The educational value of outpatient CL rotations- a white paper from the ACLP residency education subcommittee

Zimbrean, Paula C.; Ernst, Carrie L.; Forray, Ariadna; Beach, Scott R.; Lavakumar, Mallika; Siegel, Andrew M.; Soeprono, Thomas; Schwartz, Ann C.

BACKGROUND AND AIMS: As mental health services in outpatient medical clinics expand, psychiatrists must be trained to practice in these settings. The Academy of Consultation-Liaison Psychiatry (ACLP) residency education subcommittee convened a writing group with the goal of summarizing the current evidence about outpatient consultation-liaison psychiatry (CLP) training and providing a framework for CLP educators who are interested in developing outpatient CLP rotations within their programs. METHOD: MEDLINE (via PubMed), Embase and PsycINFO (via OVID), were reviewed each from inception to December 2019, for psychiatric CLP services in ambulatory settings that involved residents or fellows. The CLP education guidelines were reviewed for recommendations relevant to outpatient CLP. We also searched MedEd portal for published curriculums relevant to CLP. The group held 2 conferences to reach consensus about recommendations in setting up outpatient CLP rotations. RESULTS: Seventeen articles, three ACLP supported guidelines, and eight online didactic resources were identified as directly reporting on the organization and/or impact of an outpatient CLP rotation. These manuscripts indicated that residents found outpatient CLP rotations effective and relevant to their future careers. However, the literature provided few recommendations for establishing formal outpatient CLP training experiences. DISCUSSION: Outpatient CLP rotations offer multiple benefits for trainees, including exposure to specific clinical scenarios and therapeutic interventions applicable only in the outpatient setting, increased continuity of care and the unique experience of providing liaison and education to non-mental health providers. The article outlines recommendations and examples for developing outpatient CLP rotations which CLP educators can incorporate in their programs.