Education And Training on Culturally-Humble Care Through Implementation of a Cultural Psychiatry Curriculum For Consultation-Liaison Psychiatry

Abstract: Background/Significance:

The education and training on cultural psychiatry are of growing importance as psychiatrists strive to deliver high-quality and equitable care to the increasingly diverse populations in this country (Trinh, 2020). Consultation-liaison psychiatrists routinely juggle multiple tasks including treatment of psychopathology and facilitation of patient-provider relationships, and the lack of cultural assessment and perspectives can significantly compromise patient care and management (Tseng, 2004). It is therefore crucial for consultation-liaison psychiatrists to develop a culturally-informed and -humble approach to clinical care, which can be achieved through formalized and structured training sessions.





Methods:

We have developed a curriculum for cultural psychiatry, with a particular focus on the consultation-liaison psychiatry providers. The curriculum combines didactic components including lectures and educational videos, with active learning experiences through clinical case discussions. The didactic materials focus on topics such as principles of cultural psychiatry, relevance of culture to consultation-liaison psychiatry, and issues affecting mental health disparities. The sessions also include guidance on the applications of the Outline for Cultural Formulation (OCF) from DSM-IV-TR and the Cultural Formulation Interview (CFI) from DSM-5. The curriculum has been implemented with the residents of our psychiatry training program, and program participants were asked to provide feedback through pre- and post-surveys comprised of seven-point Likert scale questions.





Results:

The feedback from the psychiatry residents was overwhelmingly positive, with most residents finding the lectures and consultation-liaison case discussions very helpful. Residents report Likert scale increases from 2.3 to 4.8 and 2.2 to 5.1 in their familiarity with OCF and CFI, and an increase from 2.2 to 4.8 in their comfort level in using these instruments in the clinical setting. Residents also reported increased desire to incorporate cultural psychiatry into their general and consultation-liaison practices.





Discussion:

Our cultural psychiatry for consultation-liaison psychiatry curriculum has shown great promise, having received positive feedback from our cohort of residents. The combination of didactic lessons on clinical applications with case discussions appear to yield early dividends, as participants report immediate improvement in their proficiency in culturally-informed patient care. Participant feedback on curriculum components will allow us to refine the course materials and case discussion sessions. Ideally, this program can be accessible for and adapted to other psychiatry residency programs, consultation-liaison fellowships, medical student curricula, and even continuing medical education for practicing psychiatrists.





Conclusion:

Education on cultural psychiatry is crucial for the training of consultation-liaison psychiatrists who can provide comprehensive care to our patients. We are hopeful that the continued refinement and expansion of this curriculum will instill a culturally-humble approach to patient care in current trainees and future psychiatrists.





References:

Trinh,N.H., Tuchman,S., Chen,J., Chang,T., & Yeung,A.(2020).Cultural Humility and the Practice of Consultation-Liaison Psychiatry.Psychosomatics,61(4),313–320.https://doi.org/10.1016/j.psym.2020.03.002

Tseng,W.-S., & Streltzer,J.(Eds.).(2004).Culture and Consultation-Liaison Psychiatry.In Cultural competence in clinical psychiatry.American Psychiatric Publishing,Inc.