Behavioral Medicine Curriculum

Introduction

The behavioral sciences are increasingly at the forefront of the provision of family medicine. Success with behavioral assessment and intervention is central for treating many common patient conditions including, depression, anxiety, substance use, diabetes, obesity, chronic pain, tobacco dependence, family conflict, domestic violence, and poverty.

Provision of primary care counseling and competence in assessment and treatment of common mental/emotional health disorders is central to the entrustable professional activities (EPAs) expected of licensed and boarded family physicians and critical to full-spectrum care of patients.

Goal of Behavioral Medicine Curriculum

To prepare residents for a career in medicine that demonstrates enduring patient relationships, skill in diagnosing and treating psychiatric conditions, collaboration with behavioral specialists, promotion of healthy behaviors in practice and community, and balance between work and personal life.

Learning Objectives

Based on the family medicine milestones and competencies (ACGME), our team has developed a curriculum-based coaching rubric. This rubric is designed to provide residents objective and discrete behavioral/skills-based anchor points for evaluation and feedback/coaching for clinical skill development. See coaching rubric for full description of competencies and skills.

Learning Environment

The Resident’s longitudinal experience will include:

PGY 1:

  1. "Circle” Meetings: held on a weekly basis for the first four months of PGY1 and then quarterly throughout residency.
  2. N.I.R.A (New Intern Readiness Assessment): Interns will have the opportunity to respond to a standardized clinical case that incorporates biopsychosocial aspects of clinical practice with observation and feedback.
  3. Psych Days: 2 ½ days with Dr. Olson. Foundational skills Biopsychosocialspiritual approach, Intro to Motivational INterviewing, Solution-Focused Therapy for Primary Care, Agenda Setting/Appt. Management, Video Review, Role-Playing, etc.
  4. Joint Appointments: Residents will conduct at least 2 joint appointments with Behavioral Medicine faculty each year. Faculty will provide written/verbal evaluation after the appointment.
  5. Focus Resident: During internship year, residents will be scheduled for at least 2 FOCUS resident sessions in outpatient clinic. These will be observed and can be recorded using our A/V system and precepted by behavioral medicine faculty or doctoral fellow. Time allotted in schedule for feedback/teaching.
  6. Clinical Precepting: All faculty will precept interns in clinic and evaluate range of competencies, including behavioral medicine components.
  7. FMTS: Interns will have the opportunity to work with Dr. Olson and the doctoral fellow during FMTS. Generally, this will include shadowing during morning report/hand-off and walking rounds. A brief feedback session occurs prior to sit down rounds, using the competency-based coaching rubric. Faculty/fellow will be available after sit-down rounds to assist in additional teaching, observation, and support as needed.

PGY 2:

  1. Primary Care Behavioral Health (PCBH) and Psychiatry: 10 half-days of training over course of second year, including 5-6 days focused on primary care counseling and behavioral health skills (FM physician and behavioral medicine faculty) and 4-5 days of psychiatric training with focus on primary care management with Dr. Amy Davis.
  2. Focus Resident: FOCUS resident sessions will continue in the outpatient clinic (same description as above). Goal is to continue to develop skills with continuity of feedback and individualized support/coaching.
  3. Clinical Precepting: All faculty (MD/DO and Ph.D.) will precept in clinic and evaluate range of competencies, including behavioral science components. 4. FMTS: PGY2 residents will have the opportunity to continue to work with a behavioral medicine faculty during FMTS (see above description).

PGY 3:

  1. Third year residents will continue to be involved in FMTS shadowing/precepting, FOCUS resident in out-patient clinic setting, and clinical precepting by faculty. Goal is to advance skills toward competency as measured/observed using coaching rubric and to inform CCC and achievement of EPA for graduation.
  2. Homeless Day Center: 3rd year residents will each have 3-4 half-days seeing patients at the Day Center with the MedFT Fellow. After each day the team will discuss how the process is going. After the 3rd day the resident and fellow will each provide more formal feedback on strengths and areas for growth.

PGY 1-3:

  1. Education Day: Wednesday PM there will be presentations by faculty, fellows, and community specialists to enhance and round out exposure to relevant clinical topics.