3 results
Balint Group Sessions for Medical Students: A Pilot Study
- Victoria Cowell, Chukwunwike Ayalogu, Annette Ros, Harvey Brown, Bayode Shittu, Anusha Akella, Adeolu Lasisi, James Bancroft, Holly Whitcroft, Indu Surendran, Christopher Bu, Abby Older, Eleanor Gaynor, Kathia Sullivan
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, pp. S16-S17
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Aims
The issue of health and well-being amongst the National Health Service (NHS) workforce has never been so prominent. Balint groups are facilitated discussion sessions aiming to help clinicians reach a better understanding of the emotional content of the doctor-patient relationship. Evidence suggests participation decreases rates of burnout and increases empathic ability. A Balint group pilot scheme for medical students was launched within Cheshire and Wirral Partnership NHS Foundation Trust (CWP), facilitated by both core and higher trainees in psychiatry, and supervised by a consultant psychotherapist. Feedback from both participants and facilitators was collected to gain a greater understanding of how these groups can shape our clinical interactions, and benefit the mental well-being of both patient and doctor.
MethodsWe approached the University of Liverpool School of Medicine, who did not have a formal Balint programme, and proposed a pilot scheme with 4th year medical students rotating through psychiatry in CWP.
Sessions were conducted in four week blocks, during a student's psychiatry rotation, and were facilitated by two psychiatry trainees. At the end of each block, anonymised feedback was collected, and small alterations were made to the programme during the course of the pilot in response to attendance rates, punctuality and feedback.
Results143 students participated in the programme in the first 11 cohorts, between September 2021 and December 2022, and 72 (50.3%) submitted feedback forms.
98.6% agreed that the programme helped them reflect more on their interactions with patients, and that it helped them gain insight into how others think and feel when caring for patients.
91.7% enjoyed the groups and 97.3% would use the skills learnt in Balint group in the future.
100% of students gave a positive response when rating their overall experience of the programme.
Facilitators reported increased confidence in their psychotherapeutic knowledge, and an improvement in leadership and communication skills.
ConclusionThe student experience of the Balint programme was positive for the vast majority, and from a facilitator perspective, we have found involvement to be very rewarding.
Psychiatry trainee group facilitation was well received by students, allowed a greater number of groups to run, and is beneficial for trainees’ professional development.
Before this pilot, approximately only 1/3 of University of Liverpool medical students had the opportunity to attend a Balint group.
However, our findings have contributed to a decision by the University of Liverpool to extend the scheme to all 4th year students on psychiatry placement from August 2023.
Physical Health Screening in a Mental Health Setting
- Laura Middleton, Katherine Ashcroft, Alex Mather, Georgina Gargan, Abby Older, Andrew Mitchell, Elizabeth Shaw
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- Journal:
- BJPsych Open / Volume 8 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 20 June 2022, p. S7
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Aims
Research demonstrates greater mortality and physical health morbidity in those with mental illness, as compared to the general population. National Health Service (NHS) England has introduced policies to reflect this and promote improvements in physical healthcare for mental health patients. Inpatient admission provides a valuable opportunity to action such recommendations and offer a detailed health review, guided by local frameworks. A new annual audit commenced in Cheshire and Wirral Partnership NHS Foundation Trust (CWP) assesses admission physical health screening on its adult acute inpatient wards.
MethodsAudit standard was 100% compliance to CWP's admission pathway (Policy CP35). Parameters included doctor's review, medical history, physical examination, drug history, medication chart, allergy status, venous thromboembolic risk, blood tests, electrocardiogram (ECG), physiological observations, smoking history, body mass index (BMI) and falls risk. Data were collected retrospectively for all patients admitted or transferred to Juniper Ward, an acute adult inpatient unit in Bowmere Hospital in Chester, during October 2020 (cycle 1) and September 2021 (cycle 2). Different months were assessed due to senior staff changes in October 2021.
Results30 patients were identified in 2020 and 37 in 2021. In 2020 the most consistently achieved parameters were, in order, medication chart/drug history, doctor's review and past medical history. In 2021 the most consistently achieved parameters were medication chart/drug history, smoking status and past medical history. Across both years completion of the cardiometabolic tool was lowest, although this improved from 6.7% to 16.2%. In 2020 there were 5 parameters achieving <50% compliance (cardiometabolic, physiological observations, smoking status, BMI and falls risk). In 2021 this reduced to 3 parameters (doctor's review, cardiometabolic tool, falls risk). Local policy was updated following the 2020 results, amending the criteria for doctor's review from commenced within 6 hours, to completed within 12 hours. Improvement was seen in all other areas in 2021, with medication chart/drug history documentation achieved in 100% of admissions.
ConclusionGeneralised improvement was seen following the 2020 audit, although only one parameter reached 100% compliance and most remained under 75%. The first cycle led to a policy change with respect to the doctor's review timeframe, although this limited direct comparison between years. A flow chart will be trialled on Juniper Ward, highlighting required tasks and assigning ownership to specific team members. The local Medical Education team were also made aware of the results to inform junior doctor induction. The audit will be repeated in Autumn 2022.
Balint Group Sessions for Medical Students, a Pilot Study
- Annette Ros, Abby Older, Eleanor Gaynor, Bayode Shittu, Christopher Bu, Kathia Sullivan
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- Journal:
- BJPsych Open / Volume 8 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 20 June 2022, p. S32
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Aims
Core trainees in psychiatry all complete a year of Balint group sessions. These sessions are invaluable, as improved awareness of our own thoughts and feelings is a crucial part of our development as clinicians. We considered that it may have been helpful to have started these sessions at an earlier stage of medical training, for example, in medical school.
MethodsWe approached the University of Liverpool School of Medicine and proposed a pilot Balint programme with 4th year medical students rotating through psychiatry in Cheshire Wirral Partnership Trust.
Sessions were conducted in 4-week blocks, corresponding with the students’ psychiatry rotations. To allow sufficient time for all students to contribute in each hour-long session, groups were limited to a maximum of 7 students. Each group was allocated 2 facilitators and was conducted on Microsoft Teams because of COVID-19-related restrictions. Facilitators had fortnightly supervision with a consultant psychotherapist.
At the end of each 4-week block, anonymous feedback was collected. Small alterations were made to the programme during the course of the pilot in response to attendance rates, punctuality and feedback.
Results18 (approximately 50%) of the students from the first 3 cohorts submitted feedback:
• All said the experience helped them reflect more on their interactions with patients and colleagues and improved their insight into how others think/feel in caring for patients.
• 94% said they enjoyed it; they thought they would use the skills they had developed; and they would participate again in future if given the option.
• 83% said 4 sessions was ‘just right’, 11% said ‘not enough’ and 6% said ‘maybe too much’;
• 72% rated their overall experience of the programme as ‘excellent,’ 17% as ‘good,’ 11% as ‘fair’.
As facilitators, the experience has helped us increase our reflective capacity and gain confidence in leading, managing group dynamics and setting boundaries.
ConclusionStudent experience of the Balint programme was positive for the majority. From a facilitator perspective, we found the experience rewarding and beneficial for professional development. Currently only approximately 1/3 students rotate through this trust and can therefore benefit from the sessions. This pilot study provides supporting evidence for extending the scheme to all 4th year Liverpool University medical students.