This paper introduces a new approach to producing case formulations, the integrated case formulation (ICF) approach, and a rating scale, the Case Formulation Scale (CFS). Twenty-four psychiatrists participated in a single-blind randomised controlled trial to evaluate the effectiveness of teaching using this new approach. The intervention group (n = 12) received teaching about using ICF, whereas the control group (n = 12) received teaching as usual. The scores on the CFS were compared before and after teaching.

Prior to teaching, psychiatric trainees had poor scores on the CFS. The CFS score for the group taught the ICF approach improved five times more than the control group.

This study demonstrates that case formulation skills can be taught. With further improvements, the ICF approach might be useful in the teaching of case formulation.

Newly appointed consultant psychiatrists have reported that management and leadership is an area for which they are unprepared. Our aim was to evaluate the impact of a leadership development programme based on the principles of ‘action learning’ for higher trainees. A questionnaire survey was sent to 54 trainees and consultants who had attended the programme. Qualitative interviews were conducted with 15 participants using the concept of maximum variance sampling.

The relevance of the topics covered, the opportunity for free discussion and increased understanding of National Health Service policy were rated highest. At the end of a thematic analysis, themes were organised into four major categories: (a) lack of engagement with management during training; (b) the lasting impact of the leadership development programme; (c) understanding the larger organisational context; and (d) transition to consultant psychiatrist.

The findings suggest that programmes such as this can be successful in raising awareness and increasing engagement in medical leadership and management.

To determine knowledge, skills and confidence of junior medical emergency department staff in managing mental health patients. Over a 2-year period new emergency department junior doctors were given a questionnaire to complete early on in their post and prior to any mental health training. The questionnaire asked about knowledge, confidence, concerns and skills in the management of mental health patients in accident and emergency services.

More than half of the 32 doctors surveyed said they lacked knowledge, skills and confidence when assessing mental health patients.

The survey has demonstrated a need for mental health training of new doctors working in the emergency department. Effective training for such doctors can be offered by a liaison psychiatry service. This should be embedded in their teaching programme and be continually responsive to their perceived training needs.

To examine the documentation regarding patients driving while under the care of a crisis resolution team and whether advice is being given by all members of the team. An audit was carried out looking at the case records of patients and information was collated about whether they had been asked if they were driving and whether any advice had been given. Following the audit there was a team presentation and guidelines distributed. The audit was repeated 6 months later.

The first cycle of the audit included 58 patients. There was documentation about driving for two patients and appropriate advice given for one. The second cycle included 53 patients. There was documentation about two patients and advice given for one.

Patients are not being asked whether they drive and advice is not routinely being given despite clear guidelines. Further research is needed to look at interventions at a local level that could improve this.

Portfolios are now used extensively within the field of psychiatry and our aim was to obtain trainees' feedback on their value. We used a questionnaire to evaluated trainees' priorities, what educational tools they found most helpful, how much time trainees spent on preparing their portfolios and the best and worst aspects of the portfolios.

The survey was completed by 207 out of 228 trainees (90.8%). The majority (58.4%) rated ‘Passing the ARCP [Annual Review of Competence Progression]’ as their top priority. More trainees found benefit from the feedback of workplace-based assessments (33.3%) than the ratings given (24.1%). Time spent on portfolios on a weekly basis ranged from 5 min to 12 h (the most common answer was 1–2 h). A total of 50.7% felt they did not have enough time to spend on their portfolios. Many found it encouraged reflective practice, but wanted more training for both trainees and trainers on how to use them properly.

The expansion of portfolios within the changing National Health Service requires careful planning and training, and perhaps some allocated time to complete them, so that trainees can derive the maximum benefits from the portfolio's intended purpose.

To test whether medical students find case-based discussion of child psychiatry more educationally stimulating and more enjoyable, and whether this leads to greater knowledge acquisition than traditional didactic lectures. Four cohorts of Cambridge medical students (n = 54) were randomised to case-based discussion or traditional didactic lectures for two topics in their psychiatry placements. Enjoyment and stimulation were determined by feedback forms; knowledge acquisition was tested by an end-of-placement exam.

Students in case-based discussion groups scored significantly higher than students in the lecture groups in the extent to which they enjoyed the teaching session (P = 0.006); the extent to which they understood the principles of management of real-life patient problems (P = 0.044); and their interest in looking up further information (P = 0.003). There was no significant difference in exam performance (P = 0.9).

Medical students find case-based discussion more engaging and enjoyable than didactic lectures, with no reduction in exam performance.

Students at St George's, University of London, complete a long case with a reflective component as part of their psychiatry attachment. This consists of a case history and reflection about how meeting the patient has affected them and how it will change their practice. This study aimed to analyse the reflection content, to better understand the student psychiatry experience. A hundred consecutive assignments underwent content analysis to establish the main themes.

Six main themes were elicited: stigma, social and cultural aspects of psychiatry, fear of mental illness in the students themselves, fear of conducting the interview and criticism of the care the patient received.

Negative attitudes towards psychiatry are common among medical students, although many showed mature reflection. Anxiety about interviewing patients with mental illness should be acknowledged by educators.

To gather opinion from trainees across England about their current experiences and future career plans. This was done via an internet-based survey.

Out of the 359 responses we received, 65.8% of trainees planned to stay in psychiatry until retirement. Trainees felt several issues were problematic, including the attitude of other specialties towards psychiatry, perceived substandard treatment of psychiatric patients by other specialties and implications of New Ways of Working.

Despite there being many areas of training respondents were happy with, if attrition is to be minimised, issues such as how psychiatric trainees integrate with the other medical specialties and how the role of doctors in the specialty is perceived need to be addressed.

The law allows courts to exclude evidence from police interviews if it is obtained unfairly or would have an adverse effect on the fairness of proceedings. The assessment of a detainee's fitness to be interviewed is therefore of paramount importance. We surveyed 70 psychiatrists in higher training within the Yorkshire and Humber Deanery to ascertain their current understanding of this clinically important task. The psychiatrists' level of training received and awareness of local employee guidance in relation to their responsibilities in this field was investigated. We then piloted an interactive teaching session aimed at improving knowledge in this area and gained feedback from attending higher trainees.

There was a 64% response rate to the survey before implementation of the teaching session. The survey found that half of all respondents had been asked to carry out a fitness to be interviewed assessment at some point in their higher training. Only a third of the respondents had attended formal teaching in this area, and only a fifth were aware of local employee guidance. All the trainees who attended the pilot teaching session felt it was beneficial to their future clinical practice.

It is imperative that all the higher training schemes in the country incorporate training in this field to help satisfy the Royal College of Psychiatrists' intended specialist trainee learning outcomes and, more significantly, to avoid potential miscarriages of justice.

To create a simulated patient with psychosis for psychiatric training within the online virtual environment of Second Life. After design and delivery of the scenario, medical students were asked to complete it and provide feedback.

A total of 24 students tried the scenario and gave feedback via an online survey. The project had been offered to 150 students so the take up was low. The feedback was predominantly negative with 53 critical responses to 32 positive ones. The consensus was that the scenario was cumbersome, did not imitate real life and was of little educational value. Multimedia representations of psychotic symptoms were more positively received and there may be scope for further development.

Interactive technology has a role in psychiatric education but we would not recommend the use of scenarios that rely predominantly on verbal communication within Second Life.

The assessment of capacity is integral to all areas of medical practice; however, research has shown that doctors in many specialties have inadequate knowledge about both the Mental Capacity Act and the Mental Health Act. In this study, 39 trainee doctors and 49 fourth-year medical students completed an e-learning package, which included a pre- and post-evaluation of knowledge of the Mental Capacity Act and confidence in the use of this act.

In comparison to pre-intervention scores, trainee doctors and students displayed a statistically significant improvement in knowledge and subjective confidence.

The e-learning package is an effective educational tool for improving knowledge about the Mental Capacity Act for trainee doctors and could be included as part of induction training for all foundation doctors as well as being considered for use in the induction programme of other trainee doctors. It is an effective tool for educating clinical medical students about the Mental Capacity Act.

Non-medical staff are eligible to assess trainee doctors through mandatory workplace-based assessments (WPBAs). An anonymous questionnaire was given out to non-medical staff working with trainees in community and in-patient settings at Royal Blackburn Hospital. Our aims were to look at their awareness of and familiarity with assessor guidance, trainee competencies, training needs and assessors' views on completing these assessments.

In total 118 of 150 (79%) individuals returned a questionnaire and 89 WPBAs had been carried out. Most assessors were Band 6 (or equivalent) or below (53%). Most assessors had neither read any assessor guidelines (75%) nor were familiar with the competencies required of a doctor (76%). Although 79% felt that non-medical staff should be assessing trainee doctors, only 44% felt comfortable doing this. None had been trained and 92% felt this would help. Twenty WPBAs (excluding mini-peer assisted tools) were carried out by staff at Band 6 or below.

No respondents received guidance or training on being an assessor. This highlights the need for urgent action and delivery of training. This can easily be adapted from training packages developed for medical staff.