bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Peer Supervision Pilot Scheme
Authors: Middleton Laura , Johal Jag , Swift Geraldine 
Published: June 2022

AimsFollowing mixed feedback from Foundation (FY) trainees during their Psychiatry placements, Cheshire and Wirral Partnership NHS Trust introduced a pilot scheme whereby FY and General Practice (GP) trainees were paired with a current Psychiatry Core Trainee (CT). This was in addition to regular Clinical Supervisor meetings with weekly self-directed sessions encouraged. Suggestions included covering portfolio requirements or facilitating joint learning. The study aimed to improve FY/GP experience through increased learning and relationship-building opportunities. It equally offered leadership experience for CTs and development of supervision skills. Feedback gathered from the initial pilot would highlight difficulties and guide future peer supervision schemes.MethodsAll FY/GP trainees allocated to the Trust from April–August 2021 were included. CTs were included by default but given the option to opt-out (opt-out policy). Pairings were made based on locality where possible (group sizes ranging from 2 to 3) and an initial supervisor training session was provided by the Director of Medical Education. Online feedback surveys were sent to all participants at baseline and after the pilot.Results44 doctors were included in the pilot scheme, of which 26 completed the pre-pilot survey and 16 completed the post-pilot survey. Expected personal benefit prior to the scheme averaged 7.1/10, where 10 was deemed “extremely helpful” and 1 “not at all”. Following the scheme, experienced personal benefit was valued at 4.7/10. Reported benefits of the scheme were friendship, support and learning, although around a third described no benefit whatsoever. The most common problem encountered was that of being unable to meet and was seen in almost half of cases, with detailed feedback citing rota clashes or working on separate sites. Other problems included poor engagement and feeling the pairing was a poor match. Written feedback stated that the scheme was a good idea and well-supported, however there were challenges with its execution.ConclusionResponse rates were low throughout but particularly in the post-pilot survey, limiting interpretation. Overall, final scores did not appear to reflect initial optimism. The next cycle will include only CTs who have requested to be involved (opt-in policy), to establish whether this improves engagement. It will additionally incorporate a mid-point review to highlight and address issues at an earlier stage. The scheme is due to be repeated in 2022 and re-evaluated.
“Decolonising” the University of Edinburgh Medical School Psychiatry Curriculum
Authors: Nelson Emily , Cooper Deborah , Gandhi Pujit , King Heather , Lloyd Elizabeth , Burrell Jamie , Pathak Anushka 
Published: June 2022

AimsThe concept of “decolonisation” has gradually evolved within higher education, and can be defined as seeking to discern how historical systems of discrimination have shaped the networks around us, and how to adjust to the perspectives of those who have been oppressed and minoritised by these systems. Our aim was to assess what gaps there are in the Edinburgh Medical School psychiatry curriculum, in order that this might inform our next steps in “decolonising” the curriculum.MethodsWe reviewed all the teaching materials used for teaching Year 5 Psychiatry at the University of Edinburgh (n = 101). We made a count of the number of people or cases in each resource and the diversity of examples used. We subsequently examined each resource to see if it touched on each of six key areas considered to be representative of a “decolonising” effort. These were the assignment of gender only where necessary, cultural/religious differences, historical context, health inequalities, the patient-doctor relationship and global topics.ResultsOf the resources where each of the criteria were applicable, 18% only assigned gender where necessary or left gender neutral, 4.35% addressed cultural or religious differences, 5.8% discussed the historical context, 4.35% tackled health inequalities, 1.45% raised the doctor-patient relationship and none introduced global topics. Of all the resources that include a direct reference to a patient or case, only 5.41% were explicitly from a different ethnic group other than “white”.ConclusionOur results show that all the key areas can be improved on. Addressing these issues has not been a focus for the curriculum before now and our next steps will be to approach each topic in turn and consider how the key areas can be introduced. We are assembling a focus group of psychiatrists and medical students and have designed a survey for students who have completed their psychiatry block.With time, we hope to cultivate an attitude amongst students and teachers of psychiatry at Edinburgh University that boldly confronts the historical development of our subject, acknowledges those who have suffered for it, picks up on what may be missing or misrepresented, and encourages critical analysis of research. Our teaching materials should include examples which explore stereotypes and challenge prejudices. By broadening our repertoire, confronting the darker parts of our history, listening to those with quieter voices, and paying attention to lived experience, we can foster a culture of teaching and learning which is open, flexible and humble.
Using Social Media to Improve Mental and Physical Health Literacy: The Meeting of Arts and Sciences
Authors: Okhiai Lopez , Loo Jiann Lin 
Published: June 2022

AimsGeneration Z and millennials are tech-savvy and they learn more from videos compared to books. On average young people from the digital age spend more than five hours on digital gadgets. Innovative use of social media technology will improve the access to health information amongst this group of users. This article aims to share the project of using short video clips in social media, combined with poetry to improve mental and physical health literacy.MethodsShort video clips (ranging from one to three minutes) were produced out of passion by the first author using the elements of poetry, rhyming, humour, artistic expressions, simulated play of clinical scenarios and news reporting style which depends on the creativity and suitability of the content. The production process includes initial conceptualisation, script drafting and editing, video-recording using a smartphone, and subsequent editing using phone and Canva software. Subtitles and captions were added to increase accessibility. The videos were uploaded in Instagram, Twitter, and TikTok under the name of “dr_lokai”. There is no external funding involved. The cost involved included subscription of editing software and the purchase of recording equipment.ResultsThe project was first conceptualised in 2014. Total videos produced so far is 70. The topics of mental health included both normal psychological topics (mental health, self-reflective practice, self-motivation, self-compassions, and self-actualisation) and disorder-related topics (delirium, generalised anxiety disorder, emotionally-unstable personality disorder, attention-deficit hyperactivity disorder); while the physical health topics included cardiology, dermatology, infectious diseases, etc.). There were also videos on stigma, interesting contemporary topics around public health and healthcare education. One of the videos was a collaborative work with The Royal College of Physicians, elaborating on the personal and non-clinical facet of journey in medical school. As of the day of submission, the number of followers was 1710. Qualitative feedback from the audiences was generally positive. There were frequent requests from audiences for videos on specific medical topics.ConclusionA creative generation requires a creative approach in outreach. The strength of this initiative is the low-cost production nature and it is freely accessible by anyone with internet access. In the future, more videos which involve debunking medical myths and history of medicine can be added. The main challenge is finding time to write the script, rehearse and record. Although the effectiveness and efficiency of this innovative initiative requires a systematic evaluation, passions in sharing medical knowledge using social media have kept this initiative alive.
Findings From Three Neurodevelopmental Psychiatry Educational Events Aimed at Medical Students and Junior Doctors
Authors: Shaikh Nasreen , Singh Niraj , Barrett Mary , Tromans Samuel , Jaggi Prabhleen Singh 
Published: June 2022

AimsTo review feedback from three Neurodevelopmental Psychiatry educational events attended by medical students and junior doctors, to establish their impact and whether they can influence interest in Psychiatry/Neurodevelopmental Psychiatry as a career.MethodsThree events were organised to a) increase understanding of Neurodevelopmental Psychiatry and b) promote career interest in the specialty, aiding recruitment efforts. Two were Face to Face Events (FFEs) whereas one was an Online Event (OE) in keeping with COVID-19 restrictions.The programme for the events was varied including key clinical topics such as Intellectual Disability, autism, ADHD and epilepsy as well as leadership, management, research and training information. Presentations were approximately 20 min in duration. 31 delegates attended the 2018 FFE, 28 attended the 2019 FFE and 65 attended the 2020 OE.The 2018 FFE and 2020 OE were primarily attended by medical students whereas the 2019 FFE was attended primarily by junior doctors.Delegates rated each presentation from 1 (poor) to 5(excellent) and provided comments. At the 2018 and 2019 FFEs we assessed impact on career interest.Results•The majority of delegates from both FFEs agreed that such events helped to facilitate understanding of neurodevelopmental psychiatry and encourage recruitment to psychiatry.•The majority of delegates at the 2019 FFE agreed that their interest in a career in neurodevelopmental psychiatry had increased following attendance•Attendance was highest at the 2020 OE and overall rating was 4.63/5.•Across the events, popular topics were Autism, Career path and Physical Health needs in Intellectual disability.•Themes in terms of comments included “friendly, inspiring speakers” and “opportunity for interactivity” (noted at OE).ConclusionBoth the OE and FFEs were enjoyed by medical students and junior doctors.Analysis showed key topics such as autism attract interest but also that diverse topics in different formats are important. Human factors that seemed important included inspiring, friendly speakers and a relaxed, interactive atmosphere. OEs are cost-effective and have the potential to attract a bigger audience but may present a challenge in terms of interaction. FFEs impact positively on career interest and this needs to be assessed further in terms of online events.
Setting Up an Out of Hours Supervision Group at St Charles Mental Health Unit
Authors: Thet Win , Naismith Hamish , Rahman Mehtab 
Published: June 2022

AimsPsychiatric on-calls are often regarded as the most challenging aspect of core psychiatric training. This audit aimed to gain trainee feedback about on-calls at one of London's busiest mental health units, whether they were receiving adequate supervision for emergency and out of hours work and to design an intervention to improve on-call supervision experience for core and higher trainees.MethodsA qualitative survey to assess the out of hours clinical experiences of trainees was conducted. The survey explored the following domains: trainees’ confidence in dealing with emergencies out of hours, quality of supervision and individual learning opportunities.ResultsResults indicated low to moderate confidence levels among trainees in performing out of hours’ clinical tasks. The majority were of the opinion that further supervision for on-calls would be beneficial. 59% of trainees stated they struggled to complete work place based assessments (WPBAs) on out of hours cases. In view of the findings, a quality improvement framework was used to introduce a supervision group that gave trainees the opportunity to learn from their out of hours complex cases with a Consultant Psychiatrist as a chair. Following the implementation of the group, a qualitative survey revealed improved confidence, morale and training satisfaction among trainees. The results of the survey and feedback from trainees will be shared in details in the poster. This group has been running successfully for the last one year.ConclusionThe introduction of an out of hours supervision group in busy mental health units can lead to an improvement in confidence and enable professional and educational development for trainees, which will also help improve overall morale as evidenced by this audit. Additional supervision and developing confidence of junior doctors in dealing with out of hours’ complex cases has enabled trainees to feel more supported and has led to increased training satisfaction at St Charles Hospital, London.
Mental Health Literacy in Foundation Doctors - a Survey in the York and Humber Area
Authors: Varvari Ioana , Foster Harry , Nirodi Pratibha 
Published: June 2022

AimsWe aimed to measure the baseline mental health literacy in Foundation Doctors in the Yorkshire and Humber area, identify any gaps in knowledge with the purpose of addressing these within the new foundation psychiatry teaching program, developed by North Yorkshire Health Education England.MethodsIn January 2021, a questionnaire comprising of O'Connor's Mental Health Literacy Scale was sent electronically to all Foundation Doctors in the York and Humber area, that were in a placement at that time. The O'Connor's Mental Health Literacy Scale (MHLS) has been used since its publication in 2015 and is a 35 item, univariate scale that demonstrated good internal and test-retest reliability. It covers the following attributes: a) ability to identify disorders, b) knowledge about seeking information, risk factors and etiology, self-treatment, resources and support available, c) attitudes about mental disorders and seeking professional help. The anonymized data were collected and analysed in Microsoft Excel.ResultsIn total, we received 49 responses to the questionnaire. Overall, 85% of respondents demonstrated good mental health literacy. Breaking this down further, 91% demonstrated knowledge of core psychiatric diagnostic criteria, 68.4% were literate in etiology and risk factors, 92% and respectively 95.9% understand what resources for treatment and professional help are available. Importantly when looking at attitudes about mental disorders overall 17% of respondents showed a degree of stigma and barriers in seeking professional help. For example, 2% strongly agreed that mental health conditions are not real illnesses, 34.7% were unsure whether people with mental illness are dangerous, 40.9% neither agreed nor disagreed they would move next door with someone with a mental illness and 14.3% would not be willing to have someone with a mental illness marrying into the family. When looking at barriers to seeking help, 12% answered they would not tell someone if they had a mental health problem, with 16.3% unsure whether they would tell someone if they had a mental health problem.ConclusionOverall, our survey demonstrated good mental health literacy in our cohort, however, there are areas of improvement, the main ones being etiology, risk factors, and attitudes towards mental health. It is important to recognize these deficits, as they have been linked with poor health outcomes and barriers in seeking and providing care. Moving forward, standardization of teaching programs and anti-stigma training could be an evidence-based approach to tackling these issues.
Gender Identity and Questioning in Klinefelter's Syndrome
Authors: Cai Valerie , Yap Tet 
Published: June 2022

AimsKS is a congenital condition with 47, XXY chromosome karyotype. Due to a lack of understanding of the condition amongst healthcare providers, KS is grossly underdiagnosed, with most patients never receiving a diagnosis. Within this population, gender dysphoria is suggested to be of higher incidence than in the general population. To establish the validity of this claim and to improve care for patients with KS, particularly in the area of gender service provision, we need to identify whether there is a significant proportion of XXY individuals that experience gender dysphoria. The aim of our study is to determine whether UK patients with a diagnosis of KS are more predisposed to gender dissatisfaction.MethodsA PRISMA literature review was conducted on the epidemiology, management, and treatment outcomes of KS patients with gender dysphoria. Based on the results of the literature review, we then conducted a cross-sectional survey of patients serviced by the Klinefelter Syndrome Association on gender satisfaction. The survey recorded 81 responses.ResultsOf the entire study population, gender distribution was 65% male, 6% female, 4% non-binary, 2% gender fluid, 3% neither, 1% equally male and female, and 1% intersex. This contrasted with most patients’ assigned birth on their birth certificate, which was 92.5% male and 3.75% female. Most patients surveyed enjoyed living as the sex written on their birth certificate (61.64%), which seemed to correlate closely with the proportion of patients that identified as male (65%).ConclusionLiterature Review: As a whole, KS patients documented in research presented to psychiatric and sexual health services during adulthood, requesting either sex reassignment surgery or changes to hormonal replacement therapy. The sparse amount of research over a long period of time has created a reliance on outdated research techniques. Patient Survey: Survey results show that there are a significant proportion of survey respondents that do not identify as male despite it being written on their birth certificate; however, the majority prefer to be identified as male. This suggests that certain individuals with KS are at higher risk of gender dissatisfaction and dysphoria. Importantly, these observations are not substantiated with clinical judgement of a psychiatrist/mental health worker, which should aim to be incorporated in future research. Additionally, longitudinal studies should aim to establish whether certain age groups would be more at risk of gender dissatisfaction and gender dysphoria or if trends change with age.
Impaired Grid-Like Representations at Theta Frequency in Schizophrenia
Authors: Convertino Laura , Bush Daniel , Zheng Fanfan , Adams Rick , Burgess Neil 
Published: June 2022

AimsSchizophrenia is a chronic brain disorder characterised by distortion of thoughts and perception. Several studies have shown a key role of the hippocampal formation in the pathophysiology of schizophrenia. Patients show impaired theta coherence between medial temporal lobe and medial prefrontal cortex (mPFC), and impairment of knowledge structuring and inferential processes. Both the hippocampal formation and mPFC contain hexadirectional modulation of activity, indicative of grid cell populations. Grid cells play an important role in mapping the environment and are believed to represent the transition structure between task states. With other cell populations in the hippocampal formation, they play a fundamental role in inference, episodic memory, and spatial navigation. Here, we investigate whether schizophrenia is associated with disrupted grid firing patterns.MethodsTo test this hypothesis, we asked 18 participants with diagnoses of schizophrenia and 26 controls (matched for age, sex and IQ) to perform a spatial memory task in magnetoencephalography (MEG), while navigating a virtual reality environment. We first analysed theta (4–10 Hz) power during movement onset compared to stationary periods. We then source-localised the signal and looked for the hexadirectional modulation of theta band oscillatory activity by heading direction during movement onset. We also controlled for other symmetries in theta frequencies (four, five, and eight fold) and hexadirectional modulation in other frequencies. The same participants performed an inference task outside MEG, which we used for correlation analysis.ResultsThe peak of theta power during movement onset was stronger in controls compared to patients (p < 0.05). In the control group, we found hexadirectional modulation of theta power by movement direction in the right entorhinal cortex (p < 0.005). This effect was absent in patients with a significant difference between groups (p < 0.05), suggesting that their entorhinal grid firing patterns may be disrupted. No other symmetry modulated theta power significantly in controls or patients, and hexadirectional modulation during movement onset was found only in theta frequencies in controls. Performance in the inference task was significantly impaired in schizophrenic patients, and spatial memory performance in both controls and patients was positively correlated with their performance in the inference task.ConclusionThese results are consistent with the hypothesis that impairments in knowledge structuring and inference associated with schizophrenia may arise from disrupted grid firing patterns in entorhinal cortex. Although further work is needed to better understand the role of grid cells in health and disease, this work provides new insights into dysfunction of the hippocampal formation in schizophrenia.