‘Job plans must include dedicated time for academic and educational activities such as attending journal clubs’, declare the eligibility criteria for the Member of the Royal College of Psychiatrists (MRCPsych) examinations (Royal College of Psychiatrists 2021, p. 12). Journal clubs also meet the requirements for continuing professional development (CPD) for UK consultant and staff grade and associate specialist (SAS) psychiatrists as defined in College guidelines (Royal College of Psychiatrists 2015). Since the critical review paper was introduced into the MRCPsych examinations in 1999, journal clubs have been seen as one of the main opportunities to teach these skills in psychiatry, and the curriculum for core training in psychiatry requires trainees to present a journal club annually. However, Glasziou’s complaint that ‘Many journal clubs are boring because the articles are quickly trashed as poor research and nothing changes’ (Glasziou 2007) is not uncommon. Can journal clubs promote understanding and practice of evidence-based medicine (EBM) principles?

This chapter examines the ways in which people with mental health conditions who also belong to other excluded groups may be particularly disadvantaged, in general and by mental health services. People with mental health conditions are at risk of social exclusion, but many from certain social identity groups are particularly at risk: for example, women, people from black and minority ethnic groups, and those from sexual minorities. In addition, certain groups of people are defined by their exclusion from society, such as refugees and asylum seekers, prisoners, and the homeless. The occurrence of mental health conditions in these groups is much higher than in the general population and they will often face barriers to accessing essential material resources and adequate healthcare. The presence of mental health conditions and group characteristics intersect to exacerbate the degree of exclusion experienced by the people in these groups. Some combinations may result in particularly profound states of deprivation and destitution. These severe and multiple forms of exclusion have been named ‘deep social exclusion’ or ‘people with multiple and complex needs’, two examples of which are seen in ‘multiple exclusion homelessness’ and people with multiple diagnoses.

This chapter provides an overview of the methodological challenges in researching social inclusion amongst people with mental health conditions and gives examples of interventions that have been shown to be effective in addressing social exclusion including pre-school parenting programmes, early intervention, peer support, recovery colleges, self-care, self-management, and self-directed care. As with all clinical practice, the starting point is the establishment of a therapeutic relationship that encompasses empathy, understanding, hope, and a willingness to help, along with a recovery orientation encompassing collaborative and strengths-based approaches. Much of this does not require a major reorganisation of services, but rather a refocusing and reprioritisation of existing tools and clinical skills, alongside commitment by mental health organisations to ensure their structures facilitate service-user involvement in the planning and delivery of services

Interprofessional education was originally defined by the Centre for the Advancement of Interprofessional Education in 1997 and clearly articulated in 2002 (Barr 2002). There has been international agreement that it ‘occurs when two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes’ (World Health Organization 2010: p. 13). This definition implies that students from different professions must come together in the learning process to achieve their intended learning outcomes. In this way, students bring their uniprofessional specific knowledge and skills into interprofessional learning to mirror the complexity of team-based clinical practice.

Interprofessional education has existed in the formal preregistration curriculum for about 15 years, and is affirmed as essential by the General Medical Council in Outcomes for Graduates (General Medical Council 2018). As a result, students are emerging from preregistration courses primed to learn in this way.

This chapter pulls together the findings presented in Section 2 on the extent of social exclusion in people with mental health conditions and the possible causal links between social exclusion and mental ill-heath and health, to build a descriptive model linking these. The evidence supports the contention that people with mental health conditions are excluded from participation in many areas of society and that there are clear social inequalities in mental ill-health. Although this is the case across all forms of mental health conditions, some groups are more at risk of exclusion than others. To build a picture of the relationship between mental health conditions and social exclusion we need to take into consideration the nature of the mental health conditions, material disadvantages, stigma and discrimination, and the effects of the wider community and society. The dynamic nature of exclusion must be considered, including its effects across the life course and generations and the interaction of the factors affecting exclusion. There are the strong contextual effects of material factors, summarised by the association of poor health with income inequality, suggesting that above a certain level economic growth does not produce an increase in population health and may be damaging.

Assessment is a key part of the educational process. It directs learning and significantly influences the learners’ behaviour. Not only can assessment form the basis for planning educational programmes, it can also enable learners and their teachers and mentors to check progress and attainment. However, the process of assessment has potential pitfalls, which are mainly due to the content and methods of assessment, the expertise of the assessors and the outcomes of assessment in respect to feedback and career progression. Issues connected with appeal procedures and feedback must form an integral part of the process so that both trainees and trainers/assessors can learn from it. Another key problem is the burden of assessment and the extent to which this impairs, rather than supports, good learning practices and takes time away from actual learning.

Conducting a literature search can be a daunting experience. Most medical educators are in the difficult position of striving for a high-quality search while working in a busy academic and clinical environment.

The practice of research according to the principles of evidence-based medicine (EBM) has been perfected (i.e., has become richer and more complex) over the years, and the same goes for literature searching – an integral and key aspect of EBM (McKeever et al. 2015). However, the thought of dealing with an astonishing amount of literature (more than 55 million records only between the two major databases, PubMed/MEDLINE and Embase (Lefebvre et al. 2021)), would likely overwhelm even the most enthusiastic individual. The task of conducting a literature search thus often seems like a twofold burden that presents both psychological and practical barriers. In this chapter, we intend to lighten this burden by adopting an accessible language and approach.

Doctors in training do their learning ‘on the job’. Supervision in the workplace has a key role in ensuring patient safety and promoting professional development as part of this learning process. These twin elements are critical to understanding good supervision. If trainees are learning in their workplace, there must be systems in place to ensure they do not make mistakes that affect patient safety, but at the same time support them in learning new skills.

This chapter discusses the supervision of trainee psychiatrists and is based on an article first published in 1999 (Cottrell 1999). It is gratifying to note the many significant and positive changes in the organization of supervision that have taken place since that date. In 1999, the Royal College of Psychiatrists had responsibility for approving training schemes and specified that each trainee should have a ‘protected hour per week’ with his or her educational supervisor.

Changes to the Member of the Royal College of Psychiatrists (MRCPsych) examination and the current COVID-19 pandemic require adaptation of existing teaching and training for core psychiatry trainees. With the General Medical Council (GMC) also limiting the number of times that a candidate can attempt the MRCPsych examination, there is growing pressure to ensure that course organizers are maximizing trainees’ potential to pass. Using our experiences of running MRCPsych courses in Birmingham and Keele we discuss how courses can be developed to best prepare trainees for the MRCPsych written papers and the Clinical Assessment of Skills and Competencies (CASC).

This chapter introduces Section 2 of the book and briefly examines the social inequalities that are risk factors for mental health conditions. Not only do we find that inequalities are associated with the prevalence of mental ill-health, the most disadvantaged also tend to have reduced access to mental health and social services, and, when they do access help, the quality of their experiences and outcomes are often poorer. The chapters in Section 2 examine the social exclusion of people with mental health conditions in five areas of reduced participation: exclusion from material resources, productive activity, social relations and neighbourhoods, civic participation, and health and health services.

Drawing on case studies, updated papers from BJPsych Advances and specially commissioned new chapters, this book takes a scholarly approach to the whole range of teaching and learning as applied to psychiatry. This covers direct teaching of the speciality of psychiatry through to educational management, coaching and mentoring. It provides essential information on topics not often covered, and it will provide guidance for busy clinicians who are acting as trainers, and for those who teach and train medical students in university departments

Many of the chapters are written by figures of significant educational status within clinical psychiatry. These include a new chapter on literature searching; chapters on technological aspects of teaching such as webinars and virtual placements (the importance of which has been brought into focus by the recent effects of the pandemic on how training is organized); and writing for learning and publication.