LAUSR

INTRODUCTION Mental health problems in children and youth are growing exponentially. General pediatricians, while in a unique position to address these issues as they arise, report they lack adequate training in assessing and managing behavioral/mental health (B/MH) problems. Underscoring the importance of this area, the American Board of Pediatrics has defined B/MH as one of only 17 foundational entrustable professional activities (EPAs) for general pediatric practice. OBJECTIVE Explore the facilitators and barriers associated with implementing and assessing the B/MH EPA among pediatric residency programs in order to identify best practices and potential solutions to common barriers. METHODS In this qualitative study, 18 key faculty members from 4 residency programs with 3 years' experience implementing and assessing their residents on the B/MH EPA were purposively sampled. Semi-structured interviews were conducted with each participant, and interviews were analyzed utilizing a thematic analysis. RESULTS Five themes were defined in the thematic analysis: 1) B/MH training: who's responsible?, 2) local context can serve as a barrier or facilitator, 3) B/MH may require longitudinal, integrated, and multi-disciplinary training, 4) B/MH specialists: indispensable, yet a hurdle?, and 5) resident and faculty confidence and skill impact B/MH training. CONCLUSION The need for robust training to prepare pediatric residency graduates to meet the needs of patients with B/MH problems has never been greater. This study provides important insights about gaps in B/MH training. These should inform future directions focused on addressing this need.