Ethics in Child and Adolescent Psychiatry Training: What and How Are We Teaching?

Abstract

Objective: This article describes survey results describing ethics/professionalism curricula of US child and adolescent psychiatry (CAP) residency programs. This project repeated and expanded upon an earlier survey.

Methods: CAP program directors were sent an e-mail with a link to an anonymous electronic survey.

Results: Ninety-nine programs responded with 92 completing the majority of the survey. All had instruction during both training years; reading seminars and lectures were the most common teaching formats. The median number of teaching hours was 10. Teaching was considered inadequate by 22%. Confidentiality, child advocacy, and informed consent were the most frequent ethics topics. Communication, patient care during working hours, and conduct at work were the most common professionalism topics. Faculty and resident opinion differed on certain topics. CAPs were preferred educators in 56.5%. External program resources were available to 87% but over 30% used them rarely or never. Faculty evaluations, 360-degree evaluations, and faculty observations were the most common assessment methods; 38% thought trainee assessments need improvement. Programs were classified into more confident and less confident. More confident programs used available ethics resources more frequently (25% vs 8%, p = 0.30) and had more than the median teaching hours (58% vs 35%, p = 0.035).

Conclusions: Compared to the previous study, CAP programs had increased use of interactive methods with more programs reporting having adequate hours. These results are consistent with existing literature confirming the importance of this curriculum but significant issues with adequately educating and evaluating trainees remain.

Keywords: Child and adolescent psychiatry; Curriculum; Ethics; Residency training.