P4.008: Faculty and Resident Physician Knowledge, Skills, and Comfort Related to Mental Health Competencies for Pediatric Practice

Background: Kansas is ranked 50th overall in youth mental health rankings; it has < 20% of its needed workforce for youth psychiatric care and the behavioral health system meets only 26% of mental health needs. As such, primary care physicians (PCPs) must be well-trained to provide basic mental and behavioral health (MBH) care to youth. The American Academy of Pediatrics (AAP) recommends mental health competencies for pediatric practices to address care that pediatricians should be prepared to provide in the primary care setting.

Methods: Pediatric faculty and residents at a single institution completed surveys regarding knowledge, skills, and comfort with the four domains of the AAP Mental Health Competencies: 1. Promotion and Primary Prevention (Prevention), 2. Secondary Prevention, 3. Assessment, and 4. Treatment. Independent t-test or Mann-Whitney U test assessed difference between faculty and resident responses.

Results: Forty faculty (response rate: 79% paid faculty; 17% volunteer faculty) and 24 residents (response rate: 71%) responded (Table 1). Most faculty had practiced more than 10 years (69%) and reported the highest composite score for Prevention. Residents scored highest for Assessment (Table 2). Treatment was the lowest reported competency for both groups. Significant differences between faculty and residents were observed for only two subcompetencies (n=2/30), one each within the domains of Prevention and Assessment. In terms of training, compared to faculty, residents reported receiving didactic (26 vs 19; p=0.014), direct patient (26 vs 17; p=0.004), and simulation training (15 vs 8; p=0.011) on significantly more of the subcompetencies measured.

Conclusion: Findings show a lack of significant differences between faculty and resident competency in the provision of pediatric mental health care. To meet the needs of the pediatric population in mental and behavioral health, residency programs must equip trainees with a solid foundation in all aspects of mental health care. This research exposes educational gaps for both residents and faculty that should be addressed.