Surviving your first on-call in psychiatry: a bootcamp for junior doctors

Aims
The psychiatry ‘bootcamp’ forms part of the psychiatry induction for junior doctors within NHS Lanarkshire. It was developed to better prepare them for common scenarios on-call and therefore alleviate any anxieties. The session is based upon a weekend on call where a fictional patient is admitted to the psychiatry ward with a psychotic presentation. It introduces the participant to the topics of Mental Health Act utilisation, capacity, acute behavioural disturbance management, and adverse effects of psychotropic medications.

Methods

Focussed teaching regarding fundamental theory for each topic is provided. Following this the facilitators engage the audience through reflective group discussion. Relevant parts of the session involve practical work including individual completion of detention paperwork. Targeted teaching is provided by the facilitators for any knowledge gaps identified.

Pre and post course questionnaires are completed by participants where they provide both written feedback and score various domains between 0 (least confident) and 10 (most confident). Domains are capacity assessment, assessing detention criteria, the process of detaining a patient, and recognition and management of extrapyramidal side-effects.

Results

This course has been run on two separate occasions with a total of 28 participants. All domains assessed on feedback questionnaires have shown an increase in confidence amongst the participants. Following analysis of all pre and post course questionnaires session one showed an average improvement from 4.87/10 to 7.56/10 across all domains. Session two showed an average improvement from 5.34/10 to 8.6/10.

Themes identified on participant feedback included the benefit of having the opportunity to individually practice completing detention paperwork. Another theme identified was that participants found the case used for session delivery relevant to their practice. A final theme identified was the engaging nature of the session which encouraged the participants to ask questions. If a didactic approach was used this could restrict such discussion.

Conclusion

Feedback received suggested that this session was well received by all participants and was felt to be beneficial in both preparing them for and alleviating anxieties ahead of their first shift on-call within psychiatry. Feedback demonstrated that running the session in small groups with a blended approach of direct teaching, reflective discussion, and practical work maximised engagement and was an appropriate approach for session delivery. Feedback suggests that this session has the potential to be an essential part of future junior doctor inductions due to it identifying and meeting the learning needs of the participant.