Aims: Professionals in Child and Adolescent Mental Health Services (CAMHS) inpatient settings frequently manage cases of heightened emotional dysregulation, self-harm, and risky behaviours. Successful management required specialised techniques and a deep understanding of both therapeutic interventions and legal frameworks.

We have created a one-day simulation course run multiple times reaching approximately 80 members of staff working across different Child and Adolescent Mental Health Services (CAMHS) units. The deliveries for this run from November 2024 through to March 2025, and are therefore still in progress at the time of submission. The course focuses on the use of Dialectical Behaviour Therapy (DBT) techniques and crisis de-escalation strategies. It also highlights the importance of legal frameworks, family involvement and inter-professional collaboration in the management and support of high-risk self-harm or suicidality.

Methods: Each course opens with introductions and an interactive icebreaker. The Maudsley Learning team, prioritises creating a psychologically safe environment that encourages learning and participation. To achieve this, we use a range of approaches, including a thorough icebreaker to build rapport, introducing the concept of the Basic Assumption, and integrating Equality, Diversity, and Inclusion (EDI) as a core focus throughout the day. We also emphasise learning through imperfect practice, fostering a supportive atmosphere where participants feel comfortable engaging and refining their skills. The course involves a full day of face-to-face teaching, with participants encountering five simulated patient scenarios. Each participant has the opportunity to engage in a realistic, high-fidelity patient scenario designed to replicate the challenges of working with children and young people in inpatient settings. Scenarios are tailored to focus on key issues such as crisis management, self-harm, and family dynamics. These simulations are followed by in-depth debriefing sessions, led by experienced faculty members, where participants will reflect on their use of techniques, risk assessment, and the legal and ethical considerations involved in each case.

Results: At the time of submission, not all deliveries of the course have taken place. However, initial feedback shows increased confidence across all the learning objectives and very positive written feedback. These will be presented in full in the poster.

Conclusion: This simulation course provides novel training to CAMH’s inpatient staff in DBT and de-escalation skills. It also provides a reflective space for staff to discuss the emotional impact of these presentations, and may be beneficial in reducing compassion fatigue.

Aims: Differential Attainment (DA) based on place of qualification has been demonstrated with consistent trends in Psychiatry. Factors contributing to this however, are ill understood. A significant proportion of residents in core training in Psychiatry are International Medical Graduates (IMG). Retention and consultant recruitment continue to be ongoing challenges in Psychiatry. We aimed to explore the awareness amongst trainers and to explore factors that influence DA, in relation to passing rates in MRCPsych examination, between the groups of IMGs and UK Medical Graduate (UKMG) resident doctors in core training.

Methods: Following a constructivist ontology, eight semi-structured interviews were conducted with core psychiatry trainers who were recruited via purposive sampling technique. Interpretative phenomenological analysis was used to identify themes.

Results: DA in the CASC diet of the MRCPsych examination is known but not the extent of this. Trainers are not aware of DA within theory papers. Five themes were identified that influence DA: Trainee factors, examination factors, trainer factors, training factors and the relationship between trainer and trainee. Greater emphasis for communication in exams along with difficulties in communication within IMGs were identified as the most important factors driving DA. Understanding the nuances of cultural differences and mastering exam technique requires time, and IMGs may feel unprepared but feel pressured to follow the same progression timelines as their UKMG counterparts. Trainers are well placed to address this within supervision early in the training, but competing priorities to cover within supervision, along with the sensitivity of the topic and fears of being perceived negatively pose as barriers. Misinformation and lack of awareness of extent of DA within trainers also contribute to this. Unfamiliarity with exam technique amongst trainers combined with residents perceiving exams as being personal rather than a shared objective of training, affects this being actively addressed within supervision.

Conclusion: Implementing practical, person-centred and consistent measures to support equity rather than equal opportunities is key. Communication skill courses are well embedded within training programmes, but trainers need to be supported in enhancing sociolinguistic competence of individuals rather than just improving language. Involving all core trainers in local CASC revision sessions and encouraging them to be CASC examiners will improve their confidence in supporting residents. Raising awareness of DA with both groups of trainers and residents whilst making simultaneous efforts to understand and tackle unconscious bias, improving cultural intelligence and reinforcing trainer-trainee relationship will create a safe space to address this sensitive yet important issue.

Aims: Medical professionals are highly likely to come into contact with individuals who experience gambling harm during their careers. Around 5.5% of women and 11.9% of men globally experience some degree of gambling harm, and they are 15 times more likely to die by suicide than the general population. For every person that gambles around six others are affected. Our aim was to create a memorable teaching session involving people with lived experience of gambling harm.

Methods: The two-hour online teaching session was created in collaboration with Gamcare, a charity which supports individuals who are affected by gambling harm. Two individuals shared their experience of gambling harm; the first experienced significant gambling harm and attempted to end their life. The second was an affected other and highlighted their experience as a partner. The session was then followed by gambling training by one of Gamcare’s training leads.

Results: We had exceptionally positive feedback from the students with a highlight being the individuals who shared their lived experiences. Many students commented that the topic was one that they hadn’t had exposure to before this session. Students said they were able to learn the best ways to approach the conversation around gambling addiction and gained a better understanding of the signs of gambling harm.

Conclusion: Gambling harm is experienced by our patients regardless of our chosen speciality. This session delivered by providing students with a foundation of understanding which will enable them to open conversations and support individuals affected by gambling harm within their future practice.

Aims: New psychiatry trainees face several challenges during their initiation to training including adaptation to a new trust, familiarising organisation-specific systems, and understanding training requirements. These challenges affect trainee’s overall confidence and wellbeing. The Buddy Scheme was intended to tackle these by creating a “psychiatry family” for the new trainees. “Psychiatry Family” includes a core trainee and a higher trainee, aiming to foster peer support and mentorship. The goal was to improve new trainee experience, build confidence, and enhance training experience.

Methods: In order to identify the need for the Buddy Scheme and determine common challenges faced in the beginning of the training we conducted a semi-structured focus group including 6 trainees from the previous cohort. The discussion was focused on personal experiences, challenges, perspectives and expectations. A thematic analysis was performed to identify common challenges and priorities. According to the findings we designed a guidebook and a checklist to support new trainees, created a semi-structured mentorship schedule and selected mentors. The scheme is currently being piloted, with a preliminary evaluation questionnaire assessing baseline concerns and a post-pilot evaluation planned to measure its impact on trainee confidence, adaptation, and satisfaction.

Results: The focus group highlighted several main areas of need, including the need for structured guidance, access to peer/mentor support, and access to relevant resources. Participants expressed enthusiasm for a mentorship programme which can help improve their training experience both professionally and personally. Insights and comments from trainees shaped the structure of tailored resources. The resources include a practical checklist for early requirements, a guidebook containing key trust-specific resources, guidance on Royal College portfolio and compliance expectations in training.

Conclusion: Buddy Scheme offers practical and compassionate support to new trainees who are facing many challenges during their transition to their new role. Focus group findings highlight the need for a structured mentorship programme. While Buddy Scheme pilot is yet to be finalized, the initial stages have prepared a strong ground for implementation. Future evaluations will assess the scheme’s impact on trainee adaptation, confidence, wellbeing, and training experience, providing great insights into its potential scalability.

Aims: The MRCPsych results report and GMC annual report on trainee performance highlighted that UK PMQ candidates perform better than OS PMQ candidates and that White candidates perform better compared with candidates with other ethnic backgrounds. A mentoring scheme was designed as a proposed solution to bridge the gap of differential attainment in Core trainees in Psychiatry with a focus on improving ARCP outcome and Exam Pass rate in Psychiatry.

Methods: The Mentorship Scheme was piloted between August 2023 to August 2024 among Core trainees and Higher Trainees working in Psychiatry in Mental Health Trusts in East Midlands. Higher trainees took part in the project as mentors and were required to complete mentorship course from e-lfh hub prior to start of mentorship.

The evaluation was of a longitudinal, prospective design. It spanned 12 months, with two waves of data collection. Using a mixed methods approach core trainees were required to complete survey with numerically rated items and open-ended questions pre- and post-intervention. Recruitment of core trainees and higher trainees was achieved through purposive sampling.

A 18-item survey was designed to enable quantitative analysis of training needs in Psychiatry and qualitative analysis of conceptions of mentorship. There were a total of 9 Likert questions and 1 open-ended question that enabled free text entry for qualitative analysis. A 23-item questionnaire was designed to evaluate Mentees response post-mentorship scheme.

Results: Pre-intervention: 75% identified career goals as an area that they would mostly likely value support with, closely followed by 68.3% reporting exam preparation, 31.3% reported support with e-Portfolio training and 25% with ARCP preparation as areas that they were hoping to get support with through mentorship.

Post-intervention: 66.7% reported improvement in competence in areas of difficulty which included:

55.6% improvement in clinical skills.

44.4% improvement in exam preparation.

66.7% improvement in diary management.

33.3% improvement in ARCP preparation.

44.4% improvement in e-portfolio training.

88.9% valued the presence of having to speak to someone as a useful aspect of the mentoring scheme and 44.4% reported recommending mentoring scheme to other trainees.

Conclusion: There is a breadth of evidence substantiating use of mentorship as a helpful tool in improving competence in doctors across different levels of their training. This finding was supported through a 12-month evaluation of the Mentorship scheme which appears to afford core trainees a cost-effective opportunity in improving training needs.

Aims: Improve the knowledge and confidence of Year 4 Bristol medical students in assessing and managing patients presenting with persistent physical symptoms (PPS) through the delivery of an online teaching package.

Methods: We assessed outcomes using PDSA cycles.

Plan – We first identified the problem: Bristol medical students report low confidence and knowledge in assessing and managing patients presenting with PPS.

We then designed an intervention in the form of an online teaching package delivered to all Year 4 Bristol medical students during their psychiatry placement. The teaching package included:

Pre-module knowledge quiz.

2 recorded Powerpoint lectures covering aetiology, pathophysiology, assessment, management and prognosis for PPS.

2 × 20–30 minute videos. With support from Bristol University, we filmed 2 mock consultations with Consultants working at the local specialist neuropsychiatric unit assessing patients (actors) presenting with PPS.

Clinical knowledge quiz based on videos.

Chronic pain lived experience video followed by knowledge quiz.

PDSA 1 – piloted the teaching package to a cohort of 20 students. Collected written feedback and subsequently edited recorded lectures and questionnaires.

PDSA 2 – rolled out to all 4th year medical students in Severn Deanery from September 2023. Collected pre- and post-course questionnaires (69 students September 2023–January 2024) to assess change in knowledge/confidence.

PDSA 3 – Adapted the intervention based on written feedback. Added in a chronic pain lived experience video and knowledge questionnaire.

Results: We compared pre- and post-module quantitative and qualitative feedback. Mean questionnaire scores from PDSA cycle 2 (69 students) demonstrated significant improvement in a) confidence in history taking (3.4 to 7.0 on Likert scale) and b) confidence in explaining a diagnosis of PPS (5.2 to 7.3 Likert scale) following the intervention. On average students scored 7.9 (Likert scale 0: not at all useful to 10: extremely useful) to the question ‘How useful do you think this module will be for your future clinical practice?’

Conclusion: Despite the high burden of PPS within both primary and secondary care, the topic is poorly covered within medical student curriculum nationally. Bristol medical students report low confidence and knowledge in assessing and managing patients presenting with PPS.

Adding in content to an already busy 6-week medical student psychiatric curriculum is challenging. Our intervention has demonstrated that an interactive e-learning tutorial involving recorded lectures, clinical videos and knowledge quizzes is an effective method to improve students’ knowledge and confidence for this important topic.

Aims: Starting a new role as Clinical Teaching Fellows, early student feedback identified a gap between students’ academic understanding of the Mental State Examination (MSE), and confidence in its application and interpretation. Assessors recognised similar uncertainty in students regarding findings in the MSE, and a lack of confidence in presenting. This project aimed to improve medical students’ self-reported confidence in the MSE via an interactive workshop. Each PDSA cycle, we aimed to implement feedback suggestions through creative teaching methods, to improve confidence, engagement, and interaction in the MSE teaching.

Methods: Year 3 and 4 medical students attended the MSE workshop during their rotation in Psychiatry. Quantitative and qualitative feedback was gathered via feedback surveys, accessible via a QR code. Using a Likert scale, students rated their confidence performing the MSE before and after the workshop. Thematic analysis of the qualitative feedback was undertaken to explore attitudes, aspects most enjoyed, and suggestions for improvement. The workshop began with simulated videos to explore and develop knowledge on the MSE. In the second PDSA cycle, we added a creative small group task, asking students to perform the MSE on a fictional/famous character and present back to the group. Finally, a documentation task was added whilst students observed a simulated patient interview.

Results: 64 students participated in the MSE Workshop feedback survey. Students reported an average confidence rating of 56.0% prior to the session. After the workshop, the average confidence level increased to 86.8%. Furthermore, 76.6% of students rated the session as “extremely useful” for improving their skills in MSE when compared with previous teaching at medical school. 81.3% would “definitely” recommend the workshop to other medical students.

Qualitative data showed the use of narrative videos was well received by students, with 16 responses highlighting this as a strength of the workshop. “I loved the example videos; helping to clarify and talking through it afterwards was exceedingly helpful!” The opportunity to practice documenting the MSE was another theme within the positive feedback (7 responses). Students highlighted the interactive elements, clarity, and structure as further strengths. Suggestions to improve the session included activities to support phrasing of questions to patients and promoting consolidation using a quiz.

Conclusion: The workshop increased students’ confidence in MSE performance. Students appreciated the use of creative elements, video examples, and documentation tasks. Future improvements could be made to support communication skills, question phrasing, and promote engagement via game-based knowledge assessments.

Aims: The use of high-fidelity simulation in psychiatry remains under-utilised. We aimed to evaluate the impact of high-fidelity psychiatric simulation on final-year medical students at two UK medical schools using a mixed-methods approach.

Methods: We delivered psychiatric simulation to final-year medical students using simulated patients, in a simulated medical ward or emergency department. Scenarios provided an integration between physical and mental health. Thirty-four students completed pre- and post-simulation questionnaires, rating their confidence in assessing patients with mental health problems, performing a suicide risk assessment, understanding different sections of the Mental Health Act and recognising bias towards patients with mental health problems on a 10-point Likert scale. Paired Likert data were analysed using Wilcoxon signed rank test, with correction for multiple comparisons with the false discovery rate (FDR). Ethical approval was sought from Queen Mary University of London to undertake a focus group, in which eleven students participated. Data were analysed using a reflexive thematic analysis technique using NVIVO 14.

Results: The simulation resulted in a statistically significant increase in students’ confidence in assessing patients with mental health problems (pFDR <0.001), performing suicide risk assessments (pFDR <0.001), recognising bias (pFDR <0.001) and understanding different Mental Health Act sections (pFDR <0.001). 100% of participants enjoyed the integration of physical and mental health and felt the scenarios were realistic. Over 90% wanted to see more psychiatric simulation in the undergraduate curriculum. The following themes were identified from the thematic analysis; 1) Student anxieties relating to psychiatry, 2) Current psychiatry teaching methods, 3) Recognising the utility of simulation and 4) Limitations of psychiatric simulation.

Conclusion: There is a gap in the undergraduate curriculum to incorporate high-fidelity psychiatric simulation. Final-year medical students found the simulation to be enjoyable and beneficial for learning. Future work should involve larger sample sizes, simulation of psychiatric emergencies and expansion into postgraduate teaching programmes. Subsequent curriculum evaluations should distinguish between high and low-fidelity simulation so we can accurately assess its implementation in UK medical schools.

Aims: Trainees in core psychiatry training are expected to complete at least 20 sessions of long case psychotherapy within 6 months. However, many take significantly longer. This study explores the typical duration of long case psychotherapy and the challenges that contribute to delays.

Methods: Data was collected from the psychotherapy tutor who supervised 16 trainees who had completed their long case. Additionally, a survey was conducted among 12 trainees to identify factors contributing to delays.

Results: Among the 16 trainees, only 4 (25%) completed their long case within 6 months. 3 completed in 7–8 months, 3 in 9–10 months, 3 in 11–12 months and 3 took 13–15 months.

Survey results showed that among 12 respondents, only 2 (16.6%) completed their long case within 6 months, 3 took 8 months, 2 took 9 months, 2 took 10 months, and then 3 required more than 14 months.

Session cancellations emerged as a significant factor in delays. Regarding patient non-attendance, 6 trainees reported 1–3 missed sessions, 2 reported 4–6 missed sessions, 1 reported 7–9 missed sessions, and 2 reported over 10 missed sessions. Trainees themselves cancelled 1–3 sessions (7 trainees), 4–6 sessions (2 trainees), and 7–9 sessions (1 trainee). The reasons for trainee cancellations included out-of-hours commitments (60%), annual leave (80%), sick leave (30%), and study leave (60%).

The longest gap between sessions was reported as 3 weeks by 41.7% of trainees, 4 weeks by 8.3%, and more than 4 weeks by 16.7%. 66.7% of trainees believed breaks affected therapeutic relationships. Furthermore, 63.6% reported that cancellations often led to consecutive missed sessions. To maintain continuity, 75% of trainees had to conduct sessions on their scheduled days off.

However, 72.7% of trainees were satisfied with the therapy they provided, although only 54.5% believed their patients were satisfied with the treatment received.

Conclusion: The expected 6-month completion for long case psychotherapy is rarely achieved, with most trainees requiring longer due to cancellations, scheduling conflicts, and patient non-attendance. Long breaks between sessions negatively impact rapport, and many trainees resort to working on days off to meet requirements. Learning from colleagues that the long case takes considerably longer than initially anticipated, we aim to change the psychotherapy planning to ensure that all psychiatry residents start their long case as early as possible, ideally during CT2, with communication regarding the importance of consistent attendance.

Aims: International Medical Graduates (IMG) constitute a significant portion of the NHS workforce and play a vital role in psychiatric care. However, many face challenges in navigating the United Kingdom (UK) healthcare system, medico-legal responsibilities, and cultural differences, particularly when psychiatry training is their first NHS role. Despite these challenges, no dedicated IMG induction programme previously existed at South London and Maudsley (SLaM) and Oxleas NHS Foundation Trusts. Existing induction sessions were not tailored to IMG-specific needs, leaving trainees without structured guidance. Feedback from IMGs highlighted the need for a formal induction to provide essential training and signpost available support.

Methods: A structured International Medical Graduate Induction Programme was introduced as a mandatory, protected-time event for new core and higher psychiatry trainees. The first session, held in August 2024, was delivered by consultants, IMG core and speciality trainees, British Medical Association representatives, and medical indemnity advisors. The programme covered supervision and support in psychiatry training, medico-legal responsibilities, the Mental Health Act assessment, documentation standards, differential attainment, and practical aspects of living in London.

Results: Ten IMGs attended the August 2024 session, with six providing feedback. All respondents (100%) reported that the programme met their expectations. The most valued sessions were Mental Health Act assessment training and documentation in psychiatry. Feedback suggested a need for greater clarity on support services and professional indemnity.

Conclusion: The introduction of a structured IMG induction programme at SLaM and Oxleas NHS Foundation Trust was well received with positive feedback reinforcing its value in supporting IMG trainees’ transition into UK psychiatry training, enhancing their confidence and competency. The plan is to integrate this with routine inductions for each new cohort of trainees. The next IMG induction is in February 2025 for which more than 15 new IMG trainees have signed up. Attendance remains mandatory for new core and higher psychiatry trainees. Future sessions will incorporate feedback to further refine the programme, ensuring it remains relevant and responsive to the needs of IMG trainees.

Aims: More than half of new recruits in the NHS are International Medical Graduates (IMGs). It is recognised that IMG need additional support, however to offer this their supervisors need to be aware of the landscape and resources to effectively support them. We developed a training for supervisors of IMGs using a mix of didactic, group work and simulation training.

Methods: The Faculty Development and IMG tutors surveyed and worked with several IMGs to identify topics for the training learning from their recent lived experiences. They also looked at guidance for IMG induction as published by General Medical Council (GMC) and British Medical Association (BMA). We identified that challenges of IMGs evolve through their journey and developed 3 simulation scenarios targeted at early, mid and later stages of the IMG pathway.

The one day face-to-face course included:

An introduction into current IMG landscape including the identified challenges. AS offered lived experience of IMG journey. This allowed for a discussion among the supervisors to reflect on their role.

This was followed by the 3 SIM scenarios:

An IMG doctor who had just moved to the UK and introduced to the supervisor the various practical hurdles that this entails around immigration and joining the NHS.

An IMG had been living in the UK for a few months and was starting a training job, with the focus on fleshing out the differences in healthcare systems.

Managing feedback about communication skills in an IMG who had significant clinical experience in their home country before moving to the UK a few years ago.

We gathered quantitative and qualitative feedback from the participants.

Results: 6 of the 7 candidates offered feedback which was unanimously positive. All found the content useful, most found the course extremely helpful to manage IMGs and an overall rating of excellent by 83% (5 out of 6). We received qualitative feedback as well, ‘It was amazing’ & ‘so grateful especially simulation rather than only theory’.

Conclusion: As IMGs enter the workforce through different pathways and at different times, organising focused IMG induction can be challenging. Moreover the needs of IMGs evolve over time. In psychiatry we have a structure of regular supervision which offers an opportunity of ongoing support to IMGs through the supervisors. However we believe supervisors are not always up to date with the IMG landscape or resources and would benefit from upskilling and updating in this field.

Aims: We have observed that many trainees lack confidence in maintaining their e-Portfolio and meeting training requirements. This initiative aimed to provide structured, peer-led support to improve understanding and engagement with portfolio tasks.

Methods: We implemented a one-hour, non-mandatory monthly drop-in session, led by core trainees. Topics were selected based on a pre-session survey and further refined through feedback during and after each session. Trainees with experience in specific portfolio components led discussions, with additional guidance from senior (CT3) trainees. Sessions focused on navigating the portfolio, understanding training requirements, and organizing evidence for the Annual Review of Competence Progression (ARCP).

Results: Sessions covered topics such as logging clinical assessments, reflective practice, personal development plans, emergency case documentation, and ARCP preparation. Common challenges identified included mapping evidence to competencies, structuring reflections, and creating personal development plans. The peer-led approach facilitated practical, experience-based learning.

Conclusion: While online portfolio resources are available, face-to-face peer-led learning provides a valuable supplement in medical education. The monthly drop-in sessions have been well received and have enhanced trainees’ confidence in portfolio management. This model could be beneficial if replicated across other NHS trusts to support core psychiatry trainees nationally.

Aims: At several regional representative meetings held by the National Trainee representatives for the Intellectual Disability (ID) faculty within the Royal College of Psychiatrists a number of themes emerged. There were concerns around the ability to disseminate information to new starters as often groups like the Trainee ID whatsapp group are dependent upon word of mouth. Some trainees talked about difficulties meeting particular competencies such as inpatient experience whilst others felt isolated due to small training numbers. There were also changes to the portfolio system that had raised concerns for some.

Due to the small number of trainees who attend the meetings, we were unclear as to how widespread the themes were. We agreed a national survey of ID trainees would be beneficial.

Methods: We constructed a survey for ID and dual trainees via Google forms to assess their knowledge of the ID faculty, whether they had access to the communication channels used by trainees, trainee competencies and trainee loneliness. We advertised this survey via the trainee ID whatsapp group, through regional representatives, discussions with local training programme director (TPD) to encourage ID trainees to participate. We added a section around thoughts as to how we could improve the ID trainee experience like a virtual event and/or an induction page on the Royal College website.

Results: 46 people responded ranging from ST1 to ST8 across the nationals. 60.9% of ID trainees didn’t have a good understanding of the ID Faculty’s role. 80.4% didn’t feel well inducted into the portfolio. 69.5% of trainees felt sometimes or often lonely within their jobs. 50% were signed up to the Faculty Newsletter and 43.5% weren’t confidently aware of the other channels to disseminate information. There were about 33% of trainees felt they were struggling to gain experience within inpatient or CAMHS ID or forensic ID. 67.4% ID trainees supported a virtual event and 69.6% supported an induction page.

Conclusion: Based on the results, we proposed a virtual ‘Welcome Event’ aimed at new ID higher trainees. This was supported by the wider ID faculty. The event was held virtually on 15 October and 39 participants joined which included ID trainees and TPDs. A feedback survey was circulated to evaluate the event, unfortunately only 5 people responded. All responded positively and agreed that they would recommend this event to others. We hope this event will become a bi-annual event to help strengthen the trainee experience along with developing an induction page.

Aims: BG is named after its founder, Michael Balint, a trained therapist. BGs are reflective practice groups and have been shown to help with critical reflection, self-discovery and deep connection to others. It can enhance empathic understanding of the doctor-patient therapeutic relationship and has been used to facilitate reflections amongst doctors and other healthcare professionals. Its application in medical students have not been widely studied.

Loss of empathy and burnout as they began clinical training have been widely reported amongst medical students. As part of our hospital’s initiative to support their wellbeing, our Education Office offered medical students the experience of BGs by trained facilitators. We aim to understand students’ experiences of attending BGs and its impact on their wellbeing.

Methods: Students were invited via an email detailing the purpose and structure of BG. A non-random purposive sample of medical students with clinical postings of at least 6 weeks were included. BGs were conducted based on the students’ clinical groupings. Data was collected through self-reported questionnaires and qualitative feedback to capture the students’ experience with BGs in the clinical setting.

Results: 58 medical students participated in 6 sessions of BG conducted in groups of 8 to 10 with 1 or 2 facilitators. About 70% of the students were better able to appreciate the psychological aspects of patient encounters and endorsed that they benefited from facilitation of reflections during BGs. Content analysis of qualitative feedback supported the following themes: 1. Safe space to reflect on difficult clinical encounters; 2. Improved self-awareness; 3. Appreciation of different perspectives.

Conclusion: Providing the students with a safe therapeutic space to share their thoughts about difficult clinical encounters supported critical reflection and develop others’ awareness as they consider different perspectives. The sense of camaraderie and togetherness provided by the group may help to build empathy amongst our students and address burnout and compassion fatigue. BGs can also foster a sense of belonging and support during medical students’ stressful clinical years with the provision of a safe and secure space to explore emotions and attitudes. There are ongoing efforts to incorporate such reflective groups systematically into the undergraduate medical education clinical curriculum.

Aims: Psychoeducation for patients with anxiety disorders has been associated with reduced symptoms, improved quality of life, and increased response to treatment. However, there is much heterogeneity in such interventions. Patients with anxiety disorders can have maladaptive cognitive patterns such as catastrophic thinking, attentional biases toward threat, and cognitive avoidance. These patterns can interfere with the processing and assimilation of psychoeducational content, potentially reducing its effectiveness. Our hypothesis is that psychological safety plays a key role in increasing the effectiveness of psychoeducational interventions for patients with anxiety disorders. We aim to critically review the role of psychological safety in such interventions and to explore its impact on medical education in psychiatry.

Methods: Sources were identified through searches via databases including PubMed, PsycINFO, Scopus, Cochrane Library, and Google Scholar. Results were then critically analysed with key themes extracted to evaluate the role of psychological safety in psychoeducation. A narrative synthesis was then performed, exploring the influence of this on medical education in psychiatry.

Results: Several key themes were identified. Psychological safety has a mediating role between the quality of doctor-patient communication and patients’ self-disclosure, which can be limited by various fears, including a fear of negative judgment in this population. Patient engagement, which has a multidimensional construct, is also impacted by the presence of psychological safety which increases patient openness and comfort. Psychological safety also aids collaborative efforts within the healthcare ecosystem, positively impacting the outcomes of psychoeducational processes. The influence of psychological safety on the concept of the therapeutic interpersonal relationship in psychoeducation was also explored, with implications for open communication and the perception of threats. Proposed enhancements to assessments and curriculum for educational efforts in anxiety disorders and corresponding psychoeducational interventions through the active provision of psychological safety concepts were discussed.

Conclusion: This critical review highlights the pivotal role of psychological safety in enhancing the effectiveness of psychoeducational interventions for patients with anxiety disorders. By equipping clinicians to create safe environments, these efforts can optimize psychoeducational interventions and ultimately improve care for patients with anxiety disorders. Targeted studies on specific subgroups of patients with anxiety disorders should be performed to better qualify and quantify the impact of psychological safety in psychoeducational interventions in these subgroups.

Aims: This survey aimed to assess the training conditions of psychiatry resident doctors, within Cwm Taf Morgannwg University Health Board (CTMUHB). The survey provided an opportunity for trainees to share their experiences, highlight challenges, and contribute to improving training. Participation was anonymous to ensure confidentiality for sensitive topics such as discrimination.

Methods: The survey was developed in collaboration with resident doctors and the College Tutor Committee (CTC). Initial planning took place in May 2024, with survey design and distribution occurring in July 2024. Data collection focused on themes such as induction, rota design, and supervision. Data were cross-referenced with the GMC National Training Survey and HEIW Core Psychiatry Training data for validation. Although our respondent numbers vary vastly from that of the GMC National Training survey, significant proportionate interpretation of concerns raised in CTMUHB were made. Results are currently guiding discussion with the CTC and Health Board executives to implement strategic interventions.

Results: Respondents highlighted several concerns, particularly in induction processes, rota design, facilities, and consultant availability. Governance-related issues, such as inadequate escalation pathways, were also evident. 22% of respondents strongly disagreed that they had received all necessary information during induction, compared with just 2% in the national GMC survey. 11% rated their induction as “very poor”. Rota management was another major concern, with 33% of residents expressing dissatisfaction over unfilled rota gaps, which they felt resulted in missed learning opportunities. Additionally, 44% of CTMUHB residents reported working beyond their rostered hours, a figure substantially higher than the national rate of under 12%. Alarmingly, 22% of respondents were unaware of how to raise concerns about their training, indicating a critical gap in reporting mechanisms. Reports of discrimination, burnout, and negative workplace experiences further underscored the need for urgent intervention.

Despite these challenges, positive aspects were noted. All respondents agreed that their educational supervisor was easily accessible, and every trainee received formal feedback. However, 22.2% found this feedback unhelpful. Many residents highlighted teamwork and a supportive work environment as key factors contributing to overall job satisfaction.

Conclusion: The Health Board specific findings highlight the need for targeted interventions to improve training conditions. Recommendations include enhancing induction processes, redesigning rota management, increasing consultant availability and improving reporting systems. Addressing workplace discrimination and fostering a supportive environment remain critical priorities. Continued collaboration between resident doctors and the CTC is essential to drive meaningful improvements and ensure a better training experience for future trainees.

Aims: Specialist mood disorder services in the UK are diverse in structure and spread over different clinical-academic centres in the UK. Relationships between these centres are strong but often based on academic projects, with limited opportunities for clinical case discussions. The NIHR Mental Health Translational Research Collaboration, together with the ASCEnD trial team, has set up an online monthly meeting of tertiary mood disorder services: the Mood Disorders Grand Rounds (MDGR). The aims are: 1) to bring together people with expertise and interest from different centres across the UK; 2) to discuss complex and difficult to treat (or interesting) cases; 3) to consider treatment options. The format includes a 20-minute anonymised case presentation by a specialist, covering clinical and thematic aspects, followed by a 40-minute panel discussion focusing on case management, related themes, and relevant research studies. The presentership rotates between centres around the country and encourages a multidisciplinary approach.

Following the first 12 months of MDGR, we distributed a survey to evaluate and develop the meetings.

Methods: An evaluation form was developed and sent to all registered attendees over the course of six months, on a rolling basis. Participants were asked to both rate the effectiveness of various aspects of the programme and to submit suggestions for improvement, including suggestions for future speakers. Questions included both Likert scored items and free text responses.

Results: We received 21 responses (12% of those registered). 75% of respondents had not been to a similar regular collaborative programme previously. 50% of respondents stated that the MDGR had directly influenced their clinical practice, examples being of “Using MAOIs in a case where I hadn’t considered it before” and “identification of a patient with likely autoimmune encephalitis”. The remaining 50% stated that whilst the programme was relevant it had not had a direct result on practice.

Conclusion: A high proportion of respondents reported their clinical practice had been directly influenced by attendance. This suggests the MDGR is fulfilling the stated aim of focusing on clinical discussions and is of value to attenders. The rate of response is low and could be biased to those who found it more useful.

Aims: Falls are the most commonly reported patient safety incident in all older adult (OA) inpatient wards, and studies suggest there may be up to three times as many falls in OA mental health, compared with physical health settings. Many factors present on the mental health wards may influence this, including higher levels of agitation, psychotropic side-effects, a culture of promoting recovery through activity and a higher prevalence of side rooms resulting in less direct observation. There are four OA mental health wards within South London and the Maudsley NHS Trust. Following an analysis of serious incidents, falls prevention and management was identified as an area for improvement. Work to date has included updating the clinical falls policy, promoting a ‘falls awareness week’ and introducing a mandatory falls e-learning module. However, concerns remained about the practical application of this learning. As such we developed and delivered a half-day simulation course, with the aim of engaging staff in a enjoyable, practical session which would allow for reflective discussions and embed the new falls policy within ward culture.

Methods: The simulation course is designed to reach approximately 100 multi-professional staff across the four wards. Eight deliveries have taken place, or are scheduled to take place, between December 2024 and March 2025. Learning objectives, which were informed by trust protocols and incident reports, included increasing confidence with: identifying physical signs and symptoms of fractures and head injuries; initial assessments, management, ongoing review, and escalation process following a fall; the role of team working, handover and communication with family and colleagues; documentation and reporting systems after falls incidence, and increased awareness of the tools available to assist on the intranet.

Each delivery is co-facilitated by simulation faculty and ward staff. The course features four simulated patients, portrayed by actors. The scenarios are designed to each include different risk factors, mechanisms and consequences of falls. Each scenario is followed by a reflective modified diamond debrief.

Results: Pre and post-course questionnaires currently show increased confidence with regard to all the learning objectives. A thematic analysis of free text comments will also be presented, alongside reflections from the facilitators.

Conclusion: Simulation using live actors is an under-utilised medium for training in situations where physical and mental health presentations co-occur, and can be instrumental in embedding new policies or learning from serious incidents.

Aims: Individuals with ADHD and autism may face increased risks of cardiovascular issues or metabolic disorders influenced by both their neurodevelopmental traits and prescribed treatments. Ensuring consistent monitoring can help manage these risks and support better long-term outcomes. This paper explores the challenges of physical health monitoring in ADHD and autism and presents a quality improvement project aimed at enhancing monitoring practices in clinical care.

Methods: Challenges in physical health monitoring for individuals with ADHD and autism include variability in practice, limited access to medical equipment, space constraints in clinical settings, and the need for clearer guidelines. To address these issues, we conducted an assessment within the ADHD and autism service in Oxfordshire to identify essential materials for comprehensive monitoring of ADHD medications, antipsychotics, and antidepressants, alongside overall physical well-being.

Results: Key materials identified included blood pressure monitors, ECG machines, height and weight measurement tools, blood glucose and cholesterol testing kits, liver and kidney function tests, electrolyte testing kits, drug screening tests, and nutritional assessment tools. The assessment identified several challenges in physical health monitoring within ADHD autism service. Out of 12 assessed items, 58.33% had the necessary materials available, though essential equipment was not always present, and time constraints made integration difficult. Among those, 85.7% had functioning equipment, while 14.3% had non-functional equipment.

Conclusion: In ADHD and autism services, where psychopharmacology plays a central role in treatment, the importance of physical health monitoring becomes even more critical due to the side effects of medications such as stimulants, antipsychotics, and antidepressants. Inconsistencies in equipment availability, maintenance, and staff training were noted, leading to potential risks to patient safety, reduced efficiency, and increased costs. Recommendations include improved maintenance, acquisition of additional equipment, and enhanced staff training to ensure effective monitoring across services.

Aims: Raising concerns is an important duty for those working in medicine, which can have a broad impact on factors including safety, training, and wellbeing. This project aims to explore resident doctors’ experiences of raising concerns in psychiatry, including establishing awareness of available processes, and identifying barriers to utilising these. This work has been conducted as part of a wider Quality Improvement Project, aiming to improve resident doctor awareness and engagement with the process of raising concerns by overcoming identified barriers.

Methods: Resident doctors of various grades working in psychiatry within a six month period were invited to attend focus groups to gather information about their perspectives of raising concerns. Thematic analysis of focus group discussion was conducted. Quantitative data was obtained from an online survey which was sent to all resident doctors working in the trust for anonymous completion.

Results: 19 resident doctors attended focus groups. Thematic analysis of this content demonstrated five key themes with additional subthemes:

Repercussions (impact on career + feedback, wellbeing, reputation).

Futility.

Uncertainty (culture, acceptability, process).

Division (hierarchy, staff groups).

Variability (receptiveness, response, supervisor relationship).

25 resident doctors responded to the survey: 52% felt unfamiliar with the process for raising concerns; 5 respondents had raised a concern within the trust; 9 had experienced concerns that they had wanted to raise but could not.

Most concerns related to training (56%), supervision from seniors (31%), patient safety (25%), bullying/harassment (19%), and resident doctor wellbeing (13%). 16% of respondents felt that a barrier to raising a concern was related to race, sexuality, gender, or any other protected characteristic. 57% felt they were not taken seriously when they had raised a concern. 71% felt they had not received adequate feedback after raising a concern.

Conclusion: Resident doctors are experiencing a range of concerns, but many find that barriers prevent them from raising these. These barriers generally relate to uncertainty regarding the process, futility of raising concerns based on previous experiences, and fear of repercussions. This data suggests that there are issues resident doctors are experiencing that are going unreported, relating to their own training experiences as well as patient safety concerns. Focus group data has allowed us to have a better understanding of the barriers resident doctors face when raising concerns. Subsequently, we are working alongside resident doctors and key stakeholders using Quality Improvement methodology to trial the implementation of several change ideas to streamline the process of raising concerns.