Falls are common in older subjects and result in loss of confidence and independence. The Falls EYcacy Scale (FES) and the Activities-specific Balance Confidence scale (ABC) were developed in North America to quantify these entities, but contain idiom unfamiliar to an older British population. Neither has been validated in the UK. The FES and the ABC were modified for use within British culture and the internal consistency and test-retest reliability of the modified scales (FES-UK and ABC-UK) assessed. A total of 193 consecutive, ambulant, new, and return patients (n=119; 62%) and their friends and relatives ("visitors", n=74; 38%) were tested on both scales, while the last 60 subjects were retested within one week. Internal reliability was excellent for both scales (Cronbach's alpha 0.97 (FES-UK), and 0.98 (ABC-UK)). Test-retest reliability was good for both scales, though superior for the ABC-UK (intraclass correlation coeYcient 0.58 (FES-UK), 0.89 (ABC-UK)). There was evidence to suggest that the ABC-UK was better than the FES-UK at distinguishing between older patients and younger patients (|t ABC | = 4.4; |t FES | = 2.3); and between fallers and nonfallers (|t ABC | = 8.7; |t FES | = 5.0) where the t statistics are based on the comparison of two independent samples. The ABC-UK and FES-UK are both reliable and valid measures for the assessment of falls and balance related confidence in older adults. However, better test-retest reliability and more robust diVerentiation of subgroups in whom falls related quality of life would be expected to be diVerent make the ABC-UK the current instrument of choice in assessing this entity in older British subjects.
AimsStress and burnout is increasingly recognised as an issue for doctors in training. The 2022 General Medical Council (GMC) National Training Survey revealed that 39% of respondents were suffering from burnout to a ‘high’ or ‘very high’ degree. 51% felt their work is emotionally exhausting. There are multiple sources of stress for psychiatry trainees, including clinical demands, adverse events, the impact of emotional labour and moral injury. The Royal College of Psychiatrists recognises the importance of supporting trainees’ well-being; this has been reflected with the inclusion of personal well-being-focussed key capabilities in the new Core Psychiatry Training curriculum.MethodsTo meet these needs, we developed and delivered two interactive face-to-face workshops for Year 1 Core Psychiatry Trainees (CT1s) in the West of Scotland. Training is embedded within the CT1 educational programme and facilitated by higher trainees. The sessions cover key aspects of well-being, including the physiology of stress, risk factors for burnout and the evidence base for developing resilience. We explore the impact of errors on doctors and the health service, relevant clinical governance systems and regulatory policies, focussing on psychiatry training issues. Feedback was obtained immediately after each session via anonymous questionnaire with a mixture of Likert scale and free text responses.ResultsThere were 27 responses for workshop one and 21 for workshop two. 14 respondents felt the teaching should be mandatory for core training. There was mixed opinion regarding the overall benefit and optimum timing of the sessions within the training year. Overall, CT1s valued group discussions and wanted more time for this with less focus on GMC policy. There was also split opinion on the value of discussing institutional responses to errors, including significant adverse event reviews and Datix reporting.ConclusionOur feedback showed differing opinions on which topics should be covered during the training and their level of detail. Overall, the opportunity for group discussion – in order to share experiences with peers – appeared to be valued most. We feel the sessions provide new CT1s with an opportunity to explore problems they may encounter in a safe and supportive environment.We aim to provide trainees with a ‘toolkit’ to support their personal well-being within the workplace, as well as demystifying clinical governance systems. We plan to further develop our course materials based on our feedback, and deliver the workshops again in 2023.
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