Previous research has shown that repeated retrieval with written tests produces superior long-term retention compared to repeated study. However, the degree to which this increased retention transfers to clinical application has not been investigated. In addition, increased retention obtained through written testing has not been compared to other forms of testing, such as simulation testing with a standardized patient (SP). In our study, 41 medical students learned three clinical topics through three different learning activities: testing with SPs, testing using written tests, and studying a review sheet. Students were randomized in a counter-balanced fashion to engage in one learning activity per topic. They participated in four weekly testing/studying sessions to learn the material, engaging in the same activity for a given topic in each session. Six months after initial learning, they returned to take an SP test on each topic, followed by a written test on each topic 1 week later. On both forms of final testing, we found that learning through SP testing and written testing generally produced superior long-term retention compared to studying a review sheet. SP testing led to significantly better performance on the final SP test relative to written testing, but there was no significant difference between the two testing conditions on the final written test. Overall, our study shows that repeated retrieval practice with both SPs and written testing enhances long-term retention and transfer of knowledge to a simulated clinical application.

Purpose Religion and spirituality are well-researched concepts within the field of psychology and mental health yet they have rarely been researched in high-secure services within the UK. Research in mental health and prison contexts suggests benefits of religion/spirituality to coping, social support, self-worth, symptoms of depression and anxiety and behavioural infractions. The purpose of this paper is to investigate the role of religion/spirituality in high-secure service users’ personal recovery. Design/methodology/approach Semi-structured interviews were carried out with 13 male patients in a high-secure hospital, with primary diagnoses of mental illness (n=11) or personality disorder (n=2). Participants were from a range of religious/spiritual backgrounds and were asked about how their beliefs impact their recovery and care pathways within the hospital. Data were analysed using interpretative phenomenological analysis. Findings Three superordinate themes were identified: “religion and spirituality as providing a framework for recovery”; “religion and spirituality as offering key ingredients in the recovery process”; and “barriers to recovery through religion/spirituality”. The first two themes highlight some of the positive aspects that aid participants’ recovery. The third theme reported hindrances in participants’ religious/spiritual practices and beliefs. Each theme is discussed with reference to sub-themes and illustrative excerpts. Practical implications Religion/spirituality might support therapeutic engagement for some service users and staff could be more active in their enquiry of the value that patients place on the personal meaning of this for their life. Originality/value For the participants in this study, religion/spirituality supported the principles of recovery, in having an identity separate from illness or offender, promoting hope, agency and personal meaning.

Research on the application of multisystemic therapy (MST) has focused on the experiences of caregivers, families and the young people with behavioural conduct difficulties for whom MST has been established as an effective intervention. Perspectives of MST therapists are lacking, yet hold relevance for MST model adherence and services. Using a social constructivist grounded theory approach, eight MST therapists in the United Kingdom took part in a semi‐structured interview designed to explore the requirements of the role. Data revealed four categories: two of explicit roles that included establishing rapport, engaging with families, defining the drivers to a young person’s behaviour, and doing ‘whatever it takes’ to overcome challenges; while underpinning these were two categories of implicit roles related to coping with the organisational environment and interpersonal skill demands of the role. This study widens the understanding of both individual and organisational factors/climate and its impact on therapist performance in MST practice. Practitioner points Supervisors need to monitor therapists’ workloads, organisational climate and the emotional impact of their role, applying a greater duty of care in an ethos of doing ‘whatever it takes’ Maintaining engagement is a distinct and essential phase of MST. Non‐engagement can be overcome by therapists who adapt their interpersonal style to meet individual needs Collaboration with external agencies (e.g. schools) supports cross‐agency working in line with MST principles

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