4 results
Evaluation of the Psychiatry Early Experience Programme: Thematic Analysis of Baseline and One-Year Follow-Up Surveys
- Lucia Almazan Sanchez, Zena Tansley-Ahmed, Hamilton Morrin, Lia Orlando, Grace Crowley, Theo Boardman-Pretty, Raphael Rifkin-Zybutz
-
- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S13
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Aims
The Psychiatry Early Experience Programme (PEEP) is a long-standing scheme, collaboratively run by GKT School of Medical Education and SLaM Trust, which pairs medical students with core psychiatry trainees for clinical shadowing, mentoring and educational talks for the duration of their degree. We aimed to understand the motives of first year students signing up to PEEP and compare these to their feedback after one year.
MethodsBefore the 2015 and 2016 academic years we administered an online survey to 159 medical students interested in joining PEEP, asking the free-text questions: “What do you most hope to get out of PEEP?”, and “Why are you interested in the PEEP programme?”. Eighty students were selected for enrollment and of these, sixty who participated in one year of the programme completed a follow-up survey, including the question “What have you taken away from your experience of PEEP so far?”. Authors conducted thematic analysis of the qualitative responses at both timepoints, identifying common themes and seeking feedback from third raters when conflicts emerged.
ResultsThemes identified in responses to the baseline survey fell into two categories: psychiatry-related and non-psychiatry-related. The three most common psychiatry-related themes, were: Better understanding of the specialty (n = 67), Role of a psychiatrist (n = 16) and Evaluating interest/suitability to the specialty (n = 7). The four most common non-psychiatry-related themes were: Obtaining clinical experience (n = 70), Insight into the role of a junior doctor (n = 22) and to the Training pathway (n = 10) and Developing clinical and communication skills (n = 14).
Themes identified in responses to the follow-up survey closely reflected those from the baseline survey. Students commonly expressed that they gained a better understanding of what psychiatry is and what working in psychiatry entails (n = 24) and explored their interest in pursuing a career in psychiatry (n = 10). Similarly, they valued the ability to gain early clinical experience (n = 16) and to develop their clinical and communication skills (n = 9).
ConclusionThe results support the value of PEEP in providing opportunities for medical students to better understand what psychiatry is and explore their interest in the specialty. PEEP is also meeting students’ expectations outside of the realm of psychiatry by facilitating early clinical experience and the development of clinical and communication skills which are less available for medical students in their pre-clinical years.
Further collection and analysis of annual quantitative and qualitative data will ensure continuous evaluation and tailoring of the scheme to meet both students’ expectations and its purpose to foster interest in psychiatry.
A Quality Improvement Project to Improve Audio Quality for Remote Attendees of a Ward Round at a London Older Adult Psychiatric Ward
- Omer Hamour, Hamilton Morrin
-
- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S94
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Aims
Our aim was to investigate the extent and impact of poor audio quality during remote ward rounds using Microsoft Teams. We intended to compare attendees' audio quality experience with our expectation that a cardioid polar microphone would make it difficult for attendees to hear all members of the multidisciplinary team. We also hypothesized that switching to an omnidirectional recording system would improve perceived audio quality, communication, and patient care.
MethodsThis study is a continuation of a previous quality improvement project carried out on a general adult ward within the same Trust. This iteration involved individuals who participated remotely in ward rounds at a dementia specialist ward over a four-month period in 2022/2023. Participants of the study included staff from the ward team, community care coordinators and patient family members, who completed a digital feedback questionnaire about the audio quality. Due to the nature of their illness, no patients completed the questionnaire.
There were no exclusion criteria. Data from Likert scale questions were analysed. Little demographic data were collected, and qualitative data were analysed by identifying themes and grouping responses based on thematic frequency.
ResultsIn the pre-implementation survey, 12 responses were received from patient family members, 9 ward team members and 2 community mental health workers. Before the intervention, 3/12 participants rated the sound quality as "bad" and the same number were "dissatisfied" with the sound quality during ward rounds (modal response "neutral" for both, 6/10). Only 3/12 attendees reported being able to hear and understand everyone present in the ward round all the time, and one person reported only rarely hearing and understanding a single person in the room when they spoke.
All respondents agreed that the sound quality impacted their experience of the ward round. The three most common issues reported were people speaking too far from the microphone, voices sounding muffled, and poor internet connection causing gaps in speech.
Common themes identified in the qualitative data included: frustration, disengagement, and damage to patient care.
ConclusionIn summary, our findings indicate that when using a built-in laptop microphone with unidirectional pick-up, remote ward round attendees were not satisfied with the audio quality. However, this may be improved through the use of an omnidirectional system. Potential benefits from this technology may be optimised through the use of automatic transcription for individuals who may be hearing impaired, and ensuring optimal positioning for adequate sound detection.
A Quality Improvement Project to Improve Experiences of Audio Quality for Remote Attendees of a Ward Round at a London Acute Adult Mixed Psychiatric Inpatient Ward
- Hamilton Morrin, Vinitha Soundararajan, Rupa Ramesh, James Woollard
-
- Journal:
- BJPsych Open / Volume 8 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 20 June 2022, p. S104
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Aims
We sought to assess the degree, nature and impact of poor audio quality during ward rounds for individuals attending remotely using Microsoft Teams. We aimed to evaluate attendee experiences of audio quality against our expectation that due to the existing ward microphone system using a cardioid polar pickup pattern that attendees would have difficulty hearing all members of the multidisciplinary team, as well as the patient, gathered in the conference room. We also hypothesised that after switching to an omnidirectional sound recording system, we would observe an improvement in attendee satisfaction with audio quality during ward rounds.
MethodsIndividuals who had remotely attended ward rounds at Lesney Ward, Oxleas NHS Trust between 01/11/21 and 01/01/22, mainly patient family members and community care co-ordinators, completed a digital feedback questionnaire regarding audio quality. There was no exclusion criteria. Data from Likert scale questions were analysed with descriptive statistical tests (mode and distribution of responses). As minimal demographic data were obtained, inferential statistical tests were not used. Qualitative data were analysed using thematic sorting based on prevalence of themes in the data.
ResultsFeedback was provided by three family members, one ward team member and six members of the community mental health team prior to the intervention. Pre-intervention feedback indicated high levels of dissatisfaction with 6/10 respondents reporting they were “dissatisfied” and 1/10 “very dissatisfied”. Only 3/10 of attendees reported being able to hear and understand all individuals physically present in the room. In addition, respondents agreed that the audio quality was poor (modal response “bad”, 6/10), and that the sound quality impacted upon their experience of the ward round (modal response “yes, greatly”, 6/10).
The three most common main issues reported by respondents were: people speaking too far from the microphone (7/10), voices sounding muffled (6/10), and too much background noise (4/10). Using their own words, respondents described how the ward round sound quality made them feel. Common themes identified through thematic sorting included: distress, difficulty in understanding information / management plan, ward round prolongation and inability to comprehend the patient or staff.
ConclusionIn conclusion, we found that when using an in-built laptop microphone with unidirectional pick-up remote ward round attendee satisfaction was poor, though this improved with the introduction of an omnidirectional system. Key areas for improvement include assessment of optimal positioning for adequate audio pick-up, and the introduction of automatic transcription for individuals with hearing impairments.
Systematic review of the efficacy of non-pharmacological interventions in people with Lewy body dementia
- Hamilton Morrin, Ton Fang, Donald Servant, Dag Aarsland, Anto P. Rajkumar
-
- Journal:
- International Psychogeriatrics / Volume 30 / Issue 3 / March 2018
- Published online by Cambridge University Press:
- 09 October 2017, pp. 395-407
-
- Article
- Export citation
-
Background:
Pharmacological interventions for Lewy body dementia (LBD), especially for its non-cognitive symptoms, are limited in their efficacy and tolerability. Clinicians are often uncertain about non-pharmacological interventions and their efficacy in managing cognitive and non-cognitive symptoms of LBD. Therefore, we aimed to systematically review the existing literature on non-pharmacological interventions for people with LBD.
Methods:We carried out a systematic search using six databases. All human studies examining impact of any non-pharmacological intervention on LBD were assessed for cognitive, physical, psychiatric, and quality-of-life outcomes. Study quality was assessed by Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies and the CARE criteria checklist.
Results:Prevailing evidence supporting the efficacy of non-pharmacological interventions is weak. We screened 1,647 papers. Fifteen studies (n = 61) including 11 case reports were found eligible for this systematic review. Interventions and reported outcomes were heterogeneous. Deep brain stimulation of the nucleus basalis of Meynert reportedly conferred cognitive benefit. Electroconvulsive therapy and repetitive transcranial magnetic stimulation have been reported to ameliorate depressive symptoms. Transcranial direct current stimulation was observed to improve attention. Exercise-based interventions reportedly improve various clinically important outcomes. Spaced retrieval memory training and environmental intervention for “mirror sign” have also been reported.
Conclusions:Several non-pharmacological interventions have been studied in LBD. Although evidence supporting their efficacy is not robust, prevailing preliminary evidence and limitations of available pharmacological interventions indicate the need to consider appropriate non-pharmacological interventions, while planning comprehensive care of LBD patients. Larger trials evaluating the efficacy of non-pharmacological interventions for LBD are needed.