title: The current and ideal state of mental health training: pediatric program director perspectives.
abstract: OBJECTIVE
  To assess pediatric residency program director (PD) perceptions of the current state of mental health (MH) training, their receptivity to curricular changes, and perceptions of their residents' knowledge and skills in MH care.
  
  
  METHODS
  We performed a cross-sectional study utilizing a Web-based survey of pediatric residency PDs to assess program characteristics, learning modalities PDs currently had or would implement, and their knowledge of the new American Academy of Pediatrics' MH competencies. PDs then ranked their residents' knowledge and skills for 29 MH competencies. Analyses included descriptive statistics and bivariate and multivariate analyses to assess for associations between variables, particularly MH model of care and perceived competence.
  
  
  RESULTS
  Ninety-nine PDs (51%) responded. A total of 87% of PDs reported that MH care was taught as part of another rotation, yet PDs were receptive to curricular changes. Only 45% of PDs were aware of the 2009 American Academy of Pediatrics competencies, and PDs infrequently rated their residents' MH skills and knowledge to be above average. Attention-deficit/hyperactivity disorder (ADHD) was an exception: 64% reported above-average ADHD knowledge in diagnoses and 57% in treatment. There was an association between enhanced MH services in continuity clinics and perceived resident systems-based practice (P < .01) and medical knowledge (P = .04).
  
  
  CONCLUSIONS
  PDs acknowledged that MH training is not emphasized, leading to deficiencies in their residents' knowledge and skills in MH care. The receptivity of PDs suggests the need for targeted dissemination of national guidelines or curriculum. Integrated models of care may be one way to improve resident competencies, but this deserves further study.
authors.affiliation: Department of Pediatrics, New York-Presbyterian Hospital/Weill Cornell Medical College, New York, NY. Electronic address: cmg9004@med.cornell.edu.
authors.forename: Cori
authors.initials: C
authors.lastname: Green
authors.affiliation: Department of Pediatrics, New York-Presbyterian Hospital/Weill Cornell Medical College, New York, NY.
authors.forename: Elisa
authors.initials: E
authors.lastname: Hampton
authors.affiliation: Department of Pediatrics, New York-Presbyterian Hospital/Weill Cornell Medical College, New York, NY.
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Ward
authors.affiliation: Baptist Memorial Health Care Corporation Department of Quality, Memphis, Tenn.
authors.forename: Huibo
authors.initials: H
authors.lastname: Shao
authors.affiliation: Department of Pediatrics, New York-Presbyterian Hospital/Weill Cornell Medical College, New York, NY.
authors.forename: Susan
authors.initials: S
authors.lastname: Bostwick
mesh_terms: D000296:Adolescent Psychiatry / Q000193:education* / Q000592:standards / Q000706:statistics & numerical data; D002665:Child Psychiatry / Q000193:education* / Q000592:standards / Q000706:statistics & numerical data; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007396:Internship and Residency / Q000592:standards / Q000706:statistics & numerical data*; D008603:Mental Health / Q000193:education / Q000592:standards / Q000706:statistics & numerical data; D008605:Mental Health Services; D010372:Pediatrics / Q000193:education* / Q000592:standards / Q000706:statistics & numerical data
keywords: mental health; pediatric program directors; pediatric residency training