scholarly journals Core psychiatry trainees views on MRCPsych course structure and delivery at East Midlands Deanery

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S141-S142
Author(s):  
Asma Javed ◽  
Hetal Acharya ◽  
Ian Yanson
Keyword(s):  
Clinical Practice ◽  
Small Sample Size ◽  
Small Sample ◽  
Teaching Programme ◽  
Course Structure ◽  
Face To Face ◽  
East Midlands ◽  
Technical Issues ◽  
Level Of Training ◽  
Full Day

AimsThe RCPsych curriculum for core training in Psychiatry (2013) requires each Deanery to run regional MRCPsych teaching programme.The East Midlands School of Psychiatry run a local MRCPsych course aimed at all core psychiatry trainees in the deanery. Before the pandemic, the course took place between two venues – Nottingham and Leicester. During the pandemic, the course was delivered via Microsoft teams. We aimed to collect the feedback from trainees regarding the course to help shape the MRCPsych Course programme according to their training needs.MethodWe devised an online Microsoft forms questionnaire which included:Level of trainingNumber of exams passedRelevance of MRCPsych content to clinical practice and membership examUsefulness of mock exams, simulation scenarios and workshops towards clinical and exam practiceOverall experience of the courseWhich additional sessions they would like to be includedThe effect of COVID-19 on their ability to attend in MRCPsych programmeThese forms were sent to all the trainees in the region via email.ResultOut of 44 trainees, 9 responded. 66.6% of the trainees who responded were CT1 and 33.3% CT2. 45% had passed Paper A and 55% had not passed any exams. 78% of them agreed and 11% strongly agreed that course was relevant to the clinical practice. 55.6% agreed that course was relevant to membership course. 44.4% agreed and 11% strongly agreed that mock exams were useful. 66.7% agreed and 11% strongly agreed that simulation case scenarios and workshops were useful for exam and clinical practice. 22.2% strongly agreed and 33.3% agreed that sessions were engaging and motivating. Overall experience of MRCPsych exam was rated as excellent (11%), good (55%), satisfactory (22%) and poor (11%).Suggestions to add additional sessions included antiracism in psychiatry, more mock exams, practical management of cases, to organise more interactive sessions on Microsoft teams, in-depth coverage of exam topics, to organise full day teaching sessions instead of half day.33.3% of trainees commented that COVID-19 had impacted on their ability to attend the exam as initially face to face sessions were cancelled till end of May 2020 and when started there were technical issues with the online platformConclusionConsider feedback received in modifying aspects of the MRCPsych courseTo share the results with trainers and course tutorsArrange relevant mock exam sessionsInclude the topics suggested by trainees and improve the experience of online learning by making it more interactiveLimitations: small sample size.

Focal Seizures in Patients With SCN1A Mutations

2016 ◽  
Vol 32 (2) ◽  
pp. 170-176 ◽  
Author(s):  
Christopher L. McDonald ◽  
Russell P. Saneto ◽  
Lionel Carmant ◽  
Márcio A. Sotero de Menezes
Keyword(s):  
Clinical Practice ◽  
Time Course ◽  
Pediatric Patients ◽  
Small Sample Size ◽  
Genetic Mutation ◽  
Small Sample ◽  
Focal Seizures ◽  
Clinical Considerations ◽  
New Research ◽  
Scn1a Gene

The SCN1A gene has been implicated in the etiology of various forms of epilepsy. New research has linked this gene to specific types of epilepsy, all of which present in infancy or early childhood. This study examines the time course and pathology of pediatric patients who have a mutation in the SCN1A gene in order to open a discussion regarding the key trends of this form of epilepsy as well as important clinical considerations in management for patients who present with symptoms relating to the SCN1A mutations. We retrospectively examined 20 patients who presented to the clinic with focal seizures, as well as were positive for an SCN1A genetic mutation. Despite the small sample size, we were able to find important trends in the time course of the disorder as well as important areas of clinical practice that must be taken into consideration for these patients.

The Debt Burden of Entry-Level Physical Therapists

2019 ◽  
Vol 100 (4) ◽  
pp. 591-599 ◽  
Author(s):  
Steven B Ambler
Keyword(s):  
Clinical Practice ◽  
Physical Therapy ◽  
Physical Therapists ◽  
Small Sample Size ◽  
Small Sample ◽  
Student Debt ◽  
Practice Setting ◽  
Entry Level ◽  
Debt Burden ◽  
Educational Debt

Abstract Background The growing student debt of physical therapists entering the workforce, coupled with the growth in projected need, raises concerns about where and how entry-level physical therapists will practice and if these choices will be affected by their debt burden. Objective The purpose of this study was to identify the debt profile of entry-level physical therapists and explore relationships between student debt and clinical practice setting choices. Methods This study utilized a cross-sectional survey design to identify debt profiles and explore relationships between student debt and the clinical practice choices of entry-level physical therapists. Results The mean debt-to-income ratio based on the total reported educational debt was 197% (93%). The most frequently reported debt range for doctor of physical therapy (DPT) debt and total educational debt was $100,000 to $124,999. Despite the setting itself being rated as the most important factor (83%), 28% of participants reported debt as a barrier to their desired practice setting. In addition, when considering job choice overall, 57% of the participants reported that their student debt has had an effect on their decision. Limitations This study is limited by its small sample size, originating from 1 state, and being taken by convenience from a special interest group. Data were collected via an anonymous survey, which increases the risk of selection bias. In addition, there are further personal, family, and institutional characteristics that were not collected in this study, which may influence the interaction between student debt and clinical practice choices. Conclusion The results of this study suggest that practice setting choice may be affected by physical therapist student debt, and student debt may be a barrier overall to practice and career choices in physical therapy.

Assessing the Reliability and Use of the Expository Scoring Scheme as a Measure of Developmental Change in Monolingual English and Bilingual French/English Children

2016 ◽  
Vol 47 (4) ◽  
pp. 297-312 ◽  
Author(s):  
Elizabeth Kay-Raining Bird ◽  
Nila Joshi ◽  
Patricia L. Cleave
Keyword(s):  
Clinical Practice ◽  
Elementary School Children ◽  
Developmental Change ◽  
Small Sample Size ◽  
Age Groups ◽  
Small Sample ◽  
Intrarater Reliability ◽  
Spoken Discourse ◽  
Language Groups ◽  
Expository Discourse

Purpose The Expository Scoring Scheme (ESS) is designed to analyze the macrostructure of descriptions of a favorite game or sport. This pilot study examined inter- and intrarater reliability of the ESS and use of the scale to capture developmental change in elementary school children. Method Twenty-four children in 2 language groups (monolingual English and bilingual French/English) and 2 age groups (7–8 years, 11–12 years) participated (6 in each subgroup). Participants orally explained how to play their favorite game or sport in English. Expository discourse samples were rated for 10 macrostructure components using the ESS. Ratings were summed for a total score. Results Inter- and intrarater reliability was high for the total ESS score and for some but not all ESS components. In addition, the total score and ratings for many ESS components increased with age. Few differences were found in use of macrostructure components across language groups. Conclusions The ESS captures developmental change in the use of expository macrostructure in spoken discourse samples. It may be beneficial to take into account the lower reliability found for ratings of some ESS components in clinical practice. Due to the small sample size, these results should be considered preliminary and interpreted with caution.

scholarly journals Problem and Challenges Faced by Students, Parents, and Teachers in Google Classes & Television Lessons

2021 ◽  
Vol 2 (1) ◽  
pp. 88-97
Author(s):  
Tshewang Dorji
Keyword(s):  
Small Sample Size ◽  
Small Sample ◽  
Research Approach ◽  
Mixed Method Research ◽  
Group Discussions ◽  
Heavy Load ◽  
Face To Face ◽  
Television Lesson ◽  
Academic Year ◽  
And Training

The qualitative study was carried out under Thimphu Thromde, Bhutan, to assess the use of Google class and Television lessons during the emergence of COVID-19 in the 2020 academic year. The study used Google class & Television lesson observations to gain the first-hand experience and face-to-face interviews with students, parents, and teachers to get in-depth views. The Google class and television lesson observation and interview data were analyzed using emerging themes. The findings revealed that Google class and Television lessons played an essential role in making up lessons lost during schools' closure. However, the study further revealed some pertinent issues related to the Google class and Television lessons, including students resorting to copying assignments and homework directly from friends or copying directly from textbooks and the internet. Students were overburden by the heavy load of assignments assigned by different subject teachers, among many others. More preparedness and training for teachers in ICT based pedagogy was required. The study might draw policy attention to consider the problem and challenges before implementing Google class and Television lessons shortly to avoid pitfalls. The study was limited to the Thimphu Thromde, Bhutan, using a small sample size of students, parents, and teachers. A future mixed-method research approach uses surveys with students, parents, and teachers; focus group discussions with students, parents, and teachers; and policymakers' interviews are recommended.

Implementation of a Participant-Centered Weight Management Program for Older Nurses: A Feasibility Study

2014 ◽  
Vol 19 (3) ◽  
Author(s):  
Eun-Shim Nahm ◽  
Joan Warren ◽  
Erika Friedmann ◽  
Jeanine Brown ◽  
Debbie Rouse ◽  
...  
Keyword(s):  
Weight Management ◽  
Vegetable Consumption ◽  
Small Sample Size ◽  
Management Program ◽  
Small Sample ◽  
Weight Management Program ◽  
User Centered Design ◽  
Face To Face ◽  
Post Test ◽  
Post Menopausal

American nurses (3.06 million) are at high risk for being overweight, as the majority are post-menopausal women (93.3% female; mean age 47). Studies have indicated that more than half of all nurses are either overweight or obese. This fact is of concern because nurses often lead major health promotion efforts. The aim of this study was to examine the feasibility of a novel participant-centered weight management program (PCWM) among nurses. The participant-centered (P-C) theoretical framework used originated from the field of usability engineering (i.e., user-centered design). Study methods included a single group pre-test/post-test design (baseline, eight weeks, three months) and an intervention consisting of face-to-face education sessions, technology-augmented exercise programs, and an eHealth portal. The results demonstrated a significant decrease in body weight, increased fruit and vegetable consumption, and increased exercise at eight weeks. In our discussion of this study, we note that although the intervention effects decreased at three months, these results are promising, considering that the intervention used was not regimented and relied only on nurses’ activation of their planned health behaviors. The major limitation of the study was the small sample size recruited from one large community hospital. Further research is needed to improve the sustainability of the program.

scholarly journals Attitudes towards CBT in trainee clinical psychologists

2020 ◽  
Vol 15 (5) ◽  
pp. 275-286
Author(s):  
Laura Jane Hancox ◽  
David M. Gresswell ◽  
Danielle De Boos
Keyword(s):  
Clinical Practice ◽  
Small Sample Size ◽  
Behavioural Therapy ◽  
Influential Factors ◽  
Small Sample ◽  
Clinical Psychologists ◽  
Mixed Effect ◽  
Content Type ◽  
Individual Level ◽  
Significant Positive Change

Purpose This paper aims to address how one Doctorate in Clinical Psychology (DClinPsy) programme contributes to the shaping of attitudes of its trainee clinical psychologists (TCPs) towards cognitive behavioural therapy (CBT). Design/methodology/approach A total of 28 TCPs completed an online, mixed-methods questionnaire relating to their attitudes towards CBT, what factors had influenced their attitude and how competent they felt in applying CBT to clinical practice. Findings The majority of respondents reported a positive attitude towards CBT. There was a statistically significant positive change at an individual level in TCPs’ views of CBT between the point at which they applied for the DClinPsy and the present day. Thematic analysis of qualitative data identified influential factors on the development of TCP attitudes towards CBT. The vast majority of TCPs reported that they felt competent applying CBT in their clinical practice. Research limitations/implications Overall, the DClinPsy has a positive effect on TCPs’ attitudes towards CBT. However, the influence of placements has a more mixed effect on attitudes. A small sample size reduced the reliability of these conclusions. Recommendations for further evaluation have been made. Originality/value This paper evaluates the effect of a DClinPsy programme on TCPs’ attitudes towards CBT. The value is that it establishes which components of the course have different effects on trainee attitudes.

scholarly journals Identity, glass borders and globally mobile female talent

2019 ◽  
Vol 7 (3) ◽  
pp. 285-299
Author(s):  
Susan Kirk
Keyword(s):  
Single Case ◽  
Small Sample Size ◽  
Identity Work ◽  
Small Sample ◽  
Single Case Design ◽  
Senior Managers ◽  
Content Type ◽  
Face To Face ◽  
Global Mobility ◽  
Identity Narratives

Purpose The purpose of this paper is to explore the interplay between identity and global mobility in the careers of senior, female talent, uniquely taking into account the perceptions of both female and male participants. In addition, the role organisations can play in enabling women to overcome these identity constraints is identified. Design/methodology/approach This interpretivist study draws on data from 38 in-depth interviews with senior managers in a large, multinational organisation to elicit a rich picture of how such careers are enacted. Findings Findings reveal how identity conflicts function as a glass border for globally mobile, senior female talent. Ways in which talent can access positive identity narratives to inform global mobility choices are identified. Research limitations/implications The limitations of this study include the relatively small sample size and the single case design of this research. The findings, however, offer insights into the identity work of globally mobile, female talent across different contexts. Practical implications Organisations can facilitate access to identity narratives through mentoring, face-to-face forums and via the internet to enable globally mobile, female talent to make more informed global mobility choices. Originality/value Drawing on identity theory, this paper examines how identity work for globally mobile, female talent has more fluid interpersonal boundaries than for men, creating on-going identity struggles. In highlighting how identity narratives can act as a means of breaching the glass border and facilitating global mobility for female talent, a contribution is made to existing debates in the fields of identity, gender studies and global talent management.

scholarly journals P140 As we move to using short-acting drugs for the treatment of RA in the time of a pandemic, does baricitinib live up to its trial data in clinical practice?

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Henry J S Vardon ◽  
Karen M J Douglas
Keyword(s):  
Clinical Practice ◽  
Tyrosine Kinases ◽  
Disease Duration ◽  
Small Sample Size ◽  
Small Sample ◽  
Real World Data ◽  
Short Acting ◽  
Serious Infections ◽  
Significant Difference

Abstract Background/Aims  Baricitinib is an oral, reversible and selective inhibitor of JAK1 and JAK2 tyrosine kinases. It was approved for use in 2017 by NICE for the treatment of moderate to severe rheumatoid arthritis (RA). Considering the current risk of COVID-19, the BSR have advocated the use of short-acting drugs such as baricitinib when escalating treatment in RA. As real-world data is limited, we aimed to explore the efficacy of baricitinib in clinical practice. Methods  Observational data was collected retrospectively for patients at the Dudley Group NHSFT with RA (ACR/EULAR criteria) who had received at least one dose of baricitinib prior to 1st October 2019, with a follow up period to 1st October 2020. Patients were identified from a local biologics database. Further data was identified from patients’ medical records including, demographics, features of RA, previous RA therapy history and disease activity scores (DAS28) at 0, 6 and 12 months. Data was input into an Excel spreadsheet with subsequent analysis conducted using SPSS Version26. Results  We identified 26 RA patients (77% female) treated with baricitinib; mean age 61.6 (SD 14.6) years and median disease duration of 12.1 (IQR 5.8-18.4) years. Rheumatoid factor and anti-CCP antibody were positive in 73% and 65% respectively. 35% (n = 9) of patients were biologically naïve, in whom baricitinib was chosen due to needle-phobia (n = 7), or where anti-TNF drugs were considered inappropriate (bronchiectasis, ANA positivity). Mean DAS28 (SD) scores at baseline, 6 and 12 months were 5.9(0.8), 2.8(0.9) and 2.7(1.3) respectively, with significant reduction from baseline to both 6 and 12 months (P < 0.001). A drop of ≥ 1.2 in DAS28 was recorded in 94% of patients with complete data at 6 months (n = 18, 4 missing, 4 discontinued). At 6 and 12 months, 85% and 81% of patients remained on Baricitinib. In total five patients discontinued Baricitinib due to side effects or tolerability issues. Reasons for discontinuation did not include thromboembolic events, zoster or serious infections. When comparing naïve and non-naïve groups, there was no significant difference in age, sex or disease duration. The number of previous biologics used by patients were 1(n = 6), 2(n = 3), ≥3(n = 8). Biologically naive compared to non-naïve patients had a higher DAS28 at baseline, (Mean [SD]) (6.2[0.9] versus 5.7[0.8] NS) but lower at 6 months (2.1[1.6] versus 3.1[1.1] P = 0.023) and greater DAS improvement at 6months (-4.4[1.2] versus -2.5[0.9] P < 0.002). Conclusion  We observed that up to 94% of patients responded to baricitinib with a mean DAS improvement at 6 months of -3.1, biologic naïve patients doing best. Drug survival at 12 months was 81%. These trends are comparable to findings in clinical trials. However, due to our small sample size, the findings are vulnerable to type 1 and 2 errors and should be interpreted with caution. Disclosure  H.J.S. Vardon: None. K.M.J. Douglas: None.

scholarly journals Post-stroke fatigue: a scoping review

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 242 ◽  
Author(s):  
Ghazaleh Aali ◽  
Avril Drummond ◽  
Roshan das Nair ◽  
Farhad Shokraneh
Keyword(s):  
Clinical Practice ◽  
Scoping Review ◽  
Current Knowledge ◽  
Small Sample Size ◽  
Small Sample ◽  
Risk Of Bias ◽  
Observational Research ◽  
Stroke Severity ◽  
Level Of Evidence ◽  
Post Stroke

Background: Post-stroke fatigue (PSF) is one of the most common and frustrating outcomes of stroke. It has a high prevalence and it can persist for many years after stroke. PSF itself contributes to a wider range of undesirable outcomes that affect all aspects of daily life. The aim of this review was to identify and summarise the most recent research on PSF, in order to update the evidence base. Methods: We updated an existing review (Hinkle et al. 2017) systematically searching CINAHL, MEDLINE, PsycINFO, and PubMed to cover new research studies between 1st March 2016 and the search date (19th January 2020). We included interventional and observational research, and clinical practice guidelines that were not covered in the original review. After duplicate removal in EndNote, two reviewers screened the search results in Rayyan, and data from eligible full texts were extracted onto an Excel spreadsheet. Finally, we used RobotReviewer and a human reviewer to assess the risk of bias of randomised trials for this scoping review. Results: We identified 45 records for 30 studies (14 observational, 10 interventional studies, and 6 guidelines). Apart from one, the interventional studies were single-centred, had high risk of bias and small sample size (median 50). They investigated exercise, pharmacotherapy, psychotherapy, education, and light therapy. Observational studies mainly reported the factors related to PSF including co-morbidities, depression and anxiety, quality of life, activities of daily living, stroke severity, medication use and polypharmacy, polymorphism, pain, apathy, limb heaviness, neuroticism, mobility, and thyroid-stimulating hormone. Guidelines either did not report on PSF or, when reported, their recommendations were supported by little or low level of evidence. Conclusion: Although we identified a number of recent studies which have added to our current knowledge on PSF, none are robust enough to change current clinical practice.

scholarly journals Post-stroke fatigue: a scoping review

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 242 ◽  
Author(s):  
Ghazaleh Aali ◽  
Avril Drummond ◽  
Roshan das Nair ◽  
Farhad Shokraneh
Keyword(s):  
Clinical Practice ◽  
Scoping Review ◽  
Current Knowledge ◽  
Small Sample Size ◽  
Small Sample ◽  
Risk Of Bias ◽  
Observational Research ◽  
Stroke Severity ◽  
Level Of Evidence ◽  
Post Stroke

Background: Post-stroke fatigue (PSF) is one of the most common and frustrating outcomes of stroke. It has a high prevalence and it can persist for many years after stroke. PSF itself contributes to a wider range of undesirable outcomes that affect all aspects of daily life. The aim of this review was to identify and summarise the most recent research on PSF, in order to update the evidence base. Methods: We updated an existing review (Hinkle et al. 2017) systematically searching CINAHL, MEDLINE, PsycINFO, and PubMed to cover new research studies between 1st March 2016 and the search date (19th January 2020). We included interventional and observational research, and clinical practice guidelines that were not covered in the original review. After duplicate removal in EndNote, two reviewers screened the search results in Rayyan, and data from eligible full texts were extracted onto an Excel spreadsheet. Finally, we used RobotReviewer and a human reviewer to assess the risk of bias of randomised trials for this scoping review. Results: We identified 45 records for 30 studies (14 observational, 10 interventional studies, and 6 guidelines). Apart from one, the interventional studies were single-centred, had high risk of bias and small sample size (median 50). They investigated exercise, pharmacotherapy, psychotherapy, education, and light therapy. Observational studies mainly reported the factors related to PSF including co-morbidities, depression and anxiety, quality of life, activities of daily living, stroke severity, medication use and polypharmacy, polymorphism, pain, apathy, limb heaviness, neuroticism, mobility, and thyroid-stimulating hormone. Guidelines either did not report on PSF or, when reported, their recommendations were supported by little or low level of evidence. Conclusion: Although we identified a number of recent studies which have added to our current knowledge on PSF, none are robust enough to change current clinical practice.

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