A guide to support trainee's success in the psychotherapy written case submission.

OBJECTIVE: Many trainees find the Psychotherapy Written Case (PWC) requirement of the Royal Australian and New Zealand College of Psychiatrists training program challenging. The skills developed and assessed through this experience are critical to the competencies expected of a psychiatrist. However, the process of psychodynamic psychotherapy is often dramatically different from the expectations associated with early clinical placements in acute psychiatric settings. To support trainees in achieving success in the PWC, a guide to the written report was developed based on a review of existing resources and various stakeholder perspectives. CONCLUSIONS: The submission should reflect a training case rather than an idealised or fictionalised story attempting to demonstrate the therapist's competence. The PWC submission must meet the requirements of a general psychiatric report and provide a considered reflection on the experience of the novice therapist.

Formulation in psychiatry - a guide to developing competence.

OBJECTIVE: This paper highlights the importance of psychiatric formulation and provides guidance to those learning the art of formulation. To achieve this, we explore the guidance on formulation that has been previously published in Australasian Psychiatry, identify the key components of psychiatric formulation, and outline an approach to comprehensive formulation in routine clinical practice. CONCLUSION: Formulation is the foundation of good psychiatric practice but presents a considerable challenge to the novice practitioner. Understanding the ingredients of formulation and a method for meaningfully putting these together will guide deliberate practice to learn the art of psychiatric formulation.

Enhancing the quality of supervision: description and initial outcomes of a blended-learning approach to RANZCP supervisor accreditation.

OBJECTIVE: Evaluation of a blended learning adaptation of the accreditation process for supervisors in the Royal Australian and New Zealand College of Psychiatrists' (RANZCP) Competency-Based Fellowship Program. METHOD: The adaption of the accreditation process is described, and a mixed-methods approach was taken in its evaluation. Descriptive statistics are presented for participant responses to and engagement with interactive workshop elements. The Wilcoxon signed ranks test was applied to examine the change in participants' confidence in their understanding of the expectations of a supervisor at the commencement and conclusion of the workshop. Free text evaluative responses were subject to qualitative content analysis. RESULTS: Most participants expressed a preference for the blended learning workshop format and indicated that live polling improved the learning experience. Additionally, participants expressed greater confidence in their understanding of the expectations of the supervisor role following workshop completion. CONCLUSIONS: The blended learning approach to supervisor training was preferred by participants and may provide a model to be adopted by other training committees and institutions.

Working towards success in the Royal Australian and New Zealand College of Psychiatrists Modified Essay Question Exam.

OBJECTIVE: To describe an approach to support Royal Australian and New Zealand College of Psychiatrists (RANZCP) trainees achieve success in the Modified Essay Question (MEQ) examination. METHOD: Synthesis of the opinion of the authorship encompassing a range of relevant stakeholders, supported by a qualitative content analysis of published examination feedback from the RANZCP Committee for Examinations. RESULTS: In approaching the MEQs, candidates are encouraged to (1) read the scenario and questions carefully, (2) answer questions broadly and with justification, (3) manage time effectively, (4) undertake deliberate practice in preparation, and (5) 'check your own pulse' (i.e. limit the detrimental impact of anxiety on performance). CONCLUSION: Preparing for the MEQ examination through deliberate practice will help candidates become competent psychiatrists. The ability to critically think in clinical practice, a key focus of this assessment, is an essential skill all psychiatrists need to develop and maintain.

Understanding the drivers of bottlenecks in RANZCP training: modelling and a calculator to determining sustainable trainee intake.

OBJECTIVES: Demand for places in postgraduate psychiatry training programmes has increased over recent years. All systems have capacity limits, and concerns have been raised regarding the sustainability of the current intake. This paper presents a modelling exercise to exploring the presence and strategies to resolve bottleneck in the Queensland training programme. METHODS: Mathematical modelling based on the RANZCP training regulations and the characteristics of the accredited training programme. RESULTS: A training bottleneck was identified which has been impacted by increased training intake, demand for Advanced Training certificates, and location factors. CONCLUSIONS: This investigation raises important questions regarding the future management of postgraduate training in psychiatry in Queensland that may be applicable more widely across Australia and New Zealand. In particular, it highlights the large impact that can result from even small incremental increases in trainees across varying levels of the postgraduate programme and the importance of limiting trainee intake in a manner proportional to the availability of mandatory terms.

Gaming the system: using transactional analysis to explore dysfunctional processes in clinical supervision.

OBJECTIVE: This paper discusses the ongoing relevance of concepts derived from transactional analysis to understanding the challenges that can emerge in clinical supervision under the Competency Based Fellowship Program. CONCLUSIONS: Defensive game playing has face validity as a framework for understanding dysfunctional processes in clinical supervision. Being aware of these concepts may aid trainees and supervisors in promoting effective clinical supervision practice.

Supervision contracts for mental health professionals: a systematic review and exploration of the potential relevance to psychiatry training in Australia and New Zealand.

OBJECTIVE: The use of formal supervision contracts has been strongly advocated across non-medical mental health professions. However, the use of such agreements is not a feature of the RANZCP Competency-Based Fellowship Program. This paper critically examines the evidence to support the use of formal supervision contracts. METHOD: A systematic review of empirical studies relating to the outcomes of supervision contracts was completed. Included records were subject to quality appraisal. RESULTS: Two studies met the inclusion criteria; both were assessed to be of poor quality. One study found improved supervision effectiveness associated with the use of supervision contracts, and the other found no significant differences associated with formal contracting. CONCLUSION: Despite strong advocacy, limited empirical evidence was found to support the value of formal supervision contracts across mental health professions. PROSPERO registration - PROSPERO 2018 CRD42018104142.

An outline of the planned work of the Royal Australian and New Zealand College of Psychiatrists' Board of Education.

OBJECTIVE: The aim of this paper is to inform College Fellows, trainees and other stakeholders about the structure, principles and functioning of the new Board of Education. CONCLUSION: The educational activities of the College are likely to evolve and to be developed over the next 5 years by a process taking account of the views of key stakeholders. In the short term, there will be no changes to training or examination processes which would disadvantage trainees.