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www.SchoolofPsychiatry.net NW School of Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” Dr Latha Hackett Course Director NW School of Psychiatry Email: [email protected] Sam Abbott Dr Raghu Paranthaman Medical Education Manager Trust MRCPSych Lead NW School of Psychiatry Greater Manchester West NHS FT Email: [email protected]: [email protected]

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Page 1: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

HENW (North Western) MRCPsych Course

“Theory to Practice”

Dr Latha Hackett

Course Director

NW School of Psychiatry

Email: [email protected]

Sam Abbott Dr Raghu Paranthaman

Medical Education Manager Trust MRCPSych Lead

NW School of Psychiatry Greater Manchester West NHS FT

Email: [email protected]: [email protected]

Page 2: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Background

• The process

• The course: Academic programme, LEPP

• *Training of Educational Supervisor

• Evaluation

• Challenges

• Future plans

Page 3: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Health Education North West

• Brought together two former

Deaneries, North Western

& Mersey

• Oversees postgraduate medical

education & training with

responsibility for over 7,000 trainees

• Process of aligning activity

• Currently still two Schools of

Psychiatry

– Psychiatry trainees in the NW - 120 Core

trainees, similar No of HST

Page 4: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

The NW School of Psychiatry

Page 5: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Background to MRCPsych Course

• Historically delivered via Manchester University

• 30 day MRCPsych course

• Delivered over 2 year period

• Has been running for more than three decades

• In the last three years the course moved towards blended learning,

distant learning, face to face and periods of private study

• Summer 2013 - £3,500 per trainee per year, due to

increase for 2014...

• Termination of contract by the Deanery in 2013

Point of no return, hence opportunity for a new NHS

developed and locally delivered programme

Page 6: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

From September 2014

• No University run course for CT1s

• CT2 trainees to continue on the University course. Last

cohort completed in the of summer 2015

• No extra money

• NHS had to provide the training

New NHS run course for CT1 had to start September 2014

Page 7: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Setting up the Course…

• Commenced in Post 1.4.14 - 1 day a week secondment

• Studied core curriculum, examination, Wessex NHS run

course, Mersey University course & Manchester

University course - April 2014

• Phase 1 completed by July 2014

• Phase 2 commenced September 2014

Page 8: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Consultation May – June 2014

• CT/STs currently on the course or who had recently

completed the University MRCPsych

• Site tutors as a group, some individually, School

Operational Board, DMEs – across the patch of 9

Trusts

• MHSC, GMW, Pennine Care, Lancashire Care,

Cumbria, CMFT, 5BP, Macclesfield and Calderstones

• One half day (tutors/CTPD) and 1 full day (included all

interested parties)

Page 9: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Consultation Findings

• Considerable variations in training provided by different

LEPs

• Some really excellent models of training e.g. 555

presentation

• In some LEPs – there was variation between own sites

• Psychotherapy training - Met the College requirement 30

sessions of Balint group, one long case and one short

case in two different modalities. Again delivery varied

across LEPs

• No consistency & parity in training

Though every body was keen & trying their best and

there was a lot of enthusiasm for training on all sites

Page 10: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Disconnection & Variation

Between:

• Learning in the Placement

• Educational Supervisor supervision

• LEP Programme

• University run course

• Psychotherapy

• MRCPsych examination

Page 11: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Outcome

Curriculum Development

• Subgroup established in June 2014 (recommendation, major

educational role)

• LEP Programme/Handbooks/Website operational by

August 2014

Delivery

• LEP programme to commence September 2014

• Academic course to commence September 2014 for CT1

• Evaluation

Page 12: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

New Course Principles

• Psychiatrists are medically qualified doctors with a

specialism in Psychiatry

• Adult learning principles

• Achievement of core skills for core trainees:

– Training close to patients, learning from patients, learning from ES,

in MDT, in the LEP Programme

• What cannot be done locally in placements – done

centrally e.g. academic day, exam preparation

• Good practice on sites incorporated - 555, psychotherapy

• Training offered on different sites are now comparable &

measurable

Page 13: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

New Course Aims To:

• Reconnect the four training strands:

– Educational Supervisor supervision

– LEP run weekly sessions

– Academic course at the Medical Education, School of Psychiatry

(replaced the “University run course)”

– Psychotherapy

• And link them to:

– MRCPsych examination

• Achieving:

– “Consistency/parity across sites and increase depth of knowledge”

to address differences in training provision across LEP’s

Page 14: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Some Parallels To:

• PBL for Medical students in Manchester

• Run on different sites with the same PBL format with PBL trained

Doctors

• Have handbooks prepared by a committee that PBL tutors follow –

handbook for tutors and handbook for students

• Students do have some lectures centrally – e.g. statistics during

their Project Option etc etc…

Discussion with Manchester Medical School lead for PBL re:

how the University reviewed its PBL teaching

Page 15: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Module Leads Site Leads • General Adult – Dr Brijesh Desai,

Lancs Care – recommended by TPD

• Old Age – Dr Gareth Thomas, Lancs

Care, MEF, recommended by TPD

• Child & Adolescent Psychiatry – Dr

Neelo Aslam, CMFT (TPD)

• Intellectual Disability – Dr Nasim

Chaudhry, GMW, Dr Sol Mustafa

Pennine – recommended by DMEs

• Forensic – Drs Vicky Sullivan &

Hany El-Metaal, GMW – by STP

• Substance Misuse – Dr Patrick

Horgan, GMW - by STP

Psychotherapy – Dr Adam Dierckx,

MMHSC, by STP

• GMW – Dr Raghu Paranthaman

• Pennine Care – Dr Ema Etuk

• MHSC- Dr Adam Dierckx

• Lancashire Care – Drs Brijesh

Desai/Gareth Thomas

• Cumbria - Dr Andrew Morgan,

Tutor

• 5BP – Dr Nithya Anand, Tutor

• Acute Trusts - trainees based

in acute Trusts (CAMHS) tend to

join local mental health trusts

Page 16: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

• School of Psychiatry Postgraduate Collaborative

managed by Samantha Abbott

– With the enormous help of administrators, Janene Chesters,

Laura Griffiths and Angela McMahon

• Operational Group meets 2-4 times a year

• 2014 - July 14, August 14, October 14

• 2015 – January 2015, July 2015,

• 2016 - January 2016

Supported by:

Page 17: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry NW Psychiatry School Board

MRCPsych Course Oversight Committee Prof D Longson - HoS, Dr M Campbell – DME, Dr L Hackett – Course Director, Ms S Abbott – NW MEM, Trainee & User Reps

Course Director Dr Latha Hackett

NW PG Medical Education Dept Ms Samantha Abbott – NW Med Ed Manager

Angela McMahon, Laura Griffiths & Janene Chesters – Med

Ed Administrators

Trust Leads 5BP – Dr Nithya Anand

Cumbria – Dr A Morgan

GMW – Dr R Paranthaman

Lancashire Care – Dr G Thomas/Dr B Desai

Manchester Mental Health – Dr A Dierckx

Pennine Care – Dr Ema Etuk

Module Leads General Adult – Dr B Desai/Dr R Thomasson

Old Age – Dr G Thomas

Forensic – Dr H El-Metaal/Dr V Sullivan

CAMHS – Dr N Aslam

ID – Dr N Chaudhry/Dr S Mustafa

Substance Misuse – Dr P Horgan

Psychotherapy – Dr A Dierckx

Page 18: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Theory to Practice

Educational

Supervisor/

Supervision -

weekly an hour

Psychological

modalities

30 Balint gps +

Long case &

Short case in 2

diff modalities

Academic

Programme –

Ct1-12 days

Ct2 – 12 days

Local

Educational

Provider (LEP)

(44) 30

sessions a year

Attain core competencies +

MRCPsych Exam (Progress Test – Written & Clinical)

Page 19: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

• Local Education Provider Programme – LEPP

• Every LEP was providing weekly Journal club and case

presentations (44 sessions annually)

• Many were already providing, weekly, half day sessions

for the whole year

• The main difference from the old course was to

strengthen this bit of the training

• We recommended that all LEPs provide mandatory 15,

half day sessions every six months with the content

recommended

North Western Course

“ES+LEP+Psychotherapy+Academic programme+ Exam Practice”

Page 20: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

• LEP programme

• Modular, two year rolling - 4 x 6 months

• Each 6 month block has 15 half day sessions

• Each block has General Adult, Old Age, Specialties – CAP, ID,

Substance Misuse, Forensic, one across ages

• LEPs had to meet, FY,GP, CT training needs

• Psychological modalities – 30 (25) sessions of Balint group, one

long case and one short case in two different modalities +

preparation of trainees for providing therapy

• Academic Programme (2 years) – 12 days a year for CT1 and 12

days a year for CT2 and no programme for CT3

North Western MRCPsych Course

Page 21: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

• Supported centrally from the School of Psychiatry,

Module Leads and Course Director, producing:

• Handbooks for GA for 6 months, OA, CAP, ID, Forensic,

Substance Misuse completed – August 2014

• Trainee and ES handbook

• Dedicated password protected on-line materials

• Journal papers sent out 2-4 weeks in advance

• Expert Led Sessions – Prepared lectures were available

• Feedback & Reflective notes

North Western Course

Page 22: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

SchoolofPsychiatry.net

Page 23: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

• Induction

• Communication skills training – verbal, non verbal and

written skills

• Once the Academic programme and LEP programme is

established we will jointly look at Communication skills

training to share good practice & achieve best practice

August & February annually

Page 24: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

63 CT1/2 on the course to date

Trust Attending LEP Sessions at:

5BP Leigh

Calderstones Preston

Central Manchester University Hospital Trainees join GMW & MMH&SCT

sessions

Cumbria Carlisle

Greater Manchester West Prestwich (GMW)

Lancashire Care Blackburn

Blackpool

Preston

Manchester Mental Health & Social Care

Trust

NMGH (MMH&SCT)

Pennine Care Bury

Rochdale

Oldham

Tameside

Stockport

Page 25: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

• Local Education Provider Programme commenced with

the same modules across all areas

• Mandatory 15 half days (4 hours)

• Clear guidance on what must be covered during the 6 months

• Modules could be delivered in any order as long as all were covered

during that 6 month period

• LEP still has 7 sessions available to cover topics of their

choice e.g. audit/communication skills etc etc

• Open to all trainees in psychiatry – FY, GP, CT1-3

• FY’s/GPs can do joint presentations with CTs

September/March- Programme starts

LEP + academic programme

Page 26: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

LEP Component • General Adult – 6 (7) sessions

• Old Age - 2 sessions

• Child and Adolescent – 2 sessions

• Intellectual Disability – 1 session

• Forensic – 1 session

• Substance Misuse 1 session

• Every 6 months – a theme across

ages e.g. Psychosis across the

ages

• 2 hours on MCQ’s, exam practice etc

during the whole 6 months

• Total 15 sessions of 4 hours each

every 6 months

• Total LEP (2 years) - 60 sessions

in 24 months – 25-GA, 8 –OA, 8

CAP, 4 – ID, 4-Foren, 4 Substance

misuse, 3 to Psychotherapy. 4

sessions themed across ages e.g..

Psychosis, Depression, eating

disorder, Mental Illness in the family

Centrally developed handbook for LEP advice on Journal club papers, Clear learning

outcomes, Link with Competencies (ILO), Cases for case presentation and ES handbook

Centrally developed handbook for LEP advice on Journal club papers, Clear learning

outcomes, Link with Competencies (ILO), Cases for case presentation and ES handbook

Page 27: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Topics for LEP Programme • General adult topics - Topics for LEP – GA (25 sessions): Psychosis (4

sessions), Depression (4 sessions), Bipolar 4, Personality disorder 3,

Anxiety disorders/GAD/Phobic/Panic -2,

• Suicide and self harm – 2, MHA/MCA, PTSD

• Organic, General Hospital, OCD – 1 each

• Papers, RCT, Meta-analysis/Systematic review, Economic study,

Genetics

• Old age (8) – Assessment, Alzheimer’s dis, Other Neurodegenerative

disor, Delirium, Mood disorders, Psychosis, anxiety disorders, Medico-

legal aspects

• CAP (8) – Assessment, ADHD, ASD, Anxiety/Depression, Attachment

disorder, eating disorders, ID in CAP, Legal aspects

Page 28: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Topics for LEP Programme - 2

• Psychotherapy – 3 – Psychotherapy services etc, Emotionally

unstable personality disorder, 1 more

• ID (4)– Assessment, Mental disorders, Behavioural issues,

Offenders

• Forensic (4) – Psychiatry and CJS, Link bet Crime and mental

disorder 1 & 2, Psychiatry in court

• Substance Misuse (4) – Diag and treat of Alcohol problems, D &

T problems with substance misuse other than alcohol, D & T of

dual diagnosis, Recovery concepts, psychosocial treatments and

service developments

• Across the ages – 4 sessions. Psychosis across the ages,

Depression, eating disorders, mental illness and Family/Carers

Page 29: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

MRCPsych – Academic Modules

• Covers aspects that cannot be covered in the

LEP course or in Placement

• 12 days a year X 2 year course

• 6 September-January 2015 – 6 days

• 6 Feb- July 2015 – 6 days

• September – December 2015 – 6 days

• March-June 2016 – 6 days

• Run at the School of Psychiatry on Thursdays

• Exam syllabus to follow

Page 30: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Academic course 2014-2016

• First 6 months:

• 2 days in September, October & November ( 6 days)

• Topics covered: Introduction to the MRCPsych

including the new exams, Classification, Critical

appraisal, Philosophy of psychiatry – 1 day

• Basic Psychology, Neurosciences – 1 day each

• Human development – 1 day

• Psychopharmacology – 2 days

• Every session they had MCQ’s

Page 31: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Academic course cont…

• II six months

• Feb-July 2015 – 4 days for Psychotherapy, 1 day each for GA and

OA

• III six months

• September 2015-Jan 2016 – 2 GA , 2 OA (Physical health), 1

stats & research methodology, 1 each for Neuropsych

• IV six months

• March –July 2016 –, 1 GA, CAP, ID, Foren, Sub misuse & 1 for

exam

• Total for 24 months – 24 days

• Run as seminars/Workshop, a few lectures

• *Consultant CPD – Consultants welcome to attend

Page 32: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Typical Academic Day Programme

9:30 Expert session - Anorexia Nervosa

11:00 Coffee

11:15 Expert session - Bulimia Nervosa & other eating

disorders

12:15 Lunch

13:00 Group work through 3 x 30 minute case vignettes

Each case 15 minute group work then 15 minute

discussion. Examples include assessment and

treatment of complications, medicolegal frameworks

for urgent treatment, strategies for relapse prevention)

15:00 Coffee

15.15 MCQ workshop

Page 33: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

• Every LEP session trainees have MCQ/EMI practice

• Every academic programme MCQs

• 3 hours exam Written practice every year (July 2015)

• Yearly Progress Test – 11/12/15/16 June 2015

– Sat by ALL CT Trainees

Exam Preparation

Page 34: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Exam Feedback to Trainees

Page 35: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

• Pivotal in training of trainees, hence have to be well supported

• Know the curriculum and know what the exam is about

• Clear about competencies and training requirements of core

trainees in their placement

• Educational supervision – to achieve consistency across the

region - clinical and educational supervisor

• ES being able to link the trainees learning – LEP, MRCPsych,

Psychotherapy etc in educational supervision

Points for us to consider –how we do this – in LEPs, across

LEPs by pooling of resources across LEPs, this will start

this Summer

Educational Supervisors

Page 36: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

• Weekly feedback from LEP programme

• Feedback from the Academic Teaching Programme after each

session

• Generally extremely positive

• Few recommendations

• Some cancellations: • 3 slots cancelled – 1 JC on one site, 2 – 555 (all 3 different sites) (Sites are

5+1+1+3 = 11 sites (2))

Feedback

Page 37: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Academic Day Feedback How would you Rate these Sessions? Did they meet your expectations?

Page 38: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Encouraged Trainees to Prepare

Page 39: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Sessions were Lively & Stimulating

Page 40: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Trainee Feedback

“The entire

session was

made simple and

kept me

interested”

“Activities

related to

exams and

ARCP “

“Exam focussed

– this is how

these sessions

SHOULD be!!!”

“MCQ – enough

time was given

for us to

discuss in

groups”

“there was a

lot relevant

to exams

“Very stimulating

discussions by

speakers

interested in the

topic

themselves”

“has

encouraged

me to read

more”

“has sparked

an interest!”

Fascinating!

Page 41: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

LEP Programme

Greater Manchester West LEP Experience

Raghu Paranthaman

MRCPsych Tutor

GMW NHS Trust

Page 42: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Overview • Background

• Setting up of course

• Practical aspects of running the course

• Feedback for the first year

Page 43: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Educational

Supervisor/

Supervised

training weekly

an hour

Psychological

modalities

30 Balint gps +

Long case &

Short case in 2

diff modalities

Academic

Programme –

Ct1-12 days

Ct2 – 12 days

Local Educational

Provider (LEP) 30

sessions a year – 4

hours each

MRCPsych Exam(MCQ practice, Progress test)

Slide coutresy of Dr. Latha Hackett

Page 44: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

Local Educational Programme(Trust )

• Two year rolling modular programme - 4 x6 months

block

• Same modules across all trusts in the region

• Minimum of 15 half days every 6 months

• Each block will have General Adult, Old age,

Specialties – CAMHS, LD, Substance misuse,

Forensic

Page 45: HENW (North Western) MRCPsych Course · Psychiatry HENW (North Western) MRCPsych Course “Theory to Practice” ... distant learning, face to face and periods of private study

www.SchoolofPsychiatry.net

NW School of

Psychiatry

GMW NHS Trust

• Provides mental health services to Bolton,

Salford and Trafford residents in Greater

Manchester

• Provides a number of specialist (substance

misuse, adolescent inpatient, forensic) services

for a wider geographical area

• Trainees are mainly based in 4 sites

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Trainees in GMW CT GPST ST FY

Salford 9 2 8 6

Bolton 6 2 3 6

Trafford 7 1 2 4

Prestwich 10 0 7 0

Total 32 5 20 14

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Setting up of Course

• Lead appointed - June’14

• Support from Lynda Hurst, Medical Education

Manager

• Meeting with tutors-variability in teaching across

sites, feasibility of delivering 4 hour programme in

each site

• Attendance in directorate consultant meetings

• Centralised Programme set up (start from Sep’14)-

race against time!

• Support from a higher and a core trainee from

second semester

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GMW MRCPsych Programme

• Started Sep’14

• Two semesters have been completed

• Initially only for trainees in the 3

districts(Bolton, Salford & Trafford)

• Trainees in specialist placements joined

in Feb’15

• One centralised teaching for all junior

doctors in our trust

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MRCPsych Teaching

• Wednesday afternoons (1PM till 4.30 PM) –Trust HQ,

Prestwich site

• Protected teaching time for all trainees

• Light sandwich lunch provided

Course has evolved:

• Expanded from 15 sessions to 20 sessions per semester

• CASC training and audit presentations- successful with

excellent feedback

• Sessions have been made shorter with more breaks

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MRCPsych Teaching

• 20 weeks from March to July and September to January

• Each week will have a theme , eg: Depression

• First 15 weeks :

– Part of school of Psychiatry MRCPsych course

– 70% attendance mandatory for Psychiatry CT1’s and

CT2’s

• Last 5 weeks

– “Extra” Forensic & CAMHS sessions, CASC training

& Audit presentations

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Example Programme : Depression

13:00 – 13:45 Depression

14:00 – 14:45 Case presentation

15:00 – 15:15 555 presentation (on a depression topic eg:

psychological therapies)

15:15 – 16:15 Expert led session(on a depression topic eg:

Treatment of depression)

16:15 – 16:30 MCQ

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Slot Allocations

• All CT’s do at least 1 presentation

• Extra slots allocated to CT1’s/CT2’s and then

CT3’s

• No trainee does more than 2 presentations

• Trainees do case conference in the speciality

they are working in. Same for journal clubs as far

as possible.

• Other trainees(FY doctors, GP trainees and

BBT) are not allocated slots

• All ST’s chair a session

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MRCPsych teaching

• College(Site) tutors act as “co-ordinating tutors” for 5

sessions each every 6 months (4 tutors x 5 sessions =

20)

• Agreement reached with the Consultant body that

each consultant would aim to attend a minimum of 4

MRCPsych teaching sessions every year

• Consultants deliver all the Expert led sessions

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Teaching

• There are guidelines for case conferences,

journal clubs and chairing sessions

• All the information is embedded in a word

document- journal papers , 555 topics,

guidelines

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Attendance- Second Semester

• Average- 32 per session

• Range - 22 to 43

• Consultants- 8 per session

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Feedback- First Semester

Were the overall aims and objectives for the day met?

N=172

78%

1%

21%

Yes

No

No Comment

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Feedback- Second Semester How would you rate this training session overall?

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Feedback: Free text comments

• “Well organised and I have really learned a lot”

• “Really useful and thought provoking”

• “Interesting, Interactive, Concise, Crisp”

• “Excellent Excellent session”

• “Range of topics covered”

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Challenges

• Venue

• Cancellations- affects training of all

trainees

• IT issues

• Lunch/range of refreshments provided

• Local teaching(in each district) missed by

some

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• Focus groups of trainees (GT & DM)

• Feed back from Tutors, ES, Consultants

of the day – Spring/Summer

• Advice obtained from Education

Psychologist and Senior Lecturer in EP

at Manchester University

Formal Evaluation

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There were a few sleepless nights….

• Main challenge was “fear of change and uncertainty”, “we

get good feedback from trainees, what we do is very

good, why should we change?”

• For me - having a Belief, to Listen, Develop, Change &

Support & convince people it will work

• Some rather difficult views, thankfully in the minority

• The very tight timescale – April to July 2014 to

organise, convince providers and deliver

The Challenges - 2014

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Positives • All trainees access same teaching regardless of Trust.

• Expert resources pooled across the NW

• Holding one event rather than 3+ in some trusts saves time

and money…

• Consultants across the NW contributed to the

development/delivery not just a few academics at the

University

• closer links to the exam

• ES’s feel more connected to the MRCPsych training

• Presentations are much closer linked to the

curriculum/exams/syllabus than the University course

which often felt detached – as commented by a university

course trainee

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Positives cont…

• ES’s feel more connected to the MRCPsych

training

• Presentations are much closer linked to the

curriculum/exams/syllabus - University course

often felt detached – as commented by a

university course trainee

• School much more involved with trainee

development/progress - therefore rapid access

to TPD/HoS or Trusts when required to resolve

issues - health issues, excessive on call etc,

patterns emerge…

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Challenges • Trainees feedback - Being on call and missing some of these sessions – want these

sessions to be protected as this is their study leave

• MCQs not being done in LEPP routinely

• General adult – LEP 24 sessions over two years. To do the expert led sessions on

time, though we have got better at this. Agreeing to do it and not arriving on time

• Academic programme – Psychosexual and eating disorders

• Some speakers wanting to be paid

• Across the ages topics – need re-thinking

• More admin time was funded in year two, still not enough

• Up keep of the website

• Feedback forms had to be re-designed

• Small number of trainees in some sites

• Not all expertise available in some sites e.g. forensic

• New challenges that need to be looked at e.g. Communication workshops etc

• Working together will really help these challenges

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Comments from a DME…

• Trainees say meets educational needs better

• Trainees spend more time in the clinical

placement – learning on the job!

• Teaching more organised and planned

• Excellent resources available on the school

website

• We learn from each other…

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Comment from a Consultant

“Good CPD, I’d Forgotten

most of what I thought I

should have known, good to

go back, read up and

update”

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• Re-Visit med ed committees, Meet ES’s, observe LEPP

• Progress test both Written and Clinical exam annually

before RCPsyc exam

• Review Communication skills/Simulation training in

placements – Started August 2015

• Training the ES in curriculum and examination (on line

module under preparation) and CASC level training

• CT1and CT2 course is running from September 2015

• Review the whole course again in Spring 2016 –

Consultation with all Trainees, Educational supervisors,

Tutors, TPDs, DME

• Format will remain same but up to date journal clubs etc

The next 12 months...

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• Quality Assure

• To link with the TrOn –trainee online (RCPsych) -Trainees can evidence for

Portfolio & Triangulation, FY do it

• Communication/Simulation training – look at the practice across the patch and

provide guidance on good practice

• MRCPsych website

• On line lectures, links to guidelines, news letters

• Regional training day for all, every two years. Updates on every branch of

Psychiatry – Local/National/International speakers, hosted by the NW School of

Psychiatry

...“American Congress”- North of England Psychiatry Congress

• NW School of Psychiatry Debates

Maudsley style debates – two or three times a year

• In conjunction with the Medical School, Royal College of Psychiatrists, School of

Psychiatry etc

The next 12 months...

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Quote

“Change is hard at first,

Messy in the middle

And

Gorgeous in the end” Robin Sharma

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My experience

Human beings, generally are not made for change

But….

Most of us can be Persuaded

Some of us are Malleable

A few of us, have to be worked around

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• Wessex School of Psychiatry

• Professor Damien Longson

• Samantha Abbott and Team NW School of Psychiatry

• Subgroup leads, Trust leads, Tutors, CTPD’s & HTPD’s

• NW Directors of Medical Education

• New Consultants, especially: Dr Gareth Thomas & Dr

Neelo Aslam & Dr Brijesh Desai

• Trainees – a number of Core and higher specialty

trainees

• Steve Glover, CMFT Librarian

Acknowledgements

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Webshots

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Tutor Resouces

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Thank you for your time…

Any Questions?