Virtual human technologies are now being widely explored as therapy tools for mental health disorders including depression and anxiety. These technologies leverage the ability of the virtual agents to engage in naturalistic social interactions with a user to elicit behavioural expressions which are indicative of depression and anxiety. Research efforts have focused on optimising the human-like expressive capabilities of the virtual human, but less attention has been given to investigating the effect of virtual human mediation on the expressivity of the user. In addition, it is still not clear what an optimal task is or what task characteristics are likely to sustain long term user engagement. To this end, this paper describes the design and evaluation of virtual human-mediated tasks in a user study of 56 participants. Half the participants complete tasks guided by a virtual human, while the other half are guided by text on screen. Self-reported PHQ9 scores, biosignals and participants' ratings of tasks are collected. Findings show that virtual-human mediation influences behavioural expressiveness and this observation differs for different depression severity levels. It further shows that virtual human mediation improves users' disposition towards tasks. CCS CONCEPTS• Human-centered computing → User studies; • Applied computing → Health informatics; • Computing methodologies → Artificial intelligence.

Summary The Royal College of Psychiatrists’ Leadership and Management Fellow Scheme aims to develop and support a new cohort of leaders within psychiatry. This article provides an introduction to the scheme, which is accessible to all higher trainees with the support of their host organisation. We explore its development, structure and how it is evolving to provide a strong platform for achieving the College's ambition to benefit patient care by embedding a culture of medical leadership within mental health services.

AimsTo develop and implement a QI training programme for trainees, Trust grade doctors and Consultants in Nottinghamshire Healthcare NHS Trust (NHFT) to enable them to deliver change in practice through acquisition of new knowledge and practical application of skills in QI projects using Model for Improvement.BackgroundQI is crucial to improve patient care. Doctors are uniquely placed to input into patient safety and service delivery of healthcare. The skills required to be future clinical leaders and undertake improvement work are not innate and formal teaching and support is required.What is DrQI?DrQI is a trainee-led QI teaching programme developed in collaboration with Trainees improving patient safety through QI (TIPSQI) in North West deanery.MethodA pre-implementation survey amongst doctors in NHFT in February 2019 (33 responses) suggested that 90% of doctors were interested in learning QI and about 48% preferred face-face workshops with support from the QI team.A list of change ideas were created using a driver diagram with QI education and project support identified as key primary drivers.PDSA cyclesNine interactive workshops teaching key QI concepts (based on model for improvement) in NHFT, training more than 100 doctors. A workshop in Derbyshire Healthcare NHS Foundation Trust (70 doctors) and Nottingham University Hospital (20 doctors). Workshops were continually adapted based on qualitative and quantitative feedback. Different formats were tried including virtual sessions, game-based and problem-based learning approaches using small group activities.ResultPre-course and post-course questionnaires were used to assess change in understanding of individual components of QI methodology (SMART Aim, Driver diagram, PDSA cycles, outcome and process measures and run charts). Mean pre-course self-assessment score collated from seven QI workshops in NHFT (2019-2020) was 3.3 and mean post-course score was 7.68, showing an improvement in understanding of QI methodology.Participants were asked to score the relevance (8.4) and quality of teaching (8.4) and the support from the QI team (7.4) on a scale of 1-10 (1 = poor and 10 = excellent). Additional free text feedback was obtained to help us improve the teaching programme.ConclusionCollaborative leadership trainee-led initiative to increase the QI capacity. A bottom up approach to complement the top down approach from the Trust QI team. Future steps include further collaboration and expansion of the scheme to other Trusts, Train the trainer sessions and building a network of QI champions.

2. To deliver formal quality improvement (QI) training via our management teams, to help trainees conduct small-scale QI projects and obtain formal management qualifications. Methods and resultsWe invited all interested to apply with a good spread of 27 trainees from FY1-ST7. The pre-course questionnaire showed most had little prior experience of management training. Only 8.5% of participants agreed that they had 'confidence understanding the leadership and management structure of the NHS as a whole and at a King's level.' Our first day was structured into a series of speakers, ranging from our King's Head of Transformation to previous FMLM fellows running workshops on leadership techniques and on NHS structure. 87.5% of participants reported an improvement in their knowledge of the leadership and management structures within the NHS and KCH. Also, 100% of trainees reported an increased awareness of the leadership and management opportunities available with 95.8% of candidates likely to take this further. With our transformation team, we delivered Sigma Six yellow belt training over two one-day courses. We split participants into QI groups of 3 or 4. The training was well received and 100% of participants will use their training to help their QI project and that it was useful for their non-clinical development. Conclusions Working collaboratively with our management and transformation teams, have enabled us to deliver effective QI training to participants, propelling smaller QI projects within the hospital which have been showcased at the trust awards ceremony.We firmly believe management and leadership training should begin early in our careers, and programmes like KITE, highlight this well. Given the program's success it will be repeated again next year.