Core trainees in psychiatry (CT) must attain competencies in at least two psychotherapy modalities before they are allowed to sit for the final Royal College of Psychiatrists’ membership exam. The common training approaches in the United Kingdom include regional training workshops, weekly Balint groups, and access to individual supervision. Some CTs express their wish to have extra opportunities to practice psychotherapeutic skills and discuss cases in order to enrich their experience in learning psychotherapy. Therefore, the peer-led GC-PSP, i.e. Gogledd-Cymru (North Wales) Peer Supervision in Psychotherapy is conceptualised as a quality improvement project (QIP) for North Wales CTs. This article aims to illustrate the lessons learned after two years of GC-PSP.

A baseline survey was done to identify trainees’ ideas, concerns, and expectations in psychotherapy training and weekly one-hour supervision sessions were set up in May 2021. Sessions were facilitated by a speciality trainee (ST) in psychiatry with experience in psychotherapy. The agenda was determined on the day based on the specific issue or expectation brought up by trainees which could include: clarification of psychotherapeutic concepts and knowledge learned elsewhere, skill training through role-playing, case formulation of clinical encounters, discussions on suitable intervention, and any topics that were relevant to psychotherapy or combination. Subsequent written and verbal feedback was gathered.

A total of 48 sessions had been conducted in two years, with 37.5% covering knowledge teaching, 45.83% skills training, and 39.58% case-based discussions. The top five modalities requested by CTs included: cognitive behavioural therapy (32.35%), psychodynamic therapy (20.59%) acceptance and commitment therapy (17.65%), motivational interview (11.76%), and behavioural activation (8.82%). The overall attendance had been inconsistent, ranging from no attendees and the highest of eight attendees comprising medical students, foundation year trainees, core psychiatry trainees, general practitioner specialist trainees, and specialist registrars.

Although inconsistent attendance results in the repetition of discussions and topics, all trainees feel the extra sessions support their learning in psychotherapy in a safe space as they feel the small group discussion allows more active participation and they are able to learn from others on top of their individual supervision (positive Kirkpatrick level 1 reaction). All trainees wish to have this initiative continued and prefer a semi-structured rather than totally flexible agenda so that they can plan for their attendance, which can be a consideration for future implementation.

To establish a mentorship programme for all grade of Psychiatrists working within Surrey and Borders Partnership Trust.

RSPsych guidance was used to establish a mentoring programme within Surrey and Borders Partnership Trust.

A core leadership team was identified and established, this included the Director of Medical Education, a Higher Specialist Trainee, and a Core Trainee.

The decision was made to structure the programme to involve all grades of doctor within the trust, with pairing of Mentor and Mentees tailored to mentee needs. Support from the core team will also be offered to both Mentees and Mentors on a regular and drop in basis, as well as support groups for each group.

The programme was then advertised using a trust email list and training days were held via Microsoft Teams and delivered by the West Midland Mentoring Team RCPsych.

The programme is due to launch in February 2023 with expected widespread engagement, followed by evaluation survey.

We received a good response from all grades of doctors targeted in the Mentorship Scheme.

Following this a prelaunch meeting, facilitated by the core leadership team, was organised for all those involved in the scheme.

This meeting outlined the aims of the scheme and support available to both Mentors and Mentees.

The Mentors and Mentees have now been paired and the scheme will be launching in February 2023.

Burnout is a significant and highly prevalent phenomenon within the Psychiatric community.

Mentorship is shown to reduce rates of burnout as well as improving staff well-being, productivity and retention.

Following RCPsych guidance this project aims to establish a mentorship programme for all psychiatrists within the Surrey and Borders NHS Trust.

The Surrey & Borders Mentorship Scheme will launch in February 2023.

To promote physical and mental health in underprivileged communities; (II) to increase awareness on health matters in the community and students.

May 25th 2011, remains etched in author's mind. Her brother, Dr Syed Arshad Abbas, had a fatal accident while on duty. In 2012 family established a Memorial Trust. Since then, the following are provided:

1. 1. A free medical health camp twice a year. Patients receive free consultation, free medication and referral to secondary or tertiary services.

2. 2. An ambulance service available all times.

3. 3. Two blood donation events, 2012 in collaboration with Red Cross and 2022, in collaboration with an international charity and the hospital of Baramulla.

4. 4. Sponsorship to students, from primary school to university, with a mentoring scheme for university students.

5. 5. Mental Health awareness programme every year in different Universities.

1. 1. To date, 3122 patients were seen at the camps. Medical and psychiatric specialist services are offered face to face or virtual. Depression, Anxiety Disorder and PTSD are the most prevalent disorders. There is an increase in substance use in youth. Polypharmacy is common practice.

2. 2. Ambulance catered for 2404 patients. The first patient was an 11-year-old boy, with acute abdomen. He was transferred to tertiary hospital and operated within three hours.

3. 3. Second blood donation event has broken the World Record of number of donations in one day. A database of regional donors was set up. Screening has identified two women with anaemia, highlighted health inequalities which were reported to local government.

4. 4. Sponsored and mentored university students have completed their degrees and secured placements in tertiary hospitals.

5. 5. Mental Health awareness programme identified the need for counselling services in universities and need for similar programmes.

This project has given an opportunity to turn loss into positive and a grief into hope. It will help family to move on by providing to the local community. Being a medic trained in UK the author was able to utilize skills into serving her home community, put vision into action and fulfil Hippocratic oath.

Social determinants of health (SDOH) are social factors that have a causal role in ill health and have an adverse effect on health outcomes. SDOH are part of the UK medical student curriculum but mainly discusses epidemiologically. There are few educational approaches that aim to incorporate an understanding of SDOH into the experiential and competency-based elements of undergraduate medical education. Prisoners are a population who experience high levels of stigma, social adversity and health disadvantage. Clinical attachments in prison may teach students about the impact of SDOH in a vivid and memorable way. Aims: We aim to explore changes in medical students' knowledge/attitude towards SDOH during and after psychiatry placements at HMP-Berwyn prison.

All year four medical students on psychiatry placement in North East Wales during 2021–2022 participated. In each of the six placement cohorts, one student did their psychiatry placement in prison. All the other students visited for one day. All students participated in two seminars focused on their prison experience and SDOH in psychiatry. Baseline and mid-placement bespoke questionnaires were completed, and all students participated in end-of-placement individual interviews.

29 students participated. Student assessment of the importance of SDOH did not show a significant change between baseline and mid-placement. However, student attitudes to experience in prison became more positive at end-of-placement. Comparing baseline to mid-placement questionnaires showed a 14% increase in students' rating of prison placements as educationally beneficial. 14% of students mentioned improved confidence in dealing with challenging patients, and 28% commented on the benefits of exposure to incarcerated patients. Interestingly, only 3% of students considered hospital placement more beneficial than prison placement. Prison placement was considered an exceptional experience than other settings by 17%.

There are no previous UK empirical studies on medical student placements in prison. Overseas studies identify reduced anxiety over dealing with demanding patients. Our findings so far lack statistical power but show positive satisfaction and knowledge trends amongst participants. Prison placement appears to be acceptable and educationally valuable. It offers opportunities for experiential teaching about SDOH. In addition, it may improve student understanding of a marginalised and stigmatised population.

On completion, this study may provide evidence on one method of improving attitudes toward marginalised people and understanding SDOH in the medical profession.

This research was funded by Betsi Cadwaladr University Health Board and sponsored by Bangor University.

The study aimed to check impact (active mentoring and willingness to mentor) following a mentoring and coaching training event facilitated by RCPSYCH and ABP-UK. The program involved watching two pre-recorded videos and a full-day practical session on mentoring and coaching skills.

The training was targeted at psychiatrists of black heritage, working in the UK. They were recruited through social media adverts and emails sent to members of the organization. A predesigned questionnaire assessing feedback about the program and mentoring activities was sent to the emails of attendees immediately after the program and a year later.

Forty-four participants attended the program; 32 completed the feedback immediately after the program, and 20 responded to the one-year follow-up.

From the initial survey, majority of respondents (78%) rated the program as excellent, and most (78%) found it relevant to their professional needs. Slightly more than half of the group (53.1%) were involved in mentoring, but only a few (6%) were involved in mentoring activities within a structured organization. Ninety-seven percent felt confident to mentor immediately after the program while 84.4% expressed interest in joining a college division for mentoring.

In the follow-up data with 20 respondents, 60% were involved in mentoring and 23% of respondents were new mentors. More respondents were engaged in college-related mentoring (41.7%) than in the previous year and majority (83.3%) expressed that the program had influenced their mentoring.

Results from the follow-on survey shows that a good number of attendees at the training event had taken up mentoring roles at local, regional levels and at the College. We therefore recommend continued rollout of more targeted mentoring and coaching training programs, with consideration for cultural needs. This will boost the availability of diverse mentors within mentoring schemes available for doctors, ultimately improving quality of care to our diverse patients.

The aim was to design and run a communication skills simulation session for psychiatry trainees with the following learning objectives. 1) Exposing trainees to challenging clinical scenarios to increase their confidence in dealing with these. 2) Improving communication skills of trainees in dealing with anxious, psychotic, disinhibited or non-engaging patients. The facilitation of the session would be done by two medical doctors working alongside a communication skills coach (CSC).

Trainees were informed of these optional sessions via email. The majority of those who attended were core trainees, specialty doctors and foundation year doctors.

The session was around 3 hours in length. Trainees began by completing a questionnaire which rated their confidence in several domains including when dealing with patients that are anxious, psychotic and disinhibited. This would be repeated at the end of the session to allow for comparison.

Trainees were provided with background information for each scenario and were also given a task such as performing a brief risk assessment. The scenarios lasted 10 minutes and involved 1 trainee and 1 professional actor. A 15 minute debrief would then follow. This would cover what went well, what could be improved and feedback from the actor. The CSC would then provide detailed personalised feedback covering both verbal and non-verbal communication. 6 scenarios took place over the session.

The session was run 5 times in total. The first 4 sessions were held virtually (Zoom) and a total of 29 trainees attended these. The 5th session was held face to face at the Experiential Learning Centre and 5 trainees attended. 25 of the total 34 attendees completed both questionnaires.

In all 5 sessions there was noted to be an increase in confidence ratings when comparing pre and post session scores. Trainees had been asked to rate themselves out of 10. Average increases of 1.8 (anxious), 1.6 (psychotic) and 2 (disinhibited) were noted. An average increase of 1.3 was noted when dealing with an angry/upset relative.

Trainees had rated the debrief process as 4.6 (scored from 1 to 5) and had given an overall rating of 8.8 (scored from 1 to 10) for the entire session. Oral and written feedback from trainees praised the input from all facilitators, especially the CSC.

We feel that the addition of a CSC enhanced our medical simulation training significantly. We hope that others may be inspired to trial something similar in their teaching.

The COVID-19 pandemic had an adverse toll on undergraduate medical education, resulting in less access to work experience opportunities for aspiring medical students, a vital component of the application process. With some studies reporting over 75% of work experience opportunities being cancelled due to COVID-19 restrictions, King's College London Psychiatry Society offered a unique chance for sixth-form students to experience a day in the life of a medical student, providing an authentic insight into the healthcare world. 'Psych for 6th' was a novel outreach programme offered to aspiring medical students in Year 12, helping them to better understand the style of learning in medicine through the lens of psychiatry. This aimed to raise their awareness of mental illnesses, prepare them for medical school applications and promote a career in psychiatry.

In March 2021, the King's College London Psychiatry Society committee members delivered two interactive sessions online via Microsoft Teams. Session 1 saw students discussing the philosophy of psychiatry and medicine, being taught basic history-taking skills, followed by a chance to practice these as a group with simulated patients.

Under the safeguarding of their teachers, the second session involved teaching Major Depressive Disorder to the pupils as if they were medical students, and then having the chance to take a complete psychiatric history in groups from simulated patients.

Out of 16 students who took part, 11 students (69%) reported not being confident at all talking to a patient before the sessions. After participating in the sessions, 14 students (88%) felt confident talking to a patient. 15 (94%) reported considering psychiatry as a career in the future, with all 16 (100%) recommending these workshops to other schools. Qualitative feedback commended the encouragement of active participation, and how their perception of psychiatry has positively changed.

Follow-up with the students found that 14 (88%) of students mentioned this programme either in their personal statements or their medical school interviews.

The Psych for 6th programme has given a competitive edge to student applications, especially in light of the effects of the COVID-19 pandemic on work experience, and expanded students’ appreciation of mental health diagnoses and treatment.

Considering this was a school where over 90% of the pupils were from BAME backgrounds, these workshops have demonstrated that we have been able to put across a positive image of psychiatry, especially in communities where mental health disorders can carry a stigma.

The aim of the project is to support new psychiatric trainees identify common and serious physical health issues on psychiatric wards out of hours; along with the appropriate management and escalation.

The project began in March 2021, supporting our Medical Education Team with a film project to be shown at induction. Doctors coming to psychiatry jobs come from many different clinical roles. Feedback was received that trainees were unhappy managing medical emergencies in psychiatric hospitals. Most new trainees don't necessarily have knowledge of the capabilities and limitations of care on a psychiatric ward.

A survey completed from two trainee rotations regarding the most common physical health issues they encountered and the challenges they faced was used to narrow down to 3 film scenarios, incorporating a comprehensive list of clinical cases that could be encountered on call. We included physical health and mental health emergencies, use of MHA & capacity assessments. We worked with a production company producing scripts and expanded on the scenarios with the help of medical and nursing staff to ensure the scenarios remain relevant, and as realistic as possible to existing trainees. The final stage of the project was November 2021 which involved filming with the production company and professional actors who brought our concept to life. Post-production, we presented them during trust academic program to launch the videos in mid-2022.

The videos were received positively and quantitative scores completed by a questionnaire before and after showing the videos showed an improvement in confidence in assessing, managing and treating patient with physical health issues and those with physical health complications of their mental health in a psychiatric hospital from 39% to 88% (response rate 62/90).

We are proud to report that these videos are now being used during every junior doctor induction and can be referred to if a refresher on that topic is required later.

We are excited about this innovative method of training using high-quality videos to ensure trainee engagement. We hope it will form a baseline for further discussions and teaching around the topics derived from the scenarios. The videos were designed to last many years and so we hope will be of benefit to current and future trainees of all levels. This successful project will be expanded further and we are in the process of developing other scenarios that can be used for training.

Social psychiatry faces a challenging relationship with pop culture. Understanding pop culture portrayals of mental health culture could be valuable to public mental health. ‘ Top Boy ‘ is a fictional show touching upon the experience of individuals living in the grip of a mental health syndemic in inner-city London.

AS & WQ had structured discussions to analysing themes, social determinants and psychiatric correlations in Top Boy.

Top Boy touches on aspects of mental health including immigration, the impact of violence, the impacts of urbanicity and deprivation syndemics, domestic abuse and PTSD.

Violence as a trigger for PTSD is illustrated in the story of Jason, a young child who is exposed to domestic violence, resulting in avoidance of this environment and association with gangster Sully. Jason becomes desensitised to violence. Greater PTSD is linked with violence in a dose-dependent fashion (Abram et al., 2004).

Sully watches Jason die after a racially motivated attack, illustrating the nested nature of such trauma as Sully develops PTSD; he is seen re-experiencing the fire. Sully can later be seen to be hyperaroused to perceived threat. Exposure to violence, particularly in the context of gang membership, is strongly associated with anxiety disorders. (Coid et al 2011)

Impacts on relationships and childhood neglect are explored through Ra'Nell and Lisa. Lisa is a single mother who's survived an abusive relationship. She becomes severely depressed resulting in her being sectioned and an extended psychiatric admission. Ra'nell, her son, falls into the narcotic trade, leading to truancy and violence. His friend Gem is seen to try drugs when forced to act as a mule. Involvement in the drug economy leads to drug dependence among gang members (Coid et al 2011).

These come together in the estate syndemic; psychiatric morbidity is exacerbated synergistically with health inequalities caused by poverty, stress, structural violence and racial discrimination. This leads to educational disadvantage through truancy in the cases of Ra'nell and Ats, who's mother suffers from the mental health effects of unemployment and deportation threat. Individuals are then more likely to interact with gangs in this syndemic environment and so the cycle of illegal activity, violence and ill health perpetuate.

Gang members currently will make a large contribution to mental health disability and service burden in syndemic areas. Top Boy illustrates the challenge and opportunity for public mental health in the context of such syndemics.

Several studies on simulation as a method of teaching have identified advantages- on attitudes, skills, knowledge and behaviours, and non-technical skills such as situational awareness, team working, interpersonal interactions with improved confidence. Use of simulation in Psychiatry is growing, but studies are limited. We decided to evaluate our own delivery of simulation in trust and align this to the national strategy to identify gaps and further work

What are we offering now?

• • Core trainees- Emergencies in Psychiatry- seclusion, suicide risk assessment and fracture neck of femur. Communication skills course, mock CASC, ILS.

• • Higher trainees- Tribunal preparation and providing evidence, Induction- Out of hours supervising 1st on call, Managing serious incident

• • In development-Immersive technology- Higher trainee supervising a junior doctor OOH

Challenges and solutions

• • Participant anxiety-Performing in front of peers can be demanding and reduces take up. ‘What to expect’ pre-session workbook, small group numbers (3), reiterating the focus of session on learning and confidentiality has improved participation.

• • Resource (scenario development) - Takes time and effort to achieve high quality, piloting and continual adjustments to tailor to the learners' needs. We appointed 3 SIM leads and hold regular meetings.

• • Resource (trainers)- Hard to resource trained trainers. Developed an in-house training programmes for trainers, but persistent difficulties in maintaining consistency and time commitments with same group of ‘trained trainers’. Included brief training pre-session in morning for facilitators.

• • Resources (finance)-Expensive to support Simulated patients. We used COVID-19 recovery funds and constructed purpose-built SIM rooms in education centre, which adds to fidelity

Feedback: Excellent feedback received with positive comments about supportive learning, SIM facilities and debriefing.

Despite being highly resource intensive, simulation is a powerful, unique, and valuable method of training in Psychiatry. Availability of resource will continue to pose challenges, but use of digital Immersive technology and focussing on relevant areas in line with National vision strategy and with identified groups- Induction, SuppoRTT, new to NHS, Remediation, CASC preparation and enhancing capacity of learning environment where there are gaps may be a good starting point. Use of MDT integrated scenarios can offer more fidelity.

Future identified areas will be

• • CT1s-Physical health skills (refresher), history taking, MSE, handover. Emergency scenarios- NMS, lithium toxicity, cardiac complications due to clozapine

• • Higher trainees- Mental health act assessments, supervising doctors in training/members of MDT. Chairing team meeting, handover, breaking bad news, presenting in a coroner's court

A significant number of Psychiatrists will experience a serious incident (SI) whilst in training. CNTW Trainee Led Implementation Committee (TLiC) felt that the trust SI reporting process and support offered for trainees was inconsistent, anxiety provoking and at times insensitive. We decided to review existing processes to support trainees through SIs and develop a programme that addresses these areas.

Improve trainers’ confidence in supporting a trainee involved in SI. Establish robust mechanisms to support trainees involved in SI

The SI medical education quality team with a trainee representative, set up a comprehensive programme to address above objectives.

• • Process: System for weekly notifications of incidents from trust safety team and producing a useful algorithm to decide thresholds for reporting to Live flow (Health Education North East). Trainee notification of incidents via their named Clinical and Educational supervisors.

• • Trainers support: Produced a template that would form basis of discussion with trainee covering educational and governance areas, resources and support offered- uploaded to trainee's portfolio/form R for ARCP review. Workshop conducted for trainers to enhance their knowledge in supporting trainees.

• • Trainee support: Rolling training programme for trainees-sessions from trust SI team, trainee sharing personal experience of involvement in SI, Coroners Inquest by trust Legal department and Interactive Human factor approach-based case studies. Ongoing support from trust safety team- immediate (team debriefing, after action reviews) and long-term support (SI panel and legal representation) offered to all trainees. Learning opportunities offered - observing coroners and joining SI panels.

We have run 5 trainee days since 2019- attended by 79 trainees in total.

• • All sessions rated excellent. Sessions of trainee's perspective, legal perspective and case study discussions being rated the best.

• • Almost all trainees felt that the session would have a significant impact on their clinical practice- in particular contemporaneous documentation reflecting decision making. Many felt the need for an informal peer support group that they could access.

• • Workshop for trainers was also rated good/excellent

Creating a culture which supports reporting concerns around safety and focuses on learning is crucial. Trainers often feel ill equipped to support a trainee. Our programme which now includes a peer support group provides a comprehensive and systematic package to help address all these areas and promote a culture of openness with quality and safety being the top priorities, right from a grass root level.

The Psychiatric Trainees Committee (PTC) is a national community of psychiatric trainees comprised of representatives from all College areas. Over our recent term, Dr Deepa Krishnan, Dr Kris Roberts and Dr Emma McPhail covered the Trent region. In addition to national roles, we were keen to encourage trainees to engage with the PTC to improve trainee advocacy in line with National PTC strategy. Engaged and supported trainees are vital for ensuring good standards of patient care, and for safeguarding the future of the workforce in terms of recruitment and retention, which further intersects with ongoing quality and provision of patient care. The agreed aims, which were agreed with the RCPsych Trent Executive Committee, were formulated in-line with the national PTC priorities for 2021–2022: 1,to enhance communication, visibility and reach of the RCPsych within trainees in the Trent region; and 2, being mindful of challenges around recruitment and retention in psychiatry training posts, to improve education and support for trainees.

Using quality improvement methodology, we hypothesised there to be two aspects to trainee engagement. These were conceptualised in two ways: emotional engagement (meaning feeling supported, valued, and promotion of well-being); and intellectual engagement (meaning cognitive stimulation, recognition, and access to opportunities to develop knowledge).

A free, online trainee-specific conference, the first of its kind in the Trent Division, was agreed as an intervention to address trainee engagement across both domains. Because it was run “for trainees by trainees”, we were able to tailor the content to be specifically helpful and relevant to trainees.

We were keen to offer a varied program within the broad domains affecting engagement and we were delighted to be able to secure an exciting line-up of speakers both from within the Trent region and from further afield.

The conference proved so popular to sign up to that it had to be closed early. The conference gathered excellent feedback from participants, with 100% of trainees rating the conference overall as “good” or “excellent.”

The Trent PTC hopes to run the conference again in the coming year, we hope it will become a regular fixture in the RCPsych Trent calendar, to ensure that trainees are kept at the heart of division planning. This project spearheaded by trainees for trainees to improve trainee engagement and support exemplifies collaborative leadership.

In 2021, The Royal College of Psychiatrists declared a climate emergency, stating that “The disruption to life posed by climate and ecological degradation is a crisis which presents an unprecedented threat to human health”. In 2022 the College released an updated curriculum for both Core Trainees and Higher Trainees, which included the requirement that trainees “demonstrate an understanding of the principles of sustainability and how they underpin sustainable psychiatric practice”. We aimed both to understand whether Core Psychiatry Trainees (CTs) are meeting the new sustainability curriculum requirements and to increase awareness of the connections between the climate crisis and mental health.

We used an electronic questionnaire to survey CTs baseline understanding of the climate emergency and sustainable practices in psychiatry, with reference to clauses included in the 2022 curriculum and Silver Guide. An educational module on the climate emergency was planned and delivered to CTs in 2022 and 2023. Content included sustainable practices in psychiatry and the relevance of the climate crisis to mental healthcare. Feedback was gathered afterwards.

The questionnaire showed 44% of CTs surveyed disagreed or felt neutral that they could demonstrate an understanding of the principles of sustainability and 56% disagreed or strongly disagreed that they understand how the mental healthcare system can work to reduce potential negative impacts of healthcare on the environment. Feedback from the initial teaching day in 2022 included the following suggested improvements 1) Highlighting the relevance to psychiatry 2) Holding the day in person 3) Avoiding sessions with too many facts. These suggestions were incorporated into the second teaching day, along with the new College Silver guide curriculum requirements. 32 CTs attended the second teaching day (16 in person and 16 online), with some overlap in attendees from the previous year. Feedback from the second day was very positive. Respondents particularly found the session on young people and eco-distress useful, and reported finding the day ‘educational’, ‘insightful’, ‘practical’ and ‘accessible’. Further suggested improvements were to incorporate a nature based intervention into the day.

Our findings showed psychiatry trainees find educational sessions on the climate crisis and psychiatry necessary and useful for their practice. This project gives an insight into how to provide this teaching in way that is reflective of the scale and urgency of the issue whilst also providing practical advice, optimism and active hope for the future.

Stress and burnout is increasingly recognised as an issue for doctors in training. The 2022 General Medical Council (GMC) National Training Survey revealed that 39% of respondents were suffering from burnout to a ‘high’ or ‘very high’ degree. 51% felt their work is emotionally exhausting. There are multiple sources of stress for psychiatry trainees, including clinical demands, adverse events, the impact of emotional labour and moral injury. The Royal College of Psychiatrists recognises the importance of supporting trainees’ well-being; this has been reflected with the inclusion of personal well-being-focussed key capabilities in the new Core Psychiatry Training curriculum.

To meet these needs, we developed and delivered two interactive face-to-face workshops for Year 1 Core Psychiatry Trainees (CT1s) in the West of Scotland. Training is embedded within the CT1 educational programme and facilitated by higher trainees. The sessions cover key aspects of well-being, including the physiology of stress, risk factors for burnout and the evidence base for developing resilience. We explore the impact of errors on doctors and the health service, relevant clinical governance systems and regulatory policies, focussing on psychiatry training issues. Feedback was obtained immediately after each session via anonymous questionnaire with a mixture of Likert scale and free text responses.

There were 27 responses for workshop one and 21 for workshop two. 14 respondents felt the teaching should be mandatory for core training. There was mixed opinion regarding the overall benefit and optimum timing of the sessions within the training year. Overall, CT1s valued group discussions and wanted more time for this with less focus on GMC policy. There was also split opinion on the value of discussing institutional responses to errors, including significant adverse event reviews and Datix reporting.

Our feedback showed differing opinions on which topics should be covered during the training and their level of detail. Overall, the opportunity for group discussion – in order to share experiences with peers – appeared to be valued most. We feel the sessions provide new CT1s with an opportunity to explore problems they may encounter in a safe and supportive environment.

We aim to provide trainees with a ‘toolkit’ to support their personal well-being within the workplace, as well as demystifying clinical governance systems. We plan to further develop our course materials based on our feedback, and deliver the workshops again in 2023.

Dual diagnosis (i.e. co-occurrence of substance misuse and mental health problems) is a norm rather a rarity making it vital for service users to receive high quality, patient focused and integrated care. That being said, patients with dual diagnosis often feel excluded from services with neither of the services taking overall responsibility. Lack of broad spectrum of expertise required to treat both conditions, has been identified as reason for gaps in service provision where NICE guidance emphasizes the need for staff training and supervision. This was highlighted during survey with doctors in LPT as baseline assessment to assess training needs. This project aims to upskill junior doctors in the assessment and management of patients with Dual Diagnosis by delivery of a training package to each round of junior doctors during the induction period. The training package includes an ebook as pre-requisite for attending induction followed by teaching and short video clip. The training module aims to:1)afford junior doctors the opportunity to assess and manage patients with dual diagnosis effectively. 2) minimise prescription errors, missed diagnosis and missed referrals to substance misuse services 3) improve compassion and reduce stigma

Training package was delivered to new cohort of junior doctors Jan 2023during their induction period.

We used pre teaching and post teaching questionnaires a means to measure the change in level of confidence that the junior doctors experienced across three domains:

1. 1. Assessment of service users for substance misuse

2. 2. Using validated tools for screening of service users for substance misuse

3. 3. Making referrals to appropriate services using substance misuse pathway.

14 responses have been collected from junior doctors to date.

There was an improvement in level of confidence from across the three main domains.

In carrying out assessment for substance misuse, 86% reported “somewhat confident” (after teaching) compared to 7.1% (before teaching).

In using validated tools, 78% reported “somewhat confident” (after teaching) compared to 7.1% (before teaching).

In making referral to substance misuse services, 64% “somewhat confident” (after teaching) compared to 14% (before teaching).

The training package helped in improving the confidence level of junior doctors in carrying out assessment , using validated tools and making referral to substance misuse services. However, whether this translates to making them adept at assessment and management of substance misuse will need to be corroborated by measuring prescription errors and number of referrals to substance misuse services.

To improve emergency psychiatry experience for Core Trainee doctors in Southwest London in accordance with the Royal College of Psychiatrists curriculum requirements.

A scoping questionnaire was sent to all core trainees over a 3-month period (February 2022-March 2022) regarding on-call commitments. This incorporated evaluation of emergency psychiatry experience which was provided through Crisis Assessment Team (CAT) on-call shifts. Direct responses were utilised in conjuncture with the feedback from the Junior Doctor Forum and engagement with trust senior management to promptly identify and implement alternative provision of this training need. This resulted in On-call Core Trainee emergency cover being changed from CAT to the Liaison service.

A second questionnaire was then sent over a further 3-month period (November 2022-January 2023) to trainees participating in liaison shifts to evidence outcome.

From the initial questionnaire a total of 93 responses were collected, with 19 from CAT shifts. Of these, 42.1% indicated they found it was useful in meeting the training need of emergency experience. 47.3% reported no assessments or admissions to the unit over the shift.

From the second questionnaire a total of 22 responses were collected from liaison shifts. 77.3% reported the shift to have been useful in meeting the training need of emergency experience. 100% of respondents reported exposure to a wide range of emergency psychiatric presentations over their shift. 63.6% also reported feeling their confidence had improved in managing emergency psychiatric scenarios independently in the future.

Overall, this showed a 35.2% increase in trainee satisfaction that their emergency psychiatric training need was being met following the change to on-call arrangements.

Emergency Psychiatric experience is a curriculum requirement and is vital in preparing for higher training. Consultation with trainees has been used to drive change with evidence of improved exposure to emergency psychiatry, increased trainee satisfaction and enhanced clinical confidence. This has highlighted the benefit of involving trainees in devising provision of training opportunities in this trust and would be recommended in training schemes nationally.

Media coverage and representations in popular culture can positively and negatively impact wider social attitudes to mental health and illness.In the light of the George Floyd and Tyre Nichols murders and the discussion about racism and its legacy on Black mental health, it has become especially important to discuss the effect of popular culture on Black mental health and vice-versa. The Culture Club was formed in 2021 as an offshoot of the Association of Black Psychiatrists-UK (ABP-UK) with the aim of analysing popular culture and black mental health with a view towards finding recurring themes about Black mental health and our lived experiences of racism and racial trauma. The Culture Club comprises doctors at all levels and medical students affiliated with ABP-UK. We initially started off reviewing films as the cinema offers an accessible and enjoyable way to explore the link between popular culture and mental health. The proposed future direction is to further incorporate other media to offer a more holistic experience and to further support public education efforts.

Media from across the world featuring the intersection of racial trauma and black mental health are selected. The feature is watched individually, with a club discussion occurring virtually. Discussions are centred on the plot, characters, mental health correlations, and themes relative to our own lived experiences. We then note major or recurring themes for further exploration.

To date, we have discussed “Thirteenth”, a documentary by Ava DuVernay, “Da Five Bloods” by Spike Lee, “Red, White and Blue” by Steve McQueen, The Nollywood blockbuster series “Blood Sisters” created by Temidayo Makanjuola and “Queen and Slim” by Melina Matsoukas.

The emerging critical themes from the screenings and our lived experiences are systemic racism, differential attainment, vicarious trauma, stigma and its impact on mental health, and the law.

Key themes underpin black mental health and racial trauma. These themes, if studied further, could potentially be targeted to improve the lived black experience and, in turn, black mental health.

Popular culture remains an important tool in understanding Black mental health.

We welcome further ideas towards improving the culture club experience.

Psychiatry Pitstop is a communication skills teaching programme for fourth year medical students that is led and run voluntarily by trainee psychiatrists. Initially, the format was a 6-week course after working hours, with each week covering a different topic and three simulated patient scenarios using professional actors. Since 2020, this programme has been run online. Aims: 1. To use pre and post-course questionnaires to study whether online delivery is comparable to face-to-face. 2. To gain qualitative and quantitative data from students to assess advantages and disadvantages of online delivery.

Pre- and post-course questionnaires using Likert scales have been used since the Programme's 2015 inception. Additional questions asked about medical students’ views on the online delivery. Pre- and post-course questionnaires were analysed using Chi-squared to determine whether there had been a subjective improvement in communication skills, and online courses were compared to face-to-face.

17.9% students agreed with “My communication skills in psychiatry are good” before the face-to-face course, compared with 81.32% of medical students afterwards (p < .01). 26.47% agreed before the online course, compared with 80.95% afterwards (p < .01).

22.7% students agreed with “Talking to patients about mental illness makes me uncomfortable” before the face-to-face course, compared with 6.87% afterwards (p < .01). 11.77% agreed before the online course, compared with 14.29% of students afterwards (p = .785).

51.55% students disagreed with “I do not know how to ask about symptoms of mental illness” before the face-to-face course compared with 91.2% afterwards (p < .01). 47.05% disagreed before the online course compared with 80.95% of students afterwards (p < .01).

Students enjoyed online delivery, feeling it was realistic and reflected current consultations. Online delivery also made sessions more accessible and time-efficient. However, students reported that they would prefer at least one session to be face-to-face.

The study shows that online delivery of Psychiatry Pitstop leads to a similar improvement in medical students’ subjective assessment of and confidence in their communication skills, and an increased knowledge of questions to ask in a psychiatric history. The face-to-face sessions have been shown to reduce the level of discomfort experienced by medical students when talking to patients with mental illness. This improvement was not replicated with the online delivery of teaching, but as this result was not statistically significant, further data should be obtained.

Students value being able to engage in additional communication skills training and future Pitstops should consider trialling a hybrid model.

Trainee doctors may find it difficult to express their thoughts and feelings concerning their workplace experience. It is important to gain feedback on their experiences allowing potential issues to be addressed and rectified. Identifying and managing concerns at an early stage with the provision of support may have a positive impact on trainee well-being and workforce retention in the future. This project aims to survey trainee doctors working in a rural mental health trust (Lincolnshire Partnership Foundation Trust - LPFT) on aspects relating to their experience, well-being and effect of rurality. This may allow greater insight into issues affecting trainees and allow improvements to be made.

An electronic survey, created on the website SurveyMonkey, was distributed to 43 trainee doctors within the LPFT. This sample represented all the trainees on placements in Lincolnshire.

Twenty-three out of forty-three trainee doctors (53.49%) submitted responses. Analysis of responses showed some common themes of trainees reporting on supportive workplace supervisors and good relationships with staff in general. Other key findings highlighted those living a greater distance from their workplace found longer commutes difficult, especially if there was reliance on public transport. This had a significant impact on stress levels and well-being. Some trainees reported feelings of loneliness, conversely, other trainees felt fulfilled and settled in their current training programme.

This survey identified both positive and negative factors affecting the experience and well-being of trainees. Despite some long commutes, isolation from family and friends and other stressors (exams, fuel costs), positive factors were recognised. This included good supervisor support and relationships. Overall, 78.26% of trainees reported they felt the benefits of their training in the LPFT outweighed the drawbacks. However, it is important to recognise these conclusions are drawn from trainees responding to the survey and are not necessarily fully representative of all trainees’ perspectives.

The new United Kingdom Foundation Programme Curriculum was implemented in 2021 and emphasizes the importance of Foundation Trainees (FTs) acquiring mandatory core skills and knowledge in mental health. The primary aim of this evaluation study is to assess the effectiveness of Maudsley's Training Programme in teaching these skills. Secondarily, it looks at FTs' preferred method of acquiring the mandated competencies. Finally, it aims to shine a light on an area of program evaluation that is lacking in the literature.

An outcome analysis evaluation design was used with a pre and post-quantitative questionnaire as the preferred data collection tool. The outcome measured was confidence and corresponds to Level 2 – Learning on Kirkpatrick's Evaluation Hierarchy. Our questionnaire comprised 4 stem questions, using a 5-point anchor Likert scale. The scales were tailored to reflect the core curricular competencies. Data were collected from a sample of 85 FTs between August 2021 and March 2023 and analysed using Excel functions and a Power Shell Script to calculate measures of central tendency.

Entry median confidence levels were: 3 (Fairly confident) for recognition, 3 for assessment, and 2 (Slightly confident) in managing common mental health conditions. Post-training, the median confidence level in our sample increased to 4 for recognition, 4 for assessment, and 3 for management which denotes a significant positive impact. Examples of outliers are the median confidence seen in assessing Personality Disorders, which increased from 1 (Not at all important) to 3, whereas for recognizing and assessing Delirium and Substance use disorder the median did not change. Looking at teaching methods preferred by the trainees, ad-hoc training on the job and small group seminars were by far most preferred with 24% and 23.6% of responses respectively followed by Self-directed learning and Simulation with 13.8% each and the least preferred were reflective practice (Balint) and mentoring with 3.7% each.

There is a trend of FTs becoming confident post 4 months of psychiatric training in recognizing assessing and managing mental health conditions. Ad hoc and seminar teaching being is the preferred method of acquiring these skills. Moving forward, efforts should be made in evaluating training programs for FTs in psychiatry with the purpose of improving the acquisition of such skills and understanding the best way to teach these. Then, consideration should be given to how we apply these to FTs that don't rotate in psychiatry.