Recent Submissions

  • West Midlands general adult psychiatry higher trainees’ peer group wellbeing away day

    Fisher, Emma; Fisher, Emma; Adult Psychiatry; Medical and Dental; Coventry and Warwickshire Partnership Trust (Cambridge University Press, 2021-06)
    Aims 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.
  • 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.

    Bunning, Karen; Jimoh, Oluseyi Florence; Heywood, Rob; Killett, Anne; Ryan, Hayley; Shiggins, Ciara; Langdon, Peter; Langdon, Peter; Learning Disabilities; Additional Professional Scientific and Technical Field; et al. (BMJ Publishing Group, 2022-03-31)
    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.
  • The biopsychosocial model: not dead, but in need of revival

    Williamson, Simon; Williamson, Simon; Psychiatry; Medical and Dental; University of Warwick; Coventry and Warwickshire Partnership (Cambridge University Press, 2022-06-09)
    The 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.
  • Reflective practice and psychotherapy case experience of Specialty Doctors and Associate Specialists (SAS) working in psychiatry: UK-wide survey

    Vaida, Alina; Awal, Masud; Vaida, Alina; Psychiatry; Medical and Dental; Birmingham and Solihull Mental Health NHS Foundation Trust; Coventry and Warwickshire Partnership NHS Trust (Cambridge University Press, 2023-01-27)
    Aims 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.
  • Using Precision Teaching to Improve Typically Developing Student’s Mathematical Skills Via Teleconferencing

    Vostanis, Athanasios; Kapoor, Geetika; Mejía-Buenaño, Suzy; Langdon, Peter; Langdon, Peter; Medical and Dental; EdEssential, Punjabi Bagh, New Delhi, India; Tizard Centre, University of Kent, Cornwallis North East, Canterbury, Kent; Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry; Coventry and Warwickshire Partnership NHS Trust, Coventry, (Springer, 2023-05-23)
    This 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.
  • Psychodermatology in psychiatry : awareness and education among psychiatry trainees

    Blee, Ilona; Da Costa, J.; Powers, N.; Omanyondo, S.; Charles, A.; Goulding, Jonathan; Blee, Ilona; Goulding, Jon; Dermatology; Medical and Dental; et al. (Oxford University Press, 2022-01)
    A letter to the Editor reporting the results of a survey of awareness of psychodermatology among psychiatry trainees.