Training the trainers: Finding new educational opportunities in the virtual world

With the COVİD-19 pandemic disrupting scientific gatherings and conferences throughout the world, virtual meeting platforms have facilitated the process of learning and exchange of knowledge (Adhanom, 2020; Ng et al., 2020; Rojnic Kuzman et al., 2021; Unützer et al., 2020). The World Psychiatric Association (WPA, n.d.) has also realized the significant potential of online meetings and wants to develop virtual avenues and information systems for capacity building of mental health professionals (Sartorius & Sartorius, 2020; Schulze, 2020a, 2020b).

Recently, the WPA, in collaboration with the WPA Section on Education in Psychiatry, organized its first virtual workshop entitled “Train the Trainers” as part of its educational activities (Fiorillo et al., 2021; Herrman, 2019, 2020; Ng, 2020). This workshop was attended by as many as 123 participants, including psychiatrists, psychiatric trainees, and educators, from 45 countries. It was an innovatively designed, interactive event to discuss and share recent developments and experiences in the respective fields of participants. In particular, the workshop was organized with the aim to discuss and learn about recent developments in psychiatric education from mental health professionals around the world and encourage potential collaborations between them (Botbol, 2019, 2020; Kallivayalil, 2019, 2020a, 2020b).

As pointed out by WPA President Prof. Afzal Javed in his opening lecture that although the COVID-19 pandemic has set several limitations in daily life, it has also opened up new avenues for professionals to meet, greet, and speak to each other even while sitting thousands of miles away. Prof. Javed reiterated that the WPA was focused on education, teaching, and training of medical students and psychiatric trainees, adding that capacity building was the need of the hour. “Specifically, medical students should be attracted towards psychiatry, otherwise we will not be able to promote psychiatry as a scientific discipline and a career choice for future doctors,” he observed.

Prof. Norman Sartorius, one of the most eminent educators in psychiatry worldwide, stressed upon the importance of finding innovative solutions in psychiatry training and the need to improve teaching and training in the field of psychiatry, especially in the provision of leadership and communication skills.

The workshop aimed to give answers to three main questions: (a) How should we teach in the future?; (b) Who should decide the content of training?; and (c) What should be the main content of training?

Since the COVID-19 pandemic has restricted the amount of traveling and physical contact, virtual teaching would acquire more usefulness. According to Prof. Sartorius, there is an urgent need to bring together all stakeholders such as psychiatrists, trainees, peers, patients, families as well as professionals from other disciplines to decide about the future content of psychiatry training (Fiorillo & Gorwood, 2020). The development of a learning community in which all groups have a word to say on the teaching content could then help us to answer what should be the main content of all courses. It has been noted that professional leadership and communication skills are a “significant omission” in psychiatric training, which should be corrected as soon as possible (Brittlebank et al., 2016; Pinto da Costa, 2020; Pinto da Costa et al., 2019).

The workshop comprised different sessions and began with a “Meet and Greet” session, similar to the concept of speed dating. Each participant had three seven-minute rounds of “dating” opportunities with a colleague from another country via a one-to-one video call. The participants were instructed to introduce themselves to their partner to get to know each other, exchange educational experiences, and ask questions or receive advice. The primary learning aim of this session was networking between health professionals from different countries and facilitating connections, which can help to give or take advice for career or teaching. This session allowed both experienced professionals and early career psychiatrists to have an open conversation about their careers and educational experiences.

In the next session, participants were distributed in nine virtual breakout rooms each with up to 12 participants. In each room, there were two senior professionals as moderators who facilitated three speakers in the session. A total of 26 short presentations ranging between 7 and 10 min covered topics ranging from pedagogical tips and advice, skills training, and clinical discussions on personal and institutional experiences. Each presentation was followed by feedback from the moderators and questions from the participants, aiming to facilitate the development of key “take-home” messages. In particular, this session aimed to provide the participants with knowledge about: Networking—by getting to know the trainers; exchanging knowledge, ideas, and experiences; learning from senior psychiatrists; entering the scientific community; and forging collaborations. Teaching and leadership skills—how to be an effective teacher; teaching online using web apps; interprofessional teaching and collaborations; enhancing didactical skills; improving teaching for students, trainers, and specialists; peer-teaching; learning from experts; and teaching communication skills. Professional enhancement—learning new teaching formats (such as educational games); improving psychotherapy skills; research options in medical education; involvement in WPA activities; different psychotherapy approaches; and training in specific aspects such as suicides, psycho-oncology, neuropsychiatry, HIV, and insomnia. The presentation sessions were followed by another innovative session, where all participants were sent to the “Lobby” where numerous events were running simultaneously. Inside a “Café,” participants could enjoy a casual conversation with others over a virtual coffee. A “Games Room” invited participants to relax while playing educational games. In a “Take Home Message Room,” participants were encouraged to leave their feedback messages and share educational resources such as book recommendations, website links, or guidelines. Other rooms, such as “Meet the Organizers”, gave the participants further opportunities to interact with more experienced psychiatrists and teachers.

After this 45-minute candid session, all participants were invited to the closing session and given an opportunity to present their final thoughts. All chairs and co-chairs of the different sessions and break-out rooms were asked to share their take-home messages with all participants. Educational activities as well professional experiences from diverse cultures and countries in Americas, Africa, Asia, Europe, and Oceania, were shared, highlighting the rich diversity of the psychiatry discipline and the role of the WPA to try to harmonize the educational activities around the globe. The importance of continuing such efforts to galvanize and strengthen links of the global psychiatric community were reiterated by Prof. Sartorius and Prof. Bulent Coskun in their final remarks. During the closing session, the participants agreed that the workshop was an enriching experience for psychiatrists to meet their professional colleagues from different parts of the world. It provided them with an opportunity to share their experiences, visions, and hopes for the future of education in psychiatry and psychotherapy. Also, the workshop served as a hub for participants to stay connected for prospective projects and future collaboration.

The one-day workshop was designed by Dr. Franziska Baessler and members of the WPA Section on Education in Psychiatry and moderated by Dr. Baessler with the assistance of Prof. Coskun. It brought together professionals interested in medical education in the psychosocial field and made it easier for professionals from around the world to connect and learn from each other. The authors appreciate the great efforts of the committee members of the WPA Section on Education (Hasanen Al-Taiar, Franziska Baessler, Bulent Coskun, Mariana Pinto da Costa, Hussien Elkholy, Andrea Fiorillo, Rodrigo Ramalho, and Gaia Sampogna) together with Ali Zafar, Cenan Hepdurgun, Damla Haznedaroglu, Dorota Frydecka, Olga Kazakova, Olena Zhabenko, and Dewanto Andoko among others, who made this event possible. It is expected that all participants will remain connected after the workshop and will have an opportunity to discover issues of common interest, which might lead to collaborations and to a strengthening of networks including both senior and less experienced colleagues.

The COVID-19 pandemic has forced the scientific community to find, develop, and embrace new avenues of learning and sharing latest advancements as borders closed down and countries adopted strict measures to control spiraling infections. For over 18 months now, research and academic institutions worldwide have shifted to digital and virtual modes of teaching apparently very similar to distance learning. Digitalization, online workshops and conferences currently comprise the sole and most important medium of international academic exchanges and collaborations and have filled the educational gaps while also circumventing the traditional barriers that hinder knowledge transfer, especially in middle- and lower-income countries (Kokhanovskaya et al., 2021; Weber & Ahn, 2020; Woolston, 2020).

Among their biggest advantages, online training methods provide easy access to academics and students from within the comfort of their homes without the need for physical, financial, or logistical efforts. On the part of the organizers, the organizational costs can be at a minimum which excludes the need for participation fees. This is in contrast with the real-world conferences where only those participants who can afford the participation and traveling expenditures are present. Thus, online training methods have the potential to reduce educational inequalities and at the same time allow the voice of the underprivileged scientists to be heard across the globe.

Approximately 70% of the university psychiatric faculty is concentrated in just 30% of countries (https://www.wpanet.org/education-portal), resulting in gross inequalities in access to qualitative mental health education (Baessler et al., 2021). A WHO survey conducted between June and August 2020 revealed that the ongoing COVID-19 pandemic disrupted critical mental health services in 93% of the 130 countries surveyed worldwide (WHO, 2020). The devastating impact on access to mental health services underscores the urgent need for finding innovative ways to provide essential mental health training and supervision outside of the more traditional face-to-face channels (Gnanavel et al., 2020; Inoue & Fukunaga, 2021; Ramalho et al., 2020; Ransing et al., 2021; Stewart & Appelbaum, 2020; Vieta et al., 2020). Online modes of learning can be particularly useful in countries where the ratio of psychiatrists to patients is inadequate and doctors concentrate more on treatment than on research and education. Such virtual interactions could also be helpful networking resources and allow early-career psychiatrists to learn from senior colleagues and specialists in countries with better resources.

Despite tremendous efforts by the professional psychiatry community, curricular recommendations frequently fail because they do not consider local teaching resources or the clinical bases necessary to implement state-of-the-art treatments. The solution to improving the field of psychiatry requires the development of educational networks that can bring expertise from multiple institutions to provide education in every location, designed for the existing local needs (Fiorillo & Maj, 2018; Hariman et al., 2020; Mao et al., 2021). An essential step necessary to ensure that every patient, no matter where they live, can benefit from the most complete knowledge base is to have innovative educational approaches suitable for local needs and conditions. Educational interventions using both internet-based learning, taped lectures, and live distance-learning, using a modality such as Zoom, could prove incredibly useful on a large scale in the future just as they are being successfully utilized in local and regional contexts during the pandemic (Linardon et al., 2019; Torous et al., 2020).

Keeping in mind the importance of psychiatric interventions in the coming months or even years after the COVID-19 pandemic, the WPA workshop provided a platform for participants to discuss their experiences in the field and share their visions for future education in psychiatry and psychotherapy. The online workshop showed that professionals working in any location can use their knowledge and skills to advocate for the development of necessary additions to the clinical base of psychiatric care (Collins, 2020; Kutcher & Wei, 2020; Ranjbar et al., 2019). This workshop not only achieved its goal of training the trainers, but also introduced an innovative and interactive framework that might be adapted in various contexts in the future (Baessler et al., 2015; Ruble et al., 2021; Schwartz & Brenner, 2021; Ulupinar, 2021).

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