Telepsychiatry skills & limits
Learning objectives
- Open a visit by confirming identity, location, and who else is in the room.
- Explain privacy limits of the video connection.
- Describe the on-site tele-presenter's job.
- Name situations that should move to in-person care, including delirium, severe agitation, and technology failure.
- State the local escalation contact before the visit starts.
Learn
Follow APA Telepsychiatry resources for how virtual practice is framed. The remote clinician and the person on site both need to know where the person is, who can hear the visit, and what happens if the connection fails.
The tele-presenter is the local staff member who can see the room, call for help, and carry out an in-person task the remote clinician cannot. Convert to in-person care when you cannot examine what matters, when agitation cannot be managed through the screen, when delirium or another medical emergency is possible, or when the technology fails. Do not continue a visit you cannot safely complete.
Standards: Reflects APA telepsychiatry resources for virtual practice. Sources: APA Telepsychiatry resources.
Practice
Behavioral Skills Training:
- Instruct the opening script: identity, location, others in the room, privacy, and the backup plan.
- Model that script, including a failed-connection plan.
- Rehearse the remote clinician and the tele-presenter together.
- Feedback on whether escalation was named before it was needed.
Simulate
Scenarios: the connection drops during a risk question; the person is more agitated than the local staff described; a family member is off camera and answering for the person. Debrief what the tele-presenter does in the room and when the visit stops.
Measure
| Skill | Observed? |
|---|---|
| Confirms identity and location | ☐ |
| States who else is present | ☐ |
| Explains privacy limits | ☐ |
| Names the tele-presenter's role | ☐ |
| Names a reason to convert to in-person care | ☐ |
| Has a local escalation contact before starting | ☐ |
Set your own mastery threshold, for example all safety items plus most others. Reassess at one month.