Aims: The culture of psychiatry in the UK is deeply rooted in Western biomedical paradigms, raising questions around its ability to meet the needs of culturally diverse patients. Literature consistently demonstrates that individuals from diverse backgrounds experience disproportionately poorer mental health outcomes, highlighting the need for a more culturally responsive approach to care.

This research examines how the concept of 'cultural competence’ is understood by current trainee and consultant psychiatrists, through the retelling of their experiences of navigating culture in the clinic.

This research aimed to (1) explore perspectives of UK psychiatrists of navigating culture in the clinic, and to (2) evaluate the effectiveness of the current postgraduate psychiatric curriculum in fostering cultural competence.

Methods: Employing a narrative inquiry approach, the primary source of data was collected through open interviewing to promote the process of storytelling. Three clinicians of various clinical grades were recruited, and five narratives extracted for analysis. Data was analysed using Labov’s method of structural organisation.

Results: The findings demonstrate that clinicians consistently frame their encounters with cultural diversity as challenging, often conceptualising them as conflicts to be overcome. Three core competencies for effective cross-cultural practice emerged:

1. 1. Curiosity and openness.

2. 2. Polycultural practice.

3. 3. Critical evaluation of resources.

These competencies informed the development of a new proposed model of cultural competence designed to guide educators in fostering these qualities in psychiatric trainees.

Conclusion: The findings highlight a significant gap in the existing postgraduate psychiatric curriculum, suggesting that current medical education frameworks are insufficiently aligned with the demands of a multicultural society. The study advocates for comprehensive curricular reform that starts with a shift in the underlying conceptual frameworks of psychiatric education, encouraging practitioners to adopt a more holistic, culturally sensitive approach to mental health care. Only once this conceptual foundation is established can practical reforms effectively follow, ensuring that trainees develop not only technical competence but also the cultural insight necessary for inclusive, empathetic care.

Aims: An interprofessional educational intervention integrating case-based teaching was introduced to the multidisciplinary team (MDT) of two acute adult inpatient wards aiming to improve understanding, compassion and team dynamics through protected time for reflection, learning and social collaboration.

Methods: All MDT members were invited to a monthly 90-minute teaching session for a period of 7 months. Attendees could join in person or online. Sessions were primarily led by 2–3 MDT members from different professional backgrounds e.g. doctor, psychologist, and pharmacist. Two of the sessions included external presenters on specialist topics including eating disorders and substance misuse.

Sessions were split into: A Case Presentation on a current inpatient; A Topic Presentation on a subject linked to the case.

Feedback was collected anonymously on paper forms and emailed to online attendees following each session. Likert and free-text questions were used to gather feedback on teaching content, style, quality, relevance, and value. Following the final session, feedback was collected about the overall programme and presenters were asked to provide feedback on their experiences collaborating with colleagues. Likert items were analysed using Microsoft Excel and a basic thematic analysis was undertaken for free-text questions.

Results: On average, 13 professionals attended in-person and 3 online per session. Attendees included resident doctors, consultant psychiatrists, nursing staff, physical health nurse practitioners, psychologists, pharmacists, occupational therapists, support workers, activity coordinators and speech and language therapists. The average session ratings were 9.8/10 (1 – poor,10 –excellent) for usefulness and 9.75/10 for content, relevance, and teaching skill. Attendees who provided feedback on the overall programme (n=13) found it extremely valuable and wished for the sessions to continue. Five themes were identified: improved accessibility to teaching, shared perspectives, better understanding of professional roles, improved patient understanding via case-focussed teaching and reflection, and team building. Presenters (n=7) found the experience very or extremely valuable and they would recommend it to colleagues.

Conclusion: This interprofessional case-based teaching programme was successfully integrated within the acute inpatient setting. Effective interprofessional collaboration can be a key mechanism for improving service delivery, patient care and safety, and enhancing teams. Attendees found it beneficial discussing challenging/complex cases, improving their understanding of patients’ difficulties and colleagues’ roles. The sessions allowed attendees to reflect on cases with colleagues, sharing experiences and learning from one another positively impacting professional relationships. It would be useful for objective measures to be integrated within future research design to quantitatively measure changes in outcomes such as compassion, empathy, burn-out and teamwork.

Aims: International Medical Graduates (IMGs) make up more than half of new recruits in the NHS and recent data shows that there is an increased likelihood of IMGs being referred to the General Medical Council (GMC) for fitness to practice investigations. Analysis of these complaints highlighted communication skills as an area of concern. We wanted to support relatively new IMGs, who started practicing in the country within the last 2 years, by enhancing their communication skills.

Methods: To deliver this initiative, medical education department, trust IMG tutor and two higher trainees (with recent lived experience as an IMG in the NHS) partnered with Talking Allowed (communication skills training company for healthcare professionals). 12 IMGs registered and were offered 5 half day online and 1 day face to face training using a mixed model of activities related to all aspects of communication – verbal, non-verbal and written. We ran role plays on: ‘Managing an upset relative’, ‘Breaking Bad News’, ‘Misunderstandings and Colloquialism’, ‘Dealing with disagreement/ conflict within the team’ and ‘Challenges to professional boundaries’.

During role plays, prior to candidates’ attempt, a ‘how not to do it’ version was acted out by the higher trainees followed by the enrolled participants going next. Each role play was further followed by reflective feedback sessions facilitated by PM, LH & RB to identify and reflect on positive as well as areas for improvement. Through the course one session focused on written communication, with homework and best practice guidance provided prior to the session. At the last session, there was a didactic presentation and discussion on acculturation with opportunities to reflect. Feedback was gathered at every session from the attending IMGs. 7–8 trainees engaged through the process, 2 dropouts and 2 non-engagements.

Results: 97.1% (n=35) rated the sessions as ‘highly engaging’ (on a scale of 1 to 4), 100% rated the sessions as ‘highly relevant’ (n=36); 91.4% (n=35) rated the course as ‘highly useful’. Compared with at the start of the course, subjective confidence in communication of participants improved by 2 points in a scale of 0 to 10. Initial score 6.8 and final score 8.8 (signifying 20% increase).

Conclusion: Focused communication skills training involving a mixed method of role play using simulation principles, complemented by general reflective exercises on communication especially in a cultural and emotional context as well as some reflection on the personal experience and the known intelligence on immigration and acculturation can be an invaluable tool for IMGs.

Aims: Demand for child and adolescent mental health services (CAMHS) in Northern Ireland (NI) has steadily increased in recent years. Currently, over 50% of families are waiting beyond the recommended nine-week target for assessment. A regional 10-year workforce review outlined the need to expand the CAMHS workforce by 102%, with specific focus on succession planning for psychiatrists. This highlights the need to fill vacant Child and Adolescent Psychiatry (CAP) higher training posts.

By hosting a recruitment event, we aimed to provide information regarding the application process to higher training in CAP and increase exposure to the breadth of career opportunities available. Longer term aims are to sustain recruitment into higher specialty training and bolster the consultant workforce.

Methods: The event was delivered as a two hour in-person meeting. Demographic information and anonymous feedback were collected via Microsoft forms. The programme included presentations from current higher trainees, consultants and the Training Programme Director. Topics covered included the following:

Application and interview process.

Structure of training including on-call rota arrangements.

Day-to-day experience of a consultant covering a step three community CAMHS post.

Overview of specialist service provision in CAMHS including eating disorder, autism and CAMHS intellectual disability services.

The event also provided opportunity for networking and an open-ended question and answer session.

Results: The event was attended by six local core psychiatry trainees. Four attendees had previously worked in a CAP post, whereas two had no CAP experience or only out of hours exposure to the specialty. All attendees ‘strongly agreed’ that the event had increased their knowledge about the opportunities in CAP in NI. Five attendees ‘agreed’ that the event had strengthened their aspirations to train in CAP with one attendee responding ‘strongly agree’ to this statement.

Conclusion: This was the first CAP higher training recruitment event hosted in NI. Although the number of attendees was small, feedback was overwhelmingly positive. Following a year without any regional recruitment into CAP, there have been six applicants for one post advertised for August 2025. Whilst a direct causal relationship cannot be established, we hope that this event reinforced aspirations to pursue this career path. Given the current vacancies across the CAMHS workforce, there is an opportunity to expand this event to include other members of the multi-disciplinary team, to equip the future workforce for the rising demand in services.

Aims: Developing core psychotherapy knowledge and skills is considered a key part of the Royal College of Psychiatrists curriculum. This cross-sectional study aimed to evaluate the current provision of psychotherapy teaching and supervision for core trainees within South-West London and St George’s Trust, identifying key concerns and proposing improvements to enhance the training experience.

Methods: 27 trainees participated in a trust-wide questionnaire, achieving a 58% response rate amongst core trainees in years two and three. The questionnaire was conducted online using Microsoft Forms, with a link distributed via email, including multiple-choice and open-ended questions, and focusing on the feelings trainees have towards psychotherapy teaching as well as the benefits and challenges they have observed. Data were analysed using Microsoft Excel and a thematic approach.

Results: A general feeling of anxiety was described by many, with some trainees describing the current system as “frustrating and disheartening”. Other key themes were the perceived lack of preparedness before starting psychotherapy cases, variation in expectations of supervisors and case allocation delays. 87.5% of trainees felt they lacked sufficient knowledge in psychotherapy before starting short-cases, 72% for long-cases. 56% stated they were providing or planning to provide sessions out of their working hours. Reasons given included fears of upsetting the patient, not providing continuity of care during their annual leave or zero days and not being able to complete their case in time for training requirements. 11% were dissatisfied with their short-case experience, 50% with their long-case experience. 61% of participants felt they would benefit from private therapy themselves, to support them during the process.

Conclusion: Results highlight concerns that trainees can have in psychotherapy training, which are being addressed locally but can also have relevance for other training programmes and practices. The perceived lack of adequate teaching prior to starting cases is striking, and could pose potential risks to patient safety. The high numbers of trainees who report offering therapy outside working hours poses risks to trainee well-being, as well as insurance coverage and patient safety. This study also revealed how a large proportion of trainees believe they would benefit from being offered personal psychotherapy, something that is not routinely offered in training. Enhancing psychotherapy training with timely, comprehensive and structured support, whilst also considering trainee wellbeing, could lead to improved educational impact, benefiting both trainee professional development and ultimately patient care.

Aims: Following the recent passage of the Terminally Ill Adults (End of Life) Bill (2024) through UK Parliament, we set out to understand the views of psychiatrists towards assisted dying and the nature of their education in this area.

Methods: We selected 2 previous surveys. Using a pragmatic group, we developed a survey based on previously used questionnaires in this area. We gathered demographic data including religious affiliation, and country of primary medical qualification. We surveyed 44 psychiatrists in total.

Results: 27% had experience of undergraduate education on assisted dying euthanasia while 11% postgraduate education.

We adapted a survey form to measure attitudes towards euthanasia, giving a score out of 16. 31% scored 0 (with very positive attitudes to euthanasia), 11% scored 16 (very negative), and the median was 2. Participants with negative attitudes to euthanasia had a higher degree of religiosity, were more likely to train outside of the UK, but had similar age distribution to the general population.

The second part of the survey looked at euthanasia in psychiatric patients. Only 14% agreed that it should be allowed for psychiatric illnesses, with 27% unsure and 59% opposed.

The most acceptable statement (86% agreement) was that psychiatric patients can find themselves in a medically hopeless situation. 75% agreed that psychiatric patients could suffer unbearably. 70% agreed that psychiatric patients may run out of treatment options.

Participants opposed to euthanasia also opposed it in psychiatric patients. They were more likely to doubt the above statements, but only one participant disagreed with all statements. Most disagreed with the statement that “a death request can be well-regarded and considered not only as a symptom of illness” (66%).

Of participants in favour of euthanasia in general, 42% said they were unsure of legalising euthanasia for psychiatric patients, while 21% were opposed. This group was more uncertain of the statement that “euthanasia assessment can be compatible with psychotherapeutic relationship” (50% disagreed or unsure).

Most participants had little education in this area. International Medical Graduates and those self-described as religious were more likely to have negative perceptions of assisted dying in general. While there was agreement that suffering from mental illness could be unbearable, very few supported euthanasia for mental illness alone.

Conclusion: There is a notable lack of education on euthanasia at both undergraduate and postgraduate levels which is known to have a strong influence on attitudes to assisted dying. There are aspects in medical ethics and medical law which need to be incorporated into curricula for medical training.

Aims: To establish if there is data to support the clinical impression that people with ASD are more likely to experience perceptual disturbances (visual and auditory).

Methods: Literature search using Athens/Pub Med. Clinical observations had been that young people with ASD seemed to experience increased perceptual disturbances but that these did not respond to antipsychotics. Detailed history taking also suggested that, especially visual hallucinations, were often long-standing and had started in mid childhood (typically while at primary school). These tended not to cause distress initially but often increased during adolescence.

Results: There is little specific data on this subject: there are numerous studies and case reports considering the increased risk of psychosis and schizophrenia in people with ASD but not specifically on non-psychotic young people with ASD who have perceptual disturbances (in the absence of other symptoms suggesting psychosis). Limited data that was available noted that people with ASD were 3 times more likely to experience auditory and/or visual hallucinations than their counterparts. Suggested pathways for this included shared pathological pathways (between schizophrenia and ASD), overlapping DNA (not established), that ASD is a risk factor for later development of schizophrenia and living with ASD may incur increased social stressors (bullying, exclusion, marginalisation, isolation etc.).

Conclusion: Having ASD does appear to increase the likelihood of experiencing (psychotic and non-psychotic) perceptual disturbances. The reasons for this are largely inconclusive but may explain our clinical impression; that young people with ASD who are hearing voices or seeing things but who are not psychotic, do not appear to respond positively to antipsychotics. We would advise medications are used with caution in this (non-psychotic) patient group and that other avenues are considered for treatment, including self-help, psychoeducation and psychological support. We must be cautious about causing iatrogenic harm and over medicating. More research is needed in this field.

Aims: Following the approval of the Assessment Strategy Review (ASR) in February 2023, the Formative Assessment Working Group (FAWG) was created to discuss areas for consideration, in relation to formative assessment.

The aim was to consider the broad range of the College’s assessments, including written examinations, the Clinical Assessment of Skills and Competencies (CASC) and formative assessments undertaken throughout psychiatric training in the workplace. Whilst the ASR had a broad scope, one of the recommendations was to review formative assessment in detail, due to the varied nature of specialty and sub-specialty specific assessments and the differing experiences of resident doctors in the workplace.

Methods: The Formative Assessment Working Group (FAWG) met throughout 2023 and identified four specific areas for further consideration, development and implementation:

The introduction of enstrustability scales; a behaviourally anchored ordinal scale based on progression to competence, as part of workplace-based assessments (WPBAs).

Embedding formulation skills throughout training.

The introduction of feedback from patient and carers for resident doctors.

Consideration of guided supervision sessions relating to caseload-based discussion.

Results: Entrustability scales as part of WBPAs: An entrustability scale (ES) would not be suitable to all assessment types. Therefore, an adaptation of ES will be introduced to CS and ES reports. WPBA will see an improved version of the current Likert scale. Embedding formulation skills throughout training: Formulation training will be incorporated into case presentations. Resident doctors will be advised to undertake this yearly to demonstrate progression. For ST4+ trainees, one case-based discussion (CBD) will be replaced with a case presentation (CP), with the provision of presenting to MDTs. Introduce feedback from patients and carers for resident doctors: Resident doctors will be expected to collect one set of Multisource feedback (MSF) responses during core training and at least once per speciality training year. This will apply across all psychiatric specialties, including those who undertake dual training. The feedback should also form part of ARCP considerations. Introduce guided supervision session relating to caseload-based discussion: Direct Observation of Non-Clinical Skills (DONCS) will now feature HLOs 1–9 as part of the ‘skills observed’ part of the online portfolio. This will allow for resident doctors to capture skills and experience that aren’t covered elsewhere in their portfolios.

Conclusion: The changes should allow resident doctors to demonstrate the skills and knowledge acquired across their training. They will also be able to demonstrate a clear understanding of their progression and benefit from a variety of feedback opportunities.

Aims: Medical training, particularly in psychiatry, often confronts students with emotional challenges that extend beyond clinical skills. Recognizing that medicine is as much an art as it is a science, we invited fourth year medical students at the University of Birmingham to enter a creativity competition whilst on their psychiatry placements.

This project aimed to provide a reflective outlet for the students, encouraging them to explore and express their emotional responses to the realities of psychiatric practice. By drawing parallels between their own experiences and those of their patients, the students were able to utilise art as a source of personal insight on their clinical practice.

Methods: During their 5 week psychiatry rotation, students were invited to create and submit an artistic piece inspired by their clinical encounters. Creative submissions – ranging from poetry and paintings to drawings and even baking – were accompanied by a brief explanation of the inspiration behind the work. On the final day of placement, students had the opportunity to present or perform their piece in front of their peers, fostering an environment of shared reflection and support. One entry in each rotation would be selected as a prize winner, however the main focus of the project was to encourage students to utilise art as a medium of self-reflection and therefore understanding what impact the process had on them was key.

Results: 23 students participated in the initiative, producing a diverse collection of artworks that authentically portrayed their personal and professional experiences with mental health. Extracts from the explanations that accompanied the entries highlight that the students benefited from using art as a medium for processing and communicating complicated feelings about their psychiatric placement. The students reflected that art can be used as a therapeutic tool for both patients and clinicians. Many used their creative expression to consider the importance of seeing beyond the label of a diagnosis and to focus on the actual lived experience of the patient in front of us.

Conclusion: The creativity competition was met with enthusiasm, underscoring the value of artistic expression in medical education. Moreover, it suggested that integrating creative projects into clinical rotations can enrich students’ learning experiences and bolster empathy. It also encouraged students to continue to use creativity as an outlet to improve their own wellbeing in busy clinical periods. Future plans include publishing the entries in an anthology to share the moving artwork with a wider audience.

Aims: The project aimed to establish a regular Balint group for Child and Adolescent Psychiatry (CAP) Specialist Resident (SpR) doctors in Wales, support the development of future Balint leaders through training, and enhance the sustainability of these groups. By increasing the number of accredited leaders across Wales, the project sought to expand opportunities for clinicians at various levels to engage in reflective practice, have a safe space to consider their relationship with patients, and ultimately increase levels of emotional capacity and wellbeing.

Methods: In July 2023, following notification of funding, interest was canvassed among CAP SpRs in Wales, resulting in the formation of a group of five SpRs committed to becoming accredited Balint leaders. Regular online meetings were set up for mutual support and to facilitate progress towards UK Balint Society accreditation. An online fortnightly term-time Balint group was organized for CAP psychiatrists, with an accredited leader overseeing the sessions. Despite initial challenges accessing funds, the project progressed, and the Balint group commenced in November 2023. Two members attended a Balint training day in December 2023, despite financial constraints, while plans to use funds for further events and supervision encountered delay due to complex bureaucratic pathways.

Results: A total of 16 child psychiatrists from Wales participated in the Balint group, with 12 (mostly SpRs) attending regularly. Feedback from 11 participants indicated overwhelmingly positive responses to the group’s impact on their practice and well-being, with the majority expressing that it enhanced their understanding of the doctor-patient relationship and provided a safe space for emotional reflection. Key strengths identified included the supportive environment and the opportunity for group reflection. While online participation worked well for most, there were suggestions for occasional face-to-face meetings. Notably, two of the initial Balint leadership cohort are now leading the group following the funding phase, demonstrating the project’s potential for sustainability.

Conclusion: The project successfully introduced Balint group practice to CAP SpRs in Wales and initiated a pathway for future leaders. Despite challenges with funding and administrative processes, the initiative has had a positive impact on SpRs’ professional development, wellbeing, and reflective practice. The creation of a sustainable model for leadership development is a significant outcome. The long-term success will depend on securing ongoing funding for training and supervision. Increased numbers of accredited leaders are crucial for expanding access to these valuable groups. Ongoing efforts to address financial barriers are necessary for sustaining and expanding the initiative.

Aims: Electroconvulsive therapy (ECT) is an effective treatment modality used to manage a variety of different psychiatric conditions including treatment-resistant schizophrenia, depression and catatonia. Different teaching methods have been employed by educational institutions to teach healthcare students about ECT, however synthesis of this evidence is lacking. Several sources cite that there is negative stigma and attitudes towards ECT amongst Healthcare Professionals (HCPs). Teaching within undergraduate curricula may improve knowledge surrounding ECT, further reducing negative associations.

Methods: Using pre-determined search terms, a large language model was used to screen relevant databases (including ERIC and CINAHL), identifying 5,550 studies, 453 of which were duplications, leading to a total of 5,097 relevant studies. Pre-agreed strict inclusion and exclusion criteria were applied, and 19 studies were identified suitable for inclusion. Another 14 studies were reviewed again due to conflicting views, of which 7 were deemed suitable, totalling 26 relevant studies for inclusion. These texts were analysed in their entirety. Both qualitative and quantitative data was gathered, and this was heterogenous in nature. Qualitative data was thematically analysed.

Results: Diverse teaching techniques and interventions were identified, and these were successful to varying degrees. These interventions included: the development and creation of new educational modules centred around ECT; real time ECT demonstrations; teaching sessions paired with specialised technology enhanced learning interventions hosted remotely by consultant psychiatrists. A plethora of different interventions centred around improving knowledge of ECT amongst healthcare students varied in creativity, and even included a Hollywood depiction of ECT.

Educational interventions focusing on the improvement of students’ experience whilst on psychiatric placements correlated with a global positive improvement in knowledge levels regarding ECT. Video-based educational interventions were well received by students, and an improvement in attitude and knowledge regarding ECT was noted. Passive interventions, including didactic based teaching interventions described a notable positive shift in attitudes amongst students regarding ECT. However, some studies reported that the longevity of this improvement in knowledge and attitudes may be short-lived, affecting its translation to future medical practice.

Conclusion: This systematic review highlights the need to improve education of ECT amongst healthcare students, to ensure that future clinicians are well equipped with relevant knowledge concerning this important treatment modality. Ultimately interventions that strive to improve knowledge of ECT and induce positive experiences with students, helps to reshape attitudes towards this treatment modality and future clinical practice.

Aims: Medical students’ stigma towards mental health conditions is a well-documented phenomenon in the scientific literature – recommendations to combat this include utilising a holistic approach when teaching about mental health conditions. The holistic approach can be done in a multitude of ways to deliver mental health topics in a multifaceted way. With the increase in social media consumption, there has been a significant rise in consumer exposure to mental health-based content. This content ranges from aetiology and diagnostic information to first-person accounts of living with mental health conditions, highlighting the wide range of discussion points provided by social media platforms.

The aim of this research is to determine whether there is a place for the use of social media in the holistic approach in the destigmatisation of mental health conditions in medical students.

Methods: A positivism-influenced approach was used to conduct anonymised two-part survey, using mostly a quantitative approach (60%). Participants were asked to fill out ‘yes, no, maybe, don’t know’ questions about whether they think social media could be used to teach them in medical school about mental health conditions. The remaining 40% qualitative part of the survey, allowed participants to detail their experiences of mental health on social media and express their thoughts on if and how they thought social media could be used to educate medical students. 10 participants took part in this anonymised survey. All participants were based in medical schools in Northern Ireland, in their fourth or final year of medical school.

Results: All participants reported encountering mental health-based content on social media. 90% of those participants believed that social media contributed positively to their overall opinion on mental health conditions. 80% of participants believed that social media should play a role in educating medical students about mental health conditions. Suggestions on how social media can be used in the education of medical students include showing first-person accounts of what it is like to live with mental health conditions and also showing accounts from family and friends who deal/dealt with mentally ill loved ones.

Conclusion: There is a space for the use of social media in the holistic approach to achieve the destigmatisation of mental health conditions in medical students. Social media can be used to drive empathy-based reflective practices in students via the utilisation of first-person experiences from the mentally unwell people themselves or their loved ones.

Aims: International Medical Graduates (IMGs) represent over 30% of the NHS workforce. They play a vital role in addressing healthcare shortages and enhancing cultural diversity. They are a significantly mixed group in terms of their experience, skills and overall development. Due to differing systems, IMGs often require additional support. The right support ensures that they achieve their professional goals, highlighting the need for targeted conferences.

The conference aimed to facilitate collaboration and knowledge exchange between trainers and trainees, fostering mutual understanding. It also supported IMGs by providing insights into navigating the UK healthcare system while addressing their challenges through data discussion.

Methods: The “Untying the Knots” conference, held from 09:00 to 16:30, registered approximately 100 doctors and featured a poster competition. It included 21 speakers covering diverse topics, focusing on Language, Culture and the Clinical Encounter. International speakers shared insights on training in India and Nigeria, while sessions addressed IMG challenges and personal journeys. Pre- and post-workshop surveys evaluated effectiveness and informed future planning.

Results: 89% of those who attended were IMGs, with only 7% being trainers. Majority of the attendees were core trainees or Trust staff grades (28% each). There were participants from all 7 Trusts in the region and one Trust outside the region. Most achieved their primary degree in India, followed by Pakistan, then Nigeria. Most seemed to have a good confidence level (Predominantly or very confident) on topics relating to differential attainment, language/culture, portfolio management and compassionate leadership and less confident (slightly or fairly confident) about issues relating to the impact of patient safety incidents, navigating GMC referrals/SUIs and CESR pathway. The feedback was that people enjoyed the conference and 90% would attend again with 66% wanting it as a yearly event. 96% felt the conference was well organised with the presentations and networking being the most attractive components. 86% would prefer a face-to-face conference in the future and 10% a hybrid event.

Conclusion: Overall, the feedback was highly positive, with most attendees expressing interest in future events and suggesting it be held annually. The organisation, presentations, and networking opportunities were particularly well-received, with a strong preference for face-to-face events moving forward. These findings will help shape future conferences to better meet the needs of international medical graduates.

Upcoming conferences will implement feedback, explore topics of interest further like supporting the CESR pathway, and facilitating discussions on GMC referrals and Serious Untoward Incidents (SUIs).

Aims: The General Medical Council’s (GMC) outcomes for graduate doctors includes the completion and interpretation of a psychiatric history, mental state examination (MSE), risk assessment and cognitive examination. To achieve these outcomes, medical students rotate through specialist psychiatry placements during their undergraduate training. Psychiatry rotations typically involve observing doctors in ward rounds and clinics and attending classroom-based teaching sessions. Feedback from local medical students highlighted that there was limited opportunity to complete a full psychiatric history, including a risk assessment, and mental state examination. This Quality Improvement Project (QIP) aimed to 1. Develop a reliable and accessible sign-up process and 2. Improve medical student’s bedside teaching experience during their psychiatry placement.

Methods: A driver diagram was used to identify primary and secondary drivers and interventions relating to the aims of the project. An iterative four-stage problem-solving model, Plan-Do-Study-Act (PDSA) approach was used. Students were invited to join bedside teaching sessions in pairs, with students taking turns to complete a history including a risk assessment, and an MSE, followed by feedback from a facilitator. In total 74 students attended bedside teaching sessions. Facilitators were recruited on a voluntary basis and included both foundation doctors, general practice specialty trainees and core psychiatry trainees. Student experiences of both the sign-up process and confidence in core psychiatric skills were captured in pre- and post-teaching surveys consisting of free text responses and Likert scales. In total, eight PDSA cycles were completed with the feedback from each cycle used to refine the sign-up process and improve the bedside teaching experience.

Results: In total 74 students completed the pre-teaching surveys and 48 completed the post-teaching survey. Prior to bedside teaching sessions only 18% of students felt confident visiting an inpatient ward to take a history from a patient, 17% felt confident taking a psychiatric history and 27% felt confident completing an MSE. After attending bedside teaching sessions, 73% of students indicated that they felt confident visiting an inpatient ward, 85% felt confident in taking a psychiatric history, and 85% felt confident completing an MSE.

Conclusion: Providing medical students with dedicated bedside teaching sessions led to significant increases in confidence in spending time on inpatient wards, and in the GMC core graduate outcomes of eliciting a psychiatric history, risk assessment and completing an MSE.

Aims: Foundation doctors rotate through six specialties during their programme. These may/may not include a psychiatry placement. E-learning for health (E-lfh) is a free resource which maps to the professional capabilities in the foundation curriculum, including mental health capabilities. During a six month fellowship, 4 topics were either newly created or improved within the psychiatry e-learning: anxiety disorders, substance use disorder, self-harm assessment and management and medically unexplained symptoms. Following this, the plan was to assess the impact and effectiveness of the e-learning.

Methods: The selection of modules were based on requirements from E-lfh and collaboration with the Royal College of Psychiatrists. It was agreed that the modules should be designed with as much interactivity as possible for an e-learning package, aimed at a foundation doctor (not what should be expected from a psychiatry trainee or higher) and also to equip a doctor with fundamental psychiatric knowledge regardless of if they choose psychiatry as a career.

Two modules were redesigns of pre-existing modules – self harm and substance use disorder. These originally were four distinct modules (two for each of the topics). Therefore the learning for each module was redesigned and updated. Medically unexplained symptoms (MUS) and anxiety disorders were new modules.

Feedback has been obtained via the E-lfh website which collates feedback at the end of each module and scores content, presentation, interactivity, self-assessments and overall rating. A separate survey has also questioned foundation doctors in the Northern deanery about their accessing of e-learning and evaluation.

Results: On the E-lfh website, all 4 modules have been accessed with number of feedback left ranging from 3 (MUS) to 11 participants (substance use disorders). The scores rated content, presentation, interactivity, self-assessments and overall rating. All of which were rated 4.4/5 and above.

In the Northern deanery survey, out of 27 participants, only 1 had accessed the modules – MUS. The doctor had rated the session’s overall, clarity and relevance as good, with interactivity and engagement as average. They noted the difficulty as easy and rated their preparedness for psychiatry related cases as “somewhat prepared”.

Conclusion: Whilst the scores from the E-lfh portal suggest good feedback for the completed modules, the more local feedback suggests limited uptake for e-learning modules in general. Therefore, the next stage of the project will be to design focus groups to further elicit views of foundation doctors before a full report is generated with suggestions to improve uptake and accessibility.

Aims: Teaching around the involuntary detention process under the Mental Health (Northern Ireland) Order 1986 is typically given to new rotational doctors at changeover. This can include a lot of new and technical information and likely can present as overwhelming. Initially, Quality Improvement Project was commenced to assess whether Forms under the Mental Health Order were being completed correctly pre- and post-traditional changeover teaching session.

In Northern Ireland Form 5s are completed if someone is a voluntary patient who then asks to leave hospital and is found to be a substantial risk to themselves and others. Form 7s are completed if a patient arrives on a detained basis having been assessed by a GP and Approved Social Worker.

We subsequently then developed high-fidelity simulation pilot around a patient presenting with mania and psychosis to begin to compare whether using simulation as a teaching tool was better-retained at 6-week follow-up.

Methods: Driver Diagram initially developed to assess areas in which Form 5 and Form 7 detention forms may have errors.

Didactic teaching given at doctor’s changeover in August and December with questionnaires developed to assess pre- and post-understanding.

Subsequent development of high fidelity Simulation using Scottish Sim model around the practicalities of the detention process using a patient with mania and psychosis.

Subsequent follow-up comparison at 6 weeks post-didactic teaching and simulation to compare confidence and retention of information.

Results: The trends around completion of Form 5 and Form 7s under Mental Health (Northern Ireland) Order were assessed pre- and post-didactic teaching in July, September and December 2024 was carried out.

Form 5 detention forms in July, September and December had completion rates without errors of 60, 66.6% and 100% respectively.

Form 7 detention forms in July, September and December had completion rates without errors of 35.71%, 50% and 12.5% in July, September and December.

However, in developing pilot Sim we initially ran it with one person in November 2024 and 6 weeks post-simulation, questionnaire resulted in 100% confidence in knowing when to complete Forms appropriately and comment that “simulation has been very useful in completion of forms”.

When we compared this with the didactic teaching in December 2024 this level of confidence around retention of teaching was only 60% (n=3).

Conclusion: In reviewing other data such as Systematic Reviews on Simulation in Psychiatry, it is generally seen that information learned is retained better in comparison to didactic teaching.

This would correlate with our own findings, all be it with a small sample size.

As part of my role as Education Fellow, I plan to further develop and expand use of Simulation in the Western Trust to be able to offer more tailored and realistic training around the involuntary detention process as well as other areas in Psychiatry.

This initial data is promising in terms of assessing whether simulation can be used as a more effective teaching tool and something that we plan to roll out more regularly for rotational doctors where resources allow, improving their confidence and scope to deal with the stressful situation of assessing and completing their part of the involuntary detention process under the Mental Health (Northern Ireland) Order 1986.

Aims: This qualitative research project examined the attitudes of third-year medical students to a new, weekly, one-hour, mandatory online Balint group during 4 weeks of their Psychiatry rotation.

Methods: All BSMS Year 3 students participated in 4 Balint group sessions as a compulsory part of their 5-week psychiatry rotation within a 10-week module. 193 students in the 2021–22 academic year took part in Balint groups as part of their formal psychiatry teaching. 81 participants completed part or all of the post-intervention questionnaire, which included free-text and Likert scale ratings. Thematic analysis of post-intervention free-text responses was conducted by three independent researchers.

Results: Four themes were identified.

Firstly, “Balint groups as a positive experience” with 86% (n=55 of 64) of respondents reporting they would consider attending Balint groups again as a medical student and 86% (n=53 of 61) that they would attend as qualified doctors. Students generally reported that they found Balint groups useful as a means to reflect upon clinical encounters.

Theme 2 was “Balint groups as a way to change clinical practice”, students described developing a greater understanding of how emotions may impact upon the clinical encounter. Within this theme, the subtheme of “Coping in clinical practice” emerged, with students reporting that Balint groups helped them manage feelings of isolation and improved reflective skills.

Theme 3 was “Balint groups as a way to explore perspectives”. Respondents reflected that Balint groups allowed them to explore different dimensions of the doctor-patient relationship. This included accepting that doctors may be impacted emotionally by patients and that the emotions of both the patient and the doctor can affect or challenge the clinical encounter and relationship.

Theme 4 centred around “Barriers to the experience”, with recurrent themes of time pressure, fear of being judged by others and some feelings that Balint groups were not relevant to their practice. Within this theme, some students seemed to misunderstand the aims of Balint groups. For example, some students wished that concrete techniques and 'coping strategies’ had been taught, a subtheme of an “expectation/reality mismatch”.

Conclusion: Our results show that students found the Balint group both well tolerated and useful. However, notably few mentioned the doctor-patient relationship in their feedback, despite it being the core aim of the Balint group. Our research shows that while Balint groups can benefit students in various ways, further work may be needed to help students understand their scope and purpose.

Aims: Psychiatric Intensive Care Units (PICUs) present a unique and challenging environment for staff, requiring specialised knowledge and skills to manage complex clinical presentations and ensure patient safety. Currently, there is a gap in readily available, comprehensive training programmes specifically tailored for PICU staff. This project aimed to develop and evaluate a bespoke training programme for staff at Roxeth Ward PICU, addressing this gap and focusing on key clinical and operational challenges pertinent to the PICU setting. The programme sought to enhance staff competency, improve patient care, and create a more positive and therapeutic ward environment.

Methods: A bespoke training programme was designed and implemented for all staff at Roxeth Ward PICU, including nurses, psychiatrists, allied health professionals, and support staff. The programme incorporated a variety of interactive learning modalities to maximize engagement and knowledge retention. These included didactic lectures providing foundational knowledge, simulated scenarios (covering both mental health crises, such as managing acutely agitated patients, and medical emergencies, such as NMS), interactive group discussions to facilitate shared learning and problem-solving, and problem-based learning activities focused on real-world case studies encountered in the PICU. Topics covered a range of pertinent PICU issues, including the ward’s structure and processes, the function and purpose of operational/governance meetings, the safe and effective use of rapid tranquillisation and Acuphase, management of psychiatric emergencies, a comprehensive overview of the Mental Health Act and its legal implications for PICU practice, substance misuse management training, de-escalation techniques and strategies, quality improvement initiatives, the use of sensory modulation to create a therapeutic environment, understanding and applying knowledge of common mental health diagnoses, and the management of violence and aggression. Pre- and post-training assessments were conducted to evaluate the impact of the programme on staff knowledge, skills, and confidence.

Results: Quantitative feedback from the 35 participants demonstrated a substantial 64% improvement overall in knowledge and confidence following the training programme. These improvements were observed across all domains and topics covered in the training programme and a detailed breakdown of the results for each topic is included in the poster. Qualitative feedback from participants was overwhelmingly positive, with many staff highlighting the value of the interactive learning methods, particularly the simulated scenarios, in enhancing their understanding of complex clinical situations and improving their ability to apply theoretical knowledge to real-world practice. Participants specifically mentioned the increased confidence they gained in managing acutely agitated patients, understanding the legal implications of the Mental Health Act, and applying de-escalation techniques. The programme’s practical application to the PICU setting was consistently highlighted by participants, reinforcing the need for bespoke training tailored to this specialised area.

Conclusion: Our bespoke training programme represents a significant step towards addressing the gap in PICU-specific staff training. The diverse and interactive learning modalities, combined with the focus on key clinical and operational challenges specific to the PICU environment, appear to have a positive impact on staff knowledge, skills, and confidence. Further evaluation will explore the longer-term impact of the programme on staff practices, patient outcomes, and the overall ward environment. This model could serve as a valuable framework for other PICUs seeking to develop and implement tailored staff training programmes and contribute to best practice in mental health care.

Aims: To support psychiatry core trainees in navigating their core training, ensuring a smooth and successful ARCP outcome, and facilitating the development of a comprehensive CT portfolio for competitive HST applications.

Methods: We analysed data from the Royal College of Psychiatrists’ Gold and Silver Guides, supplemented by additional relevant resources. Based on this, we developed scripts and storyboards for an educational short film, currently in progress, and designed an accompanying educational poster to present the key information.

Results: The analysis led to the identification of key training strategies and resources critical for psychiatry core trainees. The development of the educational short film and poster has facilitated clear, accessible guidance, enhancing trainee understanding of the ARCP process and HST application requirements.

Conclusion: The educational resources developed offer valuable support to psychiatry core trainees, aiding in ARCP preparation and HST applications. Continued refinement of these tools will further enhance their utility.

Aims: Calhoun et al. assessed the effectiveness of in-situ simulation education and showed that adding in-situ simulation to current educational practices may improve patient mortality and morbidity.

Collaborative Working is when individuals with various professional backgrounds work together and combine their expertise with other individuals to provide the best care possible. The essence of collaborative working is “working as a team with respect and value for each team member’s unique role and contribution”.

The practice of interdisciplinary learning is already in place when Immediate Life Support simulation training is delivered. The concept of broadening this practice out to other areas of clinical practice is therefore not far-fetched and is evidence based.

Aims: Embed lessons learnt from serious untoward incidents within an simulated inter-professional educational environment; OSE implementation will improve staff ability to respond to clinical scenarios.

Methods: A total of 27 participants attended these sessions conducted across 2 days. The staff rotated through a four-station circuit (10 minutes each with 5 minutes verbal feedback): completing a NEWS2 chart (National Early Warning Score); recording glucose levels on a blood glucose monitoring chart; documenting neurological observations following Rapid Tranquillization administration and effective communication.

At each station, participants were asked to complete a Likert questionnaire to self-report their status in 4 key areas: Knowledge, Confidence, Management, Resource Awareness, and preference between Face-to-Face (F2F) or E-learning teaching. Following the station, participants received constructive feedback on their performance and repeated the questionnaire.

Results: Qualitative and quantitative data analysis was completed to assess the questionnaire responses, with all stations showing a significant increase in average scores (AS) across all Key Areas, ranging between 16.4% (NEWS2) and 54% (Neurological Observation).

Confidence in handling clinical scenarios showed the smallest AS increase across all stations ranging from 12.3% (NEWS2) to 46.1% (Neurological observation).

Awareness of trusted resources available had consistent minimal score change, with lowest score change of 6.1% observed in NEWS2. Post-session learning preferences strongly favoured F2F teaching, with all 27 participants preferring it for Communication and Blood Glucose monitoring stations. Neurological observation station showed the biggest improvements in knowledge (58.3%) and confidence in management (65.2%).

Conclusion: These findings highlight the importance of interactive teaching to improve clinical competency and knowledge retention. The data also suggests the need for improved resource awareness and accessibility and as a result resource folders have been disseminated. Cygnet Healthcare is also implementing OSEs across other hospital sites.