Religion/Spirituality and the Psychiatry Milestone Project: A Competency-Based Curriculum for Residency Training
Brant VanOrman, Psy.D., Licensed Psychologist/Training Faculty Pine Rest Psychiatry Residency and Training Director Pine Rest Psychology Internship
Pine Rest Christian Mental Health Services and Michigan State University College of Human Medicine
Vitaliy Voytenko, Psy.D., M.A., Michigan State University College of Human Medicine and Wheaton College
Evonne Edwards, Ph.D., Jarrad Morgan, M.D., Russell Yskes, M.D., and William Sanders, D.O., M.S., Pine Rest Christian Mental Health Services and Michigan State University College of Human Medicine.
Over the last two decades, psychiatry has been re-defining its relationship with religion/spirituality (R/S), which for many decades prior had been either dismissive or openly adversarial. A large and ever-growing body of empirical literature now documents the salutary effects of R/S on mental health. The Accreditation Council for Graduate Medical Education (ACGME) now requires that psychiatry residents learn about major religious worldviews and their implications for the practice of psychiatry. Several model curricula in spirituality in psychiatry developed with the ACGME requirements in mind have been described in peer-reviewed literature and disseminated through an association of residency program directors. However, there have been very few published studies that evaluated the effectiveness of such curricula. Furthermore, no published studies have addressed how the ACGME program requirements correspond with the new gold-standard framework for evaluation of resident physicians’ competencies, The Psychiatry Milestone Project.
Pine Rest Christian Mental Services (Pine Rest), one of the five largest free-standing behavioral health providers in the U.S. and a teaching hospital of Michigan State University College of Human Medicine, had developed a didactic training in R/S for its general psychiatry residency program launched in 2013. The course has since evolved into a competency-based vertical curriculum covering all four years of training. The curriculum includes required coursework, a bi-annual guest lecture series, quarterly multidisciplinary case conferences, and several elective training activities. Presently, the program is developing a framework for disseminating R/S training information and competencies to all residency faculty to ensure implementation of R/S training in residents’ direct patient care.
Furthermore, residents and faculty have recently collaborated in the development of a curriculum evaluation—a survey that utilizes the Psychiatry Milestone Project framework to assess the residents’ perceived competencies in the area of R/S in clinical practice. Faculty and residents proposed over 80 R/S competency items. Via collaborative item refinement and selection, the final set of competencies was determined. The resulting Religion and Spirituality Competency Questionnaire (RSCQ) includes three to four competencies for each of the six competency domains, a total of 20 items selected to define the competencies in R/S for psychiatry residents.
In order to establish the validity of the RSCQ, it will be piloted with all four residency cohorts at Pine Rest, allowing for possible modifications to the tool, based, for example, on item and factor analysis. The RSCQ will then be used for the initial assessment of incoming residents and for tracking intern progress through the residency. The RSCQ will also inform training faculty in making adjustments and improvements to Pine Rest’s training program in R/S.
Pine Rest intends to disseminate the RSCQ and R/S program to other psychiatry residency programs.
Pine Rest Christian Mental Health Services and Michigan State University College of Human Medicine
Vitaliy Voytenko, Psy.D., M.A., Michigan State University College of Human Medicine and Wheaton College
Evonne Edwards, Ph.D., Jarrad Morgan, M.D., Russell Yskes, M.D., and William Sanders, D.O., M.S., Pine Rest Christian Mental Health Services and Michigan State University College of Human Medicine.
Over the last two decades, psychiatry has been re-defining its relationship with religion/spirituality (R/S), which for many decades prior had been either dismissive or openly adversarial. A large and ever-growing body of empirical literature now documents the salutary effects of R/S on mental health. The Accreditation Council for Graduate Medical Education (ACGME) now requires that psychiatry residents learn about major religious worldviews and their implications for the practice of psychiatry. Several model curricula in spirituality in psychiatry developed with the ACGME requirements in mind have been described in peer-reviewed literature and disseminated through an association of residency program directors. However, there have been very few published studies that evaluated the effectiveness of such curricula. Furthermore, no published studies have addressed how the ACGME program requirements correspond with the new gold-standard framework for evaluation of resident physicians’ competencies, The Psychiatry Milestone Project.
Pine Rest Christian Mental Services (Pine Rest), one of the five largest free-standing behavioral health providers in the U.S. and a teaching hospital of Michigan State University College of Human Medicine, had developed a didactic training in R/S for its general psychiatry residency program launched in 2013. The course has since evolved into a competency-based vertical curriculum covering all four years of training. The curriculum includes required coursework, a bi-annual guest lecture series, quarterly multidisciplinary case conferences, and several elective training activities. Presently, the program is developing a framework for disseminating R/S training information and competencies to all residency faculty to ensure implementation of R/S training in residents’ direct patient care.
Furthermore, residents and faculty have recently collaborated in the development of a curriculum evaluation—a survey that utilizes the Psychiatry Milestone Project framework to assess the residents’ perceived competencies in the area of R/S in clinical practice. Faculty and residents proposed over 80 R/S competency items. Via collaborative item refinement and selection, the final set of competencies was determined. The resulting Religion and Spirituality Competency Questionnaire (RSCQ) includes three to four competencies for each of the six competency domains, a total of 20 items selected to define the competencies in R/S for psychiatry residents.
In order to establish the validity of the RSCQ, it will be piloted with all four residency cohorts at Pine Rest, allowing for possible modifications to the tool, based, for example, on item and factor analysis. The RSCQ will then be used for the initial assessment of incoming residents and for tracking intern progress through the residency. The RSCQ will also inform training faculty in making adjustments and improvements to Pine Rest’s training program in R/S.
Pine Rest intends to disseminate the RSCQ and R/S program to other psychiatry residency programs.