{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T12:22:03Z","timestamp":1768911723669,"version":"3.49.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Patients with complex care needs have multiple concurrent conditions (medical, psychiatric, social vulnerability or functional impairment), interfering with achieving desired health outcomes. Their care often requires coordination and integration of services across hospital and community settings. Physicians feel ill-equipped and unsupported to navigate uncertainty and ambiguity caused by multiple problems. A HIV Psychiatry resident elective was designed to support acquisition of integrated competencies to navigate uncertainty and disjointed systems of care \u2013 necessary for complex patient care.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Through qualitative thematic analysis of pre- and post-interviews with 12 participants \u2013 residents and clinic staff \u2013 from December 2019 to September 2022, we explored experiences of this elective.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>This educational experience helped trainees expand their understanding of what makes patients complex. Teachers and trainees emphasize the importance of an approach to \u201cnot knowing\u201d and utilizing integrative competencies for navigating uncertainty. Through perspective exchange and collaboration, trainees showed evidence of adaptive expertise: the ability to improvise while drawing on past knowledge.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Postgraduate training experiences should be designed to facilitate skills for caring for complex patients. These skills help residents fill in practice gaps, improvise when standardization fails, and develop adaptive expertise. Going forward, findings will be used to inform this ongoing elective.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12909-023-04233-0","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T15:58:23Z","timestamp":1682006303000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry"],"prefix":"10.1186","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5813-697X","authenticated-orcid":false,"given":"Deanna","family":"Chaukos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7508-8348","authenticated-orcid":false,"given":"Sandalia","family":"Genus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9309-3899","authenticated-orcid":false,"given":"Robert","family":"Maunder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0012-5375","authenticated-orcid":false,"given":"Maria","family":"Mylopoulos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"4233_CR1","doi-asserted-by":"publisher","unstructured":"Baird MA, Peek CJ, Gunn WB, Valeras A. 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Research participants were informed that they were voluntarily consenting to participate in a research study in an introductory email prior to the interview. We ensured that data was collected anonymously, and participants were not overly burdened or pressured to participate. We obtained informed consent to participate from all participants with either a written consent form or verbal consent process. The verbal consent process was approved by the Research Ethics Board at Mount Sinai Hospital and allowed participants who did not have the time or ability to sign the written consent form to participate in the research. The verbal consent process consisted of the researchers reading a pre-written script that informed participants of the research aims and every aspect of their participation in the research. This consent process was audio recorded and recorded in a written log detailing that all participant questions were answered, a copy of the consent form was provided to the participant, and verbal consent was obtained. All methods, including data analysis and storage, were performed in accordance with Mount Sinai Hospital guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"269"}}