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Psychiatry Residency Training Program
 
  Applicants Department GME Office Home School of Medicine UW UWHA

Residency Policies & Procedures
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V. CLINICAL ROTATIONS

GOALS AND OBJECTIVES FOR PSYCHIATRIC ASSESSMENT OUTPATIENT ROTATION

Goal: The overall goal of this rotation is to provide a supervised outpatient experience in performing psychiatric assessments.

Supervision:Residents will be supervised by an outpatient psychiatrist who is present in the clinic and who sees each patient with the resident for the evaluation appointment.  The resident and attending team will be scheduled to see two new patients per half-day.  Supervision will total at least 30 minutes per resident per half-day.

Objectives:
By the end of the rotation, the resident will be able to:

1. Patient Care

  • Introduce him/herself and explain agenda and purpose for appointment
  • Respond empathically to verbal and non-verbal cues
  • Follow clues to identify and discover important information
  • Obtain a complete, accurate, and relevant history
  • Screen for patient safety
  • Collect needed background information from the chart and/or collateral sources
  • Use a clinical hypothesis to guide information gathering in order to refine the differential diagnosis
  • Identify subtle or conflicting findings and incorporate them into case formulation
  • Create a case formulation organized around a comprehensive model, such as bio-psycho-social or 4 P’s, or a major theoretical system
  • Develop a full differential diagnosis without premature closure
  • Link formulation to treatment recommendations
  • Recommend appropriate diagnostic testing to further refine diagnoses, required prior to starting common medications, or required for monitoring during treatment
  • Identify potential treatment options, including medications and psychotherapy as indicated
  • Incorporate patient’s perspective in treatment recommendations
  • Apply understanding of potential effects of patient’s co-morbid medical conditions, drug interactions, and potential side effects to treatment selection

2. Medical Knowledge

  • Demonstrate sufficient knowledge to identify and provide diagnostic and treatment recommendations for psychiatric conditions in adults presenting in an outpatient setting
  • Display knowledge of indications for acute psychiatric hospitalization, grounds for breach of confidentiality (e.g. danger to self/others, child/elder abuse)

3. Professionalism

  • Exhibit professional and courteous manner throughout assessment
  • Incorporate understanding of ethical principles (e.g. confidentiality, informed consent) into psychiatric evaluation.
  • Demonstrate capacity for self-reflection, curiosity about and openness to different beliefs and points of view, and respect for diversity
  • Elicit beliefs, values, and diverse practices of patients and their families and understands their potential impact on patient care
  • Recognize the role of diversity in psychiatric evaluation

4. Interpersonal Communication Skills

  • Discuss diagnosis with patient, using easy-to-understand language
  • Discuss treatment options with patient, using easy-to-understand language
  • Provide patient with relevant written materials
  • Complete accurate and timely notes, consistent with institutional policy
  • Include specific recommendations in the note to the referring provider, using language common to non-psychiatric medical specialties
  • Send completed notes to referring provider, making phone contact with referring providers as needed

5. Problem-Based Learning and Improvement

  • Locate and appraise relevant scientific literature and evidence-based resources to inform differential diagnosis and treatment recommendations
  • Seek and incorporate feedback to improve performance

6. Systems-Based Practice

  • Incorporate self-help and support groups (e.g. AA), rehabilitation programs (e.g. cognitive and vocational rehabilitation), and community resources (e.g. community mental health centers) into treatment recommendations
  • Consider patient resources and practice cost-effective care in formulating treatment recommendations

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Psychiatry Residency Training Program
1959 NE Pacific Street, Box 356560
Seattle, WA 98195-6560
206-543-6577
email: psychres@u.washington.edu