Reflections on how to approach early career psychiatrist roles and challenges

2021 ◽  
pp. 103985622110108
Author(s):  
Jeffrey C L Looi ◽  
Angus J F Finlay ◽  
Daniel S Heard
Keyword(s):  
Reflective Practice ◽  
Clinical Supervision ◽  
Clinical Care ◽  
Early Career ◽  
Formal Training ◽  
Common Elements ◽  
Public And Private ◽  
Informal Mentoring ◽  
Direct Guidance ◽  
Clinical Directors

Objective: To reflect upon and provide experiential advice to address the roles of early career psychiatrists. The main roles include leading patient care; working in teams; clinical supervision and governance of trainees, and of the psychiatrist by clinical directors/managers. While these roles vary across public and private sectors, the discussion focuses on common elements. Conclusions: The first several years of an early career psychiatrist’s work often involves roles for which formal training cannot provide direct guidance, and which benefit from planning and reflective practice. Learning how to navigate clinical care, clinical supervision and governance, formal/informal mentoring and peer review are necessary to effective practice.

scholarly journals Abortion attempts without clinical supervision among transgender, nonbinary and gender-expansive people in the United States

2021 ◽  
pp. bmjsrh-2020-200966
Author(s):  
Heidi Moseson ◽  
Laura Fix ◽  
Caitlin Gerdts ◽  
Sachiko Ragosta ◽  
Jen Hastings ◽  
...  
Keyword(s):  
United States ◽  
Clinical Supervision ◽  
Online Survey ◽  
Clinical Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Physical Trauma ◽  
Abortion Care ◽  
And Gender

BackgroundTransgender, nonbinary and gender-expansive (TGE) people face barriers to abortion care and may consider abortion without clinical supervision.MethodsIn 2019, we recruited participants for an online survey about sexual and reproductive health. Eligible participants were TGE people assigned female or intersex at birth, 18 years and older, from across the United States, and recruited through The PRIDE Study or via online and in-person postings.ResultsOf 1694 TGE participants, 76 people (36% of those ever pregnant) reported considering trying to end a pregnancy on their own without clinical supervision, and a subset of these (n=40; 19% of those ever pregnant) reported attempting to do so. Methods fell into four broad categories: herbs (n=15, 38%), physical trauma (n=10, 25%), vitamin C (n=8, 20%) and substance use (n=7, 18%). Reasons given for abortion without clinical supervision ranged from perceived efficiency and desire for privacy, to structural issues including a lack of health insurance coverage, legal restrictions, denials of or mistreatment within clinical care, and cost.ConclusionsThese data highlight a high proportion of sampled TGE people who have attempted abortion without clinical supervision. This could reflect formidable barriers to facility-based abortion care as well as a strong desire for privacy and autonomy in the abortion process. Efforts are needed to connect TGE people with information on safe and effective methods of self-managed abortion and to dismantle barriers to clinical abortion care so that TGE people may freely choose a safe, effective abortion in either setting.

Feeling stuck: exploring experiences of junior doctors

2021 ◽  
pp. 1-7
Author(s):  
Lauren Alexander ◽  
Eimear Counihan ◽  
Deirdre McNally ◽  
Leonard Douglas
Keyword(s):  
Reflective Practice ◽  
Clinical Supervision ◽  
Psychiatric Hospitals ◽  
Junior Doctors ◽  
Further Training ◽  
Paper Version ◽  
Item Questionnaire ◽  
Open Coding ◽  
System Factors ◽  
Clinical Interactions

Objectives: Staff working in mental health services provide care for individuals with a variety of difficulties, which can pose treatment challenges. Perceived lack of progress in patients can engender uncomfortable feelings within the clinician, such as frustration, ‘heartsink’ and ‘feeling stuck’. The aim of this study was to explore the phenomenon of ‘feeling stuck’ amongst NCHDs in psychiatry. Methods: A total of 30 participants were recruited from three psychiatric hospitals to complete a 15-item questionnaire. The survey was designed to pursue a thematic analysis. Participants were asked to complete the survey anonymously, either online or paper version. The analysis was carried out by two researchers using open coding, with themes finalised through collective discourse. Results: Three themes were elicited from the data. The central theme – ‘causes of feeling stuck’ – consisted of three subthemes (patient, doctor and system factors). Participants were adept at describing patient and system factors, but reflected on doctor factors, such as countertransference, less often and in less detail. Other themes, explored in less detail by respondents, were ‘the experience of feeling stuck’ and ‘responses to feeling stuck’, with participants tending to seek solutions to, rather than an understanding of, these feelings. Conclusions: Trainee psychiatrists can clearly identify the situations where they are ‘stuck’ with clinical interactions. In spite of clinical supervision and reflective practice groups, they desire further training in managing these scenarios. NCHDs would benefit from further training, using these ‘stuck’ interactions as material, to further develop their understanding of the underlying factors in both themselves and their patients.

Things I wish I’d known: desiderata for early career psychiatrists

2016 ◽  
Vol 25 (1) ◽  
pp. 78-81 ◽  
Author(s):  
Lillian Ng ◽  
Richard Steane ◽  
Emme Chacko ◽  
Natalie Scollay
Keyword(s):  
Work Environment ◽  
Reflective Practice ◽  
Self Care ◽  
Career Progression ◽  
Work Life ◽  
Early Career ◽  
Life Balance ◽  
Career Plans ◽  
Zealand College

Objective: The objective of this study was to disseminate advice imparted to early career psychiatrists by a panel of senior colleagues at a Royal Australian and New Zealand College of Psychiatrists symposium, reflecting on things they wished they had known at the earlier stage in their careers. Methods: Key themes were extracted from notes taken at the symposium, where opinions were expressed by three senior psychiatrists. Results: There are components in building a sustainable career as a psychiatrist, which include considering one’s work environment and relationships with colleagues; self-care, mentorship and reflective practice; and seeking opportunities to teach and research for career progression. Conclusions: The mentorship and advice from senior colleagues can be highly influential. In order to sustain a career that has reward, meaning and longevity, psychiatrists would do well to pay attention to aspects of self-care, stay connected to their loved ones, seek an optimal work–life balance and take an interest in their long term career plans.

scholarly journals The leadership and followership challenges of doctors in training during the COVID-19 pandemic

2021 ◽  
pp. 1-9
Author(s):  
Nathan Boardman ◽  
Jack Munro-Berry ◽  
Judy McKimm
Keyword(s):  
Early Career ◽  
Formal Training ◽  
Clinical Environment ◽  
Training Experience ◽  
Healthcare Leadership ◽  
Leadership Culture ◽  
Team Working ◽  
Medical Education And Training ◽  
And Training

Research carried out in 2016 by the authors investigated the challenges that doctors in training experience around leadership and followership in the NHS. The study explored contemporary healthcare leadership culture and the role of followership from the perspective of early career doctors. It found that the leadership and followership challenges for these doctors in training were associated with issues of social and professional identity, communication, the medical hierarchy, and relationships with senior colleagues (support and trust). These challenges were exacerbated by the busy and turbulent clinical environment in which they worked. To cope with various clinical situations and forms of leadership, doctors in training engage in a range of different followership behaviours and strategies. The study raised implications for medical education and training and suggested that followership should be included as part of formal training in communication and team working skills. The importance of both leadership and followership in the delivery of safe and effective patient care has been brought sharply into focus by the COVID-19 pandemic. This article revisits these challenges in light of the pandemic and its impact on the experiences of doctors in training.

scholarly journals Strengthening the Somaliland health system by integrating public and private sector family medicine

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Muna M. Mahfud ◽  
Fathia M. Nour ◽  
Hodan J. Abdi ◽  
Sabah M. Muse ◽  
Tim Fader
Keyword(s):  
Family Medicine ◽  
Private Sector ◽  
Health System ◽  
Healthcare System ◽  
Clinical Care ◽  
Family Physicians ◽  
Public Private Partnerships ◽  
Specialty Training ◽  
Public And Private ◽  
Public And Private Sector

Four family physicians, who received their specialty training at Amoud University in Somaliland, organised a practice together that uses informal public–private partnerships to optimise their clinical care and teaching. Their experience offers insights into public–private partnerships that could strengthen the country’s healthcare system.

scholarly journals What do Master's students' structured reflections say about the learning processes involved in commencing a research project?

2020 ◽  
Vol 17 (1) ◽  
pp. 92-107
Author(s):  
Richard Warner ◽  
◽  
Michelle Picard ◽  
Keyword(s):  
Reflective Practice ◽  
Learning Processes ◽  
Early Career ◽  
Multidisciplinary Research ◽  
Project Proposal ◽  
Research Project ◽  
Master's Students ◽  
Early Career Researchers ◽  
Multidisciplinary Perspective ◽  
Learning Ecology

This study aims to unpack the reflective learning processes involved in developing a Masters’ research project proposal as part of a multidisciplinary Research Design course. Using inductive analysis, we explored students’ reflective blogs written over a period of a semester and defined the reflections according to an adaptation of Hatton and Smith’s (1995) framework. Our findings are that the nature of each individual blog topic affected the quality and level of reflection, which in turn is affected by the ‘learning ecology’ (Harvey, Coulson, & McMaugh, 2016 p. 12). More highly scaffolded blogs showed greater evidence of reflective practice. Likewise the nature of the practice (starting research) influenced reflection, since many processes are internal rather than requiring explicit practice to reflect on. In addition, as nascent practitioner researchers, the students are also involved in reflexivity rather than reflection and therefore some topics encouraged this form of reflection more than others did. This study is significant in that it explores reflection in research and practitioner contexts, focuses on early career researchers/practitioners and brings a multidisciplinary perspective.

Examining Experienced S&C Coaches’ Reflections on the Effectiveness of Psychosocial Behaviors in Coaching

2020 ◽  
pp. 1-9
Author(s):  
Christoph Szedlak ◽  
Jo Batey ◽  
Matthew J. Smith ◽  
Matthew Church
Keyword(s):  
Reflective Practice ◽  
Learning Strategies ◽  
Thematic Analysis ◽  
Constructivist Learning ◽  
Formal Training ◽  
Semistructured Interview ◽  
Development Programs ◽  
Strength And Conditioning ◽  
Holistic Development ◽  
Coach Development

This study aimed to examine elite, experienced strength and conditioning (S&C) coaches’ reflections on the effectiveness of psychosocial behaviors in S&C coaching. In particular, this study aimed to explore which psychosocial behaviors are essential, the process of how these might influence coaching practice, and how the development of psychosocial behaviors should be encouraged. Eight elite, experienced S&C coaches were recruited and partook in a semistructured interview. Using a reflexive thematic analysis, six themes were identified: understanding athlete’s needs, communicating effectively, caring and connecting with the athlete, practicing what you preach, the importance of reflective practice, and the contribution of formal training. The findings of this study enhance the literature by highlighting that elite, experienced S&C coaches perceive psychosocial behaviors to be essential in effective S&C coaching practice. In particular, the findings describe the processes of how identified psychosocial behaviors might positively influence athlete development by enhancing motivation, buy-in, and autonomy. In addition, the authors’ results suggest that current S&C coach development programs are limited in facilitating the learning of psychosocial behaviors. Thus, their findings strengthen the call for S&C coach educators to utilize constructivist learning strategies including facilitated reflection to encourage the development of essential psychosocial behaviors that contribute to the holistic development of the athlete.

scholarly journals COVID-19 mental health care toolkit: an international collaborative effort by Early Career Psychiatrists section

2020 ◽  
Vol 33 (5) ◽  
pp. e100270
Author(s):  
Frances Adiukwu ◽  
Laura Orsolini ◽  
Drita Gashi Bytyçi ◽  
Samer El Hayek ◽  
Jairo M Gonzalez-Diaz ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Clinical Care ◽  
Outpatient Setting ◽  
Early Career ◽  
Collaborative Effort ◽  
Risk Patients ◽  
International Research Team ◽  
Health Field

The collaborative effort of an international research team from the Early Career Psychiatrists section of the World Psychiatry Association has brought about an easy-to-use, quick and stepwise mental health care toolkit for the identification and appropriate referral of those in need of mental health care during the pandemic. This simple guide can be applied in the general outpatient setting and is catered for all healthcare professionals, regardless of their expertise within the mental health field with minimal training. It is our hope that by incorporating this toolkit into our daily clinical care during the pandemic for high-risk patients and patients with non-specific complaints, we will be able to bridge the mental health gap present in our society.

scholarly journals 1326. Inter-Professional Education and Training to Build Capacity Among Healthcare Workers in Singapore

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S405-S405
Author(s):  
Jessica Michaels ◽  
Dariusz Olszyna ◽  
Frank Ng ◽  
Cheng Chuan Lee ◽  
Sophia Archuleta
Keyword(s):  
Professional Education ◽  
Healthcare Workers ◽  
Clinical Care ◽  
Attrition Rate ◽  
People Living With Hiv ◽  
Hiv Education ◽  
Public And Private ◽  
Healthcare Facilities ◽  
Attitudes And Practices ◽  
Hiv Clinical Care

Abstract Background People Living with HIV (PLHIV) in Singapore continue to face stigma and confidentiality concerns in their interactions with Healthcare Workers (HCWs). There is a recognized gap in HIV-related knowledge and lack of training opportunities for HCWs in Singapore, particularly amongst nonphysicians and other HCWs who do not regularly care for PLHIV. The HCW HIV Education Series was conceptualized to address these issues and to improve the HIV-related knowledge, attitudes and practices of HCWs in Singapore. Methods The HCW HIV Education Series is organized by an interprofessional organizing committee. The series is made up of four half day modules which are conducted quarterly. The modules are designed and implemented to cater to as many HCWs as possible. The modules function as a series but can also be run as standalone education sessions. The modules are: HIV Basics, Working with PLHIV, Basic HIV Clinical Care and Advanced HIV Clinical Care. In its pilot year (2016–2017), 334 HCWs, predominantly nurses, pharmacists, and social workers attended the series. The HCWs attended from diverse healthcare settings, including public and private hospitals, nursing homes, faith based and community organizations. Pre- and post-module evaluations were completed by participants. Results Only 5% of Module 1 attendees had previously received training in HIV. Across all four modules, there was a marked improvement in knowledge and confidence pre- and post-training. 95% of attendees across all modules felt that they had gained new skills that would add value to their work. While 97% of attendees of Module 1 planned to attend future modules, the attrition rate between modules was high. Conclusion The HCW HIV Education Series is highly evaluated and well attended. Efforts to maintain and strengthen attendance across all modules is needed, the delivery of the modules over a 2-day period may be an effective way to achieve this. Research into the experiences of PLHIV in healthcare facilities should also be considered. Disclosures All authors: No reported disclosures.

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