Tobacco smoking (TS) is a major public health concern worldwide because of its association with a number of unfavorable health-related outcomes. According to recent studies TS negatively affects both physical and mental health. Suicidal ideation (SI) is more prevalent in people with mental disorders than in the general population. Factors associated with the transition from SI to suicide attempt (SA) should be detected to prevent suicide in this high-risk population.

The aim of the study is to evaluate the influence of tobacco smoking on risk of lifetime suicide plan (SP), SA and nonsuicidal self-injury (NSSI) in patients with nonpsychotic mental disorders (NPMD) and SI.

Four hundred and 78 consecutive patients with NPMD and SI were included into the study. All patients were evaluated by a psychiatrist, underwent Self-Injurious Thoughts and Behavior Interview as well as semi-structured interview designed to gather information on demographic and biographical features. Mann-Whitney, Fishers exact test, chi-square test and stepwise logistic regression were used as statistical methods.

Three hundred and 24 (67.8%) patients have smoked at least 100 cigarettes in their entire life. No differences were found between smokers and non-smokers in terms of age, gender, educational and occupational statuses as well as age at onset of self-injurious thoughts and behavior, and total number of SP, SA and NSSI (all: p>0.05). The lifetime smokers were at higher risk of SA (OR=2.379; 95% CI 1.58-3.581: p<0.001) and NSSI (OR=1.591; 95% CI 1.064-2.38: p=0.024).

Lifetime smoking in patients with NPMD and SI is associated with SA and NSSI.

Lower quality of life (QoL) scores are associated with suicidal behavior, both in the general population and in psychiatric patients. Nonsuicidal self-injury (NSSI) behavior is a public health concern because of its increasing prevalence and high risk of lifetime suicide attempt. Despite its significance QoL in patients with NSSI is underinvestigated. There is a gap in knowledge on the influence of suicidal ideation (SI) on certain domains and facets of QoL in patients with NSSI.

The study aimed to assess the impact of SI on QoL of patients with NSSI.

We conducted a case-control study (1:3): 13 consecutive patients (11 female) with non-psychotic mental disorders and NSSI without lifetime SI were compared to 39 age and gender matched patients with NSSI and SI. All patients were evaluated by a psychiatrist, underwent Self-Injurious Thoughts and Behaviors Interview (Nock MK et al., 2007) and filled out the World Health Organization Quality of Life Assessment 100 (WHOQOL-100). Mann-Whitney and Fishers exact test were used as statistical methods.

The overall QoL (p=0.001) and the perception of life (p=0.005) were significantly higher in patients without SI. Patients with SI had a lower scores in psychological (p=0.002), social (p=0.036) and spiritual (p=0.005) domains as well as lower rates in energy (p<0.02); positive emotions (p<0.001); thinking, learning, memory and concentration (p=0.007); self-esteem (p=0.013); negative emotions (p=0.035); activities of daily living and participation (p=0.014) and opportunities for recreation/leisure facets (p=0.007).

SI in patients with NSSI was found to be associated with worse QoL

Amongst different subtypes of Conversion Disorder (CD), DSM-V lists the Psychogenic Non-epileptic seizures (PNES). PNES are defined as episodes that visually resemble epileptic seizures but, etiologically, they are not due to electrical discharges in the brain.

Our study aims to explore the differences between PNES and other CDs. In particular, we studied the suicidality and its correlations with dissociation and alexithymia.

Patients, recruited from the Psychiatry and Clinical Psychology Unit of the Fondazione Policlinico Tor Vergata, Rome, Italy, were diagnosed with PNES (n=22) and CD (n=16) using the DSM-5 criteria. Patients underwent the following clinical assessments: HAM-D, BDI, DES, BHS, TAS, CTQ.

PNES showed significantly higher scores than CD in all assessments, except for BDI-somatic (p=0.39), BHS-feeling (p=0.86), and the presence of childhood trauma. PNES also showed significantly higher suicidality (p = 0.003). By controlling for the confounding factor “depression”, in PNES suicidality (and in particular the BHS-loss of motivation) appears to be correlated with DES-total score (p = 0.008), DES-amnesia (p = 0.002) and DES -derealization-depersonalization (p = 0.003). On the other hand, in CDs, the BHS-total score shows a correlation with the TAS-total score (p = 0.03) and BHS-Feelings with TAS-Externally-Oriented Thinking (p = 0.035), while only the BHS-Loss of motivation appears correlated with DES-Absorption (p = 0.011).

Our study shows significant differences between PNES and CD, in several symptomatologic dimensions, including suicidality. Indeed, in PNES suicidality appears to be related to dissociation, while in CDs it appears mainly to be correlated with alexithymia.

Starting with December 2019, the first cases of SARS-CoV2 virus appeared in the Wuhan region of China, which will become the COVID-19 pandemic and will have an impact on the bio-psycho-socio-cultural environment. Lockdown and social isolation measures have been imposed in an attempt to gain time and find a viable treatment and a vaccine, for this new infection. The media, in an attempt to promote these measures and information about COVID-19 symptoms, have further increased fear of the virus in population.

This presentation tried to observe the impact of the COVID-19 pandemic on patients confirmed positive with SARS- CoV2 infection, treated in hospitals, inpatients who died by suicide.

As methods a brief review of the literature was made, based on research in scientific articles published in PubMed, APA PsychNet, The BMJ, Who.int, using as keywords the terms “pandemic covid-19”, “inpatients” and “suicide”, published between January 2020 - October 2020.

Several studies conducted to assess the impact of the pandemic on mental health found a significant increase in dysphoria, unhappiness, irritability, anxiety, dominant thoughts related to the transmission of the SARS-CoV2 virus, a tendency to worry about their health and culminating with suicide in the medical unit.

Depending on the psychological structure of each person and the socio-cultural context, different behaviors were observed related to the impact of this pandemic on mental health. The most important is, however, the occurrence of a significant number of deaths by suicide in hospitals in the context of social isolation, patients without a psychiatric history.

Suicide is a challanging problem for a global public health and Latvia remains in the list of European countries with the highest rates of suicide deaths. Information about the epidemiology of suicidal behavior is required for suicide prevention strategy development.

To determine the prevalence of suicidal behavior (suicidal ideation, plan, and attempts) and associated factors in Latvian general population.

Computer assisted face-to-face interviews were carried out between November 2019 and March 2020 to gather information on a representative sample of the Latvian adult population (n=2687). The study sample was selected using a stratified random sampling method. The Mini-International Neuropsychiatric Interview (MINI; version 7.0.2) was used to assess suicidality. Multinomial logistic regression was applied.

There were 1238 males (46.1%) and 1449 females (53.9%) recruited. Mean age of respondents was 49.9 (SD 18.2). According to the MINI, 10.6% (n=285) of respondents reported at least some level of suicidal behaviour during the last month before interview and 7.1% (n=191) had shown current suicidal behaviour at the moment of interview, 4.0% (n=108) of respondents reported about previous suicide attempts. Non-cohabitation status, unfinished primary education and economical inactivity were statistically significant associated factors for suicidal behaviour among men, but only lower level of education was for women.

Comprehensive national suicide prevention strategy is required for reducing suicidality in Latvia. Special attention should be paid to women with lower education, and economically inactive, unmarried or non-cohabitant men, as well as man with unfinished primary education.

Suicide is one of the most relevant cause of death especially in young populations. The Interpersonal Theory of Suicide (Joiner, 2005) is an important contribution tends to explain variability in suicidal behavior, particularly the difference between suicidal ideation and suicide attempt.

This study aimed at the Italian validation of the Acquired Capability for Suicide Scale – Fearlessness About Death (ACSS-FAD), assessing fearlessness about death, one of the facets of the acquired capability (AC) to commit suicide as postulated by the Interpersonal Theory of Suicide by Thomas Joiner.

This cross-sectional research was conducted on a sample of university students (n = 458) assessed with a battery including ACSS-FAD. The sample was evaluated for the presence of suicidal ideation and suicide risk. Factor structure, internal consistency and convergent/divergent validity of the scale were assessed.

One-factor structure with good internal consistency (Cronbach’s α: 0.84) was derived. ACSS-FAD correlated with suicidal ideation and suicidal risk, and there was a tendency towards significance considering its capacity to discriminate between those who had a history of suicide attempts and those who did not. 4.1% of the sample attempted suicide at least one time. The tool showed good convergent/discriminant validity results, but the relationship between ACSS-FAD and pain needs further investigations.

ACSS-FAD seems to be a useful and valid measure of fearlessness about death especially in young adults, which could be really important to enhance suicide risk assessment.

No significant relationships.

The six-item Positive And Negative Syndrome Scale (PANSS-6) is short psychometric valid scale quantifying the severity of core schizophrenia symptoms. Using PANSS-6 to guide treatment decision-making requires that staff members’ ratings are valid and reliable.

The objective of the study was to evaluate whether such valid and reliable PANSS-6 ratings can be obtained through a video-based training program.

One-hundred-and-four staff members from Aarhus University Hospital - Psychiatry, Denmark participated in the training. Participants conducted baseline PANSS-6 ratings based on a video of a patient being interviewed using the Simplified Positive And Negative Symptoms interview (SNAPSI). Subsequently, a theoretical introduction video was displayed followed by five SNAPSI patient interviews. After each SNAPSI video, individual ratings were performed before a video providing the gold standard scores was displayed. The validity of ratings was estimated by calculating the proportion of participants not deviating from the gold standard scores with >2 points on individual items or >6 points on the PANSS-6 total score. Reliability was evaluated after each step in the training by means of Gwet’s Agreement Coefficient (Gwet).

By the end of the training, 72% of the participants rated within the acceptable deviations of the gold standard, ranging from 60% (nurses) to 91% (medical doctors/psychologists). The reliability improved (Gwet baseline vs. endpoint) for all PANSS-6 items, except for Blunted affect.

The majority of the staff members conducted valid PANSS-6 ratings after a brief standardized training program, supporting the implementation of PANSS-6 in clinical settings to facilitate measurement-based care.

Dr. Opler is a full-time employee of MedAvante-ProPhase Inc. Dr. Correll has been a consultant and/or advisor to or have received honoraria from: Acadia, Alkermes, Allergan, Angelini, Axsome, Gedeon Richter, Gerson Lehrman Group, Indivior, IntraCellular T

PsychED Up is an extra-curricular course for 3rd year medical students at King’s College London delivered by psychiatry trainees, senior students and actors. It focuses on the hidden medical curriculum, exploration of holistic care and communication skills.

Develop a responsive and sustainable template for course evaluation Obtain rich and specific feedback across multiple domains which can be translated into course improvements Work collaboratively with former students Empower current students with the knowledge that their input is valuable

Embedded evaluation in start of term course development sessions to engage faculty in evaluation processes Faculty survey to determine what student feedback would be most useful Questionnaire finalised Collaborative design and refinement of questions, confirmed sub-sections and scope

Revised questionnaire: - Included rationale at the start - Questions tailored to faculty development needs - Greater quantity of prompted questions - Specific questions for large group presentation, small group teaching, actors’ performances and students’ reflections - Quantitative ratings and open-space questions thoughtfully paired Reduced time between sessions and obtainment of feedback Quality and quantity of feedback: - High response rates: 32/30 (2 duplicates) mid-term, 29/30 end-of-term - High-quality filling of open-space feedback allowed consolidation of themes to improve the course

Co-designed questionnaire brought focus and organisation to questions leading to richer, more personalised responses for faculty More detailed reflections were attributed to better student understanding of the questionnaire rationale, and knowledge that they would aid course improvement Created a robust system for collecting long-term feedback for PsychED Up and will continue making iterative amendments

The medical case report (CR) is a vital and viable medical genre with a history of more than 3000 years. With a few exceptions, the CR has had a typical format that has been consistent with the ideals of brevity, conciseness, and a matter-of-fact approach. CR in general and psychiatric CR especially, may benefit from more systematically emphasising and integrating relevant biopsychosocial (BPS) aspects.

To discuss how to emphasise and integrate the BPS perspective in the CR.

Drawing on CR literature and our own experience as CR authors, we discuss how a broader BPS approach successfully can be included in the CR format.

Some central factors that could be considered when including a BPS perspective in the CR are: 1) Actively eliciting the patient’s perspective and including this in the final report. 2) Including relevant information about the life and circumstances of the patient beyond the basic demographic information. 3) Making an effort to preserve the patient’s privacy also when more BPS information is included. The psychological and social constituents of the patient’s life should be central in the BPS-inspired psychiatric CR.

The traditional CR has a long-standing history in medicine and follows a typial conscise and brief format. ‘Hard facts’ and biological information have typically filled most of the text. We argue that giving psychological and social information more attention would improve the quality of many CR, and that this is especially relevant for psychiatric CR.

Some of the most vulnerable psychiatry patients are children under 18, as they can’t protect themselves and their rights from unethical behaviour of mental health professionals. There is a gap between theoretical knowledge and application of ethics at the workplace. Continuous education in ethics is necessary to address this gap.

The objective of the study was to compare various forms of education in ethics and develop training for mental health practitioners.

The study had 2 groups (356 participants, aged 23 to 67, average age – 41.3) – staff of the main and oldest children’s mental health clinic in Moscow, Russia. The control group (124 participants) of mental health professionals received written materials on ethics (such as ethical codes and ethical decision-making protocols). The test group (232 people) participated in a several trainings on ethics. The trainings included 3 parts – discussing the code of ethics, creating examples of potential ethical challenges and role-plays. Participants reported that the topics on the quality of care, common ethical dilemmas and relationships between the practitioners, young patients and legal guardians, were the most helpful for them.

The survey was conducted to evaluate the results. 70.8% of staff members that participated in training shared that they feel confident about applying the Code and the decision-making protocols in unclear cases. Only 32.6% from the control group reported the same level of confidence.

Hands-on training in ethics for continuing education has shown to be more beneficial, as compared to theoretical instructions

There has been a rapidly increasing rate of students disclosing specific learning difficulties in higher education- in 2016 dyslexic students accounted for up to 5% of the student population.(Ryder D, Norwich B.)

It is important that provisions for alternative learners are developed in order to increase accessibility to medicine. Podcasts are an inexpensive, accessible and convenient method to both deliver education and interest pieces to a new generation of learners. This poster aims to explore the idea of harnessing the technology available to us to create an accessible, enjoyable platform to improve the experience of students with learning difficulties.

A literature search reviewing the past and present provisions for students with learning difficulties was conducted using a range of databases covering educational, scientific and medical backgrounds. 315 papers were found across the databases, each analysed for relevance and 25 were selected as appropriate.

identified 5 key themes; the lack of awareness and importance of education, the power of audio learning, the practicalities of podcasts, adjustments to examinations specifically and finally additional provisions which accompany audio learning to create an all-inclusive educational experience. Altogether suggesting podcasts have an improved outcome for students with learning difficulties.

It has been evidenced understanding is key to maximising learning potential and highlighted need to increase awareness of dyslexic needs in higher education institutions, generate audio centred provisions in conjunction to traditional materials and be aware of alternative provisions to cater for the spectrum of dyslexic needs.

Stigma, stereotypes, and preconceptions have meant psychiatry has been subject to poor engagement from medical students when compared to other specialties. Whilst efforts have been made to understand reasons for this and formulate strategies to build interest, the problem still exists.

This piece explores whether giving those with a passion for psychiatry a platform to share this could gradually but positively influence their peers and thus, be a potential way to drive engagement in psychiatry as a career.

Advanced literature searches explored items such as engagement in psychiatry and benefits of peer-to-peer education. CASP checklists facilitated selection and appraisal of literature for use in this discussion. Key themes were identified and used to formulate suggestions for the use of peer-to-peer teaching in building interest in psychiatry.

Thematic analysis of the data found 4 main themes relating to engagement in psychiatry. Current strategies to improve this have varying impact and include clinical exposure, using patients with lived experience in learning and enrichment activities, whilst the main negative influence is a long-standing stigma and stereotype around psychiatry. Three themes regarding the relevant benefits of peer-to-peer teaching were found, being peer-to-peer connection, peer influence and means to overcome stigma.

Three key strategies for the use of peer to peer learning are suggested. These are ‘learning from students with lived experience’, ‘peer-teaching from passionate students prior to clinical exposure’ and ‘using peer learning to initially introduce topics in psychiatry in a relatable manor’.

UK Psychiatry Trainees are allocated one day per week in their final three years of training to use for “a clinical or clinically related area of service which cannot be provided within the training post but which is of direct relevance to the prospective career pathway of the trainee”. It is unclear how trainees in the East of England are using this time and what could help them optimise use of this time. We completed a survey to evaluate these areas.

To determine details of how Special interest sessions (SIS) are spent by trainees: How much support/ planning for SIS is available and if this is adequate. Whether trainees feel they are able to use their SIS for its intended purpose of providing “a clinical or clinically related area of service which cannot be provided within the training post but which is of direct relevance to the prospective career pathway of the trainee” Exploration of barriers/tensions to maximizing use of SIS. SIS Record keeping What advice would trainees give re: special interest sessions to a new SPR? What lessons can be drawn to assist trainees from other countries/ training programmes to maximise their own development.

Survey sent to all Higher trainees in the East of England via Regional Training Programme.

Awaited. Survey sent 29/09/2020

Results pending. We will feedback in detail on outcomes from the survey and subsequent discussion with Regional training programme members.

The bi-directional relationship between mental and physical illness is well established. Therefore, in order to lower the already high mortality rates associated with psychiatric disorders, physical health issues must be closely monitored in this population [1,2]. A recent Lancet commission highlights emerging strategies and recommendations for improvement of physical health outcomes in patients with chronic mental disorders. These strategies involve better integration of physical and mental health care, combined with broader implementation of lifestyle interventions to reduce elevated cardiometabolic risk and attenuate medication side-effects [3].

To assess psychiatrists’ confidence levels in physical healthcare competencies; to explore whether confidence was related to learning opportunities.

Physical healthcare learning objectives were extracted from the Irish College of Psychiatrists’ training curriculum. An electronic questionnaire was sent to 50 psychiatrists in one Irish healthcare region with a catchment area of c. 450,000. Participants had to rate confidence levels for each competency on a five-point Likert scale and the availability of learning opportunities for attaining each competency.

66% response rate was achieved. A majority reported confidence in cardiovascular examination, interpreting blood results and evaluating comorbidities. A minority reported confidence in interpreting imaging, electrocardiograms and recognising medical emergencies. This corresponds to a relative paucity of learning opportunities.

Clinical implication Programmes for trainee doctors and CME opportunities for consultant psychiatrists would benefit from an emphasis on physical health examination and modules on interpreting investigations and the recognition of medical emergencies.

Research Domain Criteria are coming to be required for applications for mental health research funding in the United States.

To translate contemporary neuroscience research into teaching medical residents how to prescribe psychiatric medications.

We explore the neuroscience literature regarding neural circuitry and psychiatric symptoms and examine the neurotransmitters associated with those circuits. We associate psychiatric symptoms with the neural circuitry that produces those symptoms. We correlate medications with circuits which they might affect and symptoms they might ameliorate.

RDC is an alternative to DSM and ICD-10. Contemporary scientific diagnoses are not based on neuroscience. They are overlapping, contradictory, often vague, and hinder adequate research. Diagnoses are needed that are based on brain circuitry and function rather than ”expert” opinion. The basis for RDC lies in psychiatric disorders being brain disorders with a primary focus on circuitry function. This contrasts with neurological disorders that have identifiable structural lesions. Symptoms are normally distributed and exist in everyone. RDC proposes to seek the distribution of traits and characteristics, defining abnormal as the extremes of these distributions rather than by defining mental disorders by signs and symptoms which give a diagnosis. We ask what are the brain system that primarily implements the traits, functions, and characteristics of interest. We explore what accounts for the development of dysregulation or dysfunction in these systems alongside normal-to-abnormal dimensions? We describe resident reactions to this style of teaching and show greater comfort in prescribing medications.

Translating Research Domain Criteria into psychiatric prescribing will move psychopharmacology into contemporary neuroscience.

The delivery of medical education has changed alongside the effects of COVID-19. As a result, the undergraduate psychiatry training for medical students at Guy’s King’s and St Thomas’ School of Medicine had to adapt rapidly. This poster portrays the journey in which the teaching sessions were developed and delivered throughout the first academic term of 2020-2021.

To deliver an interactive online teaching day that can provide students with the knowledge and understanding of common psychiatric disorders in the interface of other medical conditions.

A clinical skills teaching day was developed to deliver the sessions via the online video calling platform Zoom. Published articles regarding online medical education as well as guidelines from the Royal College of Psychiatry were used as a resource to develop the structure. Feedback of the teaching day was collected via an anonymous survey.

78 responses were collected in total from 4 teaching days. Overall satisfaction was high with a score of 86.5/100 in overall satisfaction. Themes for positive feedback included utilising actors in simulation (38% 30/78) and high interactivity within the teaching (31% 24/78). There were a number of students who found the whole day session online tiring (13% 10/78) and others felt the variation of scenarios were too limited (12% 9/78).

As lockdown has forced students to have less patient contact, they have suffered from the lack of learning opportunities. This teaching day showed the importance of organising high fidelity scenarios in order to try and fill the void that has been created due to COVID-19.

Assessing risk is an important core skill yet there is not a consensus as to how to teach it. Clinically, there has been a move away from using risk prediction tools in favour of clinical judgement.We describe an iterative process to develop high quality, online teaching around risk assessment for medical undergraduates.

To teach the clinical skill of risk assessment to enable medical students to evaluate and manage risk when encountering patients with mental health issues.

A half day tutorial was designed and refined in an iterative process using feedback from participants on this session and other concurrent teaching occurring in the department. Sessions were also reviewed by external medical educators to ensure quality and learning objectives were met.

The average rating from 62 students was 4.4/5. Students commented that the session was well organised and delivered. Following feedback, the use of actors was prioritised to simulate evolving clinical situations. Students placed a high value on this: “simulated patients were amazing! They were really interesting and I was able to practice the skills I learnt over placement”. Logistical changes e.g. more breaks, followed appreciation of the exhausting nature of the session and maintained student engagement. There was increased emphasis on promoting group interaction through functions like a ‘break-out room’.

This session may give educators confidence that they can take risks when teaching the skill of risk assessment. Students were receptive and meaningfully engaged with concepts such as clinical judgement and bio-psycho-social formulations as opposed to ‘tick box’ assessments.

Following the national lockdown in the UK in March 2020 in response to the COVID-19 pandemic, we instigated regular online tutorials for fourth year medical students undertaking their psychiatry placement.

The aims of these tutorials were threefold: to ensure that students covered a range of key psychiatry topics, to enable them to have the opportunity for interactive tutorials with experienced psychiatrists and, not least, to create a sense of continuity and connection with their tutors and peers across the mental health block.

Each student was allocated to a tutorial group comprising 10 – 15 medical students and a psychiatrist facilitator. These groups met weekly for 7 consecutive weeks at an agreed time for 60 – 90 minutes via an online platform and all covered the same allocated topic each week. We evaluated these groups via an online survey sent to the students following the programme.

The students rated the tutorials on average as 4.5/5 on whether they met the defined learning outcomes. On average the students did not consider that the virtual format made a significant difference to their learning, but this disguised a wide range of views that were expressed via a comment box.

The evaluation of this project supports the use of virtual tutorials as a valuable learning tool but educators need to be aware that student views’ on these can be varied and so, long-term, a blend of virtual and face to face learning is most likely to meet the needs of all students.

Web Journal Club as a collaborative learning method, is an effective method to enhance the knowledge base of nursing students, their presentation skills, problem-solving skills and ability to critically appraise literature.

To describe the experience of a online journal club on education of MHN undergraduate students.

We implemented a journal club in the online classroom with a total of 24 portuguese undergraduate students enrolled in clinical training of MHN (sixth semester). Over a two-week period, five 2-hour online journal club sessions were conducted in April 2020. During each session, five journal articles were presented synchronously to a live online audience via the Zoom Classroom technology. After all sessions, students were invited by e-mail to complete an anonymous and voluntary online questionnaire via Google Forms.

All students were all very positive about the journal club sessions and found the opportunity to discuss and reflect on practice issues in depth very helpful. They found the sessions supportive, they helped to bond the group, they learnt a great deal from each others experiences, and they felt that they gained in confidence as a group. Survey results also indicated that few participants experienced technical difficulties during sessions.

This pedagogical practice enhances gains in the various actors involved: 1) in students, contributing to their learning process and acquisition of competences, articulating research and clinical practice; and 2) lastly, even more indirectly, in people receiving care, since a evidence-based practice ensures safe and quality of nursing care delivery.

COVID19 keeps being a challenge, not only facing the outbreak and the treatment of the cases, but also in the education sector. Most learning centres and high schools in the world are closed to avoid further outbreaks, as well as institutes for psychotherapy throughout the world.

To gain a better knowledge and understanding about alternatives identified in the scope of psychiatric trainee training, through the support provided by digital resources.

Systematic review on PubMed and Uptodate databases since declaration of the COVID-19 pandemic in March 2020 was performed using the keywords: Distance Education, Pandemia, COVID-19, Medical Residency. Discussing online-learning.

The described European countries (Germany, Spain, United Kingdom) used different strategies to maintain the e-learning. Practical undergraduate education was replaced in countries like Spain by “problem-based learning” tasks, clarifying and commenting case reports or videos through working groups. The increase of the resources from teachers and trainers wasn´t taken in account for the preparation of the digital program. Social inequities for the digital access for groups of students or clients were also claimed.

Each of the described countries adopted different strategies regarding continuing training of residents, their assessment and their certification. Covid-19 should set down a trend of social collaborative learning as part of resident training and asset hybrid or even digital methods for the mental health training.