bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing psychiatric resources for the new foundation programme curriculum
Authors: Kinmond Drew , Hynes Fiona , Hussain Aqib (Mohammad) 
Published: June 2021

AimsOur aim was to develop an easily accessible, relevant and deliverable resource to meet the training requirements of the new foundation curriculum for Foundation Trainees in the West Midlands. The virtual resource needed to provide information at the correct knowledge depth, whilst also being flexible enough to allow trainees to access the materials despite the challenges of remote working. The West Midlands currently holds approximately 1,300 places for foundation training with an increase in numbers planned for 2023 and 2024.MethodThe United Kingdom Foundation Programme (FP) is a two-year structured, supervised training programme of learning in the workplace developed to prepare medical graduates for speciality training. The Foundation Curriculum is currently being updated in line with the GMC Standards for Post Graduate Curricula to reflect the developing and contemporaneous training needs of doctors and is expected to go live in August 2021.Though the foundation curriculum is broad and does not usually include specific diseases, it is recognised that mental health disorders are common and are frequently missed. The new curriculum makes a specific statement regarding the importance of mental health and specifies a syllabus covering this important area of medical practiceAround 80% of doctors are expected to have exposure to a community medicine placement, with around 40% expected to have placement within a specific mental health setting. Though other community placements may provide some exposure to the acute challenges of mental health, this is not guaranteed.To assist in meeting the FP requirement for training in mental health we developed an online resource for all West Midlands trainees, with lectures and information available that covers all of the core curriculum requirements for the FP. These resources can be accessed at any time of the day, at any point of foundation training, with each module certificated to show evidence of the attainment of foundation competencies ready for students ARCP (Annual Review of Competency Progression).ResultA programme of evaluation and effectiveness will be undertaken when the new curriculum goes live.ConclusionThere is an expected expansion in the number of training Foundation doctors within the next 5 years; therefore the demand for this training is expected to increase over time. As the understanding and awareness of the interaction between physical health and mental health continues to develop, we expected the use of this resource grow into the future.
An evaluation of the Royal College of Psychiatrists' “Psych Star” scheme
Authors: Lunn India , Hyland Declan 
Published: June 2021

AimsIn 2019, the Royal College of Psychiatrists (RCPsych) launched the “Psych Star” scheme for medical students with an interest in psychiatry. The one-year scheme provides Psych Stars with a matched mentor, free registration at the RCPsych's International Congress, financial support for psychiatry-related activities, journal subscriptions and access to two online learning platforms. This project aimed to evaluate the effectiveness of the scheme in supporting Psych Stars to explore their interest in psychiatry and in promoting psychiatry as a career choice, through use of a survey for both Psych Stars and mentors.MethodSurveys were sent to all Psych Stars and mentors from the first cohort of the scheme. The mentor and student surveys contained a mixture of ranking, multiple choice, closed-ended and open-ended questions. Questions examined: clarity of the scheme's aims and objectives; benefits of each aspect of the scheme; impact of the scheme on application to Core Training; benefits and barriers to successful mentorship; adequacy of mentor support from the RCPsych and suggestions to improve the scheme.ResultSix Psych Stars and nine mentors completed the respective surveys. All Psych Stars stated the scheme was enjoyable. Five Psych Stars were more likely to apply for Core Training because of the scheme. All Psych Stars identified the most beneficial aspect of the scheme being the funded place at the RCPsych International Congress. Other aspects highly ranked included: funding to explore areas of psychiatry of interest and the opportunity to be an ambassador for psychiatry. All Psych Stars found the mentorship useful.Mentors supported Psych Stars by providing career advice, suggesting relevant conferences to attend and assisting Psych Stars make decisions on how to use their allocated funding. Barriers to mentorship that were identified included: geographical separation, limitations related to the COVID-19 pandemic and lack of time. For mentors, areas for improvement included clearer aims and objectives and more support from the RCPsych.Both mentors and Psych Stars suggested forming a network of Psych Stars and mentors would be useful to share ideas and experiences.ConclusionThis evaluation shows that the Psych Star scheme successfully supports Psych Stars to explore their interest in psychiatry, and promotes psychiatry as a career choice. This survey has been helpful in identifying what aspects of the scheme are particularly attractive, and also, importantly, how the Psych Stars scheme can be improved for future cohorts. The survey will be delivered to all future annual cohorts of Psych Stars and mentors.
Physical Health Simulation Based Education (SBE) for psychiatrists in the first COVID-19 wave: improving the competence and confidence of the medical workforce
Authors: McEwan Craig , Kerslake Richard , Hobkirk Michael 
Published: June 2021

AimsAt the start of the COVID-19 pandemic there was significant uncertainty for the NHS and it's workforce. Within psychiatry, there was an expectation that junior doctors would be redeployed, with senior psychiatrists stepping down to cover physical health and on-call duties.Senior leadership in mental health trusts were also preparing for COVID-19 outbreaks on psychiatric wards and were developing strategies for managing a novel illness with a poorly understood clinical course. Many psychiatrist expressed anxieties around their competency in assessing and managing acutely physically unwell patients in a mental health setting.This project aimed to improve confidence of psychiatrists in core physical health competencies through devising and delivering an evolving SBE package.MethodSussex Partnership Foundation Trust redeployed two higher trainees from their simulation faculty to work full time on developing a SBE package. This was requested by senior leadership to deliver training about assessing and managing physically unwell patients in the context of COVID-19. This training was devised as a 90 minute didactic lecture following by 90 minutes of SBE.This was delivered at 6 sites through 10 opt-in sessions available to all doctors in the trust over 4 weeks. Pre and post-course questionnaires were given to all participants to measure the effect.Result102 medical staff attended the SBE workshops. Feedback was completed by 93 (91%) doctors prior to the course and 97 (95%) post. Before the workshop, 33% did not feel they had a structured approach for assessing an acutely unwell patient, which reduced to 0% after completing the course.On a 5-point Likert scale, confidence in managing COVID-19 symptoms increased from 2.54/5 to 4.07/5 overall with 89% of doctors feeling “confident” or “very confident”. There were similar increases in confidence in managing critically unwell patients (2.7/5 pre; 3.95/5 post) and in identifying alternative causes for acutely unwell patients (2.63/5 pre; 4.02/5 post).ConclusionThis project demonstrates that SBE is an effective way to rapidly develop effective interventions for the medical workforce, increasing confidence in the face of significant uncertainty and reducing anxiety within the system to meet the learning needs identified by medical leadership.As part of this project Sussex Partnership Medical Education freely shared the workshop materials, which were later adopted and used by psychiatry departments internationally.
Demystifying the pathway of assessment and treatment for bipolar disorder – utilising co-production and algorithms to personalise the approach
Authors: Nicholls-Mindlin Jessica , Quested Digby , Taylor Matthew , Fuzi Lauren , Gee David 
Published: June 2021

AimsTo develop an evidence based, patient centred treatment pathway for people experiencing symptoms of bipolar disorder (BD), modifiable to include local resources.MethodThis project was developed in line with current approaches to service development such as coproduction, with patient and public involvement (PPI) and enhancing personalisation of treatment in medicine. As part of a local initiative, a multi-disciplinary team was brought together to understand and analyse the current local pathway for those affected by BD. It was found that the approach to assessment and management was not consistent between locality teams. Two experts by experience who have a diagnosis of BD were invited to become involved with the development of the pathway. Meetings were set up to enable coproduction and elicit information from those with the diagnosis. The responses provided insight into the effectiveness of different approaches used nationally to inform the methods and resources that are most helpful and appropriate to comprehensively support those with the illness.NICE guideline evidence was used to create two algorithms to streamline the care of those with BD in both primary and secondary care. These algorithms include pharmacological, psychological and social approaches. It also considers the junctions at which referrals should be made and the criteria on which decisions are based.ResultOne algorithm was designed for use in primary care and will be distributed to local GPs to clarify the initial steps for assessment and management of BD and the criteria for referral. A second decision tree will be made available to all doctors working in mental health services with detailed medication options, when they are appropriate and whether additional psychological intervention should be considered e.g. post-discharge groups. Other specialist options such as Early Intervention for Psychosis and Perinatal Mental Health Services were also included. An information pack was created to be offered to all those with a diagnosis or possible diagnosis of BD. This contains useful resources such as skills and exercises that patients may find of benefit, external resources and websites regarding additional support and further information on BD, its nature and management.ConclusionThe approach and resources collated here will help to streamline the management of those with bipolar disorder whilst also ensuring a more consistent approach. The involvement of experts by experience and the incorporation of NICE guidelines ensures a well-rounded and comprehensive set of documents that will be helpful to both clinicians and patients.
A national CASC course
Authors: Ramesh Yathooshan , Stock Lisanne 
Published: June 2021

AimsThere was understandable anxiety from trainees about the transition to the online format of the CASC due to the pandemic. There is also significant variability between trusts in the availability of lectures tailored specifically to the CASC exam. Having recent experience of the CASC exam, including the online format, we developed a free online lecture series. We aimed to address common questions relating to the exam, and selected topics that trainees may find daunting or had less experience with through clinical care. The topics covered were: An Introduction to the CASC, Mental State Examinations, Psychological Therapies, Pharmacology and a Q&A Session.MethodThe course was designed to tackle areas that trainees often find difficult based on our own experiences as well as surveying course attendees. Prior to the course, we liaised with consultant site tutors & junior doctor representatives to integrate the course into the local academic programme, and to facilitate promotion of the session to trainees across sites. We subsequently offered registration to trainees nationally. The course was planned and delivered by the organisers through interactive lecture-based presentations with handouts, ahead of the January 2021 examinations. Content was based on national guidelines and published research. 5 sessions were delivered with the final session including guest consultant panellists to answer trainee questions. Quantitative and qualitative feedback was collected from the attendees.Result172 doctors registered onto the course, with 44 NHS trusts represented. Doctors from a variety of grades attended, with 55% CT3s, 17% Specialty Doctors, 16% CT2s, 8% CT1s, 4% in other roles. 100% of attendees stated that they would recommend the course to any doctor sitting the CASC. 97% of attendees rated the course as either ‘Excellent’ or ‘Good’. Qualitative feedback was positive and 3 themes were identified- communication, content and the online format.ConclusionThe CASC course provided an opportunity to deliver national teaching to trainees based on national guidelines and peer-reviewed research, with a focus on addressing areas that trainees may feel less confident with. The course received significant positive feedback from attendees. The significant number of pre-CT3 trainees attending the course suggests that there may be an interest from this group for further support in developing the complex communication skills that ultimately are assessed by the CASC exam.
An innovative CASC training redesign – ‘experience of virtual mock CASC exam’
Authors: Rankin Jennifer , Foster Jessica , Minhas Omer 
Published: June 2021

AimsCardiff CASC Training (CCT) has provided structured and formal training for the CASC exam for Wales trainees since 2012, in conjunction with Wales Deanery. For the past 8 years CCT has delivered face-to-face mock CASC exams and received excellent feedback from candidates and examiners, in addition to an extremely positive outcome of improvement in CASC pass rate for candidates.Due to the current COVID-19 pandemic restrictions delivery of the mock CASC examination had to be adapted with the aim of running it remotely via an online platform.MethodThe examinations were run online via Zoom due to its ease of use, including the ability to screen share candidate instructions and assign participants in to breakout rooms. One lead exam coordinator manually rotated candidates around the circuit of 16 stations.ResultA total of 16 candidates sat the mock exam over two separate sittings. Written feedback was obtained from candidates and examiners. Limitations identified during the initial sitting included high logistical workload for the lead exam co-ordinator and Zoom not being supported by all hospital computer internet browsers, these issues were addressed prior to the second sitting. Feedback from candidates regarding the overall experience of the online exams ranged from 'extremely effective’ to ‘very effective’, this is in line with feedback obtained following previous face-to-face mock exam events CCT has run.ConclusionAlthough online learning may feel very different to the face-to-face interactions we are all used to we are in an era where adaption is necessary. These online mock CASC examinations have been a success and are also in keeping with how the real CASC examination is currently being run by the Royal College of Psychiatrists. CCT are running a further online mock examination to support the next cohort of candidates through their CASC exam in this particularly challenging time.
Immersive psychiatry simulation: a novel course for medical student training
Authors: Ruddock Kenneth , Herbert Kim , Neil Catriona , Gajree Neera , Dempsey Karli 
Published: June 2021

AimsOver the last decade, there have been significant developments in the use of simulation for undergraduate medical education. Despite simulation's diverse applications across the medical school curriculum, it has thus far been underutilised within psychiatry teaching. Psychiatric simulation can support students to develop strategies to elicit psychopathology, de-escalate an aggressive patient or perform a risk assessment. Such experiences can be difficult to encounter during clinical placements and may expose a student or patient to an unacceptable level of risk. We have therefore developed an immersive simulation course that aims to enhance undergraduate psychiatry training.MethodOur course was developed by medical education faculty and psychiatry staff. The course handbook includes storyboards, patient scripts and debrief guidelines. Clinical scenarios are mapped to university intended learning outcomes and include; conducting a risk assessment for a patient with emotionally unstable personality disorder and comorbid depression, managing a manic patient in the Emergency Department and assessing a patient with obsessive-compulsive disorder who has developed skin damage due to hand washing.The one-day course is delivered to groups of 4-8 students from the Universities of Glasgow and Edinburgh during their placements in NHS Lanarkshire. The course takes place in a simulation suite and is facilitated by psychiatrists and medical education faculty. Students each take the lead role during a clinical scenario in which they will encounter a simulated patient. Live video from the simulation is broadcast to other candidates. Scenarios last 10-15 minutes with a 20-30 minute group debrief immediately afterwards. The debrief utilises the PEARLS framework (Promoting Excellence and Reflective Learning in Simulation) and provides the opportunity for peer and facilitator feedback, as well as discussions regarding mental state examination, diagnosis and management.ResultQualitative and quantitative feedback has been collected via an anonymous electronic post-course questionnaire. To date, the course has received universally positive feedback. 93% of candidates rated the overall quality of the course as a learning experience as ‘excellent’. Students reported that the course helped them develop communication skills which they could apply to future clinical situations. In addition, candidates felt participation had increased their confidence in taking a psychiatric history and performing a risk assessment.ConclusionImmersive simulation is an underutilised tool in psychiatry education. Our course complements the existing educational programme of lectures and ward-based teaching and has been positively received. It provides the opportunity for students to develop interview techniques and communication skills in a safe, controlled environment.
Is it possible to use research to learn psychiatry from scratch: a reflective self-study of a pre-clinical year medical student
Authors: Selvakumar Jashan , Loo Jiann Lin , Ohn May Honey , Kelly Gabby 
Published: June 2021

AimsDespite the abundance of opportunities available for medical students to explore the field of psychiatry, active immersion through experiential learning has proven to be difficult for pre-clinical year students as a result of a busy time table and the need to wait for psychiatry postings during the clinical years. Hence, the question of “how to implement experiential learning of psychiatry in pre-clinical years” arises. This study is aimed to elucidate the attempts that have been made to use research as a proximate approach to learn psychiatry experientially, focusing specifically on the challenges faced and lessons learned by a pre-clinical medical student.MethodThis self-study outlined the informal three-months learning-by-doing journey of a year-one medical student, supervised by a psychiatrist registrar. Employing research as a proximate approach of experiential learning for psychiatry was explored based on reflection from discussion during supervision meetings and messages exchange. The agreed learning method was an active involvement in research projects on psychiatry topics, with the learning outcome of producing publications.ResultThe challenges faced included: 1) the difficulty associated with striking a balance between an ambitious project with high impact versus a feasible smaller project to keep both parties motivated through the means of short-term accomplishment; 2) the ongoing requirement for learning process adjustment to build the foundational knowledge essential for progress. Through active and deliberate effort, every step in the process was found to be an opportunity for active learning. Literature review, for example, was used to build the understanding of psychiatry topics and practise critical appraisal skills, while allowing for the recognition of knowledge gaps, which ultimately encouraged future research idea synthesis. The process of writing and submitting a manuscript was used to learn publication-relevant skills including: journal impact calculation, referencing, indexing and abstracting services, and publication ethics. Certain future proof skills were also developed, including literacy in information and communication technology which improved efficiency of research, problem solving and decision making. This was done using pros and cons whenever difficulties were faced.ConclusionAlthough research is not a comprehensive substitute for clinical posting in the process of learning psychiatry, the lessons learned from psychiatry research can potentially serve as an initial exploration tool for preclinical-year medical students interested in the field. The stimulating process has found to be effective in stimulating further interest in psychiatry but maintaining it will be the next challenge.