“The Free Association Sessions”. Perspectives on a Novel Teaching Platform by Final Year Medical Students and Basic Specialist Trainees in Psychiatry.

Abstract

Notwithstanding the many advantages of outcomes-based education within Psychiatry placements in medical school and Basic Specialist Training within the College of Psychiatry of Ireland, there is limited protected time for broad reflective practice that appreciates the complexity of working in the mental health setting. Furthermore, there are limitations to the current model of restricting reflective practice sessions to the Balint Group Format.

A novel programme of structured reflective practice was offered to students in the School of Medicine in The University of Limerick and trainees in the Mid-West Deanery. Six student and fourteen trainee participants were subsequently invited to provide perspectives on the programme via focus Groups. The study employed an inductive latent phenomenological approach for analysis of qualitative data.

Five major themes emerged: These related to the teaching environment, personal identity, complexity, awareness of cognitive dissonance and the structure of the sessions. There were a number of different perceptions, relating to the participants’ stage of training.

There was evidence that the structured reflective sessions created a comfortable environment, addressed hierarchy issues and facilitated wide-ranging opportunities for reflective practice, with an observed increased appreciation for complexity in Psychiatry. There was apparent tension between controlling content and facilitating the form of group process. Nonetheless, the structure appeared more approachable for medical students and those early in training.