Psychiatry training experiences: a narrative synthesis

Karageorge, Aspasia; Llewellyn, Anthony; Nash, Louise; Maddocks, Claire; Kaldelis, Dimitra; Sandhu, Harsimrat; Edwards, James; Kelly, Brian

doi:10.1177/1039856216646233

Cited by 7 publications

(8 citation statements)

References 29 publications

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“…Many studies have examined student attitudes towards psychiatry. 1,2 These have been measured through scales such as the Attitudes Towards Psychiatry scale (ATP-30), 3 which assesses themes of patients, institutions, pathologies, treatment modalities, teaching and knowledge base. Such scores are remarkably globally consistent, and replication studies have reached saturation point.…”

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confidence: 99%

Medical student perceptions of physical and emotional safety before and after 5-week mental health placements

Gallan

Dawes

Thomas

2020

Australas Psychiatry

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Objective: Understanding whether medical students feel safe in mental health placements is important to delivering effective and engaging training experiences. Method: Second year students completed anonymous online surveys before ( n = 37) and after ( n = 41) mental health placements, to gather qualitative and quantitative data about their sense of physical and emotional safety, and factors that positively and negatively influenced their experiences. Data were analysed using chi square and content analysis. Results: There was a disparity between students’ expectations of physical and emotional safety before placements and their actual experience. Following placement, no students reported that they felt physically ‘unsafe’ or ‘very unsafe’. Conversely, over 20% of students indicated that they had felt emotionally unsafe during their placement. When asked to compare their expectations prior to placement with their actual experience, over 13% felt ‘much less safe’ emotionally, where no participants felt ‘much less safe’ physically. Qualitative content identified included exposure to patients’ tragic life stories, aggression, the physical ward environment and adequacy of supports. Conclusions: The distinction between physical and emotional safety is a valuable framework through which to understand the student experience of clinical placements in psychiatry and to seek to best support students. The data provide rich insight into students’ experiences, particularly emotional challenges, on psychiatry wards.

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confidence: 99%

Medical student perceptions of physical and emotional safety before and after 5-week mental health placements

Gallan

Dawes

Thomas

2020

Australas Psychiatry

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“…This theme supports other research which has found witnessing patient recovery as one of the most positive experiences of a psychiatry placement. 3 …”

Section: Discussionmentioning

confidence: 99%

Junior doctor psychiatry placements in hospital and community settings: a phenomenological study

et al. 2017

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ObjectivesThe proportion of junior doctors required to complete psychiatry placements in the UK has increased, due in part to vacant training posts and psychiatry career workforce shortages, as can be seen across the world. The aim of this study was to understand the lived experience of a Foundation Year 1 junior doctor psychiatry placement and to understand how job components influence attitudes.DesignThe study was conducted using a cross-sectional qualitative phenomenological approach.SettingHospital and community psychiatry department settings in the North East of England, UK.ParticipantsIn total, 14 Foundation Year 1 junior doctors were interviewed including seven men and seven women aged between 23 and 34 years. The majority had completed their medical degree in the UK and were White British.ResultsThe lived experience of a junior doctor psychiatry placement was understood by three core themes: exposure to patient recovery, connectedness with others in the healthcare team and subjective interpretations of psychiatry. The experiences were moderated by instances of role definition, reaction to the specialty and the organisational fit of the junior doctor capacity in the specialty.ConclusionsThe study reinforces and adds to the literature by identifying connectedness as being important for both job satisfaction and morale, which is currently damaged within the junior doctor population. The study provides in-depth insights into the lived experience of psychiatry placements and can be taken forward by educationalists to ensure the placements are meaningful experiences for junior doctors by developing role definition, belonging, structure and psychiatric care responsibility.

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“…Several studies have shown that the ways in which residents and medical students experience psychiatry training is different than in other specialties, which may extend to experiences of IHD during training. [68][69][70] However, the available literature exploring the nature of the learning and training environment in psychiatry is controversial, with one study suggesting that perceptions and personal experiences of IHD within the psychiatric learning environment are low. 71 Previous studies have consistently demonstrated elevated rates of IHD among psychiatry trainees relative to other trainee groups.…”

Section: Ihd Among Psychiatry Residentsmentioning

confidence: 99%

“…75 Factors related to compassion fatigue and burnout may also be more common among psychiatry trainees given the empathic demands of their work and vicarious exposure to IHD. 69 Psychiatrists are also paid the least among medical specialties-a systematic factor that is outside of the immediate control of most physicians. [76][77][78] As IHD is considered a major risk factor for burnout, with a 2016 national survey of Canadian psychiatry residents finding that 21% reported symptoms of burnout, IHD encounters appear to play a critical role in psychiatry resident experiences of burnout.…”

Section: Ihd Among Psychiatry Residentsmentioning

confidence: 99%

Prevalence of intimidation, harassment, and discrimination in resident physicians: a systematic review and meta-analysis

Bahji

Altomare

2019

Can. Med. Ed. J

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Background: The aim of this study was to establish the prevalence of intimidation, harassment, and discrimination (IHD) reported by resident physicians during their training, to identify factors associated with reported IHD, and to identify adverse sequalae associated with IHD. Methods: This review followed the PRISMA guidelines. Eight electronic databases were searched for cross-sectional studies reporting the prevalence of IHD among resident physicians. Prevalence estimates were pooled across studies using random-effects meta-analysis, with variance stabilization using Tukey double arcsine transformation. Heterogeneity was assessed with forest plots, the I2 statistic, subgroup analyses, and multivariate meta-regression. Results: 52 cross-sectional studies were included in the meta-analysis. The overall pooled prevalence of IHD was 64.1% (95% confidence interval [CI], 51.0-77.1). Verbal, physical, and sexual IHD were the most common forms of IHD reported by residents. Training status (55.5%), gender (41.7%), and ethnicity (20.6%) were the most commonly cited risk factors for IHD. The most common sources of IHD were relatives/friends of patients, nurses, and patients (cited by 50.7%, 47.8, and 41.7%, respectively). Conclusions: The prevalence of IHD among resident physicians is high and associated with multiple negative outcomes, including burnout. Despite the availability of multiple anti-IHD interventions, reports of IHD appear to be rising in many residency programs.

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Psychiatry training experiences: a narrative synthesis

Abstract: There is a need to better understand how the junior doctor and medical student psychiatry experience influences perceptions of psychiatry and intention to specialise, especially in the Australian context.

Cited by 7 publications

References 29 publications

Medical student perceptions of physical and emotional safety before and after 5-week mental health placements

Medical student perceptions of physical and emotional safety before and after 5-week mental health placements

Junior doctor psychiatry placements in hospital and community settings: a phenomenological study

Prevalence of intimidation, harassment, and discrimination in resident physicians: a systematic review and meta-analysis

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