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A framework for telepsychiatric training and e-health: Competency-based education, evaluation and implicationsv

A framework for telepsychiatric training and e-health: Competency-based education, evaluation and implications. Hilty, D. M. et al. Int Rev Psychiatry 27, 569–592 (2015).


This paper proposes competencies for trainees and clinicians, with telepsychiatry (TP) situated within the broader landscape of e-mental health (e-MH) care. TP competencies are organized using the US Accreditation Council of Graduate Medical Education framework, with input from the CanMEDS framework.


The paper describes:

  • Applications of TP that add complexity to competencies, such as collaborative or integrated care, collaboration at a distance, and community settings.
  • Expert competencies for TP, where level of complexity is a composite of three factors (1) TP-specific complexity, (2) clinical, reasoning, and other patient-based skills issues (whether in-person or TP care), and (3) complexity based on system-based practice.
  • Contextual competency issues where competencies for TP are influenced by pre-conditions, conditional factors, and extenuating circumstances that shape the outcomes targeted, methods used, and the evaluation process. For example, a department’s TP service may be between its own clinical sites and/or between the department and primary care sites.

The paper also discusses teaching and assessment methods for TP competencies, outlined in Table 2. Learners’ skills can be gauged through programme and systems-level variables, and simultaneously, learning to incorporate quality assurance and evaluation as an important TP competency. The paper presents a case example to demonstrate how to aim for TP competencies via application teaching and assessment methods.


This paper (1) provides an overview of competencies relevant to TP, (2) provides an approach on how to assess learners related to TP competencies, (3) proposes curricular methods for TP skill development and how to evaluate TP curricula from a programme perspective, and (4) explores TP in a broader context of e-MH curricula, as new technology innovations continue to impact clinical care, programmes, departments, and institutions.


This paper is an excellent overview of telehealth in psychiatry, and specific TP competencies are outlined in detail in Table 1 for the gauntlet of lerners, beginners to experts, for novice/advanced beginners, competent/proficient learners, and expert learners. This work is incredibly comprehensive, if a little dense, and lays the ground for any institution looking to incorporate TP in their curriculum. 5/5 checks on CHEC