Teaching Telepsychiatry in the Age of Health Care Reform

John M. Kane, MD
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However, one half of the programs that responded have no exposure to telepsychiatry, potentially putting residents at some disadvantage in future careers. Of respondents without training, most expressed interest in a standardized curriculum. While telepsychiatry grows, limited information about it is disseminated to programs.

Other studies have shown that telepsychiatry is sometime used within residency training programs, often as an educational tool.2 And while some residency programs have a curriculum for teaching telepsychiatry, these appear to be the minority.3 There is also very little research on training clinicians to optimize patient encounters when utilizing video conferencing.4

It is important that such training be provided, because maximizing use of telemedicine requires experience and an appropriate understanding of the unique challenges associated with this technology. It is not simply a matter of doing the same things that one does in a face-to-face session via video conferencing.

It has been shown that patients are comfortable with this approach, even in cases with individuals who are acutely psychotic.5 However, a practitioner needs to be aware of strategies to help facilitate acceptance, as well as how to be prepared for an emergency situation such as suicidality in a patient who is at a remote location. If a psychiatrist is providing coverage to an emergency service in another location, this also requires training in how manage such a situation as a consultant to local, non-psychiatric medical personnel.

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In order to prepare the next generation of psychiatrists (and other mental health professionals) to take full advantage of the potential applications of telepsychiatry, we will have to focus more attention on ensuring that the appropriate training opportunities are more universally available.

John M. Kane, MD, is a professor and Chairman of the Department of Psychiatry at the Hofstra North Shore-LIJ School of Medicine. He serves on the Psychiatry Advisor editorial board.

References

  1. Hoffman P, Kane JM. Telepsychiatry Education and Curriculum Development in Residency Training.  Acad Psychiatry. 2014; doi:10.1007/s40596-013-0006-6.
  2. Szeftel R, Hakak R, Meyer S, et al. Training psychiatric residents and fellows in a telepsychiatry clinic: a supervision model. Acad Psychiatry. 2008; 32(5): 393–9.
  3. Jessica R, Oesterheld JR, Travers HP, et al. An introductory curriculum on telepsychiatry for psychiatric residents. Acad Psychiatry. 1999; 23(3): 166–7.
  4. Brebner EM, Brebner JA, Ruddick-Bracken H, et al. The importance of setting and evaluating standards of telemedicine training. J Telemed Telecare. 2003; 9(suppl1): 7–9.
  5. Shen JHQ, Zhao Y, Rosenzweig-Lipson S, et. al. A 6-week randomized, double-blind, placebo-controlled, comparator referenced trial of vabicaserin in acute schizophrenia. J Psychiatr Res. 2014; 53:14–22.