title: Defining competencies for the practice of telepsychiatry through an assessment of resident learning needs.
abstract: BACKGROUND
  A foundational assessment of learning needs is missing from previous reports of telepsychiatry curricula. We used an in-depth needs assessment to identify specific skills required for the practice of effective telepsychiatry, and provide an evidence base to guide the development of telepsychiatry curricula in postgraduate psychiatry training. Many of these skills set telepsychiatry apart from practice in traditional face-to-face clinical settings, or result from adaptations to clinical practice to meet the needs of a telepsychiatry interface in patient care.
  
  
  METHODS
  We used a qualitative, modified grounded theory approach to gain insight into areas of importance for telepsychiatry training in postgraduate psychiatry residency. 16 interviews of faculty and residents (9 and 7 interviews, respectively), allowed participants to reflect on their experiences in telepsychiatry. Data were then thematically analyzed.
  
  
  RESULTS
  Interview respondents identified important aspects of the context for telepsychiatry training; the skills required to competently practice telepsychiatry; and the desired teaching and learning methods for acquiring these skills. Specific domains of competency were identified: technical skills; assessment skills; relational skills and communication; collaborative and interprofessional skills; administrative skills; medico-legal skills; community psychiatry and community-specific knowledge; cultural psychiatry skills, including knowledge of Indigenous cultures; and, knowledge of health systems. The skills identified in this study map well to competency- based medical education frameworks.
  
  
  CONCLUSIONS
  Telepsychiatry is increasingly being adopted as a solution to health systems problems such as regional disparities in access to care, and it requires explicit competency development. Ensuring adequate and quality exposure to telepsychiatry during residency training could positively impact our health systems and health equity.
authors.affiliation: Department of Psychiatry, University of Toronto, CAMH, Room 825, 250 College St., Toronto, Ontario, M5T 1R8, Canada. Allison.crawford@utoronto.ca.|Outreach and Telepsychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Allison.crawford@utoronto.ca.
authors.forename: Allison
authors.initials: A
authors.lastname: Crawford
authors.affiliation: Ambulatory Care, St Michael's Hospital Mental Health and Addictions Service, Toronto, Ontario, Canada.
authors.forename: Nadiya
authors.initials: N
authors.lastname: Sunderji
authors.affiliation: Department of Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Jenna
authors.initials: J
authors.lastname: López
authors.affiliation: Department of Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Sophie
authors.initials: S
authors.lastname: Soklaridis
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education / Q000379:methods / Q000592:standards*; D003479:Curriculum / Q000592:standards; D004503:Education, Medical, Graduate / Q000592:standards*; D005180:Faculty, Medical; D006801:Humans; D007396:Internship and Residency; D007407:Interviews as Topic; D020380:Needs Assessment; D009864:Ontario; D011570:Psychiatry / Q000193:education*; D036301:Qualitative Research; D017216:Telemedicine / Q000379:methods / Q000592:standards*
references.citation: BMJ. 2002 Jan 19;324(7330):156-9
references.pmid: 11799035
references.citation: J Telemed Telecare. 2000;6 Suppl 2:S59-62
references.pmid: 10975105
references.citation: Acad Psychiatry. 2015 Feb;39(1):55-62
references.pmid: 25155424
references.citation: Can J Psychiatry. 2004 Jan;49(1):12-23
references.pmid: 14763673
references.citation: Can J Psychiatry. 2010 Sep;55(9):1-20
references.pmid: 20860107
references.citation: N Engl J Med. 2012 Mar 15;366(11):1051-6
references.pmid: 22356262
references.citation: BMJ. 2008 Aug 07;337:a1035
references.pmid: 18687726
references.citation: J Telemed Telecare. 2001;7(2):73-81
references.pmid: 11331044
references.citation: Methods Inf Med. 2013;52(3):184-8
references.pmid: 23615960
references.citation: Telemed J E Health. 2013 Jun;19(6):474-9
references.pmid: 23570291
references.citation: Med Teach. 1999;21(6):546-52
references.pmid: 21281173
references.citation: Telemed J E Health. 2013 Jun;19(6):444-54
references.pmid: 23697504
references.citation: Am J Psychiatry. 2013 Mar;170(3):256-62
references.pmid: 23450286
references.citation: Acad Psychiatry. 2012 Sep 1;36(5):408-10
references.pmid: 22983475
references.citation: Psychiatr Serv. 2007 Jun;58(6):836-43
references.pmid: 17535945
references.citation: Telemed J E Health. 2010 Dec;16(10):1074-89
references.pmid: 21186991
references.citation: Med Teach. 2010;32(8):638-45
references.pmid: 20662574
references.citation: Am J Psychiatry. 2007 Jan;164(1):115-8
references.pmid: 17202552
references.citation: Scand J Prim Health Care. 2002 Sep;20(3):139-44
references.pmid: 12389749
references.citation: Int J Telemed Appl. 2013;2013:146858
references.pmid: 23864854
references.citation: Int Rev Psychiatry. 2015;27(6):569-92
references.pmid: 26540642
references.citation: J Am Acad Child Adolesc Psychiatry. 2008 Dec;47(12):1468-83
references.pmid: 19034191