Lifelong Learning for Professional Development in Psychiatry: Pedagogy, Innovations, and Maintenance of Certification.

The American Board of Medical Specialties, which includes the American Board of Psychiatry and Neurology, promotes standards focusing on changes in physicians' medical knowledge and skills. The authors describe the literature concerning the effectiveness of lifelong learning. They review the status of the American Board of Psychiatry and Neurology Maintenance of Certification program as an example of a model of lifelong learning, including an innovative pilot.

Preparing Trainees for Integrated Care: Triple Board and the Postpediatric Portal Program.

Training combining the disciplines of pediatrics, psychiatry, and child and adolescent psychiatry dates back to World War II, but formal combined programs began more than 3 decades ago as the Triple Board Program and 10 years ago as the Postpediatric Portal Program (PPPP). Triple board training was rigorously examined as a pilot program and ongoing surveys suggest that it provides successful training of physicians who can pass the required board examinations and contribute to clinical, academic, and administrative/advocacy endeavors. As evidence grows showing the value of integrated care, physicians with combined training will offer a unique perspective for developing systems.

Prenatal management of fetal intrapericardial teratoma: a systematic review.

Objectives: The purpose of this systematic review is to provide a comprehensive overview on the clinical course, perinatal outcome, and effectiveness of prenatal management options for pericardial teratoma.

Methods: A comprehensive search including Ovid MEDLINE, Ovid EMBASE, and Scopus was conducted from inception to September 2016. All studies that reported the prenatal course of pericardial teratoma in singleton or twin gestations were considered eligible.

Comparing and Contrasting the Use of Problem-Based Learning in Child and Adolescent Psychiatry Programs.

Objective: Problem-based learning (PBL) is one of the core components of medical education. To facilitate the spread and use of PBL in child and adolescent psychiatry (CAP) fellowship training, a special interest study group (SISG) was formed at the American Academy of Child and Adolescent Psychiatry (AACAP). Different approaches to the implementation of PBL between programs represented at the SISG are compared in this report.

Practical Applications for Maintenance of Certification Products in Child and Adolescent Residency Training.

Objective: The authors evaluated whether Maintenance of Certification (MOC) Performance-in-Practice products in training increases trainee knowledge of MOC processes and is viewed by trainees as a useful activity.

Methods: Six child and adolescent psychiatry fellowships used MOC products in continuity clinics to assess their usefulness as training tools. Two surveys assessed initial knowledge of MOC and usefulness of the activity.

US Medical Licensing Exam scores and performance on the Psychiatry Resident In-Training Examination.

Objective: This study explores relationships between US Medical Licensing Examination (USMLE) and Psychiatry Resident In-Training Examination (PRITE) scores over a 10-year period at a university-affiliated program.

Methods: For all MD general psychiatry residents who matriculated from 2003 to 2012 (n = 51), we extracted three-digit first-attempt and passing USMLE Step 1 and Step 2 clinical knowledge (CK) scores and PRITE percentile scores, stratified by global psychiatry and neurology scores, for postgraduate year (PGY)-1, 2, 3, and 4. A mixed model repeated measures analysis was performed to assess the association between USMLE and PRITE scores, adjusting for age, sex, and US medical graduate versus IMG status.

Relationship between performance on child and adolescent psychiatry in-training and certification examinations.

Background: Studies across a range of specialties have consistently yielded positive associations between performance on in-training examinations and board certification examinations, supporting the use of the in-training examination as a valuable formative feedback tool for residents and residency programs. That association to date, however, has not been tested in child and adolescent psychiatry residents.

Objective: This is the first study to explore the relationship between performance on the American College of Psychiatrists' Child Psychiatry Resident In-Training Examination (CHILD PRITE) and subsequent performance on the American Board of Psychiatry and Neurology's (ABPN) subspecialty multiple-choice examination (Part I) in child and adolescent psychiatry (CAP).

Improving child and adolescent psychiatry education for medical students: an inter-organizational collaborative action plan.

Objective: A new Child and Adolescent Psychiatry in Medical Education (CAPME) Task Force, sponsored by the Association for Directors of Medical Student Education in Psychiatry (ADMSEP), has created an inter-organizational partnership between child and adolescent psychiatry (CAP) educators and medical student educators in psychiatry. This paper outlines the task force design and strategic plan to address the long-standing dearth of CAP training for medical students.

Method: The CAPME ADMSEP Task Force, formed in 2010, identified common challenges to teaching CAP among ADMSEP's CAPME Task Force members, utilizing focus-group discussions and a needs-assessment survey.

Clinical skills verification in general psychiatry: recommendations of the ABPN Task Force on Rater Training.

Objective: The American Board of Psychiatry and Neurology (ABPN) announced in 2007 that general psychiatry training programs must conduct clinical skills verification (CSV), consisting of observed clinical interviews and case presentations during residency, as one requirement to establish graduates' eligibility to sit for the written certification examination. To facilitate implementation of these requirements, the ABPN convened a task force to prepare training materials for faculty and programs to guide them in the CSV process. This article reviews the specific requirements for the CSV experience within general residency programs, and briefly describes the recommendations of the task force for faculty training and program implementation.

Directing child and adolescent psychiatry training for residents.

Directing child and adolescent psychiatry (CAP) training for residents is a complex and challenging administrative task that encompasses the broad creativity of the orchestral conductor, the social and interpersonal effectiveness of the best politician, and the orientation to details of the finest accountant. This article examines these roles in detail, recognizing the leadership, administrative, and managerial achievements of the successful child and adolescent program director. Resources for optimizing the chances for success in each of these areas, and the common pitfalls to avoid, are identified and discussed.

Relationship between Resident-In-Training Examination in psychiatry and subsequent certification examination performances.

Objective: This study analyzed the relationship between performance on The American College of Psychiatrists' Psychiatry Resident-In-Training Examination (PRITE) and the ABPN Part 1 examination.

Methods: Pearson correlation coefficients were used to examine the relationship between performance on the 2002 PRITE and the 2003 Part 1 examination for 297 examinees.

Results: The correlation between the PRITE global psychiatry and the Part 1 psychiatry scores was 0.

Models of integrated training in psychiatry and child and adolescent psychiatry.

Objective: Previous studies indicate declining interest in child and adolescent psychiatry (CAP) as a career choice during psychiatry residency training. Programs have developed integrated training in psychiatry and CAP as a means to address the workforce shortage in CAP, but little is known about the number or nature of these training tracks.

Methods: A survey was conducted among all program directors of Accreditation Council for Graduate Medical Education (ACGME) accredited CAP residency training programs in the United States.

Social support from family and friends as a buffer of low spousal support among mothers of critically ill children: A multilevel modeling approach.

Objective: To investigate whether social support from family and friends (family/friend support) attenuated ("buffered") adverse effects of having low spouse support (spousal support) among mothers of children undergoing hematopoietic stem cell transplantation (HSCT).

Design: One hundred sixty-three married mothers who were their child's primary caregiver during treatment completed assessments during the child's hospitalization for HSCT and 3-, 6-, and 12-months post-HSCT.

Measures: Family/friend support and spousal support were assessed during hospitalization.

Blinded, multi-center validation of EEG and rating scales in identifying ADHD within a clinical sample.

Previous validation studies of attention deficit/hyperactivity disorder (ADHD) assessment by rating scales or EEG have provided Class-IV evidence per standards of the American Academy of Neurology. To investigate clinical applications, we collected Class-I evidence, namely from a blinded, prospective, multi-center study of a representative clinical sample categorized with a clinical standard. Participating males (101) and females (58) aged 6 to 18 had presented to one of four psychiatric and pediatric clinics because of the suspected presence of attention and behavior problems.

The role of the child and adolescent psychiatrist on health care institutional ethics committees.

Over the past 30 years, institutional ethics committees have become the standard vehicle for addressing ethical issues in health care institutions. Early in this development, general psychiatrists became integrally involved; however, child and adolescent psychiatry roles on institutional ethics committees have been delineated less clearly. This article provides an overview of the functioning of institutional ethics committees, including composition and a definition of the roles across education, policy development, and case consultation.

Pre-bereavement meaning and post-bereavement distress in mothers of children who underwent haematopoietic stem cell transplantation.

Objectives: The purpose of this study was to explore the association of meaning-making with psychological adjustment to bereavement among mothers of children who had undergone haematopoietic stem cell transplantation (HSCT).

Design: A prospective research design was used. Regression analyses were conducted to determine the relations between pre-bereavement variables (distress, searching for meaning, and finding meaning) and distress post-bereavement.

A practical approach to implementing the core competencies in a child and adolescent psychiatry residency program.

Objective: The authors describe the development and implementation of the Accreditation Council for Graduate Medical Education's core competencies in a child and adolescent psychiatry residency program.

Method: The authors identify the program's organizational approach and participants and detail various strategies and methods of defining, describing, and utilizing the core competencies, with an emphasis on using practical, easily employed techniques within existing systems and structures.

Results: Using this approach to developing and implementing the core competencies was effective and accepted well by the participants.

Optimism and life events as predictors of fear appraisals in mothers of children undergoing hematopoietic stem cell transplantation.

Although mothers' fear appraisals about their child's future health and well-being affect their own psychological adjustment to their child's hematopoietic stem cell transplantation (HSCT), little is known about antecedents of maternal fear appraisals. This longitudinal study investigated several potential antecedents of these fear appraisals: maternal optimism, recent negative life events, lifetime history of traumatic events, and medical characteristics of the child's disease and HSCT course. One hundred-forty mothers were interviewed during their child's hospitalization for HSCT and at 3-and 6-months post-HSCT.

Overview of training in the twenty-first century.

This article provides a summary of the history of the development of the subspecialty of child and adolescent psychiatry and the concomitant development of training in the field. The historical perspective provides a context for the discussion of an overview of child and adolescent psychiatry training in the twenty-first century. Four challenges are identified: recruitment, funding, curriculum, and assessment and remediation, each of which is discussed in some depth.

Maternal perspectives on children's health-related quality of life during the first year after pediatric hematopoietic stem cell transplant.

Objective: To assess the longitudinal health-related quality of life (HRQL) of children receiving hematopoietic stem cell transplantation (HSCT).

Methods: Mothers (N = 160) of HSCT recipients aged 5-20 at six US transplant centers completed the Child Health Ratings Inventories (CHRIs), the Disease Impairment Inventory (DSII)-HSCT module, and the Short Form (SF)-36 at baseline, 3, 6, and 12 months.

Results: HRQL domain scores at baseline varied by recipient age and program site.

Changes in mothers' basic beliefs following a child's bone marrow transplantation: the role of prior trauma and negative life events.

This longitudinal study examined the relation between life stress and basic beliefs about self-worth and the benevolence and meaningfulness of the world among mothers of children undergoing bone marrow transplantation (BMT). One hundred mothers completed study measures during the child's hospitalization for BMT and 1 year later. Prior trauma and recent negative events were associated with basic beliefs during hospitalization and also with changes in basic beliefs in the subsequent year, with distress mediating some of these relations.

Mothers' perceptions of benefit following pediatric stem cell transplantation: a longitudinal investigation of the roles of optimism, medical risk, and sociodemographic resources.

Background: This longitudinal study investigated the course and predictors of benefit finding among 144 mothers of children undergoing hematopoietic stem cell transplantation (HSCT), a severely stressful and life-threatening medical procedure.

Purpose: Children's medical risk and mothers' dispositional optimism and sociodemographic resources were examined as predictors of benefit finding. The association between benefit finding and mothers' psychosocial adaptation was also investigated.

Anxiety, depressive, and posttraumatic stress disorders among mothers of pediatric survivors of hematopoietic stem cell transplantation.

Objective: To examine the prevalence and predictors of anxiety, depression, and posttraumatic stress disorder among mothers of children who underwent hematopoietic stem cell transplantation (HSCT).

Methods: A total of 111 mothers of children who survived HSCT completed self-report measures of psychological functioning at the time of HSCT and self-report measures and a structured psychiatric interview 18 months after HSCT. Demographic data and medical data were also collected.