MAP as a Model for Practice-Based Learning and Improvement in Child Psychiatry Training

Abstract

Not only is there a growing literature demonstrating the positive outcomes that result from implementing evidence based treatments (EBTs) but also studies that suggest a lack of delivery of these EBTs in “usual care” practices. One way to address this deficit is to improve the quality of psychotherapy teaching for clinicians-in-training. The Accreditation Council for Graduate Medical Education (ACGME) requires all training programs to assess residents in a number of competencies including Practice-Based Learning and Improvements (PBLI). This article describes the piloting of Managing and Adapting Practice (MAP) for child psychiatry fellows, to teach them both EBT and PBLI skills. Eight child psychiatry trainees received 5 full days of MAP training and are delivering MAP in a year-long outpatient teaching clinic. In this setting, MAP is applied to the complex, multiply diagnosed psychiatric patients that present to this clinic. This article describes how MAP tools and resources assist in teaching trainees each of the eight required competency components of PBLI, including identifying deficits in expertise, setting learning goals, performing learning activities, conducting quality improvement methods in practice, incorporating formative feedback, using scientific studies to inform practice, using technology for learning, and participating in patient education. A case example illustrates the use of MAP in teaching PBLI. MAP provides a unique way to teach important quality improvement and practice-based learning skills to trainees while training them in important psychotherapy competence.

Acknowledgments

We thank Dr. Bruce Chorpita for training and consulting with our clinic, all of the Child and Adolescent Psychiatry Fellows and Psychology Interns that participated in the piloting of MAP in the UCLA General Child Outpatient Clinic, and Dr. James T. McCracken for all of his support for the training program.

Notes

Note: ACGME = Accreditation Council for Graduate Medical Education; PBLI = Practice-Based Learning and Improvement; MAP = Managing and Adapting Practice; PWEBS = database of evidence-based child mental health treatments.