It is widely acknowledged in hospitals that the quality of design and environment can influence the quality of patient care, the sense of therapeutic security and the experience of staff. This women's PICU collaborated with the charity Hospital Rooms to realise the valuable role of art within the clinical environment. Experienced artists were commissioned to work in genuine partnership with patients and staff to re-envision the physical environment with the installation of eight imaginative, inventive and PICU compliant art works.<br/> The implementation, and both patient and staff perspectives were evaluated. There was no disruption to clinical care and engagement and participation was enthusiastic. There were 35 patient encounters and 32 staff encounters, including creative workshops and an exhibition.<br/> Patient Experience Data Intelligence Centre (PEDIC) reports showed an improvement following artwork installation. Patients were more likely to recommend the ward, felt more involved in their care and that the ward was comfortable. The art transformed clinical spaces creating opportunity for patients to have exceptional experiences: 'being here feels like sitting in the park'.<br/> Staff evaluation through a 'visual matrix' method that explores shared experience, revealed that the art has introduced further possibility of 'respite and escape' for both patients and staff. There is a sense that 'you feel like it is leading you to somewhere, you feel like there is something more'. It has also engendered 'ownership and pride': it 'feels like pushing boundaries, things you thought could never be considered at all, are now being considered'.
Aims and Method This study evaluated a pilot psychiatry summer school for GCSE students in terms of participant experience, effects on attitudes to mental illness and perception of psychiatry as a career option. This was done using the Community Attitudes towards the Mentally Ill scale, career choice questionnaires and a discussion group following the week-long programme attended by 26 students. Results Students were significantly more likely to choose psychiatry after the summer school (P = 0.01). There were statistically significant changes in scores for social restrictiveness (P = 0.04) and community mental health ideology (P = 0.02). Qualitative analysis generated four themes: variation in expectations, limited prior knowledge, perception of the summer school itself and uniformly positive attitudes to psychiatry after the summer school. Clinical implications Targeting students at this early stage appears to be an underexplored positive intervention for improving both attitudes towards mental illness and recruitment to psychiatry.
IntroductionOut of hours, there is only one on-site junior doctor. First year psychiatry trainees (CT1s) and GP trainees may have no prior experience in psychiatry. On-call shifts are therefore potentially daunting for new trainees.ObjectivesExpand the resources available for trainees when on-call.MethodsWe issued questionnaires to CT1s asking if they would have appreciated more information about on-call scenarios and in what format.Based on the questionnaire results we implemented some changes. These were:– a printed “pocket-guide” summarising common on-call scenarios;– a training video on common on-call scenarios.The handout was given to new trainees in February 2016 and in August 2016. The video was shown to new trainees in August 2016. Trainees provided feedback on the resources.ResultsOf 24 CT1s, 15 (63%) were “neutral” or “disagreed” that they had felt prepared for on-calls.CT1s wanted additional resources, especially a paper handout or phone download.Feedback on the “pocket-guide” from trainees in February 2016 (n = 8) was positive (62.5% reported increased confidence in on-call situations). Feedback is also being collected from trainees who received the guide in August 2016.Trainees in August 2016 (n = 36) liked the video – no trainees “disagreed” with statements asking if the video had been useful.The video improved the confidence of trainees about on-call situations by an average of 2.8 points.ConclusionsWe have expanded available resources relating to on-calls and improved confidence. Further improvements would include making resources more easily available in downloadable formats.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionIn recent years there has been a move towards treating depressed patients in the community.One factor that may reduce the likelihood of discharge from secondary care is suicidality. The aim of this audit was to identify factors associated with continued suicidality among Community patients.Subjects and methodsWe searched an anonymised database of patients and identified all those with previously documented suicidal thoughts or attempts. We also noted the presence of factors such as alcohol problems, drug problems, augmentation therapy and ‘other risk’ factors (e.g. financial problems or homelessness). We assessed the latest clinic letter, to see if patients were still reporting suicidality. We compared the aforementioned factors between the group of patients in which suicidality was still present (group N) and the group of patients in which suicidality was no longer a feature (group Y).ResultsOf the 56 patients with suicidal thoughts or attempts there were 44 in group N (79%) and 12 in group Y (21%). Alcohol problems, drug problems and ‘other’ risk factors were more common among group Y than group N. Conversely, the percentage of patients on augmentation therapy was greater in group N than group Y.DiscussionThe audit provides an insight into the factors that might influence outcomes among depressed patients.ConclusionsAlthough the results are suggestive, it is difficult to make firm conclusions about patient outcomes on the present data. The audit provides a useful starting point, especially in considering the treatment of patients within the CMHT.
Background: Potential augmentation regimes include the addition of atypical antipsychotics or other antidepressants (e.g. mirtazepine). There is growing evidence in the literature to support the efficacy of both the aforementioned augmentation strategies. Aim: The purpose of this audit was to compare patient outcomes between groups receiving different augmentation strategies. Subjects and methods: We searched an anonymised database of patients and identified those receiving augmentation with mirtazepine (group A), atypical antipsychotics (group B) or both (group C). For each patient we noted (1) the discharge status and (2) the presence of suicidal ideation. We then looked at clinical notes to find out whether or not patients were still reporting suicidality. Results: The proportion of patients who had been discharged was highest in group A. The percentage of patients still reporting suicidal thoughts was higher in group B than in groups A or C. Discussion: Augmentation with mirtazepine resulted in better outcomes in terms of both discharge rates and in terms of reduction in suicidality than augmentation with atypical antipsychotics. One explanation for this is that mirtazepine augmentation is a more effective method of treatment in patients with refractory depression. However, it is also possible that differences in patient factors (e.g. age and drug problems) between the different treatment groups could contribute to variability in outcomes. A previous audit (Holt et al, 2011) has already confirmed that such differences do exist among the patients being analysed in this audit.
IntroductionFollowing the national lockdown in the UK in March 2020 in response to the COVID-19 pandemic, we instigated regular online tutorials for fourth year medical students undertaking their psychiatry placement.ObjectivesThe aims of these tutorials were threefold: to ensure that students covered a range of key psychiatry topics, to enable them to have the opportunity for interactive tutorials with experienced psychiatrists and, not least, to create a sense of continuity and connection with their tutors and peers across the mental health block.MethodsEach student was allocated to a tutorial group comprising 10 – 15 medical students and a psychiatrist facilitator. These groups met weekly for 7 consecutive weeks at an agreed time for 60 – 90 minutes via an online platform and all covered the same allocated topic each week. We evaluated these groups via an online survey sent to the students following the programme.ResultsThe students rated the tutorials on average as 4.5/5 on whether they met the defined learning outcomes. On average the students did not consider that the virtual format made a significant difference to their learning, but this disguised a wide range of views that were expressed via a comment box.ConclusionsThe evaluation of this project supports the use of virtual tutorials as a valuable learning tool but educators need to be aware that student views’ on these can be varied and so, long-term, a blend of virtual and face to face learning is most likely to meet the needs of all students.
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