playing, exercises in communication and problem solving, and analysis of ethical dilemmas. An interdisciplinary approach to care was modeled through the use of teams, comprising a nurse and social worker, to deliver the continuing education program. The majority of participants were nurses, complemented by social workers, nutritionists, clergy, and pharmacists. Evaluation revealed measurable changes in psychosocial assessments, interventions, and referrals taking place at attendees’ workplaces.

Learning collaborative In conjunction with The Robert Wood Johnson Foundation, the American Association of Medical Colleges launched an Academic Chronic Care Collaborative to improve care of persons with chronic conditions who receive their care in academic health systems and to ensure that clinical education occurs in an exemplary clinical environment. Teams from 22 academic medical centers are participating in the initiative and have reported significantly enhanced clinical processes and outcomes for persons with diabetes, chronic obstructive pulmonary disease, and childhood asthma. In addition, their redesign of resident training produced new evidence-based approaches to trainees’ experiences and evaluation, as well as new insights into how to revitalize primary care in these settings (AAMC, 2006a).

CONCLUSIONS AND RECOMMENDATION

The committee concludes that the health care workforce’s attention to psychosocial needs may be inadequate for a number of reasons. As discussed in other chapters, practice environments may not be designed or organized to support efforts to identify and meet these needs. Policies of insurers and others also may create disincentives to attend to psychosocial health care. However, health professions education and training shape clinicians before they enter the workforce and are key determinants of clinicians’ attitudes, knowledge, and skills. Continuing education and maintenance-of-competency initiatives also help as new knowledge and care methods develop. Thus, professional education and training should not be ignored as a factor influencing the practices of health care providers.

With respect to workforce training and development, the committee identifies the following factors as possible impediments to the provision of psychosocial health services:

• lack of clarity about the competencies the workforce should optimally possess to provide the services;

• the absence of well-developed curricula built around clearly defined competencies;



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