John Teshima

Objective The authors explored resident experiences of telepsychiatry clinical training. This paper describes an analysis of evaluation forms completed by psychiatry residents following a required training experience in telepsychiatry. Methods Retrospective numeric and narrative data were collected from 2005 to 2012. Using a five-point Likert-type scale (1 = strongly disagree and 5 = strongly agree), residents ranked the session based on the following characteristics: the overall experience, interest in participating in telepsychiatry in the future, understanding service provision to underserved areas, telepsychiatry as mode of service delivery, and the unique aspects of telepsychiatry work. The authors also conducted a content analysis of narrative comments in response to open-ended questions about the positive and negative aspects of the training experience. Results In all, 88 % of residents completed (n = 335) an anonymous evaluation following their participation in telepsychiatry consultation sessions. Numeric results were mostly positive and indicated that the experience was interesting and enjoyable, enhanced interest in participating in telepsychiatry in the future, and increased understanding of providing psychiatric services to underserved communities. Narrative data demonstrated that the most valuable aspects of training included the knowledge acquired in terms of establishing rapport and engaging with patients, using the technology, working collaboratively, identifying different approaches used, and awareness of the complexity of cases. Resident desire for more training of this nature was prevalent, specifically a wish for more detail, additional time for discussion and debriefing, and further explanation of the unique aspects of telepsychiatry as mode of delivery. Conclusions More evaluation of telepsychiatry training, elective or required, is needed. The context of this training offered potential side benefits of learning about interprofessional and collaborative care for the underserved.

Live interactive videoconferencing and other technologies offer innovative opportunities for effective delivery of specialized child and adolescent mental health services. In this article, an example of a comprehensive telepsychiatry program is presented to highlight a variety of capacity-building initiatives that are responsive to community needs and cultures; these initiatives are allowing children, youth and caregivers to access otherwise-distant specialist services within their home communities. Committed, enthusiastic champions, adequate funding and infrastructure, creativity and a positive attitude represent key elements in the adaptation of this demonstrated user-friendly modality.

This paper describes a pediatric telepsychiatry program serving communities in rural Ontario, Canada. Since the program's inception in 2000, over 4,300 direct clinical consultations have been provided for a variety of presenting issues. Indirect consultations and educational sessions have augmented clinicians' knowledge. Participant evaluation of the program indicates that a comprehensive model of psychiatric consultation and education can be delivered effectively via live interactive videoconferencing to support primary care and to enhance capacity in remote, underserviced areas in Ontario.

Ethiopia is a country of 81 million people, half of whom are children. The prevalence of psychiatric disorders in children ranges from 3.5-23.2%. However, there are very limited mental health resources in the country, including few psychiatrists. Thus the training of more psychiatrists, including providing them with expertise in child psychiatry, is an imperative. The article briefly reviews the development of the Toronto Addis Ababa Psychiatry Project (TAAPP), a collaborative program between the University of Toronto and Addis Ababa University designed to help train psychiatry residents in Ethiopia. The article then focuses on the author's experiences on one recent trip to Ethiopia to provide some of this training. Formal teaching sessions as well as clinical supervision were provided to the Ethiopian residents. Content had to be adapted to be relevant to the Ethiopian context, but teaching approaches did not have to be modified significantly. The Ethiopian residents were very enthusiastic learners and made quick changes to their practices based on the teaching. Collaborative programs such as TAAPP may be important mechanisms to improve the training of psychiatrists internationally, especially when there are limited local educational resources.

Medical school and residency are only the beginning of a child psychiatrist's education. For the rest of her/his career, a child psychiatrist will need to learn on an ongoing basis. There will always be new understandings, new treatments, new issues to master. Child psychiatrists will always need to further their knowledge, develop new skills, and improve existing skills. For these reasons at very least, all child psychiatrists will need to participate in Continuing Medical Education (CME) activities. Many child psychiatrists will also be involved in the design and delivery of these CME activities. In both cases, understanding more about the effectiveness of CME will be important to the decisions they make. This article itself is not a systematic review of the literature, but it will highlight some of the important findings from existing systematic reviews of the CME literature. Based on these findings, the article will make recommendations for both child psychiatrists as learners and child psychiatrists as CME presenters. As learners, child psychiatrists need to be able to select CME activities that are most likely to lead to improvements in their practices. As planners and presenters, child psychiatrists need to design and deliver CME activities that are most likely to improve the practices of their target audiences. However, not all child psychiatrists have the time to review the CME literature in addition to reviewing the other bodies of literature relevant to their practices. Thus, the purpose of this article is to provide an overview of the key findings in the CME literature, focusing on the effectiveness of CME.

The Boston Group, drawing upon developmental and clinical research, has identified special moments in human interaction that they call “moments of meeting.” These moments occur spontaneously within the context of ongoing relational interaction and can effectively restructure relationships. We think of these moments of meeting as pivotal moments because of their potentially pivotal effect on relationships. In this chapter we briefly describe the theory underlying these moments of relational change, using examples from education. Then we suggest strategies that may help teachers participate creatively in such moments. Finally, we explore the implications of this theory for the concept of authenticity.