Raising concerns is an important part of being a doctor and part of the GMC ‘Good Medical Practice’ guidelines, however as a trainee it often comes with specific challenges. Historically trainees are often left feeling that their concerns are not taken seriously and there is no resolution to problems raised. Here we present the findings of a scoping exercise undertaken as part of a Quality Improvement project exploring these issues within a large mental health Trust.

Trainees across all training grades from Foundation doctors to higher trainees were invited to engage in virtual focus groups specific to their training programme. Contributions were analysed anonymously using a thematic analysis approach by two independent coders. Quantitative data were also gathered using an online survey to capture trainees who had been unable to attend a focus group.

Key results included:

• • A total of 6 focus groups were attended by more than 35 trainees, with high turnout particularly within Foundation trainees and CT1 doctors.

• • Three key themes were identified from the qualitative data: difficulties with the process of raising concerns, fear of the consequences and challenging the culture of the organisation.

• • It was noted that senior trainees felt more comfortable with the process of raising concerns compared with junior colleagues but were more apathetic about the impact of doing so.

• • 12 trainees completed the online survey. Of these, 6 (50%) reported having had patient safety concerns and 7 (58%) had had concerns about their training.

• • The most common reported barriers to raising concerns were the impact on working relationships (67%), lack of support (50%) and fear of repercussions on their training (50%). 42% of respondents were unsure of how to raise concerns.

• • Trainee suggestions for change included improved information for trainees and trainers about the process for raising concerns, sharing of feedback about concerns raised more widely and regular opportunity to meet with key stakeholders.

The majority of trainees had experienced concerns about either patient safety or training issues. It will be necessary to address the multiple barriers highlighted to enable trainees to feel more confident and able to raise concerns. Increasing awareness of escalation processes, improving the processes themselves and fostering a supportive environment which encourages and supports trainees to raise concerns will be important given the implications for patient safety and trainee well-being.

The MSc Psychiatry at Cardiff University is an established postgraduate programme offering students a sound theoretical basis in psychiatry as a medical science and specialty. The programme currently offers six taught modules (focusing on mood and anxiety disorders, psychosis, old age psychiatry, forensic psychiatry, substance misuse, and child and adolescent psychiatry), as well as a dissertation module that students complete towards the end of the programme. In catering for the professional needs of clinical students and students pursuing careers in academia, two additional taught modules have been proposed exploring Leadership and Management in Psychiatry and Advances in Psychiatric Research. Feedback on the proposed introduction of the new modules was collated from the current full-time and part-time student cohorts.

A total of 57 students currently enrolled on the programme were surveyed in relation to the proposed additional taught modules. The survey was created using Microsoft Forms and deployed via the programme's virtual learning environment (i.e., Blackboard). A mixed methods design was employed, with both Likert scale and open-ended items included in the survey. Students were informed that future cohorts would be offered a choice between the existing Forensic Psychiatry & Substance Misuse module and the proposed Leadership and Management in Psychiatry module, as well as a choice between the existing Child and Adolescent Disorders module and the proposed Advances in Psychiatric Research module.

Responses from the current student body were collated and analysed. A total of 29 (51%) students surveyed were medical professionals, with the remaining 28 (49%) students being science graduates or other clinical professionals. Descriptive analysis of the quantitative data revealed that an overwhelming majority of students viewed the introduction of the new modules as a positive development that would further enhance the student learning experience and continuing professional development. Content analysis of the qualitative data revealed further insights on the nature of the proposed modules and preferences on how these should be included within the existing programme schedule.

Students currently enrolled on the MSc Psychiatry favour the introduction of the proposed modules tailored to support professional development. Specifically, students view the proposed module on Leadership and Management in Psychiatry as catering to the needs of clinicians working in a variety of healthcare settings, whilst the proposed module exploring Advances in Psychiatric Research was considered to supplement existing course content on evidence-based medicine and caters for students with an interest in pursuing a career in academia.

In many cases there are several years between a trainee finishing foundation training and covering inpatient psychiatric wards on call. However, being resident on-call and covering psychiatric wards involves dealing with acute medical as well as psychiatric emergencies. Anecdotally trainees say that they often feel unprepared for this, and that the types of medical emergencies seen in psychiatric wards have rarely been come across in foundation training. The views of the psychiatric core trainees in the Maudsley Training Programme were audited with the aim of finding out how confident they feel in this area.

30 Maudsley core trainees were sent a questionnaire which included questions such as “how confident do you feel when dealing with physical health issues, particularly when on call?” and “how rusty do you feel on your physical health medicine from med school?” using a Likert scale.

Following the results of this initial audit an intervention was introduced which was the delivery of a monthly 10 minute slot at local teaching called “Bite-Sized Medicine”. This was a 10 minute power-point presentation on acute physical health issues.

Post-intervention there was a re-audit. Trainees were sent another questionnaire (Likert scale) asking follow-up questions to determine if the intervention had improved their confidence.

This project was approved by the South London and the Maudsley Information Governance team and did not require ethical approval.

10 core trainees responded during the pre-intervention audit and 13 during the post-intervention audit.

Mann Whitney U tests were used to compare the means Q1vs Q3 (confidence), and Q2 vs. Q4 (rustiness) pre and post intervention.

Both were significant on this output (P < 0.0005).

This shows that there is a significant difference in the mean scores pre and post intervention, with the post-intervention scores being higher. This indicates that the intervention helped trainees to feel more confident and less rusty in terms of dealing with acute physical health issues.

In this small survey, core psychiatry trainees expressed that the introduction of “Bite-Sized Medicine” was useful in helping them feel more confident and prepared when dealing with acute and emergency physical health issues. This is reflected in the statistical analysis, albeit with small sample sizes. Comments were made such as “there are a range of physical health issues that are common in psychiatric care that trainees won't have seen much of in their foundation training. This is a very useful intervention for bridging that gap”.

The global burden of mental disorders continues to grow with significant health, social and economic consequences. Unfortunately, the gap between the need for mental health care and its provision remains wide all over the world. The recruitment and retention of psychiatrists is a long-standing concern in the United Arab Emirates (UAE), with social stigma playing a potential role. This study aimed to investigate the factors that affect the choice of psychiatry as an area of practice by psychiatrists in the UAE. A secondary aim was to assess differences in the factors which affected career decisions among those participants with different backgrounds to establish any cultural and generational differences in choosing psychiatry as a career.

We conducted correlational research using an anonymised 30-item online questionnaire. We recruited qualified psychiatrists currently working in the UAE. The structured questionnaire assessed the participants’ sociodemographic factors and reasons for choosing psychiatry. Ethical approval was received from the Social Sciences Research Ethics Committee (SS-REC) at United Arab Emirates University. Statistical analysis, including Pearson correlations and chi-square tests, was performed using the statistical package for the social sciences (SPSS) version 26.

Out of 70 participants approached, 54 completed the questionnaire with a response rate of 77%. 69% of the participants were female, with a mean age of 38 years. 46% were UAE citizens. We found that the doctors trained in the UAE were statistically more likely to face opposition to specialising in psychiatry (p-value <0.001). Participants with a family member or friend as a psychiatrist were more likely to choose psychiatry as a first choice (p-value 0.01). Psychiatrists below the age of 35 were more statistically likely to face opposition to their decision to specialise in psychiatry (p-value 0.006). Psychiatrists who regretted their decision to specialise in psychiatry were statistically more likely to feel this way in their first year of residency (p-value <0.001). This study had its limitations, including the generalisability of findings and the sociodemographic factors of participants. The self-reported methodology could have subjected findings to bias, including social desirability bias.

Multiple sociodemographic factors influence the decision to specialise in psychiatry in the UAE. These findings would be helpful to identify hurdles faced by the young UAE clinicians in choosing psychiatry, partly explaining the dearth of UAE-trained psychiatrists in the country. Further research is required to study these reasons in detail, helping to improve the recruitment and retention of UAE psychiatrists in the future.

Our aim is to establish a network for clinicians working in or with an interest in the growing specialty of old age liaison psychiatry to provide peer support (inclusive of disciplines and geography) and access to CPD opportunities, to raise the profile of this subspecialty and enable it to continue to develop, to facilitate collaboration and integration with related disciplines and pathways and to strengthen the voice of clinicians in lobbying for improvements in mental health services for older people in the general hospital.

Old Age Liaison Psychiatry is a growing subspecialty in the UK and nationally, following widespread investment in development of liaison services in line with Department of Health strategy. With this expansion comes an increasing need for continuous professional development, networking and collaboration opportunities in order to nurture the specialty and those working in it.

Over 100 people registered for the initial webinar, and many more have watched the recording. Since the webinar the network has grown to 350 members. The webinars were received very positively, with many suggestions made for topics to be covered at future events.

The network has been established successfully and founders are now planning future events with the support of the Royal College of Psychiatrists, including a half day learning event in late 2022.

As part of the effort to support core psychiatry trainees in North Wales to prepare for their CASC (Clinical Assessment and Skill Competency) exam, the North Wales SPiCE (Special Preparation in CASC Examination) Project has been initiated. This article aims to evaluate the SPiCE based on medical educational principles.

A total of five candidates preparing for the CASC exam expressed interest and an organising committee was set up. Examiners consisted of a consultant and four specialist registrars while role players were recruited from non-exam sitting junior trainees. Five mock CASC stations were written and role-players were calibrated accordingly. The stations included: History taking for a patient with FTD (frontotemporal lobe dementia), MSE (Mental state examination) of a patient with mania and psychosis, explanation of CBT (cognitive-behavioural therapy), breaking bad news of NMS (neuroleptic malignant syndrome), and explanation of ECT (electroconvulsive therapy). The mock exam was conducted virtually using Microsoft TeamsTM. The specialist registrars’ performances in feedback provision were assessed for their teaching using the AOT (Assessment of Teaching) form by the consultants. For core trainees who had played the part of organising committee members and role players, their volunteerism and educational management experience were assessed using the DONCS (Direct Observation of Non-clinical Skill) form by specialist trainees.

All five candidates passed all the stations (consists of both borderline pass, pass) in the mock exam with 25% improvements in confidence level were seen among candidates in four stations, i.e. ECT explanation, breaking bad news of NMS, CBT explanation, and MSE of a patient with mania and psychosis. All candidates feel the SPiCE programme was useful in helping their final preparation and they would recommend it to other candidates. Four of the candidates sat for the immediate CASC diet after the SPiCE received a pass result. All specialist registrars received positive AOT feedback for their teaching and all non-exam sitting junior trainees received positive DONCS feedback for their spirit of volunteerism and collaborative teamwork.

The main strength of the SPiCE project is it utilises existing resources and volunteerism of the organising committee while its main limitation is it has only five stations rather than 16 stations in the real exam. Although the mock exam has improved the confidence of candidates and the majority of candidates pass the exam immediately after that, the causal link between the SPiCE and candidates’ results cannot be conclusively established given all candidates have a good baseline.

The field of psychiatry in Morocco has grown significantly since the 1970s, from less than 10 psychiatrists to the current number of around 400. The increased number of practising psychiatrists has enabled the expansion of local residency training programmes, which has been set up since 1974 to cater for the population needs of more than 36 million population of Morocco. This study is aimed to describe the current medical educational approach of the Moroccan postgraduate psychiatry training programme.

This descriptive medical educational study was based on official training documents and interviews with local faculty members involved in the training.

The entry requirement of the four-year Moroccan postgraduate psychiatry residency programme includes the completion of 1 year of foundation training and passing the entrance examination consisting of psychiatric semiology and pharmacology. The postgraduate residency programme is run by the local universities in collaboration with the Ministry of Health and accredited by the Moroccan government. Trainees have the option of taking up a voluntary or contractual position with the government or University Hospitals. All trainees will go through 34 months of general adult outpatient and inpatient, while liaison psychiatry training starts from the second year until the end of the training. On top of the core rotation, a trainee can opt for two months in old age and neuropsychiatry postings. Child and adolescent rotation is currently not available. Addiction psychiatry training is optional and can be done through a university diploma. The 4th year is a 12-month elective posting in any discipline that is relevant to psychiatry, which can be done either locally or abroad. Teaching methodologies involve lectures, seminars, ward rounds, case conferences, journal clubs, and skill training workshops. Formative assessments included case-based discussions and mini-clinical evaluation exercise. There are multiple high stakes summative assessments at year 1, year 2, year 3, and year 4. The summative assessment strategies includes modified essay question, clinical short case and long case. Viva voce is used to assess competency in research. Different mandatory skill competencies include electroconvulsive therapy, psychotherapy, and research.

The advancement of local postgraduate psychiatry residency training in Morocco has improved the access of local trainees to quality training. Similar to other developing countries, Morocco requires more psychiatrists to improve the psychiatrists to population ratio so that the mental service can become more accessible to the local population.

Job interviews are the platform for employers to identify suitable candidates for vacant posts, i.e. those who are able to demonstrate a certain set of competencies specified in the job description. In the recent psychiatry specialty training (ST) application process, candidates are required to propose a management plan for two complex scenarios. This interview can be stressful given the high-stakes nature of the outcome, i.e. the successful enrolment into a training programme of a preferred deanery. Candidates who are unable to have an organised approach to problem-solving will likely have an unfavourable result. To overcome this difficulty, a simplified “I AM” approach is being proposed to assist applicants to organise their thoughts during their ST application interview.

The “I AM” approach stands for “Issues, Assessments, and Management”, which is adapted from the “Handbook of Psychiatry: Surviving Consultation Viva Examination of Malaysian Conjoint Board”. The “Issues” are the problems identified in a scenario, “Assessments” are the investigation required to get a clearer picture of the problems, and “Management” is the action plan to solve the problems. This approach was piloted with five applicants of ST in psychiatry prior to their interview practices.

For a complex clinical case scenario, the “I AM” approach can be put into the matrix of 3 × 3 tables together with a biopsychosocial model to ensure the issues in different domains are explored thoroughly. Further sub-classification into necessary subheadings, including ideas, concerns, and expectations from different parties, can be included in the assessment matrix. Lastly, a management plan using a multidisciplinary team and collaborative decision-making model with the patient and family can be proposed. For a complex managerial scenario, the seven pillars of the National Health Service's clinical governance model involving different stakeholders can be incorporated into the “I AM” approach to explore problem-solving strategies from different angles. Positive reactions had been received from all five trainees (Kirkpatrick's Evaluation Model Level One).

The “I AM” approach can be flexibly applied in different problem-solving scenarios and it works well with other models. The approach may be limited by inadequate information and a failure to prioritise. Further systematic evaluation of the effectiveness and generalisability of the “I AM” approach to other disciplines is required.

Physician associates (PAs) are becoming more commonplace in psychiatric services in the UK to help address long term workforce difficulties. In 2019, the NHS Long Term Plan detailed a commitment to transforming mental health care in England recognising that services were not meeting current or future increase in demand. Health Education England's (HEE) report, Stepping Forward to 2020/21: The Mental Health Workforce Plan for England, described a longer-term strategy to expand the mental health workforce, including recruiting 5,000 people into ‘new roles’ including physician associates. The NHS Mental Health Implementation Plan 2019/20–2023/24 stated an aim of recruiting 140 PAs to the workforce over five years in addition to the requirements specified in the HEE report. HEE and the Royal College of Psychiatrists (RCPsych) have sought to support the integration of PAs into psychiatric teams through the development of the Inceptorship programme. The aim was to develop a bespoke training programme for PAs to bridge the gap between university and working in mental health to be rolled out nationally.

Since 2018, Sheffield Health and Social Care Trust (SHSC) have been providing an Inceptorship Programme for PAs at the trust. Unlike with trainee doctors, there was no curriculum that could be followed. The programme covers the aetiology, diagnosis and management of common psychiatric problems, communication skills and reflective practice. This programme has provided the basis for the RCPsych Inceptorship Programme supported by HEE.

The SHSC programme has been well received by the 11PAs that have been through the programme, with all PAs recommending other mental health organisations take a similar approach. There have been many additional benefits of the sessions. They allow PAs to gain peer support and it has been a forum to raise issues which often arise when integrating new roles into pre-existing MDTs.

The RCPsych Inceptorship Programme is a PA specific educational programme. It is an important tool in addressing the gap between variable mental health experience as a student (which is limited to a 3-week placement and is variable in content) and working in a psychiatric setting. RCPsych and HEE recommend that all mental health organisations employing PAs implement an inceptorship programme based on the work carried out at SHSC. These should comprise of regular, protected sessions that provide PAs with bespoke mental health training to support their integration into psychiatric multidisciplinary teams. HEE have agreed to provide funding to help organisations facilitate it.

Physician associates (PAs) are becoming more commonplace in psychiatric services in the UK to help address long term workforce difficulties. The 2019 NHS Long Term Plan detailed a commitment to transforming mental health care in England recognising that services were not meeting current or future increase in demand. Health Education England's (HEE) report, Stepping Forward to 2020/21: The Mental Health Workforce Plan for England, described a longer-term strategy to expand the mental health workforce, including recruiting 5,000 people into ‘new roles’ including physician associates. The NHS Mental Health Implementation Plan 2019/20–2023/24 stated an aim of recruiting 140 PAs to the workforce over five years in addition to the requirements specified in the HEE report. Competence frameworks make the link between evidence and practice and can be a valuable basis for training, an agenda for supervision and a guide for self-monitoring and personal development for people working in the role.

The competence framework was developed by the National Collaborating Centre for Mental Health (NCCMH). The work was overseen by an expert reference group, comprising experts in training PAs in mental health, PAs, researchers and experts by experience, all selected for their expertise in research, training and service delivery. The completed framework was then sent to relevant stakeholders including the Faculty of Physician Associates and patient groups for comment and adapted accordingly.

The completed framework has been arranged into seven domains: Knowledge of Mental Health, Professional/Legal Issues, Engagement and Communication, Diagnostic Assessment and Treatment Planning, Interventions, Team Working and Metacompetences. This reflects the expected roles and responsibilities of PAs working in mental health.

The Competence Framework for PAs will help those involved in mental health care services who wish to deepen their understanding of the PA role, and will be useful to team members working with PAs, to their managers and to commissioners. It will support the work of PA supervisors and peer coordinators, and those delivering education and training to them. It also brings a level of standardisation of the role. More work will be needed to adapt the Competence Framework for PAs for specialist contexts, such as in dementia care or children and young people's services.

Physician associates (PAs) are becoming more commonplace in psychiatric services in the UK to help address long term workforce difficulties. The 2019 NHS Long Term Plan detailed a commitment to transforming mental health care in England recognising that services were not meeting current or future increase in demand. Health Education England's (HEE) report, Stepping Forward to 2020/21: The Mental Health Workforce Plan for England, described a longer-term strategy to expand the mental health workforce, including recruiting 5,000 people into ‘new roles’ including physician associates. The NHS Mental Health Implementation Plan 2019/20–2023/243 stated an aim of recruiting 140 PAs to the workforce over five years in addition to the requirements specified in the HEE report. A curriculum for PAs working in mental health would set out the competencies required to work in mental health services.

The curriculum was developed by the National Collaborating Centre for Mental Health (NCCMH). The work was overseen by an expert reference group, comprising experts in training PAs in mental health, PAs, researchers and experts by experience, all selected for their expertise in research, training and service delivery.

The overarching aims and objectives of the curriculum was to convey a practical understanding of the attitudes, knowledge and skills that underpin the role, thus enabling PAs to offer effective and value-driven support to patients.

The completed curriculum has been arranged into seven modules: Knowledge, Professional/Legal Issues, Engagement and Communication, Diagnostic Assessment and Treatment Planning, Interventions, Managing the Interface of Mental and Physical Health and Team Working. This reflects the expected roles and responsibilities of PAs working in mental health.

HEE and the Royal College of Psychiatrist have recommended all mental health organisations implement an educational programme for new PAs. The curriculum will inform the training requirements for PAs and standardise the training they receive from mental health organisations. It should support the work of PA supervisors and peer coordinators, and those delivering education and training to them. The curriculum will be a dynamic document and work will be needed to adapt it as the role changes, for example with incoming regulation and potential prescribing rights that follow.

Emotional intelligence is crucial for medical professionals. Medical interns are expected to have a high degree of emotional intelligence to face their professional career challenges. Emotional intelligence, often measured as an emotional quotient (EQ), is the capacity to recognize and regulate emotion in oneself. It enables one to monitor own feelings and emotions and others; and guide decisions and actions, and is crucial to ensure a successful work-related outcome or good performance. A higher EQ enhances physician and patient well-being, increases patient safety and augments healthcare teamwork. However, studies about EQ among medical interns are lacking. Therefore, this study intended to determine the level of EQ among medical interns in Malaysia and its associated factors.

This nationwide cross-sectional study recruited new medical interns reporting to 17 randomly selected Malaysian hospitals accredited for medical intern training from January to April 2020. They were invited to answer an online questionnaire incorporating USMEQ-i to measure EQ, Connor-Davidson Resilience Scale-10 items (CD-RISC-10) for resilience, Brief-Cope to assess coping styles, PHPQ to assess internship preparedness, DUREL for religiosity, and questions related to sociodemographic and undergraduate training.

A total of 524 from 619 medical interns responded. Mean (SD) EQ score was 3.08(0.58). Significant factors positively associated with EQ include resilience score (adjusted b = 0.65, 95% CI 0.58, 0.72, p <0.001), preparedness for internship (adjusted b = 0.11, 95% CI 0.09, 0.13, p < 0.001), approach-style coping (adjusted b = 0.17, 95% CI 0.11, 0.24, p <0.001), and religiosity (adjusted b = 0.09, 95% CI 0.01, 0.17, p <0.001). In contrast, avoidant-style coping (adjusted b=−0.19, 95% CI –0.28, 0.11, p <0.001) is negatively associated with EQ. Adjusted R2 of 67.6% substantiated the goodness of fit of the regression model.

This study showed that there are a few modifiable factors that significantly influence EQ among medical interns; namely resilience, coping style, preparedness for internship, and religiosity. There is a positive association between EQ and approach coping style, and a negative relationship with avoidant coping. Approach coping encapsulates constructive responses to stress such as positive reframing, acceptance, seeking helpful information, and reaching for emotional support, while avoidant coping includes self-distraction, denial, venting, substance abuse, behavioural disengagement, and self-blame. These significant factors in this study such as coping and resilience can be learned and taught as a skill. These findings will aid medical schools to design programmes and improve the medical education to increase EQ among medical students who will become better medical interns and doctors in the future.

Following 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.

All 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.

44 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.

Response 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.

Simulation (sim) is an excellent but underused tool suited to key skills in psychiatry such as communication, managing agitated patients and exploring the mental-physical health interface. Access to complex psychiatric patients has always been challenging and this has been exacerbated by the current COVID-19 pandemic. This has further increased fear amongst students creating another barrier to engaging with psychiatric patients. Our aim of the study was to evaluate the use of simulation within psychiatry as the literature in this field is underrepresented compared to other medical specialities. We hope to advocate its use in future undergraduate training.

We developed 3 simulated scenarios for fourth year medical students; these involved identifying lithium toxicity and steroid-induced psychosis in ward settings and conducting an A&E risk assessment. The scenarios were developed following feedback from a focus group of foundation doctors on their psychiatry rotations. Data were collected pre- and post-simulation from a cohort of psychiatry students in this academic year. We assessed confidence levels in 7 domains using a 10-point Likert scale and obtained qualitative data to give context to the data collected.

81 and 83 students respectively completed the pre and post questionnaires. Quantitative data found that the student's confidence in all domains improved from pre to post simulation training. For example, confidence in performing a risk assessment improved from M = 4.12 to M = 7.04 and in making a basic management plan from M = 3.43 to M = 6.72. Qualitative data looked at skills gained, empathy and how the scenarios related to clinical practice. Key themes found improvements in de-escalation skills, handing over and self-reflection.

The study supports the evidence that high-fidelity simulation is an important education tool in psychiatry. As facilitators, we feel that confidence scores improved due to the debrief. The standard tool often used is the diamond debrief however we found we had to adapt this model due to fourth year students not having developed sufficient skills to reflect on complex psychiatric scenarios. Therefore, an adjusted debrief was developed featuring technical knowledge and constructive feedback. In the future, we hope to explore the long-term benefits of simulation and its impact on clinical practice.

The 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.

We 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.

Of 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”.

Our 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.

Generation 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.

Short 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.

The 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.

A 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.

In the face of constant and rapid changes in the landscape of medical practices especially psychiatry, innovation and creativity are essential competencies for all trainees to remain future-proof and competent in facing the future healthcare-related challenges. Recognising this, the General Medical Council (GMC) has highlighted the need for trainees to undertake any form of quality improvement initiatives to improve patients’ care, which trainees can struggle with. This article is aimed to share the authors reflective experience on how to improve their creativity during their training in psychiatry.

This is a self-study based on the authors’ personal reflections on experiences on promoting innovation and creativity in academic and non-academic work.

One of the beginning points of learning how to be creative is to learn from others on how to formulate a question that can be answered using research. It can be achieved by reading journals, attending conferences, and watching up-to-date webinars. By modelling others, their ideas can be translated to local practice through adaptation which essentially involves the process of innovative work. Once a person has become more adept in asking questions, deliberate observation in clinical practice helps to consolidate creativity and ideas. With an appropriate level of curiosity, everyone's experience can potentially be transformed into research questions. Effort needs be invested to review available literatures. This will help to construct a clear picture of what is available and what is the gap that has yet to be filled in, i.e., the opportunity of improvement through innovation and creativity. Working in groups allows collaborative problem-solving approaches, which is a good platform to spark new ideas. It is common to encounter obstacles and pitfalls where perseverance is crucial as a trainee can explore alternative ways of problem-solving, which again is a source of innovation.

From the experience of the authors, a broad-based creative exploration is helpful at the initial stage and further narrowing of focus once a creative idea has taken off is important to ensure the vision of a project is achieved. Erich Fromm once said creativities requires the letting go of certainties. The core nature of psychiatry, i.e., the uncertainties is not a limitation but an opportunity to be capitalised. Rather than telling ourselves what is not possible, ask the question of “how can I do this differently”.

Many of the competencies that trainees in psychiatry are required to achieve can be linked to leadership in the broadest sense, yet specific training is not often systematically provided. The West Midlands Psychiatry Leadership Development Programme aims to support the acquisition of important leadership skills already set out in the curriculum through provision of high-quality specialist leadership content within the existing programme. Here we present the findings of a scoping exercise exploring the views and attitudes towards leadership training held by higher trainees in psychiatry within the West Midlands.

All psychiatry higher trainees within West Midlands Deanery were invited to complete an anonymous online survey using Survey Monkey in November 2021. This survey incorporated questions about their preferred learning styles, confidence in their leadership skills and barriers to accessing leadership opportunities, generating both quantitative and qualitative data.

Key results included:

• • 37 responses were received. All subspeciality training programmes were represented. Almost half of respondents (46%) were ST6 or above and most were in training full time (84%).

• • Trainees expressed a preference for experiential learning about leadership (87%) as well as small group teaching (62%) and interactive workshop style content (62%).

• • Awareness of leadership opportunities was typically via their peer group (81%) or clinical supervisor (60%). Only 52% of trainees were aware of leadership opportunities within the Deanery.

• • Only 54% felt that existing leadership training met their curriculum requirements. Less than half of trainees (46%) felt confident to evidence their leadership experience within their training portfolio.

• • One-fifth of trainees (21%) reported experiencing barriers to leadership development. These included: inadequate awareness of opportunities, lack of senior support, time constraints and difficulty matching interests with available opportunities.

Trainees expressed interest in the redevelopment of a regional leadership training programme which would support them to achieve their curriculum competencies and prepare them for life as a consultant psychiatrist. The new multi-faceted regional leadership programme will offer resources in a variety of formats including webinars, podcasts, optional interactive workshops and action learning sets. It is hoped that this flexible programme, linked to the Medical Leadership Competency Framework, will better meet the needs of higher trainees as they pursue their own personal leadership journeys.

Whilst psychiatry training is both demanding and enjoyable, we feel that the theory does not fully capture what we see in our everyday work. For many of our patients, it fails to contextualise their experience within their socio-politico-economic environment. Working with patients with different ways of seeing, knowing and being necessitates an awareness of one's own and the other's sociocultural world in order to build an empathetic and empowering doctor-patient partnership.

We started a CPG with the hope of exploring resources from those whose perspectives are often left out of our training experience, with a view towards integrating these voices together with our clinical experiences and training program. We aimed to create a space where we could regularly explore the experiences of ourselves, our patients, and the societies in which we work, reflecting on the conscious and unconscious roles we inhabit.

Our aims for the space were to: recognise that everyone will have something valuable to contribute. Cultivate a space where people feel able to share openly. Maintain the safety of the space through compassion and accountability. - Show willingness to be uncomfortable but continue engaging in order to learn together.

In Spring 2021, four Core Psychiatry Trainees from BSMHFT met together to plan a trust-wide CPG. There were three clear cycles of CPG meetings, the first consisting of member led sessions, the second outside speaker led sessions and the third an amalgamation of the two. Meetings were continually reviewed throughout each cycle with more formal evaluation and alteration at the end.

The first part of the discussion focuses on what went well with the themes being:

• – Developing habits of lifelong learning

• – Developing relationships with peers and the community

• – Creating space for self and group reflection

• – Developing transferable skills (leadership, management, teamwork).

• – Technology

• – Communication

• – Engagement

• – Management.

At an individual level, this experience has been challenging but rewarding and we have received overwhelmingly positive feedback. Locally, the BSMHFT CPG has been invited to work with our trust on their “inequality strategy”, as well as universities and organisations represented by outside speakers. Nationally, the blueprint laid out in our conclusion aims to help those wanting to set up a similar group in their area benefit from our experience.

Core trainees in psychiatry all complete a year of Balint group sessions. These sessions are invaluable, as improved awareness of our own thoughts and feelings is a crucial part of our development as clinicians. We considered that it may have been helpful to have started these sessions at an earlier stage of medical training, for example, in medical school.

We approached the University of Liverpool School of Medicine and proposed a pilot Balint programme with 4th year medical students rotating through psychiatry in Cheshire Wirral Partnership Trust.

Sessions were conducted in 4-week blocks, corresponding with the students’ psychiatry rotations. To allow sufficient time for all students to contribute in each hour-long session, groups were limited to a maximum of 7 students. Each group was allocated 2 facilitators and was conducted on Microsoft Teams because of COVID-19-related restrictions. Facilitators had fortnightly supervision with a consultant psychotherapist.

At the end of each 4-week block, anonymous feedback was collected. Small alterations were made to the programme during the course of the pilot in response to attendance rates, punctuality and feedback.

18 (approximately 50%) of the students from the first 3 cohorts submitted feedback:

• • All said the experience helped them reflect more on their interactions with patients and colleagues and improved their insight into how others think/feel in caring for patients.

• • 94% said they enjoyed it; they thought they would use the skills they had developed; and they would participate again in future if given the option.

• • 83% said 4 sessions was ‘just right’, 11% said ‘not enough’ and 6% said ‘maybe too much’;

• • 72% rated their overall experience of the programme as ‘excellent,’ 17% as ‘good,’ 11% as ‘fair’.

As facilitators, the experience has helped us increase our reflective capacity and gain confidence in leading, managing group dynamics and setting boundaries.

Student experience of the Balint programme was positive for the majority. From a facilitator perspective, we found the experience rewarding and beneficial for professional development. Currently only approximately 1/3 students rotate through this trust and can therefore benefit from the sessions. This pilot study provides supporting evidence for extending the scheme to all 4th year Liverpool University medical students.