Academic Pediatrics
Volume 10, Issue 4 , Pages 252-259, July 2010

Is Developmental and Behavioral Pediatrics Training Related to Perceived Responsibility for Treating Mental Health Problems?

Presented in part at the Pediatric Academic Societies' Annual Meeting, Honolulu, Hawaii, May 2008, and at the Academy Health Annual Research Meeting, Washington, DC, June 2008.

Department of Pediatrics and Stanford Health Policy, Stanford University, Stanford, Calif (Dr Horwitz); National Opinion Research Center, University of Chicago, Chicago, Ill (Dr Caspary); Center for Clinical Investigation, Case Western Reserve University School of Medicine, Cleveland, Ohio (Ms Storfer-Isser); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif (Dr Singh); Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY (Dr Fremont); Department of Pediatrics, University of California, San Francisco, San Francisco, Calif (Dr Golzari); and Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY (Dr Stein)

Received 29 September 2009; accepted 10 March 2010. published online 31 May 2010.

Objective

The aim of this study was to investigate training in developmental and behavioral pediatrics (DBP) for graduating residents, their competencies in diagnosing and treating child mental health (MH) problems, and whether the amount of DBP training and/or perceived competencies are associated with perceived responsibility for treating 3 MH problems.

Methods

Data were collected from 636 residents who completed the American Academy of Pediatrics's 2007 Graduating Residents Survey. The survey included questions on training and self-rated competencies in multiple MH skill areas and perceived responsibility for identifying and treating/managing children's MH problems. Weighted multivariable logistic regression analyses examined associations between training, competencies, and perceived responsibility for treating/managing attention-deficit/hyperactivity disorder (ADHD), anxiety, and depression.

Results

Ninety percent of respondents completed a DBP rotation, with 86% reporting >3 to 4 weeks of training. Duration of DBP rotation was related to training and perceived competencies in MH skill areas, and nearly all residents who reported high competencies were trained in those skill areas. However, <50% reported their competencies as “very good” or “excellent.” Residents with training and high competency in dosing with medications were most likely to agree that pediatricians should be responsible for treating/managing ADHD, anxiety, and depression.

Conclusions

DBP training is highly associated with self-rated MH competencies, and highly assessed competencies are related to perceived responsibility for treating/managing common MH problems; yet 14% of graduating residents have <3 to 4 weeks of DBP training. These results argue for providing more high-quality educational experience with proven effectiveness to produce confident pediatricians who will be more responsive to identifying and treating MH problems of their patients.

Key Words: mental health, pediatric residents, primary care, resident education/training, screening

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 Dr Caspary was in the Division of Health Services Research at the American Academy of Pediatrics and managed the survey as part of her professional responsibilities at the AAP.

PII: S1876-2859(10)00055-0

doi:10.1016/j.acap.2010.03.003

Academic Pediatrics
Volume 10, Issue 4 , Pages 252-259, July 2010

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