Senior Residents' Perceived Competence in Evidence-Based Treatments for Major Depressive Disorder

Ng, E (通讯作者),Univ Toronto, Toronto, ON, Canada.
2022-12
Objective The current study aims to assess the self-reported competence of graduating psychiatry residents in Canada to provide pharmacotherapy and psychotherapy for major depressive disorder as recommended in national practice guidelines. Methods Canadian psychiatry residents who participated in an optional national review course to prepare for licensing were anonymously surveyed regarding their experience and competence in providing treatments recommended by the 2016 Canadian Network for Mood and Anxiety Treatments guidelines. Results The majority (89%, 130/146) reported competence in >= 5 medication monotherapies (e.g., selective serotonin/norepinephrine reuptake inhibitors, bupropion, mirtazapine) and >= 3 adjuncts (e.g., mirtazapine, second-generation antipsychotics). While 76% expressed interest in practicing multiple psychotherapeutic modalities, only 47% reported self-assessed competence in delivering multiple modalities. Only 42% reported pharmacological competence (>= 5 monotherapies, >= 3 adjuncts) and competence in >= 2 psychotherapies. Only 9% reported competence in offering medication, psychotherapy, and electroconvulsive therapy. Less than two-thirds endorsed sufficient didactic teaching (58%) or supervision in pharmacotherapy (50%) for treatment-resistant depression. Conclusions Canadian psychiatry residents report competence in prescribing many first-line medications. However, only a minority report competence in prescribing medications and competence in psychotherapies and/or electroconvulsive therapy. Given known biases in assessments by self-report, real-world competence may be even lower. This study identifies gaps between national practice guidelines and the comfort of the emerging psychiatric workforce in delivering recommended treatments. These gaps in resident competence may lead to under-use of effective treatments for depression. Residency programs should consider how to improve resident competence in providing the full range of evidence-based treatments for depression.
ACADEMIC PSYCHIATRY
卷号:46|期号:6|页码:692-700
ISSN:1042-9670|收录类别:SSCI
语种
英语
来源机构
University of Toronto
资助信息
EN has received funding from the University of Toronto for research and travel funding fromthe Canadian Psychiatry Association. JT has received honoraria for faculty development at the University of Toronto and Dalhousie University; he has served in leadership on and received support from the Association for Academic Psychiatry. PG has received research funding from the PSI Foundation and the University of Toronto. The study was approved by the Research Ethics Board of Sunnybrook Health Sciences Centre.
被引频次(WOS)
0
被引频次(其他)
0
180天使用计数
0
2013以来使用计数
0
EISSN
1545-7230
出版年
2022-12
DOI
10.1007/s40596-022-01605-4
学科领域
循证教育学
关键词
Graduate medical education Major depressive disorder Clinical guidelines Pharmacotherapy Psychotherapy
资助机构
University of Toronto(University of Toronto) Canadian Psychiatry Association Association for Academic Psychiatry PSI Foundation
WOS学科分类
Education & Educational Research Psychiatry