Foundation Trainees and Their Perceived Confidence in Practicing Mental Health Competencies Post Their Psychiatry Placements: An Evaluation Study

Abstract

Aims

The new United Kingdom Foundation Programme Curriculum was implemented in 2021 and emphasizes the importance of Foundation Trainees (FTs) acquiring mandatory core skills and knowledge in mental health. The primary aim of this evaluation study is to assess the effectiveness of Maudsley's Training Programme in teaching these skills. Secondarily, it looks at FTs' preferred method of acquiring the mandated competencies. Finally, it aims to shine a light on an area of program evaluation that is lacking in the literature.

Methods

An outcome analysis evaluation design was used with a pre and post-quantitative questionnaire as the preferred data collection tool. The outcome measured was confidence and corresponds to Level 2 – Learning on Kirkpatrick's Evaluation Hierarchy. Our questionnaire comprised 4 stem questions, using a 5-point anchor Likert scale. The scales were tailored to reflect the core curricular competencies. Data were collected from a sample of 85 FTs between August 2021 and March 2023 and analysed using Excel functions and a Power Shell Script to calculate measures of central tendency.

Results

Entry median confidence levels were: 3 (Fairly confident) for recognition, 3 for assessment, and 2 (Slightly confident) in managing common mental health conditions. Post-training, the median confidence level in our sample increased to 4 for recognition, 4 for assessment, and 3 for management which denotes a significant positive impact. Examples of outliers are the median confidence seen in assessing Personality Disorders, which increased from 1 (Not at all important) to 3, whereas for recognizing and assessing Delirium and Substance use disorder the median did not change. Looking at teaching methods preferred by the trainees, ad-hoc training on the job and small group seminars were by far most preferred with 24% and 23.6% of responses respectively followed by Self-directed learning and Simulation with 13.8% each and the least preferred were reflective practice (Balint) and mentoring with 3.7% each.

Conclusion

There is a trend of FTs becoming confident post 4 months of psychiatric training in recognizing assessing and managing mental health conditions. Ad hoc and seminar teaching being is the preferred method of acquiring these skills. Moving forward, efforts should be made in evaluating training programs for FTs in psychiatry with the purpose of improving the acquisition of such skills and understanding the best way to teach these. Then, consideration should be given to how we apply these to FTs that don't rotate in psychiatry.