psychiatry and ethics unit (teaching) annual...
TRANSCRIPT
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Contents
Introduction ............................................................................................................................................ 3
Report on Central Teaching 2012-2013 .................................................................................................. 4
Report on Examinations in 2012-13........................................................................................................ 5
Report on Student Feedback 2012-13 .................................................................................................... 8
Report on Student selected components SSCs ..................................................................................... 18
Report on Ethics .................................................................................................................................... 19
Clinical Teaching Fellow Report ............................................................................................................ 21
Annual Report for Gloucestershire Academy ....................................................................................... 34
Annual Report for Somerset Academy, Academic Year........................................................................ 36
Annual report for the AWP NHS Partnership Trust .............................................................................. 37
SITE TEACHING TIMETABLES FOR 2012-13 ........................................................................................... 41
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Introduction
This year has been one of improvements, innovation, and change. In
terms of improvement, the DOCS exam is now established and we
had good feedback from Professor Ania Korszun, our External
Examiner, who visited in January. The new logbook has been well
used and the emphasis on clinical exposure has been well received
and enhanced engagement. This has been complemented by great
input from our site tutors who are enthusiastic and a massive asset.
We have run a successful Certificate Course in Undergraduate Psychiatry Education for SpRs
and Speciality Doctors, which came about because we felt that trainees were often
confused with respect to how our course fits in with the rest of the medical degree, how
assessments have changed and newer approaches to teaching. We prepared a “curriculum“
which sets out the type of activities that would enable trainees to develop teaching and
educational skills in a very practical way, complemented by 10 two hour sessions at Oakfield
House to facilitate and enhance this experience. Our first “graduates” are due in July 2013
and we have been asked to run this again next year. We feel that this approach will help
engage our teachers and reduce the dislocation that can occur with academy style teaching
and I hope it will emphasise that we see the various sites as being mini parts of Bristol
Medical School with very much shared aims, objectives and outcomes. The RCPsych
Academic Faculty Teaching Leads Group is also interested in this and would like to roll out in
all Medical Schools! I am very grateful to Sherlie Arulanandam, Nicola Taylor and Janet
Hickling for helping me with this. There have been many changes in staff but I would
especially like to thank David Christmas for his teaching endeavours over the years, and
Nicola Taylor who has started as a locum in Liaison Psychiatry. However we are pleased that
Karl Scheeres has now been recruited to the CTF post and I am sure that he will continue the
great work of his predecessors. The biggest change is about to hit us. We have been told
that Psychiatry will need to move to Year 4 from September 2015. I have mixed views
regarding this; it will be a challenge (not least in terms of SIFT) and in many ways it seems a
shame given the excellent feedback that we are getting from students. However it also
represents an opportunity to establish a great course in Year 4, and I have plans to ensure
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some exposure to psychiatry in Year 3 in GP, Musculoskeletal and Surgery or MDEMO which
I hope will enhance the students’ experience further and engage them with our great
intriguing and rewarding speciality which is at the heart of the Art of Medicine. That will be
good for our students, their patients and make this evolving journey not only daunting but
hopefully exciting and rewarding too!
Dr John Potokar, Teaching/Unit Lead
Report on Central Teaching 2012-2013
Overall, this continues to be well received apart from the student
concern that it should move from a Friday (identical to the main
student concern from 2011-12).
The Central Teaching consists of one day of teaching, usually on the
second Friday of the attachment. It was comprehensively changed
in 2011-12, to give students the opportunity to have an overview of
the therapies available in psychiatry, delivered by specialists in
these areas. Psychotherapeutic (AM–covered by Dr Clark and his team) and Psychopharmacological
(PM) Treatments (covered by Dr Melichar), as well as Dr Evans’ highly respected Mind/Body lecture
bridging the two parts of the day.
Minor modifications continue to be made following ongoing feedback from the students to both
parts of the day with feedback improving. Quantitatively, the feedback continues to be excellent.
(1=poor, 2=below average, 3=satisfactory, 4=good, 5=excellent)
Central Teaching
Scores for
2012-13
Psychological
Treatments 1
Psychological
Treatments 2
Mind &
Brain
Psychopharmacological
Treatments 1
Psychopharmacological
Treatments 2
Unit 1 3.2 4.0 3.8 4.2 4.3
Unit 2 3.5 3.7 3.9 4.1
Unit 3 3 4 4 4 4
Unit 4 3.8 4.1 4 4.3 4.3
Average 3.3 3.9 3.9 4.1 4.1
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Qualitative feedback was generally good with no specific themes, apart from a wish to move the
Teaching Day away from Friday, particularly the afternoon lectures – this was identical to the major
issue students had for the course in 2011-12.
Given that this theme – moving the Teaching Day from Friday – is the key issue for the past two
years, it may be worth reviewing the perceived logistical impossibility of moving this. Certainly, in
terms of booking lecture theatre space, it is possible.
There is little planned change for the 2013/2014 talks, except Dr Thanos Tsapas, will be taking over
the lead in Psychological Treatments teaching from Dr Andrew Clark. The format is likely to change
with the move to teaching in year 4 in 2015/16.
Dr Jan K Melichar, Central Teaching Lead and Psychopharmacological Treatment Lecturer
Report on Examinations in 2012-13
The examinations for psychiatry and ethics in 2012-13 ran smoothly,
predominately because of the significant amount of work by the clinical
lecturers and the administration staff.
There were some minor changes to the exams for this year, particularly
further alterations in the clinical assessments and the feedback to
students.
Overall unit assessment scheme
The overall assessment consists of two parts; component A (clinical assessment) and component B
(written assessment).
Component A – the clinical assessment has two constituent parts:
Direct Observation of Clinical Skills (DOCS) Examination (95% of component mark)
Attitudinal Learning Objectives (ALO) (5% of component mark)
Component B-the written assessment has three constituent parts:
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Written Examination (EMQ/MCQ) (50% of component mark)
Internal Psychiatry SSC (33% of component mark)
Ethics Written Case (17% of component mark)
Candidates must pass component A (40% of the total Unit mark) and component B (60% of the total
Unit mark) to pass the Unit. To pass component A students must receive a mark of at least 50%. To
pass component B students must receive a mark of at least 50% for the component overall and a
mark of at least 45% in the written examination and the ethics written case.
Clinical assessment (Component A)
The clinical exams had been using the viva format for many years. It was decided to change the
format last year when DOCS were introduced.
DOCS (Direct Observation of Clinical Skills) are similar to an OSCE (Objective Structured Clinical
Examination) but have fewer stations. The DOCS in psychiatry consisted of three stations with each
station having a stimulated patient (ie an actor with a standardized history of a mental disorder).
Each station lasts 12 minutes which include 1 minute for the candidate to read the instructions, 8
minutes to perform the allotted task and 3 minutes to answer any questions from the actor (3
minutes to transfer to the next station and for the examiner to decide the marks). The candidate
moves directly from one station to the next and completes three stations in total. In total the whole
assessment takes 45 minutes for each candidate. There is a single examiner at each station, so each
candidate will be assessed by three different examiners.
The candidate was marked across three domains, by the examiner, at each station and there was
also a mark from the actor. The domains were knowledge (asking the correct questions), approach
to the patient and approach to the task. The knowledge domain was 50% of the mark for the
station, the approach domains were 20% each with the final 10% being the actor’s mark. Each of the
three stations contributed a third of the overall mark.
All the exam days went well and the feedback from the students and examiners was positive. The
marks were very similar with the previous year’s marks and there were no major differences
between the units.
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Summary statistics of DOCS mark distribution for Psychiatry DOCS 2012-2013.
Unit 4 –May 13 Unit 3-Mar 13 Unit 2-Jan 13 Unit 1-Nov 12
Number of students
66 63 66 65
Mean mark
65.9 64.2 62.3 61.1
Standard Deviation 6.7 5.9 7 5.8
Range
51.7-81.9 54-78.7 44.1-78.2 48.4-73.7
The main area of concern the previous year was that there were no fails in the clinical assessments
(compared to 6 in 2010/11, 7 in 2009/10 and 8 in 2008/09). This year (2012/13), 2 individuals failed
the clinical assessment indicating that the marking schedule has become more appropriate.
Written assessment (Component B)
There were minor changes to the written assessment in comparison to those in the clinical
assessment. The main change to the end of year written examination continues to be the use of the
Angoff method as a form of criterion referencing. This meant that the marks had a mean of 67.03
and a standard deviation of 4.72 with a range of 55.8-76.9. This is similar to last year when the
equivalent marks were a mean of 69, standard deviation of 4.8 and a range of 57.2-83.7.
There were no significant changes to the iSSC or the ethics assessment.
Marks to the students
Last year’s policy of giving marks to the students as soon as possible after each exam was continued.
For psychiatry, marks are available for each student individually after each module (iSSC and DOCS)
exam and then at the end of the year for the written exam.
Changes for next year
Changes for the coming academic year will be limited due to the continuing settling down of the
DOCS exam and there will be some minor alterations of how the different parts of the exams are
combined. There will also be some modifications of the DOCS.
Thanks to the clinical lecturers, the administrative staff, the examiners and the actors for a
successful year.
Dr Tim Amos, Examinations Lead
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Report on Student Feedback 2012-13
This past academic year has seen us move successfully to a web-based
system of feedback which was first introduced in block 4 of the
academic year 2011-2012. The contribution of some individuals in
facilitating this process needs mention at the very outset. First, thanks
are due to David Jackson, for coordination of the web-based
questionnaire, sending reminders to students and timely production
of spreadsheets and their dissemination to relevant individuals and
committees. One major area of concern with the introduction of web-
based feedback was the unknown effect it would have on the response rates, which in the past had
been >95%, mainly due to our practice of administering paper forms on-site immediately after DOCS
assessments. This past year, with the cooperation of our PhD students and postdoctoral
researchers who gave up their office space and computers, we created an on-site ‘feedback hub’ to
which students were directed immediately after their DOCS assessments. This process was very
successfully overseen by June Johnstone, our senior administrator and I am pleased to say that
almost 98% of students (252 out of 258) completed the online questionnaires. This figure excludes
13 duplicate entries from students who completed the questionnaire twice possibly in response to
our email reminders before and after the DOCS day. Two other individuals need special mention.
Nicola Taylor, Teaching Fellow took on the task of disseminating the feedback for individual blocks
throughout the past academic year and working with Site Tutors to action issues arising. Nicola’s
recently appointed successor, Karl Scheeres, who is yet to officially begin his role, has already shown
immense potential and enthusiasm by conducting the thematic analysis of the qualitative feedback
presented below. I am extremely grateful to both for their valuable input in the process. Finally, a
big thanks to all students for sharing their experiences of training in psychiatry; this feedback is
essential to help us realize our vision of continued improvement in placements for future cohorts of
medical students.
As I mentioned in the last Annual Report, the content of our feedback questionnaires has
significantly changed from previous years. It now includes a set of mandatory generic quality
monitoring questions required by the General Medical Council (GMC) and some additional unit
specific questions introduced following a review last year. The most recent version of the
questionnaire consists of 17 questions (several with sub-stems) most of which are likert-scale rated.
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Three questions towards the end allow free text responses. The questionnaire takes on average
approximately 15 minutes to complete, and many students have fed back informally upon
completing it that the length and scope of the questionnaire is about right.
Since much of the questionnaire is new, the results presented in this report introduce a new set of
quantitative endpoints which will be used as norms to compare future performance across units and
sites. Reassuringly, scores on the quantitative feedback in all domains across sites were largely
positive.
The responses to the questions in the sections in TABLE 1 were rated on a likert scale (5=strongly
agree, 4=agree, 3=neither agree nor disagree, 2=disagree and 1 strongly disagree) and largely
comprise the GMC quality monitoring questions. Higher ratings indicate positive responses regarding
the individual questions. These include:
Facilities: covered questions on the availability and quality of clinical and teaching areas, library
facilities, residential accommodation and IT facilities. The average score was 4.1 (maximum possible
score=5) ranging between 3.8 in Bath and Blackberry Hill/Fromeside sites and 4.2 in Gloucester and
Southmead.
Organisation and induction: This section included questions on the organization and coordination of
the block; the relevance and usefulness of the unit handbook; quality of induction and introductory
sessions; and whether administrative staff was approachable and helpful. The average score was 4.0
(maximum possible score=5) ranging between 3.7 in Blackberry Hill/Fromeside to 4.2 in Bath.
Delivery of scheduled teaching: This section had questions on the provision of a comprehensive
timetable; whether timetabled sessions took place as planned; whether tutors were prepared for
the teaching, the quality of the teaching, whether new terms, concepts and principles were
explained clearly, and whether the student was motivated to work hard during the placement. The
average score was 4.1 (maximum possible score=5) ranging between 3.8 in Blackberry
Hill/Fromeside to 4.4 in Bath.
Opportunities for learning and clinical experience to achieve pre-defined learning outcomes: This
section included questions on whether the objectives for the attachment were clearly stated; on the
availability of sufficient and relevant learning opportunities; encouragement to participate in these
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activities including direct observation of clinical consultations and opportunities to take history and
examine patients and case presentations. The average score was 4.0 (maximum possible score=5)
ranging between 3.8 in Southmead and Blackberry Hill/Fromeside sites to 4.3 in Bath.
Learning environment and support: This section included questions on whether appropriate
supervision in clinical areas was available; whether staff, teachers, junior doctors, and other
healthcare staff were approachable; whether clinical environment was friendly and supportive; and
the ratio of teachers to students. The average score was 4.1 (maximum possible score=5) ranging
between 3.9 in Blackberry Hill/Fromeside to 4.4 in Bath.
Feedback and assessment: This section included questions on feedback and evaluation of progress
being available throughout the placement, availability of practice sessions for end of unit
assessments. The average score was 3.9 (maximum possible score=5) ranging between 3.8 in
Southmead to 4.3 in Bath.
Table 1 Mean scores across feedback domains required by the GMC
Site
(In alphabetical
order)
Facilities Organisation
and
Induction
Delivery
of
Scheduled
Teaching
Opportunities
for
Learning
Learning
Environment
and Support
Feedback
and
Assessment
Bath 3.9 4.2 4.4 4.3 4.4 4.3
BBH/Fromeside 3.9 3.7 3.8 3.8 3.9 3.9
Callington Rd 4.0 3.9 4.1 3.9 4.2 3.9
Devizes 4.1 4.1 4.3 4.0 4.0 3.9
Gloucester 4.2 4.0 4.0 4.0 4.0 3.9
Southmead 4.2 3.8 4.0 3.8 4.1 3.8
Taunton 4.1 4.0 4.1 4.1 4.2 4.0
Weston 4.0 4.1 4.1 4.2 4.3 4.1
ALL SITES 4.1 4.0 4.1 4.0 4.1 3.9
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The responses to the questions in the sections in TABLE 2 were also rated on a likert scale
(5=excellent, 4=good, 3=average, 2=below average and 1=poor) and comprised specific questions
related to the overall quality and experiences of the psychiatry placement. Higher ratings indicate
positive responses regarding the individual questions. These include:
A section of questions related to the student iSSCs: (Guidance received from supervisor,
opportunity to practice, experience of the iSSC presentation and feedback received): The average
score was 3.8 (maximum possible score=5) ranging between 3.5 in Weston and Blackberry
Hill/Fromeside sites to 4.4 in Bath. A question on the overall learning experience in this unit: The
average score was 4.1 (maximum possible score=5) ranging between 3.9 in Blackberry
Hill/Fromeside to 4.5 in Bath. A question on how the unit content aided the development of
knowledge and practical skills: The average score was 4.2 (maximum possible score=5) ranging
between 4.0 in Southmead to 4.5 in Bath and Devizes. A question on the supervision and
monitoring provided by the educational supervisor: The average score was 4.3 (maximum possible
score=5) ranging between 3.8 in Devizes to 4.6 in Bath. A question on the support and advice
provided by the site tutor: The average score was 4.2 (maximum possible score=5) ranging between
3.7 in Blackberry Hill/Fromeside to 4.9 in Devizes. And finally, an overall rating of the
block/placement: The average score was 4.1 (maximum possible score=5) ranging between 3.8 in
Blackberry Hill/Fromeside to 4.4 in Bath.
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Table 2 Mean scores across psychiatry specific quality indicators
Site
(In alphabetical
order)
SSC Overall
Learning
experience
Knowledge
and
Practical
skills
Educational
supervisor
Site
tutor
Overall
Bath 4.4 4.5 4.5 4.6 4.7 4.4
BBH/Fromeside 3.5 3.9 4.1 4.4 3.7 3.8
Callington Rd 4.0 4.1 4.1 4.2 4.1 4.1
Devizes 3.9 4.4 4.5 3.8 4.9 4.3
Gloucester 3.7 4.1 4.1 4.4 4.1 4.1
Southmead 3.6 4.0 4.0 4.3 4.3 3.9
Taunton 4.2 4.1 4.2 4.4 3.9 3.9
Weston 3.5 4.3 4.3 4.2 4.3 4.3
ALL SITES 3.8 4.1 4.2 4.3 4.2 4.1
(Rated as 1=Poor, 2=Below Average, 3=Average, 4= Good, 5=Excellent)
Two of the above questions (supervision and monitoring by Consultant; and overall quality of the
placement) have been repeated from previous years although the likert scale used was worded
differently and responses are therefore not directly comparable. Regardless, the rating of 4.3 and
4.1 on these questions is higher than previous year averages (which ranged from 3.6-3.8 for both
questions in the past 3 years).
Themes arising from qualitative feedback received from students
Qualitative written feedback was received from all units and the main themes arising are
summarised below. The qualitative feedback comprised 850 distinguishable comments that were
analysed thematically. The majority of these were positive (55%) and largely constructive. In
keeping with last year’s feedback, students found psychiatry overwhelmingly a positive
experience, and enjoyed meeting patients and interacting with their teachers. The organisation
and timetabling were the areas’ most requiring improvement.
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The three questions requiring free text responses were:
1) What do you consider to be the most positive element of the unit?
“The doctors and nurses were all extremely helpful and made me feel welcome on the wards. I would
definitely consider a career in psychiatry after this unit.”
“I have never been or felt so accepted in my training so far”
Top 10 themes arising from the question ‘What do you consider to be the most
positive element of the Unit?’
Ranking Theme Total no. of
comments
1 Meeting and interacting with patients 78
2 Ward based work 48
3 Site tutor or associate unit tutor 37
4 Educational supervisor 35
5 Doctors (often junior) 33
6 Ability to choose own learning experiences 23
7 Mental health staff 19
8 Diversity of experiences 14
=9 Clinical experience 13
=9 Tutorials 13
Students repeatedly stated that the best aspect of the block was meeting and clerking patients; they
felt the wards were the best environment in which to do this. Students felt that their tutors and
supervisors’ input was excellent. They appreciated ‘on the job’ teaching from the junior doctors,
particularly on the wards, and in general found all members of staff including doctors, nurses and
admin staff to be welcoming, supportive and friendly. Students were very appreciative of mock
DOCS exams and any OSCE practice sessions. In general, they enjoyed role-play sessions, and
wanted more of them to prepare for the exams. Many students appreciated the ability to pick
aspects of psychiatry that they found interesting, e.g., “I really enjoyed the freedom that we were
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able to get in organising our own learning. More of that!” and a number commented on how the
wide variety of experiences available to them helped them to understand and learn psychiatry.
Several specialist placements had specific mentions including Crisis Teams, Old Age Psychiatry,
Liaison Psychiatry, CAMHS, Prison Psychiatry, Learning Disability and Drug and Alcohol Services.
2) What would you most like to change about the unit?
‘Organisation was very poor’
‘A focus on the exam format and assessments earlier on with a more direct approach to skills.’
Top 10 themes arising from the question ‘What would you most like to change
about the unit?’
Ranking Theme Total no. of
comments
1 More structure to the unit 43
2 Organisation in general 37
3 Timetabling of activities 31
4 Nothing 28
5 More time on the wards seeing patients 26
6 More information in advance about exams 21
7 Logistics of travel arrangements 20
8 More OSCE practice/role play sessions 19
9 Poor teaching in tutorials 12
10 Year three is too soon for psychiatry 10
Feedback arising from this question was more heterogeneous and fewer clear themes emerged;
however the majority of comments were relating to the organisation and structure of the unit rather
than the content of teaching itself. Encouragingly, several (28) students felt nothing should be
changed. A large number of students felt it was difficult to self organise aspects of the unit, e.g. “I
found it really hard to organise things at the beginning as I had no idea what all the services did.” In
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general students wanted either pre-arranged or ‘semi timetabled’ experiences (e.g. sign up sheets)
and felt they spent significant time in arranging their learning. Timetabling issues arose frequently;
this included clashes, activities being far apart geographically, cancelled sessions and time spent
‘waiting’ for the next session.
Six students stated that staff was unapproachable and that they weren’t made to feel welcome, e.g.
“Difficult on ward. .as it is chaotic and no one wants you there.” Additionally a minority of students
(nine) felt their educational supervisor’s input was poor, e.g., “he took no interest in my learning.”
This feedback has been discussed with individual supervisors through the Site Tutors.
There was a strong theme of students wanting more information given earlier on in the block about
the format of both the DOCS and ISSCs, and feeling uncertain about what was expected of them and
unprepared for the exam itself. This was also reflected in the number (19) specifically asking for
more practice sessions throughout the course.
A number of students, particularly in the first few blocks, felt that psychiatry was too soon in their
clinical phase and suggested moving it to Year 4. The reasons given for these views were that
psychiatry requires high-level communication skills, is emotionally demanding and would be better
placed later on in the curriculum once basic skills have been developed. Nine students felt the block
was too long overall, and that competencies could be acquired in a shorter space of time. From
2014-15 it is planned that a 6 week psychiatry placement in year 4 will be offered.
Finally, there were many comments relating to the logistics of transport; in more rural settings this
largely focussed upon suggestions that we take account of car ownership of students when placing
students. In Bristol, timetabling different sessions in one day in disparate locations was difficult for
students, particularly if they were relying on public transport.
3) ‘Any other comments?’
Seventy five students left additional feedback from this question- these were categorised and added
to total number of comments above for either questions (1) and (2). The most common comment
from students (18 in total) was how enjoyable they had found their psychiatry unit, e.g. “Really
enjoyed Psych and didn't think I would!”
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Feedback relating to specific aspects of the course
Wards
As mentioned above, the wards were repeatedly felt to be the most positive aspect of the course
and many students thanked staff working on the wards for helping them to learn. However ten
students felt that the wards were ‘saturated’, leading to patients being unwilling to speak to further
students, e.g., “it became a scramble to see who could find patients first.”
Tutorials
There was mixed feedback regarding tutorials; although there were 13 positive comments, a number
of students (12) felt the teaching was of poor quality and seven students mentioned frustration of
tutorials being cancelled at the last minute. Good feedback was received when tutorials were
interactive and clinically based; poor feedback mentioned ‘dry’ teaching sessions using PowerPoint.
Nine students felt the initial teaching could be condensed to allow more time for patient contact;
four students suggested spreading out this teaching to allow clinical learning and teaching to co-
exist. There was a general wish for more bedside and/or clinically oriented teaching and more
teaching in 1:1 sessions with educational supervisors.
Lack of specialist experiences in more rural locations
Several students stated that it was difficult to obtain more specialist experiences in locations such as
Gloucester, Weston Super Mare and Devizes, however this feedback was counteracted by positive
comments in these localities about feeling part of a team and well supported.
Logbooks
Feedback about logbooks was mixed. Several students felt that the logbooks were a ‘tick box’
exercise and had limited validity, e.g., “log book generally was far too much of a hoop jumping
exercise.” Others thought that the need to clerk ten patients was too great and created unnecessary
stress. Alternatively, two students felt that there should be more compulsory items in the book,
such as on-call.
Choice and diversity of learning experiences versus ‘belonging’ to a team
Although many students felt that having a choice in their learning experiences and a wide diversity
of experiences were the best aspects of the course (23 and 14 comments respectively), there were
even more students (43 comments) who felt that they would have liked more structure. Several
students pointed out that not having a regular team left them feeling ‘lost’ and as if they didn’t
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belong, e.g. “I never felt fully part of any team. I had 'experience' days with different psych teams but
they didn't know me and I didn't know them” and, “It would have been good to spend time with a
particular team to have in depth experience rather than have the breadth of experiences we had.”
Students who became closely attached to their firm gave this positive feedback, and often rated this
as the most positive aspect to their placement.
Attitudinal learning objectives (ALO)
The ALOs were introduced this year and six students commented upon them in their feedback;
largely they felt them to be unfair and not a true reflection on actual attitudes or behaviour: e.g., “I
think your Site Tutor does not mark you fairly as they do not spend enough time with you.”
Suggestions included peer marking of ALOs “I think peers should get a say, they know you better
than Site Tutors.” Others felt wary of being ‘judged’ from day one of their placement as a
consequence of the ALOs.
In conclusion: The quantitative and qualitative feedback received has been informative and thought
provoking for us at the academic unit and individual sites. Overall, it is reassuring that on average
the psychiatry placements receive positive feedback in almost all areas but also shows areas where
specific sites or the unit overall could improve. The qualitative feedback has again been very rich in
qualifying issues that are impossible to capture through numbers. Many of the positive themes
arising are identical to last year, including an emphasis on clinical experience as paramount and good
support from teachers. Timetabling and organisational issues still remain prominent criticisms which
need to be addressed. Reassuringly, several issues appear to have been largely resolved and no
longer feature in feedback (e.g. some specific teams being unwelcoming, students being unable to
contact their Educational Supervisor or tutors). It is now time for all of us to reflect and learn from
this feedback in the hope that we can continue to enhance the learning and training experience of
the next cohort of medical students to join us this autumn.
Dr Dheeraj Rai [with special thanks to Drs Nicola Taylor and Karl Scheeres], July 2013
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Report on Student selected components SSCs
Internal
All students undertake internal SSCs during their psychiatry
attachment. They choose a topic guided by the clinical tutor and
prepare a presentation which they give towards the end of their
attachment. This is a 15 minute presentation examined by two
examiners and observed by the other students. The format has
been changed this year to include a clinical case description which
raises the question to be addressed by the SSC. These are mostly reviews of the literature
on a particular topic, students often choosing to cover the evidence base for associations or
treatment and sometimes explaining theoretical framework for understanding a particular
clinical problem. Students all choose to use PowerPoint sometimes with additional aids
such as videos. The change in the format has been well received by examiners on the whole
who have completed feedback forms. Student feedback suggests that there is still some
variation between sites in guidance, opportunity for practice and feedback this could be
improved. The assessment itself is generally positively rated.
External
A number of students choose to undertake an external SSC in an area related to mental
health. This is an opportunity to extend and develop a student interest in psychiatry/mental
health and we strongly encourage these. We offer a range of supervised SSCs which take
place during July mostly with third year students. Six students undertake a project within
Schools based on Mental Health Awareness involving preparation of a lesson for year 9
students. This has proved popular and oversubscribed. A number of students undertake
the student psychotherapy scheme and write this up for their SSC. In total there are 32
students who are undertaking SSCs on mental health related topic this year. Improvements
might include getting student feedback on SSC attachments, offering a wider choice of SSCs,
engaging more clinicians from academies to offer projects and monitoring successes such as
publication, abstract presentation, completed audit or other relevant output.
Dr Jonathan Evans Psychiatry SSC Lead
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Report on Ethics
Owing to maternity leave for Dr Natasha Hammond-Browning, Dr Kerry Gutridge took over as Ethics
Element Lead from September 2012 to January 2013. In January 2013 Dr Muireann Quigley was
appointed as a Senior Lecturer with the Centre for Ethics in Medicine and was due to start as the
Element Lead. Due to Dr Muireann Quigley’s study leave, Dr Kerry Gutridge remained as Ethics Lead
from January 2013 to July 2013. Since Dr Muireann Quigley has been awarded a Leverhulme
Fellowship from September 2013-August 2014 a fixed-contract Lecturer will be appointed to act as
Ethics Lead to cover this period. This means that the post will not be covered in August 2013 unless
it can be paid on an hourly basis.
General Assessment: The Ethics Element continues to run smoothly in the main part. The ethics
case reports were of a high standard with some impressive answers. We had 20 distinctions across
the Units. Feedback on case studies is now made available to all students and we no longer reveal
marks. See below for an issue with regards to penalties.
Dr Kerry Gutridge visited all the academies this year and had a chance to observe teaching and talk
to students. The academy teaching is running smoothly with positive feedback from the students. I
would like to take this opportunity to formally thank all the academy ethics element co-ordinators
and tutors for making the 2012/13 iteration of the course a success.
Note on changes since last APR report: Written feedback is now provided to all students and they
are no longer given their marks for Ethics.
Points of Note: Due to time pressures and academy visits Dr Kerry Gutridge was unable to run an
away day this year. After next year we will remain in year 3 while psychiatry moves to year 4. Care
will need to be taken to manage this transition and we will need to consider whether the Academy
Leads and tutors are available to still teach the ethics course. The teaching materials will need to be
revised in light of the changes.
To reduce administrative tasks we will be reviewing the use of blackboard this month to see if the
assessment submission and feedback procedures can be streamlined.
There was a problem with regards to the application of word count penalties for the Ethics Case
Studies. Some penalties were applied erroneously and others were omitted. It has been suggested
20
that all word count penalties are removed but this awaits Faculty approval. If the penalties are
removed, one student will have failed ethics and will resit. The students now have options with
regards to their eSSCs. The student did not choose to do an ethics eSSC.
Looking ahead to 2013/14
Care will be taken to ensure the teachers are supported during 2013-14 while also managing the
split between the Elements ready for 2014-15.
Dr Kerry Gutridge, Locum Ethics Lead, July 2013
21
Clinical Teaching Fellow Report
Since starting the job August 2012, I’ve spent around 26 weeks as a clinical teaching fellow full time
(taking time into account for locum consultant posts). In the table below is what I’ve been doing…
Teaching
Teaching medical students 42 hours of teaching medical students in all sites AWP sites on a
variety of topics. Examples of feedback (for undergraduate and post
graduate teaching) are included in Appendix 1
Awards Top Teacher Award UHB
iSSC 4 iSSC exams completed
Exams 4 days of DOCS examinations, DOCS stations written and included in
the exam. Angoff referencing of questions completed.
‘Experience in Medical
Education’
Helped organise and run an ‘Experience in Medical Education’ course.
10 tutorials, with ‘coursework’ too. Going to run again next year.
Good feedback, with some interest in it being exported to other areas.
TLHP Completed 3 modules of the TLHP
Feedback, by medical
students
Reviewed feedback processes with the University, and completed unit
by unit site specific feedback
Ethics Delivered 4 ethics tutorials in total
Research, Publications, Presentations
Publications 4 chapters for the ABC of Alcohol submitted
Innovations iPad and learning on tablets for all! See Appendix 2. Currently in
discussion with the University and AWP IT
Research AUT evaluation, Medical student experience
Posters being presented at ASME in Edinburgh and AMEE in Prague
Presentations and
Workshops
Core medical trainees: regional teaching
Advanced medical trainees: regional teaching
British Association for Psychopharmacology
Tutor Training day
Site Tutors’ away day
GP teaching day
22
In addition…
I’ve really loved this job and valued the opportunities it’s given me.
Foundation year doctors (Deanery wide, for all 3 blocks)
AWP Induction
Yr 3 Introduction
Clinical
Acting up Locum Consultant Psychiatrist for 6 weeks
Started another Locum April 2013
Patients 40 approx new assessments, and lots of follow ups!
Development of service Scoping plans for the development of a medically unexplained
symptoms service, developing links with Hepatology and
Gastroenterology
Supervision of junior
medical staff
As a locum Consultant, Registrar and CTF
Other
Qualifications MA in Medical Ethics and Law
Approved Clinician status
CCT in General Adult Psychiatry with Liaison Endorsement
Courses Introduction to statistics
Business plans Submitted business plans for the expansion of Liaison Services through
various funding streams
Interviews Attended 2 Consultant Interviews, offered 2 jobs
Other Met with college external examiner
Supervised AUTs
Learned how to edit our medical education webpage
Attended lots of meetings…. Trying to protect and increase the
importance of psychiatry in the undergraduate curriculum.
23
I love that I can stand up and teach confidently to medical undergraduates at short notice. I love
that I understand the structure of undergraduate medical education, and am hopefully going to play
a part in shaping it over the next few years. I love knowing that some of the students I’ve taught,
and examined, and given feedback to, will use their experiences in psychiatry to ensure good patient
care for the rest of their careers.
I’ve spent a lot of time in the sites, speaking to the administrators, the site tutors, and the teachers:
trying to make sure they feel part of something bigger than their own site or academy. I hope that
one of the things I’ve managed to do is to open lives of communication, to make teaching medical
students in AWP more enjoyable and worthwhile.
Along with the introduction of the new logbook, I think that having someone around with knowledge
of the University and other parts of the MBChB course means that the standards of what we can
expect from our medical students have been raised. We need them to take psychiatry seriously, and
– judging by some of the feedback I’ve looked at - over the past year we’ve managed this.
The challenges
When I think about what I’ve found difficult in this post, I think about giving feedback.
I’ve found it difficult telling people I know and like that they need to do something differently. But I
know that by building relationships at the beginning of the job this was much easier than it would
otherwise have been.
I also found it difficult telling one student about her feedback. Not because she had failed or done
particularly poorly, but because I knew about her mental health difficulties, and how difficult a road
she was on. I have no doubt that she is clever enough to pass everything in the undergraduate
course. I also have little doubt she will experience more episodes of difficulty in this career rather
than any other. I did explore the avenues available to me regarding pastoral support and
highlighting difficulties, but she remains on the course. I can only hope that she takes up some of
the support in the future. It’s an example of the difficulties in balancing clinical confidentiality,
psychological awareness, and role differentiation. Next time I’ll feel more comfortable, because I
will know to make everyone aware of the limits of confidentiality in the medical school from the
beginning.
24
The best bit
I mentioned the teaching before, and hands-on teaching remains a highlight for me. In a more
abstract sense though was the development of relationships. At times I felt as if I was in the centre
of a web of communication. This was a privileged position, made more so by working clinically with
the psychiatry unit lead. At times I felt in the centre of administrators, site tutors, AUTs, the AWP
medical education department, the University of Bristol and other undergraduate blocks. I hadn’t
appreciated the extent of the new relationships I would make, but it was a genuinely lovely surprise.
People to thank
There is a long list of people who were instrumental in making sure I had a worthwhile experience
(worthwhile to me certainly!). Geoff van der Linden in particular has been incredibly supportive and
encouraging: it’s been an instructive pleasure to work for him.
Dr Nicola Taylor, Clinical Teaching Fellow, AWP
25
Appendix 1: Examples of Feedback
Avon and Wiltshire Mental Health Partnership
Undergraduate Medical Education
Evaluation Summary
Block 2: 25th March 2013– 31st May 2013
Lecturer: Dr Nicola Taylor
Topic: Psychopathology & Classification
I Fee
l I h
ave
lear
ned
Qu
alit
y o
f P
rese
nta
tio
n
Op
po
rtu
nit
ies
for
par
tici
pat
ion
Ove
rall
Org
anis
atio
n
Ven
ue
Ove
rall
Eval
uat
ion
of
the
teac
hin
g
Individual Rating 10 10 9 9 9 10
Average Rating 8 9 8 9 9 9
What things should WE do differently and what things the same?
Do differently
2 hrs is quite long
Less feedback
Do the same
Good interaction
Enjoyed the group exercises
Nice social environment
Great to have no PowerPoint, well
spoken, interesting, coherent, good anecdotes.
Superb
Teacher is first class, with lots of enthusiasm
Fantastic teaching, very engaging.
Useful intro information
26
Avon and Wiltshire Mental Health Partnership
Undergraduate Medical Education
Evaluation Summary
Block 2 November 2012
Lecturer: Dr Nicola Taylor
Topic: Mental Health Act
I Fee
l I h
ave
lear
ned
Qu
alit
y o
f P
rese
nta
tio
n
Op
po
rtu
nit
ies
for
par
tici
pat
ion
Ove
rall
Org
anis
atio
n
Ven
ue
Ove
rall
Eval
uat
ion
of
the
teac
hin
g
Individual Rating 9 9 9 9 8 9
Average Rating 8 8 8 8 8 8
What things should WE do differently and what things the same?
Do differently
Better room
Provide handout
Gives aims and objectives
Do the same
Group discussions
Patient examples
Break!
Great presentation
Good teacher
Great interaction
Talk through problems
So engaging
Liked how no PowerPoint was needed
Keep the same teacher
27
Pre Session Material
Was there any?
Did you read it?
Was it helpful?
Yes No
Yes No
Yes No
Severn Deanery
Structured study day for ST1, ST2
18th April 2012
Severn Deanery - Structured study day for ST1, ST2 – Wednesday 27th February 2013
Dr Nicola Taylor – Feedback comments
Thanks! Love your enthusiasm (10)
Always really entertaining + useful (10)
Funny & informative. Thanks (10)
Interesting (7)
Kind of interesting (8)
Entertaining stories (8)
Highly entertaining. Thought provoking (10)
Charismatic; great presenter, engaging, clinically useful, inspiring (10)
Good presenter. Interesting (10) (not sure if the word was interesting but looked like it!)
Interesting (8)
Inter-active. Great enthusiasm (10)
Entertaining talk (7)
Excellent speaker. Useful topics applicable to everyday (10)
Made psychiatry interesting – not usually a well taught subject (10)
Excellent presentation. Good relevance to specialty (8)
Inspiring (9)
28
Entertaining (8)
Interesting (7)
Excellent speaker. Very useful (10)
Well delivered. Thought provoking (9)
Enthusiastically presented. Made it seem interesting (9)
Brilliant, very informative + interesting. Great speaker (10)
Animated and clinically relevant (10)
Hilarious and educational (10)
Hilarious (in a good way) (10) (At least I think it said hilarious – couldn’t read word easily!)
Entertaining and very enthusiastic (9)
Once again very entertaining and makes you think in a different way about patients (9)
Amusing (8)
Entertaining and engaging presentation. Raised some interesting ( ? learning ) points (9)
V Entertaining (9)
Entertaining & useful. Wish we had a consultant psych liaison in our hospital (9)
Entertaining & informative (10)
Amazing – good speaker. Could sway me to psych! (10)
Appendix 2 Example of Innovation
Learning on Tablets for All
Background and purpose:
We want to be able to give every student a package of resources that they can take with them
everywhere, most of which won’t rely on internet connection to work. This will be most useful in
the peripheral placements. Ideally we want people to be able to have remote conferencing with
their educational supervisors, and be able to work on their logbook while, for example, waiting for
their patient. We do not want to take time away from clinical experience and have been clear that
any and all of the resources in the tablet are there to enhance, rather than substitute for, clinical
experience.
29
Below are some examples
Student Resources, pre -loaded
Induction
For each site, there could be preloaded instructions and inductions as appropriate, with a mandatory
completion date for 2 days from the start of the block.
This Part of the tablet resources could also include contact details, public transport timetables and
maps. Using something as simple as Google maps, the main sites of the placement can already be
programmed in as favourites, reducing the propensity for students to get lost.
E library
As well as having some of the e learning resources uploaded on to the tablet (which would remove
the need for a permanent internet connection), there can be specific medical search engines also
loaded, such as Skyscape. The range of resources available could be negotiated with the trust.
Films
Examples of history taking
Examples of presentations
MSE films and vocabulary
There are great resources already on Hippocrates, but these could be updated. We have a contact
that can make medical films to update this resource. This could be again preloaded on to the tablet
so students can review while waiting to see patients.
Presentations
All PowerPoint presentations and hand-outs for every presentation can be uploaded to the tablet.
This can either be done as a university wide resource as it is now, or be site specific. This means that
at every site, the students can have access to the presentation and hand-outs that have actually
been used. There is also scope for there to be a way of annotating the presentations and hand-outs
directly on the tablet. These notes can then be saved by the student on to their own computer at
the end of the block, and the file on the tablet cleared, ready for the next student.
30
Teaching/ university resources
The Network
In each of the 6 sites there would be a cascade of tablets as indicated in the figure below. All tablets
would have administrator privileges to those below. This means for example, that the Educational
Supervisor or the administrator for each site would be able to easily update any timetable changes
on each of the tablets below them in the hierarchy. It would also mean that the educational
supervisor, administrator or indeed the ADME/CTF would be able to access all the information held
on or searched for in each tablet.
The tablets would be assigned at the beginning of each block, with a master list of names and tablet
assignments available on each tablet itself. Each tablet would be individually names, e.g. “BBH Tab
2”. The tablets would also be set up to easily instant message everyone within that group, whether
that was site specific, or hierarchy specific ie all tablets at Devizes, all educational supervisors, etc.
Figure 1
Logbook application
Application development could take the logbook from its present paper format to an electronic one.
ADME/CTF
SMH
tablet 1
tablet 2
tablet 3
tablet 4
tablet 5
tablet 6
tablet 7
tablet 8
BBH
tablet 1
tablet 2
tablet 3
tablet 4
tablet 5
tablet 6
tablet 7
tablet 8
CRH
tablet 1
tablet 2
tablet 3
tablet 4
tablet 5
tablet 6
tablet 7
tablet 8
North Som
tablet 1
tablet 2
tablet 3
tablet 4
tablet 5
tablet 6
Bath
tablet 1
tablet 2
tablet 3
tablet 4
tablet 5
tablet 6
Devizes
tablet 1
tablet 2
tablet 3
tablet 4
tablet 5
tablet 6
31
Advantages:
o We could see when the work was being completed, much like the RCPsych portfolio
site. Was it consistent, or crammed into the end?
o Students could continue to work on their case presentations even when they are not
at a computer, i.e. travelling, waiting to see patients etc.
o Students could get people to confirm attendance etc. in real time
o Feedback from CBD etc. entered immediately and stored for assessment
Timetabling with remote updating
One of the most consistent pieces of feedback we have had is that there is often confusion around
the timetable, with clinics being cancelled or changed. If we were able to remotely update individual
timetables, then the onus would be on the medical student to take responsibility for their own
learning, while improving communication to make sure that the opportunities were there.
Instant Messaging
A per the network above, IMing a group network is an easy way to get information quickly to
everyone who needs it. A tutorial time has been changed? Admin at the site can easily im everyone
in the group to let them know, with no updating of email lists.
Collaborative working between students
Tutorials at the beginning of the block could be used to give students the knowledge that they can
use throughout the block. For example:
At the beginning of the block, all students attend a tutorial on the MSE. As well as having access on
their tablets to the slides of the presentation, students can be encouraged to make a collaborative
document, perhaps to a template about what sort of words they might use during a mental state
examination. This can then be saved as a collaborative document for use during the rest of their
block - tapping into deeper learning skills and engaging them in their learning.
There are also possibilities for students to be able to work on the same document at the same time.
In the future, group presentations, group assessments, and feedback can all be done at the same
time, remotely.
32
Remote Supervision
With suitable infrastructure, students can meet with their site tutors (and in the future perhaps their
educational supervisors) without having to commute to the base: saving time, and maximising
clinical opportunities.
Webinars
Like the remote supervision, this could be used to help students ‘attend’ group seminars while on
peripheral placements. Attending an ethics talk could be as simple as finding a quiet room off the
ward for 30 minutes, and then going straight back to the patients rather than travelling. Questions
can be asked and answered in real time, with support from the lecturer.
Plagiarism software
If the logbooks were electronic, then we could run each of the 10 long cases through plagiarism
software with a sensitivity to compare each long case to the others in the year. Tablets would allow
typing of the long cases into the tablet, or uploading them.
Feedback
At the end of each lecture and tutorial, the feedback can be collected and collated immediately.
This could also be true for the GMC feedback at the end of each block.
Attendance
Attendance at every lecture and tutorial and workshop could be monitored by the presence of the
tablet, or by the tutor signing each e-logbook.
Infrastructure
Wifi and 3G.
The exact capabilities of each area will have to be investigated. But each Academy building should
have WIFI, which the student can access. For large network updates, we can ask the student leave
the tablets switched on in the academies overnight, at the end of the block for example, to wipe any
stored information and update any resources.
33
Summary
Advantages:
Reduction in paper, compliant with the Trusts green agenda
Reduction in admin time in the medium to long term
Increased time available for clinical teaching and experience
Increased engagement with learning and learning materials
Immediate feedback
Improved communications
Less time wasted by timetable difficulties
More opportunity to work while not able to see patients
Less (or no?) need for individual RVN numbers
Disadvantages
Initial capital outlay
Resource development could be time consuming and costly
Training for admin staff costly in the short term
Phases
1) Contacting, research and consideration of logbook app
2) Pilot at Bath (Peripheral placement, but with academy WiFi)
3) Evaluation of Pilot
4) Hardware purchasing, further resource development
5) Roll out.
34
Costings
Other considerations:
Using IT development as an eSSC project for the students
Insurance
Cases
Compliance with return of tablets
Dr Nicola Taylor, Clinical Teaching Fellow, AWP
Annual Report for Gloucestershire Academy
We had 47 students this year and the following are the highlights from 2012/13:
Introductory Lecture Week and Weekly Tutorials
We continued the introductory week of lectures and they were generally well received. A few
students complained about the intensity of lectures during the week but most prefer this format to
remain.
We expanded the role-play sessions to 3 per attachment. The 1st two sessions (held on Weeks 2 & 3)
remain focused on developing the students’ interview skills. During these sessions, they were
guided & tasked to elicit relevant psychopathology and perform a risk assessment. The students
were divided into small groups, giving everyone the opportunity to be in the ‘hot-seat’ at least once.
Expenditure Units Total
Hardware for Pilot 10 3 000
Application development 1 10 000
Hardware for full roll out 55 16 500
Google apps 10 000
Medical film
development
5 000
4G contract 60 20 000
Total 64 500
35
The DOCS practice session was introduced this year and these sessions were held on Week 7 of their
attachment. Feedback received has been very positive
Clinical Placements
We have continued to run a clinical placement system, which allocates students to individual
Educational Supervisors across the three localities in our county. The students were also given
instructions to spend time with their educational supervisor and his/her team when the students
have nothing else timetabled.
During their psychiatric attachment, the students were allocated to specific inpatient/outpatient
teams and were swapped round halfway through their attachment. Sessions with the Old Age &
Learning Disability teams were timetabled into their schedule. They were also timetabled to spend a
morning with the Hospital Liaison Team where they received a 1:1 session with either the Consultant
or Team Manager on Deliberate Self Harm & Risk Assessment. Students were also encouraged to
explore other psychiatric sub-specialities, and contact numbers/e-mail addresses were given in their
welcome packs.
iPad Project
The students were loaned an iPad each for the duration of their attachment. The iPads were used as
the following
1) Sources of information – the iPads were preloaded with applications related to Psychiatry,
general medicine, medication (BNF) and Blackboard. In the future, we hope to include
electronic versions of textbooks including the PRN textbook we currently loan out to
students.
2) Interactive teaching tool – the use of iPads increased participation of students in discussions
by enabling ALL the students to answer questions asked during tutorials. The iPads also
facilitated learning by allowing the students to search for information and answers to
questions during the teaching sessions. The quizzes done at the end of tutorials, where the
students were randomly allocated into groups and then pitted against each other, were very
well received.
3) Electronic organiser – the students link their university e-mails to their iPads, facilitating
communication between the students and their tutors/admin staff. The students also
received teaching materials via their e-mails. All the information saved on the iPad was
copied and extracted by the students prior the return of the iPads at the end of the
36
attachment. Some of them also make use of the calendar function to help organise their
timetables.
Among the other functions currently being looked into include the use of Facetime as a direct
communication tool between tutors and students. We also hope to develop strategies to improve
the syncing of timetables and to improve the collection of feedback.
Future developments & challenges
Changes in how Mental Health Services in Gloucestershire are provided continue to have an impact
on how teaching can be delivered across the sites. The ongoing development of hubs and
movement of staff made coordination and placement of students difficult at times. Students in Unit
4 were unable to gain experience with the Substance Misuse service following the transfer of the
service to another organisation.
Dr Seng Hoong Tan, Unit Coordinator, Gloucester Academy
Annual Report for Somerset Academy, Academic Year
No particular problems this year. Quality of students generally high. All passed SSC’s. The main
complaint from students continues to be that they have to travel such large distances within this
placement.
The quality of Educational Supervisors continues to be a little variable. This is partly because some
students who are placed outside Taunton do not get to see their Educational Supervisor as often as
would be preferable and this makes a strong link difficult, students preferring to see cases based in
Taunton.
The involvement of senior trainees this year has been very positively received.
There has been some inevitable interruption with the teaching ability this year because of building
works at the main units in Taunton. This is likely to be resolved for the next year.
I have tried a number of different ways to attach students this time. Though feedback has been
generally good, the best feedback was obtained through placement of students on wards which will
be featured next year.
Feedback is generally good. As noted above, the main complaint is of distance to travel.
37
There continues to be some problem in the possible requirement to provide psychotherapy
supervision and IT difficulties.
A new development this year has been that some students have done on call placements with junior
doctors.
I was told at the meeting with the Dean that teaching at Taunton Academy generally is well received
by medical students.
Dr Jackie Rossiter, Unit Co-ordinator, Somerset Academy
Annual report for the AWP NHS Partnership Trust
Achievements
In the last academic year I think we have excelled specifically in the following areas:
Feedback
The CTF and academic staff at the university have reviewed the feedback process for all
undergraduates. The result is a reduction in tick box/Likert scale feedback (mandated by the GMC)
and an increase in qualitative feedback that we can use to improve the quality of our teaching. One
example of this is noting the problems experienced by students regarding the complicated time
table in the Bristol sites and reviewing this to a more centralised teaching for next year. The
increase in volume and quality of this ‘narrative feedback’ has continued through all four blocks.
This has allowed us to reflect on our practice, support students in difficulty and name specific
clinicians who have made outstanding contributions to undergraduate education.
Motivating students
In years past there has been some dismay that some of our undergraduate students might view this
block as a ‘psychoholiday’: but no longer! The introduction of a Logbook, developed by Site Tutor,
Sian Hughes, and Associate Unit Tutor, Claire Archdall, has helped us as educators work with
students to maximise their learning. Feedback from Psychiatry and Ethics, MDEMO and Junior
Med/Surgery have shown that students are at least as motivated to work in psychiatry as in any
other Year 3 block, and in many cases, more so.
38
Developing a Community of Educators
With the introduction of three new Site Tutors, and six AUTs across five sites, it would have been
easy to allow this, the complex timetable and geographical difficulties to cause real problems in the
organisation and delivery of teaching. However, the enthusiasm and collaboration of everyone at
the sites, including the administrators, means that we were able to work consistently and cohesively.
This meant keeping things that worked well (specific tutorials, educational supervisors), improving
things that could have worked better (developing timetables for learning opportunities at Blackberry
Hill) and responding to feedback, as mentioned above.
This collaboration was, I think, also key in supporting the new tutors in their roles, and improving the
overall feedback scores for some of the sites markedly.
Maintaining Standards
With these achievements we have delivered high quality undergraduate education this year; made
improvements for next year; and laid the foundations to ensure that the change to fourth year is
going to be seized as an exciting opportunity for even more educational excellence.
Changes in Personnel
Clinical Teaching Fellow
Dr Nicola Taylor, Clinical Teaching Fellow, completed her time with AWP at the end of March 2013.
We are very thankful for all the work that Nicola has put into improving the undergraduate teaching
in AWP over the last year.
We have recruited Dr Karl Scheeres who will be a Clinical Teaching Fellow for a year beginning 7th
August 2013 and we look forward to working with him.
Undergraduate Site Tutors
At three of the six sites in AWP we have new Undergraduate Site Tutors - Dr Eileen O’Sullivan (North
Somerset), Dr Angelika Luehrs (Devizes) and Dr Thanos Tsapas (Bath). They have all completed their
first year and I am pleased to report that the feedback in all three sites has improved since they took
up the posts. Dr Hugh Herzig has come to the end of his three years as Undergraduate Site Tutor at
Southmead Hospital and has decided to step down and we have advertised for a replacement. We
39
thank him for his contribution in the last three years, where feedback also improved during his
tenure.
Associate Unit Tutors
The Associate Unit Tutors (Doctors Charlotte Boyer-Millar in Bath, Dr Ane Gillett in North Somerset,
Dr Simon Downer and Dr Shirley Arulanandam in South Gloucestershire, Dr Elizabeth Mahoney in
Southmead and Dr Amy Green in Callington Road) have all come to the end of their posts. The
Associate Unit Tutor role has been in place for just over a year, and has been very successful in
providing support to the site tutor. The AUTs have all enjoyed their work and the scheme has been
written up and will be presented by Dr Nicola Taylor at Association for Medical Education in Europe
(AMEE) conference in Prague in August. We thank them for the contributions to enriching the
students’ educational experience and for the support given to local Site Tutors.
We have recruited five Associate Unit Tutors for the coming year to support the local Site Tutors: Dr
Alison Lerant in Weston, Dr Liz Ewins in Bath, Dr Ami Khothari in Southmead, Dr Rosemary Herbert in
South Gloucestershire and Dr Ben Wood in Callington Road. We look forward to working with them
in the coming academic year. We wish them well for the next academic year.
Challenges and Plans
Feedback from students has revealed a common theme, which is the challenge of needing to
commute to community sites around Bristol to attend lectures, tutorials and clinical activities. In
order to try and improve the experience for students for the forthcoming year, we have decided to
centralise the lectures and tutorials in the first two weeks at the Learning and Resource Centre in
Southmead Hospital for all of the students placed in South Gloucestershire, Callington Road and
Southmead Hospital (25-30 students). The Undergraduate Site Tutors and Associate Unit Tutors
from the three sites will be involved so that the larger group can break into three sub groups for
workshops without the need to travel. In AWP’s three peripheral sites the feedback about the
timetable and organisation is less of a concern.
The next academic year is to be the last when psychiatry teaching is to be delivered in the third year
of Medical School. During the fallow year that follows, we will be completely redesigning teaching of
Psychiatry in AWP for the 4th year medical students in 2015.
40
Conclusion
Undergraduate teaching in AWP has continued to improve in 2012/2013 and we look forward to the
next academic year in September, the last year in which we teach the third year medical students,
before a complete revamp of the curriculum for the fourth year medical students of September
2015.
Dr Geoff Van Der Linden, Associate Director of Medical Education (undergraduates), AWP NHS
Partnership
41
SITE TEACHING TIMETABLES FOR 2012-13 Topic Bath BBH Callington
Road
Devizes Gloucester Southmead Taunton Weston
Phen/Classification
Week 1 Week 1 Week 1 Week 1 Week 1 Week 1 Week 1 Week 1
MSE/History
Taking
Week 2 Week 1 Week 1 Week 2 Week 1 & Role-
play Weeks 2 &
3
Week 1 Week 1 Week 1
Intro
Substance Misuse
Week 2 Within 1st 2
Weeks
Week 1 Week 1 Within 1st 2
Weeks
Week 1 Week 1
Intro
Affective Disorders
Week 2 Within 1st 2
Weeks
Week 1 Week 3 Week 1 Within 1st 2
Weeks
Week 1 Week 2
Intro
Anxiety Disorders
Week 2 Within 1st 2
Weeks
Week 1 Week 2 Week 1 Within 1st 2
Weeks
Week 1 Week 2
Intro
Old Age/Dementia
Week 2 Within 1st 2
Weeks
Week 2 Week 3 Week 1 Within 1st 2
Weeks
Week 1 Week 2 and
then every
week with
course tutor
covering all
subjects
Intro Week 2 Within 1st 2
Weeks
Week 1 Week 1 Week 1 Within 1st 2
Weeks
Week 1 Week 2
42
Schizophrenia
(2) Substance
Misuse
Week
3/4/5/6/7/8
Within 1st 2
Weeks
Week 3 Week 6 Week 1 & Wk 6 Within 1st 2
Weeks
Week 5 &
revision
Week 2
(2) Affective
Disorders
Week
3/4/5/6/7/8
Weeks 4/5/6/7 Week 2 Week 3 Role-play Wk 2 Weeks 4/5/6/7 Week 2 &
revision
WEEK 2 or 3
(2) Anxiety
Disorders
Week
3/4/5/6/7/8
Weeks 4/5/6/7 Week 3 Week 4 Role-play Wk 2 Weeks 4/5/6/7 Week 3 &
revision
Week 2 or 3
(2) Old
Age/Dementia
Week
3/4/5/6/7/8
Weeks 4/5/6/7 Week 5 Week 5/6 Week 5/6 Weeks 4/5/6/7 Week 4 &
revision
Week 3
(2) Schizophrenia
Week
3/4/5/6/7/8
Weeks 4/5/6/7 Week 4 Week 6 Role-play Wk 3 Weeks 4/5/6/7 Week 1 Week 4
Risk Assessment
Week 2 Week 1 Week 2 Week 2 Week 1 Week 1 Week 1 &
throughout
Week 4
Exam Week 7 On going On going On going Week 6 On going Week 8 Week 6
43
Prep/Revision
Mental Health Act
Week 2 By the end of
Week 3
Covered with
Clinical Tutor
Week 2 Week 1 By the end of
Week 3
Week 3 Week 7
Pharmacology
Week 5 On going Week 3 Week 4 & 5 Week 7 Week 7
ECT
Tutorial within
1st 4 Weeks
Week 2 Week 5/6/7 Video available
and advised to
visit ECT suite
Tutorial within
1st 4 Weeks
Week 3 Week 5
Specialist subjects Week User
perspective
Rethink
sessions
CAMHS
Balint Group
Therapies
Week 3
Learning
difficulties
Week 4 & 5
Extra tutorials
ongoing
PTSD Week 2
Perinatal
CAMHS
Learning
Difficulties
Medically
Unexplained
Symptoms
Learning
Disability – ½
day on week 5
DSH –
allocated day
with Liaison
Team
User
perspective
Rethink
sessions
CAMHS
Balint Group
Throughout