bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surviving Your First On-Call in Psychiatry: A Bootcamp for Junior Doctors
Authors: Cooper Michael , Singh Sukhmeet , Galloway Suzanne , Hegde Rekha 
Published: July 2023

AimsThe psychiatry ‘bootcamp’ forms part of the psychiatry induction for junior doctors within NHS Lanarkshire. It was developed to better prepare them for common scenarios on-call and therefore alleviate any anxieties. The session is based upon a weekend on call where a fictional patient is admitted to the psychiatry ward with a psychotic presentation. It introduces the participant to the topics of Mental Health Act utilisation, capacity, acute behavioural disturbance management, and adverse effects of psychotropic medications.MethodsFocussed teaching regarding fundamental theory for each topic is provided. Following this the facilitators engage the audience through reflective group discussion. Relevant parts of the session involve practical work including individual completion of detention paperwork. Targeted teaching is provided by the facilitators for any knowledge gaps identified.Pre and post course questionnaires are completed by participants where they provide both written feedback and score various domains between 0 (least confident) and 10 (most confident). Domains are capacity assessment, assessing detention criteria, the process of detaining a patient, and recognition and management of extrapyramidal side-effects.ResultsThis course has been run on two separate occasions with a total of 28 participants. All domains assessed on feedback questionnaires have shown an increase in confidence amongst the participants. Following analysis of all pre and post course questionnaires session one showed an average improvement from 4.87/10 to 7.56/10 across all domains. Session two showed an average improvement from 5.34/10 to 8.6/10.Themes identified on participant feedback included the benefit of having the opportunity to individually practice completing detention paperwork. Another theme identified was that participants found the case used for session delivery relevant to their practice. A final theme identified was the engaging nature of the session which encouraged the participants to ask questions. If a didactic approach was used this could restrict such discussion.ConclusionFeedback received suggested that this session was well received by all participants and was felt to be beneficial in both preparing them for and alleviating anxieties ahead of their first shift on-call within psychiatry. Feedback demonstrated that running the session in small groups with a blended approach of direct teaching, reflective discussion, and practical work maximised engagement and was an appropriate approach for session delivery. Feedback suggests that this session has the potential to be an essential part of future junior doctor inductions due to it identifying and meeting the learning needs of the participant.
Improving Confidence and Knowledge in Raising Concerns: A Development Half-Day for Representatives of Postgraduate Doctors in Training
Authors: Thomas Katie , Davies Sian , Ibbett Vicki , Pantall Shay-Anne , Scally Ruth 
Published: July 2023

AimsRaising a concern is an integral duty for a doctor. The General Medical Council guidelines on Good Medical Practice state that a culture should be promoted that allows “all staff to raise concerns openly and safely”. Appointment of Postgraduate Doctors in Training to Representative (Rep) positions can be an effective way to allow trainee voices to be heard. Here we present the results of a Development Half-Day created to empower Reps with the knowledge and confidence to represent peers effectively within a large mental health Trust. The training session was identified as a ”change idea” in a wider Quality Improvement Project (QIP) seeking to improve trainee confidence in raising concerns.Methods16 Postgraduate Doctors in Training Reps were invited to attend a Development Half-Day in November 2022. The day included talks on their roles and responsibilities, respectful challenge and maintaining well-being.Quantitative and qualitative data were gathered using anonymous questionnaires completed before and after the session. The questionnaire contained 4 questions asking them to rate their knowledge of their role as a rep and confidence in raising trainee concerns. This was quantified using a 1-10 scale for each question with 1 being lowest confidence/knowledge and 10 being highest. Mean scores and standard deviations were calculated. A paired one-tailed t-test was used to assess the statistical significance of the difference in pre- and post-session scores.Results9 Reps attended the Development Half-Day and completed the pre- and post-session questionnaires.There was a statistically significant improvement between pre- and post-session scores for all questions (all p values <0.05). Importantly there was a significant increase in the confidence felt by reps in knowing where and who to raise trainee concerns to (p < 0.05).Qualitative feedback indicated that attendees found the session useful and they appreciated that it was in-person. The only suggestion for improvement was for the session to have been held earlier, closer to when reps were initially appointed; this will be a change that will be implemented in the next “Plan, Do, Study, Act” cycle of the QIP.ConclusionImplementation of a Development Half-Day for Trainee Reps was shown to have a significantly positive impact on their confidence in their roles and their ability to respectively challenge seniors. The Reps additionally reported being better equipped at knowing where and who to raise concerns to. This will hopefully aid in their ability to signpost and empower other trainees to do the same.
A Mixed-Methods SWOT Analysis of a Medical Student Balint Group Programme
Authors: McCarron Robyn , FitzGerald James , Swann Peter , Yang Sharon , Wraight Sally , Arends Fraser 
Published: July 2023

AimsBalint groups explore the clinician-patient relationship, with benefits for empathy, resilience, and interpersonal skills. Their use with medical students is increasing, but more research is needed to understand how their benefit, feasibility and accessibility can be optimised. We aimed to explore this over a one-year pilot of a medical student Balint group programme.MethodsAn explanatory sequential mixed methods design was used. Eight medical student Balint groups ran for six weeks during 2022–2023, with 90 students participating. Students completed quantitative and qualitative feedback at the end of each cohort. Themes were identified using qualitative content analysis. Balint group leaders kept reflective session notes and used these alongside student feedback to undertake a strengths, weaknesses, opportunities and threats analysis of the programme.ResultsStudents reported a neutral to slightly positive experience of the groups. Strengths were coded as containment, learning, and community identity. Students identified weaknesses due to pace, facilitation, and anxiety. Threats to the future success of the Balint group programme were related to engagement and the group being perceived as inauspicious and intimidating. Potential opportunities to develop the Balint group programme included widening participation and sharpening focus. The strengths, weaknesses, opportunities, and threats identified by the group leaders were in line with those of the students, but also acknowledged the broad range of ethico-legal material discussed by students, timetabling and organisational challenges. A range of opportunities were identified for how the Balint group programme could optimally enrich the clinical curriculum.ConclusionIntegrating successful Balint groups into the medical school curriculum is challenging on individual and organisational levels. However, students perceive value in these groups, and they provide a unique space to combine learning and emotional support with personal, professional and community development. Ongoing consideration is needed to optimally and sustainably incorporate Balint groups within the undergraduate medical curriculum.
Medical Emergencies in a Mental-Health Setting (MEAMS)
Authors: Fraser Sam , Barrett Megan , McLean Alex , Moulds Yvonne , Lennon Brian , Pettigrew Derek , Ryan Ashley , Toner Alison , Bell Linda 
Published: July 2023

AimsMedical Emergencies in A Mental Health Setting (MEAMS) was a proposed high-fidelity simulation training course specifically designed for the mental health multidisciplinary team (MDT). A team of resus officers, mental health nurses and psychiatric doctors worked to create scenarios reflecting the emergencies encountered in mental health. It aimed to gives staff simulated experience in approaching and managing a verity of complex emergencies, including physical health, as well as communication scenarios. Specifically the aims were: (1) Determine if course was perceived to benefit staff, (2) Determine if course subjectively increased staff knowledge and confidence in mental health emergencies, (3) Review for continued areas of improvementMethodsThe full day sessions were carried out in the Electroconvulsive therapy (ECT) suite, with it being modified into an immersive environment similar to wards or clinics. The faculty of medical resus officers, mental health nurses and psychiatric consultants ran the courses, with participants joining from across the MDT including nursing staff, junior doctors, consultants, students and nursing assistants.The morning program, run by resus officers, provided education in life support, initial assessment of the unwell patient and intraosseous access. The afternoon contained various scenarios, including for example managing neuroleptic malignant syndrome. Scenarios were observed via video link by faculty, with constructive feedback and debriefs provided.Quantitative data of knowledge and confidence was obtained pre and post sessions using Likert scales. Qualitative information regarding future proposed scenarios, areas of improvement and areas of notable value was gathered.Results36 staff attended the program, run over 4 days. Average knowledge and confidence (scored out of 10) improved from 4.9 pre-session to 8.1 post-session. All 36 staff felt the session was beneficial. Particular positive feedback on scenario realism, MDT working, safe/ supportive teaching and the resus faculty teaching was highlighted.Areas for improvement highlighted included running sessions more often, widening accessibility to more staff and teaching on resus medications and fluids. A variety of further scenarios were suggested, for example management of withdrawal seizure.ConclusionMEAMS was felt to achieve its aims, and demonstrated clear subjective increase in staff knowledge and confidence regarding common emergencies seen in mental health settings. Further sessions and wider accessibility to the mental health MDT is anticipated to continually benefit staff. Taking on qualitative feedback, the faculty aims to continually adapt the program to provide the best possible training and education, adapting and creating new relevant scenarios.
Keeping the Focus on Recruitment and Retention in Psychiatry in Scotland
Authors: Gordon Rosemary , Kader Ihsan 
Published: July 2023

AimsThe Scottish psychiatric workforce has remained largely static; in June 2022, there were 1,164.7 whole-time equivalent (WTE) psychiatrists across all grades. RCPsych In Scotland recognise the importance of focussing on, and improving, the recruitment and retention of trainees in Psychiatry in Scotland by undertaking a number of different projects.MethodsWe understand that trainees have differing needs and therefore since 2018 have looked at different ways to attract and retain trainees using different mediums. These included membership benefits, written information, policy work, and events.With funding from NHS Education for Scotland we focussed on undergraduate students creating bursaries, a new RCPsych In Scotland welcome pack and ran summer schools.Focussing on existing trainees we had a stand at the virtual international congress, training events including ST4 interview skills webinars, bursaries for trainees to attend conferences and a workforce report to illustrate the likely gaps in future consultant posts as well as barriers to recruitment and retention throughout the work span.ResultsDue to the lengthy duration of psychiatric training it is not possible to evaluate an immediate impact of the campaign on Scotland's workforce however we have seen benefit by looking at other measurable objectives. The work focussing on undergraduates had led to a 333% increase in student associate membership of RCPsych in Scotland.In 2018 there was a 63.08% fill rate for core psychiatry posts compared to 100% in 2022. As recruitment is now national, it is not possible to get Scotland only data for competition ratios however the 2021 competition ratio for the UK was 2.99 compared to 1.48 in 2018.We are starting to see a change in higher training fill rates. In 2022 there was a 69% fill rate over all specialties with Psychiatry of Older Adults and Medical Psychotherapy both having a 100% fill rate. This is a slight improvement from 2019 where there was a 61% fill rate.ConclusionThe work undertaken by RCPscyh in Scotland has increased interest in psychiatry both at an undergraduate and post graduate level although there is still work to be done with regards to retention, both into higher training and also to consultant level posts. The work we are currently undertaking with the workforce report hopes to focus on the reasons that trainees leave training and we aim to use it to advocate for policy change with regards to training numbers and pathways in Scotland.
Psychiatrists’ Experiences of the Transition From Trainee to Consultant: A Qualitative Study
Authors: Greenstone Harriet , Anderson Elizabeth 
Published: July 2023

AimsPopulation mental health relies on retention of a skilled mental health workforce, including consultant psychiatrists. The purpose of this study was to explore UK psychiatrists’ experiences, expectations, and reflections about the transition from trainee to consultant. By exploring the transition experience, it was hoped that ideas could be generated which might inform ways of supporting psychiatrists during this period.MethodsA qualitative approach was used to gather rich, detailed data about individuals’ experiences. The sample population was a large NHS mental health trust in the South West of the UK. Stratified purposeful sampling was used, allowing focus on three distinct groups of psychiatrists at different stages of transition. Four trainees, four Specialty Doctors and nine new consultant psychiatrists were interviewed 1-1 by the lead researcher. Qualitative data were analysed using thematic analysis.ResultsPsychiatrists’ experiences of transition centred on three major themes: Facing the Real World, Learning from Others, and Being Myself. These themes were connected by central concepts of belonging and identity. New consultants must survive the challenges associated with transition, and establish professional identity as a consultant; an authentic sense of self-in-role. This relied on the psychiatrist's establishment of a sense of identity, industry and belonging within professional communities.ConclusionTransition is unique for each individual but there are common aspects, and study of seventeen individuals’ experiences enriched understanding of the transition period. Clinicians and managers must not underestimate the challenges faced at transition. This matters for the specialty; consultants form a small proportion of the workforce, but their functioning has a major impact. It would be detrimental to care provision if difficulties at consultant transition resulted in attrition of psychiatrists. The main recommendation is development of a trust-level transition programme to provide support to individuals, which could also be of value to the organisation and wider profession.
Racism in Modern Media (The Sopranos) and the Application to Black Mental Health in Modern Day
Authors: Henriques La-Dantai , Sule Akeem 
Published: July 2023

Aims‘The Sopranos’ is a well known television show, following the life of an Italian-American mobster suffering from anxiety and depression. Despite the overarching theme of mental well-being, elements of racism still feature within the show. These elements are ever-present throughout society and can act as an additional stressor for black minorities, who have an increased risk of suffering from mental health problems compared to their counterparts. Racism has also been linked with an increased probability of developing depression. This qualitative study aims to look at the portrayal of black characters in Season One episodes 1 and 2, to identify themes and psychiatric associations with black mental health. It identifies negative portrayals and conceptualises how these impact black mental health in the real world. Finally, it aims to use these results to propose ways of engaging with the media and the self, to improve negative stereotyping and bias.MethodsThis qualitative study was performed using thematic analysis via a deductive approach. This included creating themes, to then apply to depictions and interactions of black characters who featured within episodes 1 and 2 of the first season of The Sopranos.Themes included: occupation, social network, verbal negative connotations, derogatory language, physical appearance.Three online databases were used: Google Scholar, PubMed and BMJ Journals to identify literature ranging from 1999–2023. This focused on literature exploring relationships between media, cognition, society and/or racism.Literature of the most recent mental health data collected within the UK Survey featuring Black Caribbean/British/African was also analysed.ResultsSeveral depictions of negative stereotypes and behaviours of both black men and women were present in both episodes. These were in the forms of: derogatory language, pacification and code-switching and negative interactions with other characters.Literature has established that negative presentations within media can result in marginalisation of ethnic groups, which can be extrapolated here.ConclusionNegative depictions and stereotypes of black minorities may be having an impact on their mental health and could explain finding of mental health within Black minorities. It could affect the way they interact with the world and apply additional stressors via unconscious bias.To resolve this, changes within social media and self-awareness should be promoted, so this is less likely to happen.
Implementing and Evaluating Online Revision Sessions for the MRCPsych Paper a Examination
Authors: Hewson Thomas , Patwardhan Swanand , Mountain Emily , Hackett Latha 
Published: July 2023

AimsPreparing for postgraduate examinations is stressful for many doctors, with psychological, financial, and social impacts. Ensuring that doctors feel supported with exam preparation is likely to improve their well-being and performance, whilst also potentially addressing workforce retention and differential attainment. This quality improvement project aimed to improve the confidence and preparedness of trainees taking the MRCPsych Paper A exam in the North West School of Psychiatry.MethodsSix weekly online revision sessions were held for trainees preparing for the MRCPsych Paper A examination. One session was devoted to each major curriculum topic, whilst two covered neurosciences. The sessions were held over Microsoft Teams for 1 hour and chaired by senior trainees and Consultant Psychiatrists. The sessions incorporated a combination of PowerPoint slides, discussion about relevant theory, and interactive practice questions using Slido. A baseline survey was completed to ascertain trainees current levels of exam preparation and confidence. Questionnaires were administered at the end of each revision session to measure their impact and gather feedback. Trainees indicated the extent to which they felt confident with each curriculum topic and their responses were compared, at group level, before and after the revision sessions (1 = strongly disagree with feeling confident, 5 = strongly agree with feeling confident).Results40 trainees completed pre-session feedback and 56 trainees completed post-session feedback. The mean confidence scores of trainees improved by between 25.4% to 51.5% after the revision sessions, with the lowest pre-session mean confidence score being observed for neuroscience and the greatest improvement being observed for psychopharmacology. 77.8% of trainees rated the revision sessions as ‘extremely useful’ and 22.2% perceived them as ‘useful’. All trainees agreed (43.4%) or strongly agreed (56.6%) that their knowledge improved after attending the sessions, and all trainees agreed (23.6%) or strongly agreed (76.4%) that they would recommend them to colleagues. Trainees favourite aspects of the revision sessions included completing multiple choice questions, combining Slido polling with PowerPoint slides, and the speakers explanations of difficult concepts. Suggestions for improvement included offering more frequent and longer revision sessions, concealing group voting choices on Slido until revealing the correct answers, and teaching more relevant theory alongside practice questions.ConclusionOnline group revision sessions combining interactive polling and didactic teaching are popular and useful amongst trainees preparing for MRCPsych Paper A. These sessions appear to improve trainees' self-reported confidence with exam curricula content, although further evaluation is required to determine whether they improve examination pass rates.