To assess the knowledge, attitude and practices of psychiatrists and religious leaders in Baguio City, Philippines regarding mental health, religion, and spirituality.

Two sets of questionnaires were adapted from the study of Foskett et al. (2004). Some questions and choices for the corresponding choices for answer were modified according to the objectives of this project. The questionnaires were prepared to collect data on knowledge, attitude and practices of psychiatrists and religious leaders regarding mental health, religion/spirituality (R/S). The questionnaire covered three main areas: (1) the links between mental health, R/S, (2) the state of collaboration between psychiatrists and religious leaders, and (3) the training each had received that was relevant to this area of their work. The platform used in the Data Collection is via Google Forms. In this method, identity of the responders were anonymized. Data like the name, clinic or office address, age, sex, religious affiliation of the responders were not collected. Descriptions and interpretations of the results were done using frequency and percentages and histograms.

Among the psychiatrists in Baguio City, only 58.8% responded to the questionnaire. Percentage of R/S leaders who responded could not be accounted due to insufficient data on the registry of all religions/spiritual groups in Baguio.

Neither disciplines has any doubts that there is a link between mental health, and R/S.

Majority of the psychiatrist respondents recognize the relevance of their own religion and spirituality. Their belief and inner resources were integral for their coping and implicitly affects their work.

Although majority of the psychiatrists think that referring a patient to R/S leaders should always be the case, and referring the terminally ill will be useful.

Majority (80%) of the psychiatrist respondents are not familiar with their institution's chaplain coordinator/unit. Also, majority (80%) never made a referral to the chaplain. It is also noted that 50% of the psychiatrist respondents did not receive referral from R/S leaders.

Majority of psychiatrists responders did not receive training on R/S aspect of mental health prior and during their qualification.

On the other hand, about 35% of the R/S leaders have a training on mental health prior and during their qualification. Religious/spiritual leader respondents equally think that they need further training on mental health.

Psychiatrist and religious/spiritual leaders both recognize the role of R/S in mental health. The relationship of the two professions in collaborating still needs strengthening by collaboration, education, and training.

Several modalities of psychotherapies have an established therapeutic evidence base for many psychiatric disorders. Stakeholders around the world including the Royal College of Psychiatrists, recommend training of psychiatry trainees in psychotherapy as part of Psychiatry training. However, the quality and quantity of training in psychotherapy differ across different regions. Psychiatry training programmes in high-income countries are regularly audited to ensure minimum standards of training in psychotherapies among psychiatry trainees. There is a lack of reporting regarding psychotherapy training in low- and middle-income countries such as Pakistan. This study explores the experiences of Pakistan-based psychiatry residents regarding their psychotherapy training within the fellowship programme of the College of Physicians and Surgeons (FCPS) Pakistan.

This study employs a mixed-method survey approach, targeting psychiatry trainees registered with College of Physicians and Surgeons (CPSP) four-year training programme (FCPS) across different cities of Pakistan. Utilising a convenience sampling strategy supplemented by the snowball sampling method, an electronic survey was disseminated using social media platform over a 4-week period. The survey was anonymous and structured into three sections; essential demographic data of the participants, experiences with psychotherapy training, and open-ended questions allowing participants to freely express their thoughts and insights on improving psychotherapy training in Pakistan.

Out of the 41 responses received, the majority were female respondents, totalling 27 (65%). All participants were FCPS trainees at various stages of their training, hailing from ten different cities across Pakistan. Findings indicated that 61% of respondents reported insufficient time to learn, understand, and apply psychotherapy techniques, while 53% identified a deficiency in supervision.

In terms of therapeutic exposure, a predominant 34 participants (82%) encountered Cognitive Behavioural Therapy during their training. Mindfulness, Dialectical Behaviour Therapy, and Family Therapy each were reported by 12 respondents (30%). Interestingly, 34 of the respondents (82%) noted an increased interest in psychotherapy since starting their psychiatric training. However, only 20 respondents (48%), felt confident in delivering psychotherapy independently.

A recurring theme emerged from the feedback: participants advocated for a more structured psychotherapy training program, emphasising the need for dedicated time specifically allocated for supervision and practical learning opportunities.

This survey highlights that FCPS Psychiatry Residents in Pakistan are keen to learn more about psychotherapy. However, identified shortcomings in delivery, structure, and supervision suggest a need for comprehensive reforms. The findings emphasise on refining the psychotherapy training in low- and middle-income countries.

Ox-CRISP is an innovative trainee-led course using Near-Peer teaching, designed to empower new junior doctors in psychiatry to enhance their diagnostic and communication skills. The course provides patient centered simulation scenarios around interview skills in Psychiatry aiming to improve patient safety, boost confidence of junior doctors and promote effective clinical strategies. The curriculum covers a wide range of topics, including mood disorders, psychotic disorders, anxiety disorders, personality disorder, intellectual disability including CAMHS, old age psychiatry, and substance use disorders.

• • Curriculum Content: Covers 9 prevalent psychiatric scenarios.

• • Teaching Strategy: Evidence-based, co-produced with experts by experience.

• • Teaching Approach: Near-peer teaching for safe, supportive learning.

• • Assessment: Pre- and post-course questionnaires to track learner progress.

• • Implementation: Offered to junior doctors in Psychiatry at Oxford Health NHS Foundation Trust's Medical Education department.

The qualitative data showed that the course, run through multiple sessions, resulted in improved confidence & competence of trainees in clinical practice, positive impact on trainers & trainees, and enhanced well-being of junior doctors. The cope of impact affected patient care across two counties in South-East England.

To our knowledge, this is a unique course of its kind in the UK. The OxCRISP course represents an innovative and effective approach to mental health education that provides learners with the skills and knowledge they need to provide high-quality patient care. The success of the OxCRISP course demonstrates the value of a patient-centred approach to medical education and highlights the importance of ongoing training and mentorship for mental health professionals.

Integrated Learning Activities (ILAs) are a teaching method in Sheffield Medical School for Phase 3a students, where students will be in their third to fourth year of study and building clinical experience and skills. They're a flipped classroom technique, meaning students should arrive prepared to provide most input and clinicians are session facilitators. Each ILA has associated learning outcomes and reading material, and one or more case scenarios are used in sessions from which questions are generated for students to discuss. There are nine ILAs covering core psychiatric presentations, for example psychosis, and self-harm. Following student feedback, it became apparent that key themes around sustainability, diversity and culture were either not evident enough or used improperly. The project aimed to review the ILAs and associated documents to update and diversify the curriculum and integrate the above themes.

Feedback was initially obtained from medical students and representatives from student societies on ILAs, with one scenario receiving strong feedback on its use of cultural themes. Further meetings with students were held, and the one scenario was collaboratively rewritten and rolled out across South Yorkshire.

A feedback survey was sent out regionally to gather facilitator feedback on the format and content of existing ILAs, and thoughts on adding content on sustainability and transcultural issues. Expressions of interest were called for from facilitators across the region, medical students and student societies, and patient experts to create a working group to review all ILAs and associated documents, with a view to diversify the curriculum and incorporate themes on culture, diversity and sustainability.

Two working groups successfully took place with diverse representation from each invited group. All ILAs and scenarios were reviewed, and these themes were able to be added using different techniques such as ensuring scenarios include cases from diverse backgrounds, removing descriptions of race and gender when not relevant, adding learning objectives on transcultural mental health issues and the impact of mental health on culture and vice versa, and adding scenarios and learning objectives on sustainability and sustainable practice.

Further surveys were generated for planned dissemination to students and facilitators for feedback which are planned for initial distribution in January 2024 onwards and results are awaited.

ILAs and associated documents were successfully reviewed allowing the curriculum to be diversified and updated. Due to the time constraints for project completion, it wasn't possible to have specialist input on gender and gender identity and so these themes were not able to be incorporated into the curriculum. Plans have been made for a further review to be conducted in approximately 12 months and these themes to be added at that time.

This review has allowed for positive changes in the undergraduate curriculum and important issues around diversity, culture and sustainability and their impact on mental health and care are now specifically addressed. This aims to be the first of such collaborative curriculum reviews to ensure that the Psychiatry curriculum is up-to-date and fit to address emerging needs in mental health.

The war-ridden northern part of Syria was struck by a powerful earthquake in February 2023 leaving thousands of people dead or injured. The consequences of the earthquake on people's mental health are harder to evaluate but are likely to be severe and long-lasting, especially as people have lived through years of war and devastation.

This poster reports on facilitating reflective practice groups, online, where Syrian mental health professionals in northern Syria explored the psychological impact of the earthquake on them as individual and as professionals.

The author facilitated a series of online reflective practice group meetings. Three distinct groups of mental health workers were formed, each group consisting of 6–12 participants. Each group met twice, each session lasting an hour and a half, resulting in 6 meetings that took place between the 25th of February and the 18th of March 2023. In the first session the group discussed the psychological impact of the earthquake on them as individuals, and in the second the psychological impact on them as professionals.

Thematic analysis was conducted on the discussions in the 6 reflective group meetings, resulting in three main themes: emotional responses, cognitive responses and helpful strategies. These themes are grouped detailed in terms of the impact of the earthquake on the personal and the professional lives of the participants.

Notwithstanding the limitations of this experience, it highlights the importance and value of group reflective spaces, as a way of helping mental health professionals process their emotional experiences in the aftermath of natural disasters.

Training within medical schools often neglects that mental health patients are very culturally diverse, contributing to a lack of cultural competence in future doctors. This deficiency exacerbates access to healthcare barriers for this population. To address these issues early in the course, we initiated a student-led teaching programme on Cultural Humility (CH) for first-year medical students, aiming to enhance cultural awareness (CA) about mental health patients.

CH emphasises the lifelong development of skills, knowledge, and attitudes, fostering a perspective of ‘becoming the student of the patient' to address power imbalances between doctors and patients with mental illness, particularly from minority groups. It promotes culture as expansile incorporating many characteristics from race and religion to sexual orientation, disability and age.

This study assessed the knowledge and perceptions of first-year medical students following the introduction of CH.

After exposure to an author-developed CH learning resource, students participated in a baseline survey to gauge their understanding of CH. Subsequently, an interactive student-led workshop with a reflective exercise encouraged medical students to embrace their cultural diversity and that of others, emphasising the multifactorial nature of mental illness. The workshop incorporated prompts inspired by peer experiences of mental illness. Students then engaged in an early clinical contact programme, interacting with patients with mental illness to implement their understanding of CH into practice. Reflective blogs, written by students as part of the programme, were analysed for data inclusion using an author-selected framework.

Out of 312 participants, 188 provided responses, revealing higher scores for perceived CH importance (4.83/5) compared with understanding (3.86/5) and perceived preparedness for CH implementation (3.98/5). Analysis of free-text survey responses identified learning gaps, particularly in demonstrating cultural sensitivity during patient interviews, and highlighted preferred pedagogies. Thematic analysis of ten collected blogs followed a 5R framework: Respect, Reflection, Regard, Relevance, and Resiliency. Findings indicated a demand for better training in identifying patient-specific sensitive topics and a preference for appreciating patient characteristics such as socioeconomic class without explicit labelling of these qualities as culturally engendered or directly linked to their diagnosis.

CH aims to foster a patient-centred approach, encouraging medical students to look beyond the diagnosis of mental illness. This study explored the multimodal integration of CH as a CA toolkit into the undergraduate curriculum, providing insights into the application of preclinical CA teaching and students’ perceptions of its clinical applicability in their learning about different patient populations experiencing mental illness.

RCPsych Dean's Grand Rounds focuses on understanding a problem or an opportunity for change in clinical practice using a patient story, academic evidence, and contextual data in this area to bridge the evidence-practice gap using a quality improvement approach. The Dean's Grand Rounds aims to embed the lived experience in clinical practice and use data to drive change.

We held five virtual Dean's Grand Rounds with this format from June 2022 to January 2024. The sessions included a variety of medical professionals, carers and expert patients presenting on the chosen theme, followed by a panel discussion. The sessions were then made available for on-demand viewing via the RCPsych website for those unable to attend the live session. Qualitative and quantitative feedback helped us improve the sessions iteratively.

The sessions have enabled discussion of broader issues facing staff and patients, facilitating the exchange of ideas between professionals from divisions of the RCPsych from around the world. Participants globally attended these sessions, with over 1,000 registrations for the Grand Rounds on memory clinics and catatonia. The feedback for the sessions was overwhelmingly positive, with many participants praising the involvement of patients and carers and the opportunity to come together at the RCPsych level for learning. Many were attracted to the sessions because of the themes discussed, with 68.5% having excellent overall experience. Over 92% of the feedback participants thought the Grand Rounds had improved their professional practice. The majority of the feedback participants strongly agreed that lived experience is an important element in understanding the evidence-practice gap (4.4 on a Likert scale of 1, strongly disagree; 5, strongly agree) and that the Grand Rounds had enhanced their understanding of academic evidence and contextual data in the area (4.4, 4.39 respectively on a Likert scale of 1, strongly disagree; 5, strongly agree). The themes that stood out in the feedback were that participants liked the Grand Rounds format and were grateful to hear from patients, with suggestions to allocate more time for questions and answers. Learning from the feedback, we set up a resources page for each Grand Rounds to enable further learning.

In their revitalised format, these sessions are proving highly effective in bringing the worldwide RCPsych community together to improve patient care and deliver educational and informative interactive content available on demand.

International medical graduates (IMG) are an important and integral part of the NHS workforce. The 2022 General medical council (GMC) Workforce Report showed that of the doctors who joined the workforce in 2021, half (50%) were IMGs and 39% UK graduates. This report also emphasized the need for better inclusion and support for IMGs in order to enhance future retention.

With this conference we aimed to empower IMGs and their educators with tools and knowledge to better recognize and help mitigate the challenges that IMGs endure whilst working in NHS. We discussed about the factors affecting IMG career progression, wellbeing, and ways to overcome them.

It was a one-day conference targeted to the PAN-London cohort of IMGs and their educators of medical and surgical specialties. The programme included distinguished speakers from all branches of medical fraternity, the GMC and medical indemnity organisations. Five poster submissions were also selected to be presented on the day. The programme started with IMG consultants describing personal challenges and success stories with a focus on long-term NHS equality diversity inclusion plan. This was followed by an invigorating ‘Schwartz round’ wherein attendees were able to engage in open and reflective discussions of shared experiences in transition to the United Kingdom. The latter half of the day included workshops on mitigating differential attainment and medico-legal aspects of clinical practice. The conference was concluded by an informative discussion led by the head of GMC London.

The conference was well-attended with 94 attendees present on the day. The audience encompassed a varied set of professionals including medical education managers, directors of medical education, educational supervisors and IMG doctors of all grades and specialties across different London trusts. The feedback was overwhelmingly positive with all the respondents in agreement that the learnings from the conference were relevant to their professional needs. The qualitative response from the attendees in summary was that conferences of a similar agenda and focus should be organized in the future as well.

Historically, there is clear evidence in literature that IMGs have lower success rates in both job and training progression, in comparison to British medical graduates. By organizing such conferences, the endeavor is to kick start a productive dialogue between IMGs and their educators, to target more favorable and successful overall outcomes, on a long-term basis. We hope that this initiative sets the building blocks for the way of the future.

Core Psychiatry Trainees (CTs) are required to complete two psychotherapy cases, utilising different therapeutic modalities as part of their training. During supervision sessions, CTs in Coventry and Warwickshire reported feeling underprepared to start their psychotherapy cases. Locally, the most frequently used modality for short cases is Cognitive Behavioural Therapy (CBT). Here we evaluate a local CBT teaching program implemented to prepare CTs, delivered by the trust Psychotherapy Tutor in conjunction with a CT, Dr Bloomfield, who has experience delivering CBT in a talking therapies service.

We implemented a teaching programme which consisted of 30-minute teaching sessions occurring immediately after Balint groups, which are usually well attended. Dr Bloomfield designed a teaching plan, with separate CBT teaching topics divided into 12 sessions. Each session focused on a CBT concept with practical examples. The effectiveness of psychotherapy teaching was evaluated with pre- and post-teaching online surveys assessing preparedness, confidence in formulation, and knowledge of specific techniques. The survey consisted of Likert scales ranging from 1–10 with lower numbers indicating a negative response. Trainees were also surveyed about Psychodynamic Psychotherapy in the absence of specific teaching, as a comparator.

13 CTs responded to the pre-teaching survey and 16 CTs to the post teaching survey, with near-equal weighting across the training grades. Responses indicated a median increase across all areas for CBT, with trainees reporting higher confidence in formulation (7 to 8.5), improved knowledge of CBT techniques (5 to 8) and increased preparedness to start seeing patients (5 to 7). By comparison, there was a modest increase in preparedness (5 to 6) and confidence in psychodynamic formulation (3 to 3.5), with knowledge of specific aspects of Psychodynamic Psychotherapy unchanged (6 and 6).

Regional teaching alone may not be sufficient in preparing trainees to start seeing psychotherapy patients. The CBT learning needs of CTs in Coventry and Warwickshire were effectively met by providing a series of short, tailored sessions covering the different aspects of CBT, resulting in improved confidence, preparedness, and knowledge of CBT techniques. The same increases were not seen in trainees’ responses regarding Psychodynamic Psychotherapy, though small increases were seen in preparedness and confidence in formulation. Our next phase of the teaching will focus on Psychodynamic Psychotherapy teaching, with further repetition of the survey.

1. 1. To provide Scotland-wide data on Core Trainees’ motivations, their future plans and the barriers to applying for Higher Training.

2. 2. To raise awareness of any collective issues.

3. 3. To provide recommendations to the Royal College of Psychiatrists, NHS Education for Scotland (NES) and the Scottish Government based on the results.

A Microsoft Forms survey was emailed to all 176 Core Trainees in Scotland through regional PTC representatives in East, West, South East and through the Core Training Programme Director in the North. Speciality doctors who were post Core Training, and waiting to apply for Higher Training, were identified by snowball sampling and were also emailed a link to the survey. Data was collected between 26/10/23 and 21/11/23.

• – All regions in Scotland and all levels of training were well represented by trainee response rates. Trainee participation was high with 90 doctors responding from across all areas in Scotland and all levels of training.

• – 83.3% of trainees feel that the current availability of Higher Training posts is affecting morale and motivation in psychiatry.

• – 96% of trainees plan to enter Higher Psychiatry Training and the majority of trainees (63%) want to enter Higher Training directly from Core Training. The availability of their chosen Higher Training post was the number one reason for not wanting to enter Higher Training directly.

• – Less than full time working is increasing and likely to increase further (nearly 29% of participants are currently LTFT. 30% definitely plan to do some of their Higher Training LTFT and a further 34% are considering it).

• – The majority of trainees (70%) wish to continue training in their current region. Trainees may be lost from Scotland if they are unable to secure a training post in their chosen region (27% of those considering another region would consider leaving Scotland). Those who would consider leaving Scotland came from all regions – of the 27%: 22% were East, 26% North, 26% South East and 26% West. Second choice regions for consideration remain those that have the most filled posts in Scotland (27% would consider South East Scotland, 22% West, 15% East and 9% North).

• – Participants included lengthy and detailed responses to a free text box at the end of the survey titled “Do you have any additional comments” with several recurring themes. These included less than full time not being accounted for in the overall Higher Training numbers, difficulties in moving region, feeling stressed and demoralised by the application process, feeling undervalued and considerations around leaving Scotland.

1. 1. The primary obstacle preventing core trainees from progressing to Higher Training, as identified by them consistently across regions, is the scarcity of available Higher Training posts across regions, relative to the number of Core Trainees finishing their Core Training.

2. 2. The ongoing increase in less than full time working, with two-thirds of trainees considering pursuing some of their Higher Training on a less than full time basis, will further delay the release of training numbers and therefore growth of consultant numbers without full time equivalent numbers.

3. 3. Trainees may be lost from Scotland. The majority of trainees settle in their Core Training region and there are several reasons that moving may be difficult. Of those who would contemplate relocation, 27% would consider leaving Scotland and the main regions in Scotland that would be considered as alternatives already have the highest fill rates.

The primary aim was to establish the preferences of the majority of core trainees regarding online, in-person, or hybrid teaching in order to assess if the online format created during the COVID 19 Pandemic should be maintained.

Secondary aims were:

• • To collect feedback regarding the barriers to in-person teaching.

• • To collect feedback regarding the course content.

• • To alter the way the course is presented (if required) and to incorporate the feedback regarding the course content into the course.

• • To re-audit to see if the intervention was successful.

• • Surveymonkey was used to generate an online survey with 5 questions.

• • There were a mix of quantitative and qualitative questions.

• • Responses were collected between 26th September 2022 and 10th October 2022 and results were presented at the Tutors Committee Meeting and Junior Doctors Forum.

• • Changes were implemented in the curriculum:

  1. 1. Introduced specific neuroscience teaching.

  2. 2. Small exam specific study groups were encouraged.

  3. 3. It was decided that teaching would remain hybrid as per the majority preference and to allow equal access to teaching for all trainees (as per the GMC guidance).

Sept – Oct 2022

• • There were 20 responses overall.

• • 50% (n = 10) preferred online teaching; 45% (n = 9) preferred hybrid; 5% (n = 1) preferred in-person.

• • The most common barriers to in-person teaching were the difficulty in finding parking (70%, n = 14), and being unable to leave work on time due to clinical responsibilities (50%, n = 10).

• • The most common preferred frequency of in-person attendance for the hybrid model was monthly (45%, n = 9).

• • Topics requested to be covered (free-form question) included psychopharmacology, CAMHS, perinatal, geriatric, neuroanatomy and neuroscience.

Nov 2023

• • There were 22 responses overall, including new trainees that had not done the survey last year.

• • 50% (n = 11) preferred online teaching, 41% (n = 9) preferred in-person; 9% (n = 2) preferred in-person.

• • The most common barriers were the same: difficulty finding parking (64%, n = 14) and clinical responsibilities (55%, n = 12).

• • It was commented that neuroscience related teaching had improved.

There was a clear preference in both surveys amongst trainees for either online or hybrid teaching formats. Hence a decision was made to continue the current format of flexible teaching.

Build relationship and understanding between International Medical Graduates (IMGs) and supervisors in core psychiatry through the Scottish Trainee Enhanced Programme (STEP) to help facilitate belonging and support a vulnerable group. Thus improving training outcomes.

There are various different areas to the PsychStep Programme.

A handbook is distributed to all IMGs which has been created in accordance with the Royal College of Psychiatrists (RCPsych) IMG Guide.

A trainee created video guide for the RCPsych portfolio is provided with the aim of this reducing anxiety around its use.

A Scotland wide WhatsApp group was created for peer support.

The final part of the programme was attendance of trainees and crucially supervisors at two half day sessions. Joint attendance is crucial in fostering supportive relationships. Content was delivered via workshops by IMG consultants with lived experience. Topics covered included communication skills, success factors, reflection, cultural transition and cultural competence. These sessions were evaluated using both scale questions and free text.

There were 6 participants in this programme. All participants reported on evaluation that they felt this course made them:

• • Feel welcome to psychiatry.

• • Realise that other trainees faced the same challenges as them.

• • Felt supported in their Journey.

All participants stated that their trainer attended the virtual sessions with them and that them being in attendance helped them understand specific challenges they would face as an IMG.

Themes identified on free text feedback from trainees were advice on how to reflect and the support that is available in general. The opportunity for shared personal experiences was also highlighted as a positive.

Themes identified on trainer feedback were guidance around both provision of a supportive environment and the importance of having open discussions with trainees.

This programme has an important role in helping IMG trainees in psychiatry succeed. Success stories of IMG consultants provided knowledge and hope for them. The IMG trainees felt better able to effectively engage with supervision following participation in this programme.

Outcomes from this programme to date highlight opportunities to build on this in the future. The organisers of this course hope to increase future attendance and share good practice across other specialities.

Promoting recruitment and retention in psychiatry is one of the core objectives for the Royal College of Psychiatrists and coaching initiatives are recognised as a means of improving retention. We developed a programme of medical coaching, available to all career-grade doctors in an NHS Trust in Northern England to support professional development. This overview describes the results of the first 4 years of the programme.

The setting was a large NHS Trust covering County Durham, Teesside and North Yorkshire employing around 150 consultants and 60 SAS psychiatrists (mean age = 49 years, 51% female). Coaching was promoted to all these doctors through the feedback form sent following their annual appraisal meeting. This coaching was later also made available to locally employed doctors and core and higher specialist trainees working temporarily in the Trust. The intervention was initially provided as a single session coaching event delivered by a consultant psychiatrist trained in medical coaching, and the programme evolved following requests from doctors. It was stated explicitly that the purpose was professional development, not an attempt to retain doctors considering their future. The outcome was measured using a post-coaching questionnaire.

Data was collected from coaching delivered from May 2019 to January 2024. 145 doctors (84 consultants, 23 SAS doctors, 6 Trust doctors, 26 training-grade doctors, 6 grade not-stated) took up the coaching offer. 524 sessions were provided in all. The mean (SD) number of sessions was 3.8 (3.7), for consultants 3.5 (3.9) and for SAS doctors 4.8 (4.4). 48 doctors accessed a single coaching session. 56% of the career-grade doctors receiving coaching were female. Data was collected from 127 post-coaching questionnaires with 116 strongly agreeing and 11 agreeing with the statement that the coaching provided was useful and many reporting a positive impact on well-being.

Findings show that the programme was popular with the medical workforce, with about half of career grade psychiatrists taking up the offer. It evolved following requests to both provide follow-up sessions and to extend the offer to trust doctors and trainees. The sessions were highly valued by the doctors with reported benefits to their well-being, but we cannot measure the impact on retention. The programme is valued by the Trust with an intention to make the programme sustainable into the long term and it now forms part of the Trust's medical workforce charter.

The GMC 2023 workforce report indicates that doctors with primary medical qualification (PMQ) outside United Kingdom (UK) made up 62% of new additions to the register in 2022, with international medical graduates (IMGs) from outside the European Economic Area accounting for a further 10%. In 2023, 49.8% of psychiatry trainees in West Midlands were IMGs.

We have enough evidence to show that IMGs experience significant differential attainment in both training and exams. They also have an added burden of adjusting to a new country, language, culture, and society, not to mention adapting to a novel medical system and work culture. Attempts have been made to address this through induction, clinical supervision, etc.

This survey aims to understand the challenges faced by West Midlands psychiatry IMG trainees and to identify how best to support their needs.

A questionnaire survey was designed using the Microsoft forms platform and disseminated via the West Midlands School of Psychiatry in October 2023 to all trainees whose PMQ was outside UK. The survey gathered feedback on quality of inductions received, clinical supervision, difficulties experienced in training/examinations and awareness of available IMG-specific resources.

36 trainees with PMQ from 14 countries outside the UK completed the survey. 31% of the respondents were CT1 trainees. 17% had less than a year of NHS experience. All respondents had attended their current job induction. 64% rated their workplace induction as ‘Good’ or above, 50% rated trust and deanery induction at ‘Good’ or above. Only 17% of respondents had received IMG-specific induction. Many felt that induction was an information overload in a short space of time. 83% received weekly, hourly supervision. 69.4% rated support from their supervisor as ‘Very good’ or above. Respondents reported difficulties in immigration, finances, systemic racism, cultural and language adaptation. Other difficulties include portfolio, research experience and audits. MRCPsych exam difficulties were reported in 46% respondents especially around study materials and preparation. Trainees wanted IMG specific induction and supervision, pastoral care, portfolio support, MRCPsych exam support, mentoring, guidance around career progression and research.

The survey results show that IMG trainees do not receive appropriate and necessary IMG-specific induction and supervision even though they make up nearly half of the trainee cohort. The Deanery, NHS trusts and clinical supervisors can utilize the results of this survey to inform strategies to support IMGs better. Focus groups are due to be held shortly to get further qualitative feedback.

Wales is the only member of the home nations without Specialist Eating Disorders Training (SEDT) and does not currently have any Specialist Eating Disorder Units (SEDU). This has resulted in varied exposure and experience to eating disorder (ED) psychiatry within psychiatrists working in Wales. Patients with ED have the highest mortality out of all conditions in psychiatry and with hospital admissions for ED on the rise it is important that we understand current attitudes towards ED and use this data to improve understanding and services provided for these patients.

The aims of this project are to

1. 1. Gauge the experience and knowledge of eating disorders of psychiatrists in Wales.

2. 2. Examine attitudes towards management of different risks and which individuals should manage what aspects of care regarding eating disorders.

3. 3. Identify future avenues of development for eating disorders services in Wales.

An online survey was sent to the 518 members in the Royal College of Psychiatrists in Wales mailing list identifying their current position within psychiatry, experience in working with ED patients and then different questions regarding their attitudes towards ED, ED management, their opinions on development of SEDT posts and their opinions on the development of SEDU in Wales.

There were 36 anonymous responses from doctors working in or around psychiatry in Wales. Responses were collected between March and April 2022 with the survey taking on average less than 5 minutes to complete.

36 individuals answered the survey with consultant/SAS (Senior) level doctors making up 69% of responses, the remaining 31% being psychiatry or GP trainees. Senior doctors mostly comprised general adult or CAHMS specialists, but other specialities were also present. 75% of responses reported some expertise in ED. 50% reported they were confident in the management of ED however there were varying responses when asked about the management of physical health in ED. 89% of responses indicated they would like to see the development of ED psychiatry posts and 78% of responses would like to see the development of SEDU in Wales for severely ill patients.

Many of the responses indicated some exposure to ED however 50% of responders did not feel confident in the management of ED. The development of ED psychiatry posts and SEDU would likely aid in increasing confidence of ED management.

To adapt a virtual simulation training session for junior doctors, developed during COVID, to an in-person format.

To compare self-reported differences in knowledge and usefulness of the session across the two formats.

Initially a virtual simulation training session was developed and run in the induction program for junior doctors rotating onto psychiatry. This involved a series of 10-minute simulations tackling 5 emergency scenarios:

Using section 5(2); Acutely agitated patient and rapid tranquilisation; Neuroleptic malignant syndrome; Alcohol withdrawal and detoxification; ligature injury.

Written briefs were constructed and standardised actors delivered the content through a video call with the doctors. A facilitator was able to provide key data, including NEWS scores and exam findings. This was followed by a ten minute debrief, giving feedback on communication, and discussion around the key learning points.

After COVID restrictions were eased, this programme was adapted to a face-to-face format. New, Trust-specific, resources were developed – paper NEWS charts, drug charts, alcohol detoxification pro-forma, and section 5(2) paperwork, which were made available to the candidate during the scenario.

Self-reported scores were collected in the virtual (N = 117) and face-to-face (N = 19) sessions across several domains: in the usefulness and relevance, improvement in knowledge, and overall benefit of the teaching programme, as well as free-text feedback.

Scores were collected on a 5-point Likert scale, (from 1 - strongly disagree, to 5 - strongly agree) and a mean score was calculated, and p value calculated with a two-tailed Mann Whitney U test. The scores showed improved ratings in the face-to-face sessions across all domains - improvement in knowledge (from 4.2 to 4.6; p = 0.0005), and overall satisfaction (from 4.18 to 4.63; p = 0.00036), usefulness and relevance (from 4.06 to 4.68; p = 0.053, though this last domain did not reach statistical significance).

Free text feedback highlighted the positive aspects of the pacing, organisation and delivery of feedback from actors and facilitators.

There were also suggestions for improvement - to adapt the scenarios to better capture the wide variation in doctors' previous experience of psychiatry, and to reduce the group sizes.

A simulation teaching session developed during COVID was successfully transitioned to a face-to-face format. This allowed a higher-fidelity environment with trust specific scenario materials and enabled more realistic communication with the actors. The face-to-face session was found to deliver higher improvement in self-reported knowledge and satisfaction, compared with the virtual session.

To provide a bespoke development program for foundation year (FY) trainees on rotation at CNWL NHS trust.

To increase interest in foundation trainees in choosing Psychiatry as a career.

Specific: 100% self-reported satisfaction with the FY development program by April 2024.

50% increase from baseline of self-reported interest in choosing psychiatry as a specialty by April 2024.

We designed an online, 12 session teaching program for each 4 month cohort of foundation year doctors on rotation at St Charles Hospital, CNWL. We collect data at baseline, after each teaching session and at exit via online questionnaires. These are reviewed at PDSA meetings (including nominees from foundation cohort) by team quarterly. First cohort started in May 2023, we are currently in our 3rd cohort of this project. Each cohort has approximately 15 Foundation year Trainees. Our curricula integrates principles of Co-Design: 2 of the 12 teaching slot topics are voted by each cohort of foundation trainees. Co-Production: 2 of the 12 slots are always for a carer, service user or expert by experience. Bespoke: Each teacher is provided a written guide outlining the training grade of foundation trainees and highlights the needs for transferrable skills as FY trainees may not pursue psychiatry as a career. Quality Improvement: iterative learning from each cohort, with robust data collection methods (dedicated time set aside for feedback completion) and regular reviews by team. Teachers are canvassed via trust emails, trainee Whatsapp groups and patient liaison services at CNWL.

Cohort 1= no data collected. Data collection methods required improvement.

Cohort 2= data collection of 3 responses (23% completion rate). Data collected insufficient. Data collection method improved.

Cohort 3= data collection of 13 responses (87% completion rate).

Self-reported satisfaction with training program: 95.3% Interest in choosing psychiatry as a specialty: 30.4% at baseline to 76.2% at time of submission.

This Foundation Year Development initiative provides a well-liked, bespoke and innovative approach to train foundation year doctors on placement at NHS trusts.

The majority of Foundation doctors (some surveys show 60%) are undecided on their specialty during foundation training and this is a unique opportunity to increase recruitment into psychiatry.

The aim of this work was to improve police force understanding of the mental health difficulties of children and their management in challenging situations.

Nationally, approximately 18% of children aged 6–16 years are likely to have a mental disorder, with the frequency increasing in regions such as North Staffordshire where there are areas of significant deprivation. During the COVID pandemic, children's wellbeing, school attendance, and isolation all worsened resulting in a tripling of urgent referrals to some crisis mental health services. Owing to underfunding and reduced resources in the NHS, the police services have had to spend more time dealing with children's mental health crises, with some forces identifying insufficient training for understanding and de-escalating these emergencies.

It was hypothesized that the preparation and delivery of bespoke training sessions, coupled with pre- and post-assessments, would help enhance police understanding of the conditions and strategies in managing these crises.

Extending previous approaches, each teaching session covered the presentation, diagnosis, and management of autism, conduct disorder, and emotional dysregulation in children, along with de-escalation. A pre- and post-session quiz was completed addressing each of the four topics. Data collection took place in October 2023 with 19 pairs of quizzes completed by local police and community support officers. Given the size and nature of the data, a non-parametric bootstrap resampling method was used to assess whether the teaching produced a statistically significant improvement in each topic and overall score.

Mean differences in scores with 95% confidence intervals (CIs) were obtained for the 19 pairs of quizzes for each mental health condition and all conditions taken together. With maximum of 16 marks possible in each condition, there were statistically significant improvements in mean scores for autism, 1.9, CI: [1.6,2.3]; conduct disorder, 2.2, CI: [1.7, 2.7]; emotional dysregulation, 2.4, CI: [2.0, 2.7]; and de-escalation, 0.9, CI: [0.5, 1.4], and for all conditions 7.4, CI: [6.5, 8.5].

Bespoke children's mental health training sessions were found to deliver significant improvements in police knowledge of crisis management and de-escalation in children affected by autism, conduct disorder, and emotional dysregulation. Given the unprecedented demands on police services, training sessions of this kind could serve as a training tool to reduce both the intensity and duration of crises they have to handle. More sessions have already been requested within the authors’ local NHS Trust.

This is a qualitative evaluation of a simulation/debrief based training session to address discrimination in an NHS workplace, delivered to psychiatry trainees. Videos portraying discrimination acted as the simulation, followed by a diamond model informed debrief.

This evaluation aimed to:

• • assess the effectiveness of this training session in terms raising awareness of discrimination, problematising discrimination, empowerment to act and skills building

• • explore the extent to which these stated aims are relevant to participants’ experience of discrimination, harassment and bullying at work

• • establish if this is a meaningful and acceptable training model for this topic

• • establish if there are more relevant themes that this training session should be focusing on and if so, what these are?

A total of 8 trainees were interviewed between December 2022 and May 2023, having recently completed the training. A thematic analysis was undertaken by two researchers following established recommendations, seeking to bring out latent themes with an inductive, interpretative approach within a constructionist paradigm.

Trainees attended with existing knowledge, skills and attitudes about discrimination, harassment and bullying, and about the training session itself.

Both the simulation and debrief were valued by trainees. The debrief was more than just a discussion. Portrayals of discrimination in the videos/simulation could have been more subtle, and tackled a more diverse range of examples such as LGBTQ+.

The learning objectives were largely met, and related to real challenges that trainees face. Trainees took away more than this, citing learning related to team cohesion and developing their sense in which discrimination in the context of mental illness requires special consideration.

This model of training is providing good value in addressing a topic of strategic importance in a novel way. The impact on empowerment and skills development is likely to be particularly valuable in impacting real world responses to workplace experiences of discrimination. Promoting team cohesion and a space to thoughtfully consider the special case of discrimination in the context of mental illness are important additional benefits. The simulation/debrief model is likely to be crucial, providing learning which would be inaccessible to didactic or e-learning based modes of delivery. The simulation materials may be improved by depicting LGBTQ+ issues, and a more subtle portrayal of discrimination. While this evaluation was situated in a psychiatric context, it could have wide applicability to tackling similar challenges throughout NHS workplaces.

This pilot program aimed to enhance the psychiatry experience for foundation doctors (FYs) working at Ayr Hospital by identifying perceived areas where psychiatric support would benefit training, development or education. Subsequently strategies were aimed to be implemented by the psychiatry liaison service to enrich FYs' experience during their medical and surgical rotations. Feedback was aimed to be obtained to determine if the program would have value to other district hospitals and grades of junior doctors.

Unstructured interviews with 4 FYs were conducted in October 2023 to explore the current experience of psychiatry in medical or surgical placements at Ayr Hospital. Identified themes included barriers to completing supervised learning events (SLEs) for mental health cases (a requirement of the 2021 Foundation Curriculum), limited exposure to psychiatry teaching opportunities, and obstacles to pursuing development of interest in psychiatry (such as time to shadow psychiatry, or discuss career prospects in psychiatry).

A pilot program was initiated in November 2023 to improve the experience and education of psychiatry for FYs. This involved:

• • Providing dedicated time on wards for FYs to complete SLEs with a member of the liaison service.

• • Providing time for FYs to shadow the role of liaison psychiatry.

• • Providing additional teaching tutorials, focused on topics chosen by FYs.

• • Providing the opportunity to discuss and develop interest in psychiatry.

A survey to obtain both quantitative and qualitative feedback was sent to each FY that engaged in the program.

17 FYs engaged in the pilot program, with 13 providing feedback. All respondents felt the program increased their knowledge and confidence in approaching cases with a psychiatry element. They also all found the experience positive and a productive use of time. All deemed the program would be useful for other foundation trainees in medical hospitals. Free text feedback highlighted the program's value in facilitating case discussions, removing obstacles in completing mental health SLEs, providing useful relevant tutorials and providing opportunity to discuss further interest of psychiatry.

The pilot program successfully achieved its aim to improve FYs' experience of psychiatry. Although not measured in the survey, the program also appeared to foster positive relationships between the liaison service and junior medical staff. It also helped identify new appropriate referrals for the liaison service. An expansion of the program is planned to other district hospitals in Ayrshire and Arran, including consideration of expanding the participation to wider members of the junior doctor cohort.