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PSYCHIATRY UNIT STUDENT LOGBOOK & CLERKING PORTFOLIO 2013-14 KEEP YOUR SIGNED AND DATED LOGBOOK SAFE. YOU WILL BE REQUIRED TO PRODUCE IT AS EVIDENCE OF YOUR LEARNING DURING YOUR PSYCHIATRY PLACEMENT. STUDENT NAME: _________________________________________ DATE: _________________________________________ PLACEMENT: __________________________________________ Logbook revised July 2012 by Dr Sian Hughes & Dr Claire Archdall
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Page 1: PSYCHIATRY UNIT - | University of Bristol ·  · 2017-12-15Schizophrenia 5. Substance Misuse ... Use the table below to record the cases included in your clerking portfolio: Brief

PSYCHIATRY UNIT

STUDENT LOGBOOK & CLERKING PORTFOLIO

2013-14

KEEP YOUR SIGNED AND DATED LOGBOOK SAFE. YOU WILL BE REQUIRED TO PRODUCE IT AS EVIDENCE OF YOUR LEARNING DURING YOUR PSYCHIATRY PLACEMENT.

STUDENT NAME: _________________________________________ DATE: _________________________________________ PLACEMENT: __________________________________________

Logbook revised July 2012 by Dr Sian Hughes & Dr Claire Archdall

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Welcome to your Psychiatry Unit

University policy is to no longer give out handbooks and to keep paper to a minimum. The following is

a very brief summary of your attachment which will help to orientate you, as well as your logbook and

clerking portfolio. Information on the Unit, together with details re assessment*, reading materials

announcements and ethics information is on Blackboard; learning resources are on Hippocrates. *All

exam marking schemes will be located on the Medical School website, this will be available shortly.

The principle aim of this unit is for students to be able to take a psychiatric history and mental state

examination and use this information in two ways. Firstly, to make a working diagnosis using

information from the assessment to justify their preferred and differential diagnosis. Secondly, to

indicate in broad terms how to manage and treat a person with a psychiatric disorder paying particular

attention to the biological, psychological and social aspects of treatment and tailoring their

recommendations in the light of the information they have obtained from the history and mental state

examination. Thirdly, to acquire skills that are useful in managing the distressed/agitated patient

irrespective of setting.

You will develop your knowledge from the text book and other books/Journals, introductory lectures,

and web based resources. You will develop clinical skills in your tutorials with your Site Tutor, and

through seeing patients. You will develop your professional behaviour skills and attitude through self

reflection and formative feedback from your clinical teachers.

Assessment: Details can be found on Blackboard in the Psychiatry & Ethics Handbook. The clinical

exam consists of three Direct Observation of Clinical Skills stations that will assess how you perform in

simulated clinical scenarios. The internal SSC is a case based presentation that gives you freedom to

expand on some relevant aspect arising from the case. At the end of the year you will have a written

MCQ and EMQ paper. For full details of this including how ethics contributes to the final mark, please

see the assessments information on the Medical School website.

Finally if anything is unclear to you within your attachment it is important that you discuss this, initially

with your Site Tutor; if this does not resolve the matter please contact us within the Centre for Mental

Health, Addiction and Suicide Research ([email protected]) and we will

endeavour to answer your query. I sincerely hope you enjoy your placement; the mind and brain are

the most complex and fascinating aspects of who we are as people and as such psychiatry is to me

the most interesting specialism within medicine – welcome on board!

Dr John Potokar, Unit Lead Psychiatry

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How to use this Logbook The logbook sets out the required activities for your Psychiatry attachment.

By the end of the Unit you should have completed all sections, including a full clerking portfolio,

professional behaviour form and case based discussions.

The logbook is set out as follows:

1. Information on reflective practice & formative assessments.

2. Clerking portfolio

3. Clinical case based discussion forms (you must complete at least 2)

4. Record of clinical activities

5. Professional Behaviour form

6. Unit forms, including mid-unit progress and end of Unit sign-off.

The clerking portfolio, clinical activities and case based discussions are part of your assessment and

will be reviewed before the logbook is signed off by the unit tutor.

At the earliest opportunity, make contact with your Educational Supervisor, and give them (and other

doctors in their team) a copy of your timetable.

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Reflective Practice & Formative Assessment

The GMC states that reflection should be an important component of any UK undergraduate medical

programme1. It is also a general and lifelong skill expected of all graduate doctors. Why and how do

you do it? Being professional when you are dealing with colleagues, patients, carers or any member

of the public is important. However, pinning down exactly what being professional is, how it is learned

and of course how it can be assessed has been a subject of much debate in the medical education

literature. What is agreed is that students learn how to be doctors and how to be professional in a

number of different ways. There is consensus that in order to give meaning to these different types of

learning experiences students, need to be encouraged to talk about their clinical experiences in a

reflective way.

For example, you might bring a case to present in a tutorial. In this safe learning environment, your

tutor will ask you questions not just about the bio-psycho-social aspects of the case but also the

context in which you met with the patient, who else was involved etc. Your tutor is giving you an

opportunity to attend to the detail that you might otherwise have missed, so you can learn how to

approach a similar situation next time with more confidence. You also learn what being professional

means by checking your own responses and those of others with your peers and tutors.

The more critical and reflective you are, the more self-aware you will become and that is what lies at

the heart of being professional.

Formative assessment, unlike summative assessment, is not a formal part of the unit exam. It is a

process that aims to improve your attainment potential by giving you feedback on things that you do

well and things that you could change and improve. Unlike assessments which rank you against

others and provide you with a “mark”, formative assessments provide individualised and detailed

responses from your site tutors and others involved in teaching. We are especially keen to enhance

this aspect of your ongoing learning, and this approach is also now expected in post graduate

medicine. Please use the Psychiatry Clinical Case Based Discussion forms to help facilitate this where

appropriate. Further copies of the form are available on Blackboard. How much formative feedback

you get will depend on how you utilize the opportunities in this logbook to share your work.

Remember, any material you provide for formative assessment will have room for improvements to

be made.

1 Tomorrow’s Doctors 2009 at http://www.gmc-uk.org/education/undergraduate.

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Clerking Portfolio

Taking a psychiatric history and being able to carry out a mental state examination are the most

important skills that you are required to achieve during this placement. Whatever you eventually

choose to specialise in you will meet patients who have mental health problems and the skills you gain

in eliciting information about a patient’s mental as opposed to physical health will provide you with a

solid foundation for taking a history in any situation.

You are expected to keep a clerking portfolio comprising anonymised versions of the psychiatric

histories and mental state examinations that you undertake during your placement.

By the end of your psychiatry placement, you should have evidence that you have undertaken a full

psychiatric history and mental state examination on at least 10 patients. You should keep these as a

clerking portfolio which you must review with your Educational Supervisor/Site Tutor. This MUST

include the core conditions:

1. Affective disorders

2. Anxiety disorders

3. Dementia

4. Schizophrenia

5. Substance Misuse

Examples of other conditions you may encounter are

Psychiatric complications of physical illness

Eating Disorder

Personality Disorder

Somatoform disorder or Medically Unexplained Symptoms

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Use the table below to record the cases included in your clerking portfolio:

Brief Details of Case (age, gender, presenting complaint, formulation)

Case 1 Diagnosis: Date seen: Setting: (outpatients /ward /community etc)

Presented Y/N SSC Y/N

Case 2 Diagnosis: Date seen: Setting: (outpatients /ward /community etc)

Presented Y/N SSC Y/N

Case 3 Diagnosis: Date seen: Setting: (outpatients /ward /community etc)

Presented Y/N SSC Y/N

Case 4 Diagnosis: Date seen: Setting: (outpatients /ward /community etc)

Presented Y/N SSC Y/N

Case 5 Diagnosis: Date seen: Setting: (outpatients /ward /community etc)

Presented Y/N SSC Y/N

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Brief Details of Case (age, gender, presenting complaint, formulation)

Case 6 Diagnosis: Date seen: Setting: (outpatients /ward /community etc)

Presented Y/N SSC Y/N

Case 7 Diagnosis: Date seen: Setting: (outpatients /ward /community etc)

Presented Y/N SSC Y/N

Case 8 Diagnosis: Date seen: Setting: (outpatients /ward /community etc)

Presented Y/N SSC Y/N

Case 9 Diagnosis: Date seen: Setting: (outpatients /ward /community etc)

Presented Y/N SSC Y/N

Case 10 Diagnosis: Date seen: Setting: (outpatients /ward /community etc)

Presented Y/N SSC Y/N

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Cases seen but not fully clerked:

Brief Details of Case (age, gender, presenting complaint, formulation) Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

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Brief Details of Case (age, gender, presenting complaint, formulation) Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

Diagnosis: Date seen: Setting:

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Case Based Discussions: Minimum of 2 must be completed.

Psychiatry Clinical Case-Based Discussion

Name of the student Date of discussion

Name of Assessor Designation

Presenting problem (eg. Low mood, hearing voices):

Assessor feedback based on case presentation (score all that apply) (1=significant development required; 2=satisfactory; 3=good; 4=-very good)

1 2 3 4 Not applicable

Case specific feedback

History O O O O O

Mental State Examination O O O O O

Risk assessment O O O O O

Differential diagnosis O O O O O

Investigations O O O O O

Treatment/Management O O O O O

Generic feedback

Communication O O O O O

Use of Structure O O O O O

Professionalism O O O O O

Overall performance of student O O O O

Feedback discussion summary Strengths of the student:

Areas of development, specific advice and actions:

Signature of Assessor and date:

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Psychiatry Clinical Case-Based Discussion

Name of the student Date of discussion

Name of Assessor Designation

Presenting problem (eg. Low mood, hearing voices):

Assessor feedback based on case presentation (score all that apply) (1=significant development required; 2=satisfactory; 3=good; 4=-very good)

1 2 3 4 Not applicable

Case specific feedback

History O O O O O

Mental State Examination O O O O O

Risk assessment O O O O O

Differential diagnosis O O O O O

Investigations O O O O O

Treatment/Management O O O O O

Generic feedback

Communication O O O O O

Use of Structure O O O O O

Professionalism O O O O O

Overall performance of student O O O O

Feedback discussion summary Strengths of the student:

Areas of development, specific advice and actions:

Signature of Assessor and date:

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Psychiatry Clinical Case-Based Discussion

Name of the student Date of discussion

Name of Assessor Designation

Presenting problem (eg. Low mood, hearing voices):

Assessor feedback based on case presentation (score all that apply) (1=significant development required; 2=satisfactory; 3=good; 4=-very good)

1 2 3 4 Not applicable

Case specific feedback

History O O O O O

Mental State Examination O O O O O

Risk assessment O O O O O

Differential diagnosis O O O O O

Investigations O O O O O

Treatment/Management O O O O O

Generic feedback

Communication O O O O O

Use of Structure O O O O O

Professionalism O O O O O

Overall performance of student O O O O

Feedback discussion summary Strengths of the student:

Areas of development, specific advice and actions:

Signature of Assessor and date:

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Record of Clinical Activities: You must ensure that you have all of the following clinical experiences. Record the significant learning points in relation to the unit learning outcomes

Half Day Learning Disability Session

Date:

Clinician Name Clinician Signature

Notes/Reflections

Attend an ECT session / watch RCPsych DVD

Date:

Clinician Name Clinician Signature

Notes/Reflections

Assessment of Suicide Risk following Deliberate

Self Harm (Liaison visit and/or role play)

Date:

Clinician Name Clinician Signature

Notes/Reflections

Undertake a full cognitive assessment

Date:

Clinician Name Clinician Signature

Notes/Reflections

Liaison experience (Hospital liaison/Primary

Care liaison)

Date:

Clinician Name Clinician Signature

Notes/Reflections

Observed/discussed the

management of the acutely distressed or agitated patient

Date:

Clinician Name Clinician Signature

Notes/Reflections

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Be observed interviewing a patient

Date:

Clinician Name Clinician Signature

Notes/Reflections

Assessor feedback based on observed interview (score all that apply) (1=significant development required; 2=satisfactory; 3=good; 4=-very good)

1 2 3 4

Case specific feedback

Introduced self appropriately O O O O

Ability to put patient at ease O O O O

Use of open questions O O O O

Use of appropriate closed questions O O O O

Listening skills O O O O

Communication O O O O

Use of structure O O O O

Professionalism O O O O

Overall performance of student O O O O

Feedback discussion summary Strengths of the student:

Areas of development, specific advice and actions:

Name and Signature of Assessor and date:

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You must ensure that you have two or more of these clinical experiences:

Home visit with a psychiatrist/allied health

professional

Date:

Clinician Name Clinician Signature

Notes/Reflections

Drug & Alcohol Unit visit / ward round

Date:

Clinician Name Clinician Signature

Notes/Reflections

Mental Health Act Assessment

Date:

Clinician Name Clinician Signature

Notes/Reflections

On Call Experience

Date:

Clinician Name Clinician Signature

Notes/Reflections

Crisis Team Experience

Date:

Clinician Name Clinician Signature

Notes/Reflections

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You must ensure you have at least ONE of these experiences:

Forensic Psychiatry experience

(prison/court visit/Forensic inpatient)

Date:

Clinician Name Clinician Signature

Notes/Reflections

Experience with Occupational Therapist/

other allied health professional

(eg patient group)

Date:

Clinician Name Clinician Signature

Notes/Reflections

CAMHS experience

Date:

Clinician Name Clinician Signature

Notes/Reflections

Discussing or witnessing an assessment with a

psychotherapist (eg CBT)

Date:

Clinician Name Clinician Signature

Notes/Reflections

Other (eg mother & baby / eating disorders / memory clinic

/neuropsychiatry /early intervention)

Date:

Clinician Name Clinician Signature

Notes/Reflections

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Professional Behaviour We expect you to be learning how to be professional throughout the unit by being more reflective, as

described in the section on reflection on page 4. Your Site Tutor and Educational Supervisor will be

observing behaviour that is indicative of professionalism during your attachment, for example

appropriate dress, punctuality, responsiveness to feedback, participation in tutorials and so on. Your

attitudes towards your peers, colleagues, patients and their families will also be observed. If

professional behavior is felt to be an issue, a student concern form will be submitted.

Whilst you are on your placement, we expect you to make the most of every learning opportunity.

Attendance at all formally timetabled tutorials or sessions is compulsory (the Faculty Rules state

100% and any less than 80% is recorded and can lead to a unit fail). Students have got themselves

into hot water in the past when their Site Tutor/Educational Supervisors have expressed concerns that

they have not seen them very often. The students often have been busy elsewhere, getting on with

their clinical activities BUT have not kept their Site Tutor/Educational Supervisor informed of what they

have been doing. Your Site Tutor/Educational Supervisor is responsible for making sure that you are

exposed to the right environments in which to achieve your learning outcomes. It is your job to make

sure that s/he is confident that you have! So, tell them what you are planning, and then tell them what

you have done. Use the logbook to your advantage.

The University has guidance relating to professional behaviour. You must make yourself familiar with

these regulations http://www.bris.ac.uk/medical-school/ click on link MB ChB Rules, Policies and

Procedures Handbook. The GMC also recently published guidelines for medical students and you

should visit the website http://www.gmc-uk.org/education/undergraduate.asp. This gives examples of

areas related to professional behavior, and you should go through them with your Site

Tutor/Educational Supervisor at least once to get an idea of how you are progressing. You can also

use this opportunity to discuss how you are progressing with your clinical skills and knowledge

development.

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PSYCHIATRY UNIT PROFESSIONAL BEHAVIOUR ASSESSMENT for student use only Use this form with your Site Tutor/Educational Supervisor to get an idea of how you are progressing. Talk through the various professional behaviour criteria. The purpose of this form is for you to discuss concerns early on. Assessed by [print name]: _________________________________ Date: _______________ CATEGORY

SA

TIS

SO

ME

RE

SE

RV

AT

ION

S

UN

SA

TIS

USE THIS SPACE FOR COMMENTS REGARDING RESERVATIONS ABOUT ATTITUDE/BEHAVIOUR AND FOR REPORTING POSITIVE COMMENTS.

Appearance: Personal hygiene

Clothing complies with dress code

Attendance & Punctuality: At formal teaching and clinical sessions

At agreed out of hours work

Reasons for absences/lateness explained

Attitude & Behaviour: Reliability in carrying out clinical tasks and communicating information

Enthusiasm for participation in clinical work

Helpfulness towards others, including fellow students

Respect for patients from all cultures and backgrounds

Respectful and appropriate communication with patients

Respect for patient confidentiality

Respect for other members of the health care team

Acceptance of constructive criticism

Ability to express an opinion/participate in discussion

Respect for needs of other students during teaching

Recognition of own limitations

Does not show evidence of abuse of alcohol or other drugs

Signed: ……………………………… Date………………. STUDENT COMMENT:

Student:

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Descriptors to aid in scoring achievement of Attitudinal Learning Objectives - Unit 1 2012-13 (MDEMO) Year 3 attitudinal learning objectives:

• Take responsibility for your own learning and progression: how you are expected to analyse, criticise and question the material, including personal development

• Develop a professional manner: how you are to relate to other people, professionals and patients.

Descriptors

Responsibility for learning Professional manner

Supporting learning Analysis, evaluation and

application Personal development Learning Style Communication Manner

Area of Concern (0-2)

Does not prepare Tutorial work at all or with little care and attention.

Is unquestioningly uncritical of sources of information.

Lacks insight into personal development. Does not identify educational needs. Does not reflect on how to meet them.

Seems positively unwilling to join in discussions in Unit Tutorials, or refuses to listen to other contributions.

Often speaks indistinctly, confusingly or in poor English to patients and colleagues. Presents indistinct, confusing or illiterate written work.

Several patients or colleagues have expressed concerns about their attitude or manner.

Area for Improvement (3-4)

Does not prepare Tutorial work well.

Uncritical of sources of information.

Rarely shows insight into personal development. Rarely identifies educational needs. Rarely reflects on how to meet them.

Does not join in discussions in Unit Tutorials even when invited, or finds it difficult to give space to others during discussions.

Sometimes speaks indistinctly, confusingly or in poor English to patients and colleagues. Often presents indistinct, confusing or illiterate written work.

One patient or colleague has expressed concerns about their attitude or manner.

Satisfactory (5-6)

Prepares Tutorial work to a minimum acceptable standard.

Critical of sources of information where the conclusions have a major impact on decisions or interpretation.

Shows some insight into personal development. Sometimes identifies educational needs. Sometimes reflects on how to meet them.

Joins in discussions in Unit Tutorials when invited and occasionally responds to other contributions.

Occasionally speaks indistinctly, confusingly or in poor English to patients and colleagues. Occasionally presents indistinct, confusing or illiterate written work.

No patient or colleague has commented positively or negatively on their attitude or manner

Good (7-8)

Prepares Tutorial work well and has read around the subject.

Critical of sources of information and able to discuss their strengths and weaknesses in a general way.

Shows good insight into personal development. Often identifies educational needs. Sometimes reflects on how to meet them and organises learning.

Joins in discussions in Unit Tutorials and readily responds to others.

Usually conveys ideas clearly and responds to questions.

One patient or colleague has commented positively on their attitude or manner

Very Good (9-10)

Prepares Tutorial work very well, has read around the subject and has selected an appropriate level of presentation.

Critical of sources of information and able to discuss their strengths and weaknesses in appropriate detail where the conclusions have a major impact on decisions or interpretation.

Shows good insight into personal development. Usually identifies educational needs, reflects on them, sets personal challenges and works flexibly towards them.

Takes the lead or follows the lead of others in discussions in Unit Tutorials as the discussion requires.

Nearly always conveys ideas clearly and responds positively to questions with good explanations.

Some patients or colleagues have commented positively on their attitude or manner.

Tutor’s overall score out of 10:

Student:

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1. Mid Unit Progress and End of Unit Sign-off

Section 1 to be completed by student in week 4 – write a summary of how much progress has been made towards achieving your learning outcomes and clinical activities. Discuss with Educational Supervisor and record any feedback. Identify areas of strength and weakness.

Comment from Educational Supervisor:

Signature ……………………………………. Date ………………

Section 2 to be completed by student in week 8 – write a summary of your clinical attachment noting the most important learning experiences for you. Discuss with your Unit Tutor/Clinical/Educational Supervisor and record any feedback.

Comment from Educational Supervisor:

Signature ……………………………………. Date ………………

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At the end of the Unit you should ensure that this is signed off by your Site Tutor. This will be a

formative record of your Unit attachment.

Section 3 to be signed at the end of the attachment by the Site Tutor Clerking portfolio completed: Yes / No Case based discussions completed: Yes / No Comment on concerns or areas of commendation: Site Tutor Signature ……………………………………. Date ………………


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