bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Cambridge Mental Health Film Club: lessons to learn, feedback, expansion and development of a standard operating protocol
Authors: Clay Felix , Osimo Emanuele , Al-Nakeeb Sara 
Published: June 2021

AimsTo report on our progress and feedback running the Cambridge Mental Health Film Club. To share the recent development of a Standard Operating Protocol to help others organise Mental Health Film Screenings in order to foster discussion, engage the public, reduce stigma about mental health and build understanding.BackgroundCinema lends itself to exploring social and mental health issues such as stigma in an enjoyable way within a limited time and budget. Viewing a film with those from different backgrounds and having a chance to discuss perspectives on meaning and significance is an effective way to promote a collaborative stance and expand perspectives. We have been running a Mental Health Film Club in Cambridge for the past 3 years and have recently celebrated our 10th screening.MethodWe give details of our screenings and feedback. We also share our Standard Operating Protocol which covers important topics such as resources to find suitable films, obtaining copyright permission, finding suitable venues, supporting open discussions, use of social media and promoting inclusivity.ResultOur Mental Health Film club shows three films a year and over time has opened up to both professionals and members of the public who are interested in discussing mental health through movies and supporting recovery. We have screened many challenging and interesting films: from the impact of religious control on emergent adolescent sexuality (‘The Miseducation of Cameron Post’) to a classic film on Alcohol Dependency (‘Days of Wine and Roses’). We also support local festivals with a similar mental health theme (e.g. MEDFEST) and have recently run a very successful screening with the University of Cambridge Psychiatry Society which was introduced by a student offering subjective experience of growing up with a sibling with an Autism Spectrum Disorder (‘Life, Animated’). We promote screenings and publish all film discussions on our website (www.tinyurl.com/psychfilmclub) and Twitter in order to contribute to resources for educational use within Psychiatry training and to further involve the wider public. Feedback shows that our sessions are highly rated at helping audiences see mental health in a new way with post film discussion especially valued.ConclusionOur experience and practical advice can inspire others to start a Mental Health Film Club and promote cohesion, resilience and collaborative thinking within their locality. For future events we plan to expand into more public engagement via local Film Festivals. We welcome delegates ideas, experiences and film recommendations.
West Midlands general adult psychiatry higher trainees’ peer group wellbeing away day
Authors: Fisher Emma 
Published: June 2021

AimsThe 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.BackgroundThe 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.MethodWe 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.Result28 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.ConclusionRegular 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.
In-situ child and adolescent mental health simulation with human factors feedback delivered by airline pilots
Authors: Fisher Megan , Jolly Alexander , Mooncey Mumtaz , Robinson Kerry , Lloyd Robert , Fielding Dave 
Published: June 2021

AimsTo encourage multidisciplinary team learning by introducing Child & Adolescent Mental Health (CAMHS) in-situ simulation training.To provide focused Human Factors feedback through the expertise of senior airline pilots.MethodThe integration of the WingFactors in-situ simulation programme to multiple departments at Whittington Health NHS Trust has transformed the education landscape. The programme has received unanimously positive feedback, and the potential benefits for not only physical, but also mental health training, have been quickly recognised. A total of 90 simulations have been performed. A number of CAMHS scenarios have been designed with the primary aims of encouraging multidisciplinary training and increasing the focus on Human Factors in Psychiatry.Simulation scenarios were performed in real clinical environments with primed actors, thus enabling high-fidelity in-situ simulation. Immediate ‘hot’ debriefs were delivered by clinical faculty and uniformed airline pilots, with emphasis on psychological safety to encourage participation from all team members. The key learning points were then detailed in written documents and circulated to the wider team as a valuable learning resource.The first CAMHS simulation involved the acute management of a collapsed patient in the Emergency Department toilet, with a ligature tied around her neck and accompanied by a distressed patient. Another scenario addressed de-escalation techniques when dealing with a patient presenting with an overdose, who was threatening to leave the ward and posing potential risk to herself.ResultThe nature of these in-situ simulations enabled the multidisciplinary team to analyse practical considerations in the management of acute clinical situations. Scenarios were designed to focus on areas which had been identified as needing improvement for patient safety.The observations provided by airline pilots increased the focus on Human Factors training. A number of key themes were identified, including the importance of effective team-briefing, distraction management and task allocation. This is of particular significance when managing a distressed patient and anxious relative, in a busy high-stress clinical environment.ConclusionIn-situ simulation is a newly emerging concept in the field of Psychiatry, and the success of this programme has been highlighted through consistently positive feedback from participants, and nomination for the HSJ Award (Best Education Programme 2021). The involvement of airline pilots has promoted collaborative learning amongst the multidisciplinary team, and increased the focus on Human Factors in Psychiatry, clearly demonstrating the value of in-situ simulation training in this field.
Creating a virtual, clinical scenario based teaching programme for foundation doctors in Leeds
Authors: Hall David , Lane Thomas , Harbinson Alexander 
Published: June 2021

AimsThrough consultation with foundation doctors on their psychiatry placements in Leeds, we established that they didn't feel the trustwide teaching programme met their needs, with them rating the relevance as 5.8 on a 1-10 Likert scale. They also reported their access to formal and informal teaching had been limited by COVID-19 restrictions. We aimed to create an accessible teaching programme that met their developmental needs as set out by the Foundation curriculum, as well as their confidence and skill set in dealing with common mental health presentations. Our supplementary aims were to promote psychiatry as a career and to provide supervised teaching opportunities to core trainees.MethodHaving assessed the foundation doctors confidence in dealing with different scenarios, we created a 9 week teaching programme covering common mental health presentations they're likely to encounter during their training. The virtual sessions focus on what assessment and management skills would be expected for a foundation doctor, as well as when and how to access support and refer on. The programme was designed to be trainee led with the teaching being facilitated by core trainees as it was felt that they would best relate to the experiences and developmental needs of foundation doctors. This also provided the CTs with an opportunity to develop their teaching skills, something that has become more difficult during COVID.ResultThrough weekly feedback of the sessions we were able to demonstrate that for 8 of the 9 sessions the foundation doctors rated them as being ‘useful’ or ‘very useful’ and we're currently reviewing the topic and materials for the outlying session.Through self-assessed ratings before and after the programme, we demonstrated significant increases in confidence in dealing with all 9 of the scenarios. All of the foundation doctors indicated that they had found the programme beneficial.ConclusionAs shown in the results, the programme has been well received by the foundation doctors who's confidence in dealing with a range of scenarios has improved. The programme has also been well received by the trust who have asked us to repeat the it for future foundation rotations and by core trainees who were grateful of the development opportunities that this provided. Further developments will include extending the programme for the duration of the placement to enable us to cover an enhanced range of presentations and to consolidate core skills.
Core psychiatry trainees views on MRCPsych course structure and delivery at East Midlands Deanery
Authors: Javed Asma , Acharya Hetal , Yanson Ian 
Published: June 2021

AimsThe RCPsych curriculum for core training in Psychiatry (2013) requires each Deanery to run regional MRCPsych teaching programme.The East Midlands School of Psychiatry run a local MRCPsych course aimed at all core psychiatry trainees in the deanery. Before the pandemic, the course took place between two venues – Nottingham and Leicester. During the pandemic, the course was delivered via Microsoft teams. We aimed to collect the feedback from trainees regarding the course to help shape the MRCPsych Course programme according to their training needs.MethodWe devised an online Microsoft forms questionnaire which included:Level of trainingNumber of exams passedRelevance of MRCPsych content to clinical practice and membership examUsefulness of mock exams, simulation scenarios and workshops towards clinical and exam practiceOverall experience of the courseWhich additional sessions they would like to be includedThe effect of COVID-19 on their ability to attend in MRCPsych programmeThese forms were sent to all the trainees in the region via email.ResultOut of 44 trainees, 9 responded. 66.6% of the trainees who responded were CT1 and 33.3% CT2. 45% had passed Paper A and 55% had not passed any exams. 78% of them agreed and 11% strongly agreed that course was relevant to the clinical practice. 55.6% agreed that course was relevant to membership course. 44.4% agreed and 11% strongly agreed that mock exams were useful. 66.7% agreed and 11% strongly agreed that simulation case scenarios and workshops were useful for exam and clinical practice. 22.2% strongly agreed and 33.3% agreed that sessions were engaging and motivating. Overall experience of MRCPsych exam was rated as excellent (11%), good (55%), satisfactory (22%) and poor (11%).Suggestions to add additional sessions included antiracism in psychiatry, more mock exams, practical management of cases, to organise more interactive sessions on Microsoft teams, in-depth coverage of exam topics, to organise full day teaching sessions instead of half day.33.3% of trainees commented that COVID-19 had impacted on their ability to attend the exam as initially face to face sessions were cancelled till end of May 2020 and when started there were technical issues with the online platformConclusionConsider feedback received in modifying aspects of the MRCPsych courseTo share the results with trainers and course tutorsArrange relevant mock exam sessionsInclude the topics suggested by trainees and improve the experience of online learning by making it more interactiveLimitations: small sample size.
Digitalised remote-delivery of AVATr Simulation in Psychiatry: a unique success in COVID-19 pandemic
Authors: Mannali Vimal , Strickland Paul , laBuscagne Craig , Clift Joy 
Published: June 2021

AimsSurrey and Borders NHS Foundation Trust's AVATr (Augmented Virtual-reality Avatar in Training) is a unique ground-breaking Virtual Patient Simulation System, which uses the Xenodu platform to train learners in essential clinical and complex communication skills. Over 30 patient scenarios have been developed after identifying learner-specific development needs, including exploration of overt psychosis, assessment of capacity, sharing bad news, and neglect in care home residents. Actors are filmed responding to several domains of clinical questions, further categorised into three narrative-modes of being ‘Engaged, Neutral or Disengaged’, to build a bank of scenarios. During the session, the trainee is projected on to a large screen, using a camera and video special effects, which results in a life-like interaction with the Virtual Patient. Trainees can view themselves interacting with the Virtual Patient in real-time, from a unique ‘out-of-body' perspective, immersed in a custom-designed interactive virtual environment. The simulation facilitator engages with the learner and determines the appropriate choices of responses for the Virtual Patient and if needed, can prompt with explorative cues to continue the narrative-linked conversation. AVATr model pioneered in United Kingdom the use of an innovative ‘self-observational approach’ in Psychiatry training. This is different to a first-person perspective used in virtual or augmented-reality systems in several clinical specialties. The use of Facilitated-Debrief and Peer-Debrief in sessions, render another layer to the simulation experience.MethodDuring the COVID-19 pandemic, we evolved the AVATr model to remote or hybrid sessions, where simulations were digitally enhanced, and have been run through Microsoft Teams. The simulation facilitator is connected to a multi-user video call, enabling the Virtual Patient to be projected as an attendee using Microsoft Teams.ResultThe hybrid model of AVATr has received tremendous feedback, as it now simulates video-consultations that a vast majority of Psychiatry trainees, especially community-based, undertake due to COVID-19 restrictions. The format of AVATr simulation sessions has remained unchanged, and the remote delivery has been particularly successful as it allows trainees to log in from different remote locations to come together for an interactive training session, without any physical restrictions.ConclusionSince 2015, our simulation platform has been utilised for Post-Graduate Medical Education, to enhance essential professional skills and stimulate professional growth. Currently the hybrid model of AVATr is being expanded to Nursing, Psychology and Allied Health Professional (AHP) clinical training streams, along with Undergraduate Medical Education, to address identified gaps in face-to-face training amidst COVID-19 pandemic.
A model for improving postgraduate medical education using the GMC survey
Authors: Schmidt Martin , Leung Timothy 
Published: June 2021

AimsTo investigate whether the General Medical Council (GMC) National Training Surveys (NTS) can be analysed to develop a plan of action that improves postgraduate training.BackgroundAs part of its role in quality assurance of medical training, the GMC conducts an annual survey of trainers and trainees. The Doctors in training survey, part of the NTS, consists of 70 questions which are grouped into 18 indicators of quality. At Surrey and Borders Partnership NHS Foundation Trust, we were keen to use the comprehensive data in the NTS to improve training. We analysed each question to create a plan of action to improve the quality of training.MethodWe used data from the online reporting tool to calculate the scores for each question in the 2018 NTS. Taking into account the impact of year-on-year changes in the content of the survey, we examined the score, change from 2017 to 2018, and difference between the score and indicator mean to identify poorly-performing questions. Other questions with clear potential for further improvement were also highlighted. A plan of action was produced by the Leadership and Education Fellow and Director of Medical Education.Result29 actions were identified. The most common were to ensure that information (e.g. job descriptions, professional opportunities) was accessible to trainees (8 actions); liaise with other teams (e.g. Human Resources, Safety team) (6); discuss issues with or provide information to trainers (5); discuss with trainees to contextualise survey results within their experiences (4); and ensure that information was delivered at induction (3).To implement these actions, we conducted a workshop for trainers and held feedback meetings with trainees. 76.5% of trainers (13/17) and 88.5% of trainees (23/26) surveyed following these respective events agreed or strongly agreed that the NTS can be used to improve the training experience. A presentation on making the most of the placement was added to trainee induction and was rated excellent or good by all respondents (28/28). Posters were also produced to disseminate information. In the subsequent NTS, there was an improvement in SABP's performance in 12/18 indicators in the Doctors in training survey, with one green flag denoting performance in the top quartile of trusts nationally.ConclusionThe NTS can be analysed to create a plan of action with elements that trainers and trainees feel can improve their experience. Our model demonstrates the potential for using NTS data to plan quality improvement in training.
Applying ethical dimensions in clinical dilemmas
Authors: Swain Rachel , Owudunni Kazeem , Behr Graham , Emmanuel Jo , Malherbe Matt 
Published: June 2021

AimsCentral and North West London's Clinical Ethics Committee (CEC) offers a non-judgmental space to discuss ethical concerns and challenges and provide ethical guidance. This project aims to publicise these ethical dilemmas and guidance to inform decision making trust-wide.BackgroundA Clinical Ethics Committee (CEC) encompasses a diverse range of figures, from psychiatrists and general practitioners to members of the clergy and experts by experience. The CEC in Central and North West London have been meeting regularly since 2003 to provide ethical assistance to a wide range of medical, surgical and psychiatric teams. Complex ethical cases are presented by the treating team, allowing a subsequent discussion of the ethical theories and frameworks within the case with the committee members. This synthesis of information can then assist the treating team in the shaping of ethical based solutions to their dilemmas.The committee wished to encourage ethical based clinical thinking within the trust and enable others to learn from the valuable insights already provided by the CEC over the years.MethodCase notes, recorded from the last 17 years of meetings of the Clinical Ethics Committee were reviewed. 98 cases were identified between 2003-2019. The contemporaneous case reports were then anonymised and indexed into one easy to use file. This file was published on the local intranet and publicised to staff.ResultThe cases were compiled into a PDF document which is available for all staff members within the trust on the intranet. This resource is open to all clinical staff, and serves the dual purpose of encouraging ethical-based thinking and also promoting the ethics committee to those who might be in need of assistance.ConclusionClinical decisions can be complex and nuanced, often complicated by multiple viewpoints and ways of thinking. The database demonstrates the use of ethical dimensions by the ethics committee to inform decision making in a series of varied clinical and management dilemmas. The project required careful consideration around preservation of confidentiality as well as overcoming the logistical barriers of trust-wide dissemination. The result is a document that will allow ethical based decision-making to be embedded into everyday practice.
Improving physical health for psychiatric patients detained in a low secure forensic psychiatric unit in the United Kingdom
Authors: Cross Cosmina 
Published: June 2021

AimsThis project aimed to improve physical health and to tackle obesity in patients detained in a low secure forensic psychiatric unit.BackgroundPeople suffering from severe and enduring mental health problems have a life expectancy of 15-20 years less than the general population. The main cause of death is cardiovascular disease due to lifestyle factors, such as smoking, substance misuse and obesity.Physical health problems such as metabolic syndrome, diabetes and heart disease have a knock on effect on motivation, self-esteem and concordance with treatment.Over 60% of the general population and up to 80% of patients detained in forensic psychiatric units in the UK are classed as overweight or obese, with serious consequences to physical health.Southfield Low Secure Unit is a 28 bed unit. Most patients suffer from treatment resistant schizophrenia and are prescribed high doses of antipsychotic medication, some up to 250% of the maximum recommended dose.MethodBaseline data were collected using Body Mass Index (BMI) and Simple Physical Activity Questionnaire (SPAQ). Following the initial data collection, patients were involved in focus groups, community meetings and a monthly physical health action group. There was input from the care team including psychology, occupational therapy, nursing, catering and security. New activities have been made available such as “physical health and mental health education group”, “rambling group”, “gym sessions”, “patient focus groups” and “walking group”.ResultThis project has been running for 9 months and is ongoing.There has been a modest change in the BMI – initial results ranging from BMI 23.6–42.8kg/m2. Of the initial cohort (n = 14), there has been weight loss (n = 3), weight gain (n = 3) and no change (n = 8).The initial SPAQ results showed that on average patients spend 19.8 hours per day either in bed or doing sedentary activities and only 1.68 hours per day walking or doing physical activities. This pattern is being reassessed.The qualitative data from patient focus groups shows increased interest in activities, motivation and desire to contribute to the project.ConclusionThe preliminary results show an increase in patient motivation and engagement with available activities. There have also been patient-led challenges which were well received. Patients feel positive about the programme and valued for their input. Further support is required to maintain progress.