Factors linked to future neuropsychology referral practices among medical residents

Abstract

Neuropsychologists receive most of their patient referrals from neurologists, psychiatrists, and primary care physicians (Sweet et al., 2015). It is consequently important to understand how to facilitate these providers’ continued engagement with neuropsychology. Prior research has demonstrated that physicians are generally satisfied with neuropsychological evaluations; however, more information is needed about factors that contribute to their decision to refer. The current study, based on the Integrated Behavioral Model and informed by prior research in the neuropsychology, psychiatry, and mental health fields, explored factors linked to future neuropsychology referral practices among medical residents. Results demonstrate the importance of educating medical residents about neuropsychology in order to promote future referrals. Exposure to neuropsychology during residency had the strongest impact on referral intentions. The most influential types of exposure were multiple lectures, seminars, or other didactic teaching or clinical rotations or other clinical experiences in which neuropsychological services were ordered or utilized. In terms of specific topics for education, results suggest that it is important to make residents aware of local neuropsychologists and help them understand the nature of neuropsychological services. Additional useful targets include the benefits of neuropsychological services, the variety of questions neuropsychologists are able to answer, and perceived barriers to making referrals. Finally, this study shows that psychiatry and neurology residents are generally better educated about neuropsychology than internal medicine and family medicine residents. Given that primary care residents constitute a larger potential referral base, particular attention should be given to improving the education of residents in primary care specialties.