Psychiatry Educators' Perception of Communication Development in Psychiatry Trainees: Developing a Competence Framework

Abstract

Introduction: In medical education, communication is recognized as a core competency for physicians. In Canada, medical students are taught core communication abilities. The importance of communication in postgraduate training is recognized in the CanMEDS competency framework. Although robust literature exists on teaching communication abilities to medical students, research in communication abilities for psychiatry residents is lacking, despite the fact that the clinical interview is frequently the only diagnostic tool available and often a key part of patient treatment. Given the transition to competency-based education in Canadian postgraduate medical education, it is critical that the psychiatric profession gains an improved understanding of the progression of communication abilities in psychiatry training. This study seeks to understand the progression of communication skills development in psychiatry. Methods: This study used a constructivist grounded theory approach. This study used purposive sampling and conducted semi-structured interviews with 14 faculty educators who regularly supervise psychiatry residents at two sites affiliated with one university-based residency program. Constant comparative analysis occurred concurrently with iterative data collection until thematic sufficiency was reached and all relationships between themes were determined. Results: Five themes outlining the progressive development of communication abilities were identified. Three themes identified three foundational sets of abilities, including refining pre-existing relational abilities, developing a repertoire of specific psychiatric communication abilities, and learning to reflect upon and manage one’s own internal reactions. These competencies served as foundational pillars for the final two themes, in which residents develop the personalized art of flexible psychiatric interviewing, which then allows them to skillfully partner with their patients in co-creating care plans. Conclusion: This research represents a first step in defining a communication competency framework for psychiatry residents. It includes defining the core abilities required for progression to unsupervised practice. Future research should explore generalizability, test the framework, and determine teaching and assessment methods.