RSS 1.0Education and Training
Recent Submissions
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QI 167 Improve Junior Doctor Induction ProgrammeTo make CWPT Junior Doctor Induction more meaningful. It was felt there was a general dissatisfaction with the Junior Doctor Induction programme among trainees. Data was gathered from surveys of doctors on rotation to gain an understanding of what were the frustrations experienced during their rotation. The information from the surveys was used to identify change ideas to be implemented. A local induction was established led by local junior doctor representatives to include a Q&A session, the handbook was updated to ensure it included relevant information, and an induction pack was created in MS Teams. Tools Used: PDSA Cycles - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-pdsa-cycles-model-for-improvement.pdf. Driver Diagram - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-driver-diagrams.pdf Project Impact: There was an improvement of 30 % of people who felt they were prepared for their psychiatry rotation and understood their roles and responsibilities following the changes to the Junior Doctor induction.
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QI 137 Standardised PreceptorshipAim: To standardise and establish preceptorship across Coventry and Warwickshire Partnership NHS Trust (CWPT) for all newly qualified staff. To begin with what was currently on offer across the Trust was reviewed and then found out what colleagues would like to see within the preceptorship programme. This was compared to other NHS Trusts preceptorship programmes and national guidance to develop our programme. The right stakeholders where involved throughout the project and the sustainability of the project was assessed as the project progressed. The completed Preceptorship study programme launched June 2022 and has evolved using Plan Do Study Act (PDSA) cycles. Tools Used: Project Charter - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-define-your-project-charter.pdf; Driver Diagram - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-driver-diagrams.pdf; Action Tracker - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-develop-your-action-plan.pdf; Stakeholder Analysis - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-stakeholder-analysis.pdf; Sustainability Tool - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-sustainability-model.pdf; PDSA Cycle - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-pdsa-cycles-model-for-improvement.pdf. Project Impact: The trust now offers 12 study days for newly qualified nurses, nursing associates and AHP's through a blended approach of face-to-face and virtual sessions. Preceptees are provided with a portfolio/framework for their preceptorship journey. Signposting to resources in CWPT Support provided for all newly qualified professionals Peer-to-peer support A point of contact for new starters outside the work place.
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Theoretical frameworks used to inform qualitative mental health research: a focus on positivism, interpretivism and critical realismQualitative research methods, defined as the collection and analysis of non-numerical data to understand concepts and experiences, are often used to inform mental health practice and policies. When utilising qualitative research methods, it is important that the researcher uses an explicit theoretical framework to guide the study. A theoretical framework informs how researchers engage with a topic or problem, report on their work with participants, describe key concepts and address assumptions within the research questions and procedures. In this article, we describe the basic concepts underpinning three of the most commonly used frameworks in mental health research: positivism, interpretivism and critical realism. We also describe how these theoretical frameworks may guide the qualitative process, including the theoretical and methodological approaches chosen and the ways in which these theoretical frameworks can be applied in practice. To enhance understanding of these frameworks, we include examples of how such frameworks can be used in qualitative mental health research.
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Effectiveness of a mental health literacy module on stigma related mental health knowledge and behaviour among youth in two educational settings in Chennai, South India: A quasi-experimental studyBackground: Improving mental health literacy (MHL) can reduce stigma towards mental illness, decreasing delays in help-seeking for mental disorders such as psychosis. We aimed to develop and assess the impact of an interactive MHL intervention on stigma related mental health knowledge and behaviour (SRMHKB) among youth in two urban colleges in South India. Methods: Incorporating input from stakeholders (students, teachers, and mental health professionals), we developed a mental health literacy module to address SRMHKB. The module was delivered as an interactive session lasting 90 min. We recruited 600 (300 males; 300 females; mean age 19.6) participants from two city colleges in Chennai from Jan-Dec 2019 to test the MHL module. We assessed SRMHKB before the delivery of the MHL intervention, immediately after, and at 3 and 6 months after the intervention using the Mental Health Knowledge Schedule (MAKS) and Reported and Intended Behaviour Scale (RIBS). We used generalised estimating equations (GEE) to assess the impact of the intervention over time. Results: Compared to baseline, there was a statistically significant increase in stigma related knowledge and behaviour immediately after the intervention (coefficient=3.8; 95% CI: 3.5,4.1) and during the 3-month (coefficient=3.4; 95% CI: 3.0,3.7) and 6-month (coefficient=2.4; 95% CI: 2.0,2.7) follow-up. Conclusion: Preliminary findings suggest that a single 90-minute MHL interactive session could lead to improvements in SRMHKB among youth in India. Future research might utilise randomised controlled trials to corroborate findings, and explore how improvements can be sustained over the longer-term.
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West Midlands general adult psychiatry higher trainees’ peer group wellbeing away dayAims The main aim of the wellbeing day was to increase the sense of wellbeing amongst psychiatry higher trainees in the West Midlands. We first wanted to understand the wellbeing needs of the trainees and what they hoped to get out of an away day. We wanted then to evaluate whether the away day had met these needs. Background The Psychiatry Trainees Committee (PTC) published a report ‘Supported and Valued? A trainee led review into morale and training within psychiatry’ in 2017. The importance of feeling valued and supported and the value trainees place upon the support of their peers, were highlighted in this report. As higher trainees we are often geographically isolated from each other, and whilst the peer group meet once per month, this is mostly for academic lectures resulting in poor familiarity amongst trainees which can leave trainees feeling unknown and unsupported. Method We decided to apply to HEE for funding for an away day. We surveyed the peer group, asking what they most wanted to get out of an away day. The results showed that ‘a morale boost’, ‘destress/relaxation’ and ‘opportunity to get to know other trainees’ were the trainee's priorities, followed by improving leadership, team working and negotiation skills. With these priorities in mind, an away day programme was developed which included a talk from Dr Mike Blaber, a palliative care doctor with a special interest in doctors’ wellbeing, a ‘getting to know you’ art activity and a team building GPS treasure hunt funded by HEE. The day finished with a dinner in a local restaurant sponsored by Recordati. The rest of the day was paid for by the peer group. Result 28 higher trainees attended the away day which was held in Birmingham on 11/07/2019. Trainees gave feedback on the day using an online anonymous survey. 81% of attendees said the away day decreased their stress levels. 90% said that the day had increased their sense of wellbeing. 86% felt an increased sense of belonging and less isolated as a trainee. Conclusion Regular trainee away days may help tackle isolation and increase morale which is linked to better patient outcomes. Improving trainees’ sense of wellbeing leads to better job satisfaction, which may ultimately lead to higher rates of retention within psychiatry.
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How are adults with capacity-affecting conditions and associated communication difficulties included in ethically sound research? A documentary-based survey of ethical review and recruitment processes under the research provisions of the Mental Capacity Act (2005) for England and Wales.Objectives: This study aimed to determine the characteristics of ethical review and recruitment processes, concerning the inclusion of adults with capacity-affecting conditions and associated communication difficulties in ethically sound research, under the provisions of the Mental Capacity Act (MCA, 2005) for England and Wales. Design: A documentary-based survey was conducted focusing on adults with capacity-affecting conditions and associated communication difficulties. The survey investigated: (1) retrospective studies during the implementation period of the MCA (2007-2017); (2) prospective applications to MCA-approved Research Ethics Committees (RECs) during a 12-month period (2018-19); (3) presentational and linguistic content of participant information sheets used with this population. Setting: Studies conducted and approved in England and Wales. Sample: Studies focused on adults with the following capacity-affecting conditions: acquired brain injury; aphasia after stroke; autism; dementia; intellectual disabilities; mental health conditions. The sample comprised: (1) 1605 studies; (2) 83 studies; (3) 25 participant information sheets. Primary and secondary outcome measures: The primary outcome was the inclusion/exclusion of adults with capacity-affecting conditions from studies. The secondary outcome was the provisions deployed to support their inclusion. Results: The retrospective survey showed an incremental rise in research applications post-MCA implementation from 2 (2012) to 402 (2017). The prospective survey revealed exclusions of people on the bases of: 'lack of capacity' (n=21; 25%); 'communication difficulties' (n=5; 6%); 'lack of consultee' (n=11; 13%); and 'limited English' (n=17; 20%). REC recommendations focused mainly on participant-facing documentation. The participant information sheets were characterised by inconsistent use of images, typography and layout, volume of words and sentences; some simplified language content, but variable readability scores. Conclusions: People with capacity-affecting conditions and associated communication difficulties continue to be excluded from research, with recruitment efforts largely concentrated around participant-facing documentation. There is a need for a more nuanced approach if such individuals are to be included in ethically sound research.
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The biopsychosocial model: not dead, but in need of revivalThe biopsychosocial model, formalised by Engel in 1977, is at its core an acknowledgement that biological, psychological and social factors causally influence health and disease.Reference Engel1 The word ‘model’ is broadly defined by Engel as ‘nothing more than a belief system utilized to explain natural phenomena, to make sense out of what is puzzling or disturbing’. In this sense, ‘paradigm’ may be a more appropriate term.Reference Pies2 Indeed, a paradigm shift in psychiatry has occurred since Engel's original paper, with a biopsychosocial framing now cemented in education, training and the Royal College of Psychiatrists’ core values.Reference Richards and Lloyd3 Despite its widespread adoption, the model is far from uncontroversial. Criticisms are multi-levelled, from philosophical underpinnings through to application in clinical practice. Below is an assessment of the fundamental challenges the biopsychosocial model faces. Although the model is not dead in any paradigm-shifting sense, significant challenges remain in translating it to practice effectively, requiring more than mere statements of value.
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Reflective practice and psychotherapy case experience of Specialty Doctors and Associate Specialists (SAS) working in psychiatry: UK-wide surveyAims and method To survey nationwide opportunities for Balint-type and reflective support group participation and psychotherapy training among doctors classified as Specialty Doctors and Associate Specialists in psychiatry (‘SAS psychiatrists’) and the professional benefits and barriers to access. Results Approximately 9% of SAS psychiatrists responded, from all UK regions. A minority reported participating in a Balint-type group (27.3%) or reflective practice/support group (30.9%), and only 6.5% were not interested in participating. Although 44.8% planned to see a psychotherapy case, most reported barriers, particularly time constraints, job plans and lack of support. The 22.1% who reported already gaining psychotherapy case experience reported many benefits, including becoming a better listener (84.8%), more empathetic (81.2%), enjoying work more (78.8%) and overall becoming a better psychiatrist (90.9%). Clinical implications The reported interest in Balint group and psychotherapy training opportunities exceeded existing provision; psychotherapy case experience benefited professional development and self-reported clinical capabilities. Healthcare trusts and boards need to consider more actively supporting SAS psychotherapy training and reflective practice.
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Using Precision Teaching to Improve Typically Developing Student’s Mathematical Skills Via TeleconferencingThis study evaluated the effects of Precision Teaching in improving typically developing students’ mathematical skills when delivered via teleconferencing in India. Four students received Precision Teaching, while nine acted as control participants. Precision teaching involved instruction in three mathematical skills; two prerequisite skills and the primary skill of mixed addition and subtraction facts. Instruction included untimed practice, timed practice, goal-setting, graphing, and a token economy. Participants who received Precision Teaching received ten practice sessions for the prerequisite skills and 55 sessions for the primary skill. The results demonstrated improvements in the prerequisite skills of varied magnitude and considerable improvements in the primary skill, which were maintained above baseline performance levels. In addition, those who received Precision Teaching were below the 15th percentile rank at the initial assessment and above the 65th percentile at the post-intervention assessment in the math fluency subtest of the Kaufman Test of Educational Achievement—Third Edition. Control participants did not demonstrate similar improvements. Results suggest that Precision Teaching could produce accelerated outcomes even when delivered via teleconferencing. Therefore, it could be a valuable system for helping students ameliorate potential learning losses resulting from the COVID-19 pandemic.
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Psychodermatology in psychiatry : awareness and education among psychiatry traineesA letter to the Editor reporting the results of a survey of awareness of psychodermatology among psychiatry trainees.
