European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S847–S910 S895
EV1493
Learning by doing, learning by seeing:
Does observation of clinical
simulation still count?
M. Fernando ∗, T. Barry , L. Chester , M. Bhat
NELFT NHS Foundation Trust, Medical Education Department,
London, United Kingdom
∗ Corresponding author.
Introduction Role-playing scenarios are widely used in psychi-
atry education, both as a means of assessment and for teaching
various clinical skills. But can you get as much from them by learn-
ing vicariously as an observer? Fourth-year medical students from
QueenMary University of Londonwere invited to a psychiatry prac-
ticeOSCE (objective structured clinical examination), shortly before
end of year exams. We created 96 places, approximately 40% of the
year, but to maximize numbers students also rotated through the
six-station OSCE circuit in pairs. For each scenario students alter-
nated either undertaking the OSCE task or observing.
Objectives and methods We sought to identify if there was a sig-
nificant difference in student experience depending on whether
they were the ‘candidate’ or ‘observer’. Students were asked to rate
their learning experience in each station on a five-point Likert scale
and this was analyzed using an ordinal logistic regression model.
Results While students rated their experiences as ‘observers’
marginally lower than that of ‘candidates’, we found no statistically
significant difference (OR = 0.629, P = 0.093). Practice OSCEs took
place over six half-days with different facilitators and role-players,
but we identified no interaction from these factors. For one sta-
tion on depression, we found a statistically significant interaction in
which ‘candidates’ rather than ‘observers’ rated better experiences
(P = 0.032).
Conclusions Observation by learners is frequently used within
simulated clinical scenarios and may have a number of potential
advantages. However, while unable to examine the direct impact on
knowledge or skills, we found no significant difference in student-
reported experiences between ‘candidate’ and ‘observer’ positions.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1494
Breaking down the barriers to mental
health crisis care: Evaluation of a
training package for emergency
department clinicians
M. Fernando ∗, M. Bhat
NELFT NHS Foundation Trust, Medical Education Department,
London, United Kingdom
∗ Corresponding author.
Introduction About one in 20 attendances at emergency depart-
ments (EDs) in the UK relate to mental health, yet recent work has
shown that a majority of people presenting with mental health
crises do not report positive experiences (Care Quality Commis-
sion, 2015). Although there are many reasons for this, one may be a
lack of mental health training for staff working in EDs. In response
to this, a new training module for multi-professional ED staff was
developed.
Objectives andmethods We aimed to assess the impact of this new
module on clinicians’ confidence in managing mental health pre-
sentations. Thirty-eight ED doctors and nurses across two centers
were asked to complete surveys before and after receiving training.
Results Following training, we found improvements in confi-
dence in each of five domains explored: assessing self-harm;
managing someone with personality difficulties; assessing psy-
chotic symptoms; distinguishing between physical and psychotic
symptoms; and, managing psychotic symptoms. These improve-
ments were seen for clinicians across both centers.
Conclusions The results show that training can help to improve
confidence around mental health. This is particularly important
given that before the training was developed a survey of local
ED doctors had shown that 31% felt under-confident in manag-
ing mental health conditions. Since developing the training, it has
been further enhanced at the request of local EDs to include video-
based scenarios. We continue to assess its impact in improving
the confidence of ED clinicians (as well as their knowledge, skills
and attitudes towards mental health), and ultimately the benefit to
patients experiencing mental health crises.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1495
Designing an instrument to assess the
competence of cognitive analytic
therapists in training
E. Gimeno ∗, C. Chiclana
1 University of San Pablo CEU, Faculty of Medicine, Department of
Psychology, Valladolid, Spain
2 University of San Pablo CEU, Department of Psychology, Faculty of
Medicine, Madrid, Spain
∗ Corresponding author.
Introduction Since its origins, cognitive analytic therapy (CAT)
has become a focused and more effective alternative that can be
approached from the first line of action by mental health teams.
However, since CAT incorporates in its intervention aspects of
other currents, it is possible that its limits and specificity may have
blurred. Furthermore, therapists in training use to report difficul-
ties related to this. For that reason, assessing the competence of
CAT therapists in training becomes so important, as it promote the
reflection of the therapist in its training and provides professionals
necessary skills to ensure a better quality care for their patients.
Aim and objectives The aim of this study was to design an instru-
ment to identify the main training problems in CAT therapists
which allows therapist’s competence evaluation.
Methods For this purpose, a specific tool to detect the main prob-
lems in the implementation of the psychotherapy by self-report
was administered and evaluated by two therapists in training dur-
ing its clinical practice.
Results The main implementation problems detected had to do
with collusions and the temporary adjustment of the sessions. The
therapists reported a high satisfaction with the instrument, which
was valued as useful to be aware of the problems in CAT training
and with clearly explained contents.
Conclusions The tool has been shown to be useful to assess thera-
pist’s competence and to take awareness of collusions allowing the
therapist to avoid them.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1496
Developing a guide to choose
psychiatry in Spain
C. Gómez Sánchez-Lafuente∗, R. Reina Gonzalez ,
E.M. Rodríguez Sánchez
Hospital Universitario Virgen de la Victoria, Psychiatry, Málaga, Spain
∗ Corresponding author.
Introduction Choosing a medical specialty is not easy. In Spain,
when medical students finish the university degree, they have to
take an exam called popularly MIR if they want to start a spe-