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

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

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

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

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.

To develop and implement a QI training programme for trainees, Trust grade doctors and Consultants in Nottinghamshire Healthcare NHS Trust (NHFT) to enable them to deliver change in practice through acquisition of new knowledge and practical application of skills in QI projects using Model for Improvement.

QI is crucial to improve patient care. Doctors are uniquely placed to input into patient safety and service delivery of healthcare. The skills required to be future clinical leaders and undertake improvement work are not innate and formal teaching and support is required.

What is DrQI?

DrQI is a trainee-led QI teaching programme developed in collaboration with Trainees improving patient safety through QI (TIPSQI) in North West deanery.

A pre-implementation survey amongst doctors in NHFT in February 2019 (33 responses) suggested that 90% of doctors were interested in learning QI and about 48% preferred face-face workshops with support from the QI team.

A list of change ideas were created using a driver diagram with QI education and project support identified as key primary drivers.

PDSA cycles

Nine interactive workshops teaching key QI concepts (based on model for improvement) in NHFT, training more than 100 doctors. A workshop in Derbyshire Healthcare NHS Foundation Trust (70 doctors) and Nottingham University Hospital (20 doctors). Workshops were continually adapted based on qualitative and quantitative feedback. Different formats were tried including virtual sessions, game-based and problem-based learning approaches using small group activities.

Pre-course and post-course questionnaires were used to assess change in understanding of individual components of QI methodology (SMART Aim, Driver diagram, PDSA cycles, outcome and process measures and run charts). Mean pre-course self-assessment score collated from seven QI workshops in NHFT (2019-2020) was 3.3 and mean post-course score was 7.68, showing an improvement in understanding of QI methodology.

Participants were asked to score the relevance (8.4) and quality of teaching (8.4) and the support from the QI team (7.4) on a scale of 1-10 (1 = poor and 10 = excellent). Additional free text feedback was obtained to help us improve the teaching programme.

Collaborative leadership trainee-led initiative to increase the QI capacity. A bottom up approach to complement the top down approach from the Trust QI team. Future steps include further collaboration and expansion of the scheme to other Trusts, Train the trainer sessions and building a network of QI champions.