore, it may be an important function of residency programs to identify those residents who may need additional instruction. Early identification of residents who need assistance in achieving psychotherapy competency will allow training programs to focus faculty attention on enhancing the supervision and curriculum of those residents to bring them up to a competent level of performance and resulting in the timely completion of their training.
To remain solvent and accredited, training programs must recognize that "the heart of adult education lies in the ability of its programs designers to perceive all of the relevant elements and to take them into account in planning and carrying out learning programs," (Houle, 1984, p. 218). Therefore, the purpose of this preliminary competency study was to identify the psychiatry resident demographic and attitudinal variables that may be predictive of psychotherapy competency.
After institutional review board approval, a complete description of the study was provided to the residents, and written informed consent was obtained. …