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Research is needed to improve the performance of primary health care. In Africa, few family physicians conduct research, and therefore an online research training and mentorship programme was developed to build research capacity amongst novice and early career researchers.
Aim:
To evaluate the implementation of the AfriWon Research Collaborative (ARC) training and e-mentorship programme in sub-Saharan Africa.
Methods:
A 10-module online curriculum was supported by peer and faculty e-mentorship, to mentor participants in writing a research protocol. A convergent mixed methods study combined quantitative and qualitative data to evaluate nine implementation outcomes.
Findings:
Fifty-three participants (20 mentees, 19 peer mentors, and 14 faculty mentors), mostly male (70%), participated in the ARC online programme. The programme was seen as an acceptable and appropriate initiative. Mentees were mostly postgraduate students from African countries. Faculty mentors were mostly experienced researchers from outside of Africa. There were issues with team selection, orientation, communication, and role clarification. Only 35% of the mentees completed the programme. Alignment of mentoring in teams and engagement with the online learning materials was an issue. Costs were relatively modest and dependent on donor funds.
Conclusion:
Despite many challenges, the majority of participants supported the sustainability of the programme. The evaluation highlights the strengths and weaknesses of the ARC programme and e-mentoring. The ARC working group needed to ensure better organization and leadership of the teams. Going forward the programme should focus more on developing peer mentors and local supervisory capacity as well as the mentees.
Research drives innovation and improved practice in psychotherapy. We describe views of members of the Faculty of Medical Psychotherapy of the Royal College of Psychiatrists (RCPsych) regarding their knowledge, experience and perspectives on psychotherapy research. We sent questionnaires to the Faculty membership emailing list.
Results
In total, 172 psychiatrists from all levels of training returned fully complete responses. Respondents considered knowledge of psychotherapy research to be important to clinical work. Many have qualifications and experience in research but lack current opportunities for research involvement and would welcome the Faculty doing more to promote psychotherapy research. Perceived obstacles to research involvement included lack of competence, competing demands and wider organisational factors.
Clinical implications
The lack of research opportunities for medical psychotherapists may lead to their underrepresentation in psychotherapy research and a less medically informed research agenda. Providing support at academic, RCPsych and National Health Service organisational levels will allow more clinically relevant research not only in psychotherapy but in other psychiatric disciplines as well.
In the past two years in France, four psychiatrists were charged or condemned for manslaughter relating to their practice with dangerous psychiatric patients escaping mental health care facilities. Facing this increasing litigation of psychiatry, the French federation of psychiatric trainees (AFFEP) set up a survey in order to assess the concern of its members of being sued, the consequences of this apprehension on their medical practice and their theoretical instruction on law and legal action risk.
Methods
An online survey was submitted by email to all the AFFEP members nationwide between the 2nd April and the 31st October 2014.
Results
Eight hundred and thirteen responses were obtained (65% response rate). Regarding the concern of being sued for their medical practice, 85% of psychiatric trainees dread legal pursuits. This apprehension is significantly higher amongst female trainees (P = 0.004). Legal risk assessment is involved in the medical decision process of 89% of psychiatric trainees. This trend is significantly lower amongst trainees with previous legal teaching during their residency (P = 0.02). Concerning theoretical instruction, 62% of psychiatric trainees rates it insufficient and 28% non-existent during their academic training; 96% of psychiatric trainees want to make this theoretical instruction mandatory.
Discussion
The fear of legal pursuit is well known in psychiatry [1,2] but this study reveals that it begins as early as residency. In France, one explanation can be that psychiatry is the second most sued medical specialty in criminal court [3]. Specific theoretical training in law seems to be a solution in order to decrease the toll taken by legal risk assessment in daily practice.
Conclusion
Concern about legal action is very high amongst psychiatric trainees and the consequences of this fear impact their day-to-day medical decision process.
Emergency medicine (EM) has been a fellowship program (supra-specialty) in France since 2004. Even though the program can be accessed after completion of one of several primary specialties, the vast majority (97%) of its residents enter the program after having completed training in family medicine. A change to develop a primary EM specialty is being discussed. Our objective was to assess French residents and young EM physicians’ attitudes toward EM as a primary specialty. We conducted a brief cross-sectional online survey among young EM physicians and trainees in November and December 2012. There were 288 respondents to the survey. Forty-nine percent (n=142) of respondents would have chosen EM if it was a primary specialty, but 73% (n=209) prefer maintaining the status quo, offering EM training as a supra-specialty fellowship program. Work-related quality of life was the main reason for those not choosing EM as a primary specialty.
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