Admiral Nurse Standards: an overview and application of ‘values based practice’

This short presentation will offer an introduction to Values Based Practice through the prism of the Admiral Nurse Standards. It is intended to demonstrate that an understanding of ‘values’ is critical to the delivery of excellent nursing care. In addition, the presentation intends to illustrate that working with values is not a theoretical and ‘airy’ idea, but rather a key practical skill that can be mastered by nurses at various levels. The presentation seeks to engage participants in a debate on whether working positively with values is a key feature of high level leadership and practice and is worthy of detailed examination

Transferring new skills and knowledge to practice: a mixed methods case study of Improving Access to Psychological Therapy (IAPT) in a single English region

Background. This thesis examined facilitative and inhibitory issues in the transfer of new skills and learning to support implementation of national policy for Improving Access to Psychological Therapy (IAPT) in primary care services within the English National Health Service (NHS). The policy for IAPT had two principal implementation strands; a) development of new services in primary care and development of a new, national education and b) training programme to support delivery of effective evidence based psychological treatments for a specified range of common mental disorders; particularly depression and anxiety. There is a paucity of research on transfer of skills and learning from formal education programmes to application in healthcare practice. Methodology. A mixed methods case study design was developed to obtain quantitative and qualitative data on the experiences of IAPT therapists prior to commencing their training programme; on completion of their educational programme and again at a follow-up period. In-depth interviews were held with key policy leads that devised, developed and implemented the IAPT initiative to examine their expectations and reflections on the programme. Formal interviews were held with IAPT therapists; their managers and clinical supervisors from a single education cohort in an English region. Focus groups were also held with other IAPT therapists to examine emerging findings from the data. Results A number of themes emerged from the merged quantitative and qualitative data. Motivation to maintain fidelity to the work of being an IAPT therapist was seen as crucial. This motivation was highly related to the self-reported force of external pressures to adapt IAPT practice in line with changed NHS commissioning requirements. System feedback was seen as a unique feature of the programme and part of this feedback process centred on the role of clinical supervision in supporting the transfer of learning and continuous development of practice. Educational programmes were based on a prescribed competency model which was designed to provide core knowledge and skills to support new workers in new roles in new service providers within Primary Care. However, respondents reported high degrees of complexity, practice isolation and political and economic stressors that were not reflected in the curriculum. Therefore the role of the curriculum as a front end model to prepare practitioners for practice was questioned. Despite this, evidence existed of high levels of confidence and capability of IAPT therapists in the extension of their core educational skills. This transfer behaviour was a feature of practice when set within the context of supported supervision. Discussion on the implications from this research Implementation of new services and a new workforce (such as IAPT) within the NHS remains challenging with few significant successes. The IAPT programme has a number of unique features, such as a focus on feedback processes and clinical supervision. These enabling forces particularly those of supervision, were considered to be under threat from cost saving initiatives. Such financial pressures appear to have the potential to destabilise one of the major enabling building blocks of learning transfer. This thesis adds to the body of knowledge in workforce development and education and training in the NHS by offering a detailed case study analysis of a range of factors that can inhibit or enable transfer of learning and promote change in professional practice. There is little research in the mental health literature on the transfer of learning that takes such a comprehensive whole systems and long term perspective on this issue

Care concept in medical and nursing students' descriptions: philosophical approach and implications for medical education

Introduction. Care is seen as something that is peculiar to the medical sciences but its meaning and status for physicians and nurses differs. Objectives. The aim of this research was to learn how nursing and medical students understand and define care, and how their definition and views on their practice of caring change as they advance through their studies. Material and methods. The study was conducted among two groups of students: before and after their first practicum (n=102). Analysis of the students' answers was carried out using Colaizzi's phenomenological descriptive methodology, which means that a qualitative approach was used. Results. The qualitative analysis shows that the medical and nursing students define care in the same way, using 9 main categories: compassion, commitment, competence, confidence, conscience, communication, patience, courage and support. The nursing students viewed their caring to be within both practical and emotional dimensions and this was a core feature of their identity as nurses. Medical students, on the other hand, viewed the practical dimension of care as an additional activity. All the students in the study underlined the importance of having time to care and showed that, for them, 'time' in this context has a moral meaning. What was interesting to the research team centered on the initial attitudes to 'caring' from both medical and nursing students. Conclusions. We found that students of both nursing and medicine do not begin their studies with different attitudes and concepts of care. However, after their initial exposure to practical placements a process begins which forges different identities around the concept of care. This implies trends in the division of professional roles during their initial education

Survivorship: promoting quality of life in cancer and long-term conditions: Interim evaluation report

This interim report provides data on the evaluation of the delivery of a post-registration training module in survivorship which was delivered through the Continued Professional Development Centre at the University of Lincoln in 2013, and is part of a wider collaborative project between Macmillan Cancer Support and the University of Lincoln. A more comprehensive evaluation which included a comprehensive literature review on the topic of survivorship, baseline measures of motivation amongst participants on the module and full analysis of a series of in-depth interviews exploration of practitioners’ perceptions on the survivorship agenda (work conducted by Amanda Thompson under the supervision of Dr Ros Kane and Dr Ian McGonagle) has previously been reported back to Macmillan. This current report aims to: • Present data from the evaluation of the module • Present key points from the in-depth interviews • Provide an update of dissemination activities to date • Outline the plans and timescale for the follow up outcome evaluation

Transferring psychological therapy education into practice: a complex systems analysis

Introduction This paper reports on a national study exploring the transfer of education to practice. A competence based programme of education in Cognitive Behaviour Therapy to treat patients with Depression and Anxiety was delivered to a cohort of health professionals who became participants in this study. This study reports on the challenges and enablers that play a role in the transfer of education in healthcare practice. Methods A qualitative study design was developed to explore the views of nurse therapists on the enablers and barriers in transferring new knowledge and skills to their practice. The cohort of individuals enrolled on a new education programme consisted of 64 nurses and other therapists. In order to explore the complex issues face to face interviews with 18 individuals were conducted and reported through thematic analysis. Results A number of themes emerged which provided the opportunity to examine the complexity and challenge of healthcare workers making use of new skills and knowledge in dynamic work environments. The themes identified a number of enablers and barriers to effective transfer in challenging and complex nursing environments. Discussion and conclusion The role of supervision was viewed as having a critical function in supporting nurse therapists’ transfer their university based newly developed skills to clinical practice. The practice environment was viewed a highly complex field which contained a number of barriers to effective educational transfer. Supervision of practice emerged as a major theme but variation in its delivery inhibited fidelity to learning transfer over time

Developing and Supporting Clinical Academic Research Careers for Nurses, Midwives and Allied Health Professionals: the UK Experience

Internationally the need for the development of clinical academic careers for nurses, midwives and allied health professionals is becoming ever more apparent. Clinical academics maintain their clinical practice whilst also carrying out research, placing them in a unique position to make connections between the two fields. Integrated academic training pathways have been introduced across the UK since 2006 to combine clinical training with research experience; however, aspiring clinical academics still face a range of challenges in balancing the clinical and research aspects of their careers and there is a lack of evidence to demonstrate impact of clinical academic career pathways, post initial training. AIMS This research aimed to follow up scholars from a Pre-Masters and Pre-PhD Clinical Academic Training Programme delivered since 2013, to investigate the extent to which their training has been implemented in clinical practice and to explore the extent to which the training enabled them to move on to develop and support subsequent research activity in the clinical setting. METHODS This qualitative study followed up participants (including those who did not successfully complete) from the Health Education England: East Midlands funded Clinical Academic Careers training programme, delivered at Lincoln from 2013-2017. All previous scholars were contacted and invited to take part in an individual interview. Data were collected from May to July 2017. Ethical approval was granted by the host Higher Education Institution. 18 in-depth interviews were conducted, transcribed verbatim and thematically analysed. RESULTS The results of the study will be presented at the conference. Key barriers and facilitators to accessing and sustaining, both initial research training and on-going implementation have been identified. DISCUSSION This research highlights the importance of clinical academic training programmes in developing and supporting an environment conducing to research in the clinical healthcare setting. CONCLUSION There is a need for on-going work to support both clinical academic scholars and also manages working in the healthcare setting, to overcome some of the practical and financial barriers to the development of clinical academics

The values, knowledge and behaviour of student nurses in promoting health lifestyles. A mixed methods study.

The values, knowledge and behaviour of student nurses in promoting health lifestyles. A mixed methods study

Barriers and facilitators to self-management in people living with and beyond cancer (PLWABC): a systematic review of qualitative evidence (PROTOCOL)

Review question The review objectives are: To identify, evaluate and synthesise qualitative evidence that has explored the perspectives of people living with and beyond cancer regarding self-management. To utilise this data to identify, explore and explain the potential barriers and facilitators to self-management in people living with and beyond cancer. Condition or domain being studied: Engagement (or lack of) in self-management practices/behaviours, support and resources in adults (≥18) with any diagnosis of cancer who have completed treatment for cancer. Whilst there is no universal definition of self-management, in cancer survivorship, it has been defined as “awareness and active participation by the person in their recovery, recuperation, rehabilitation, to minimise the consequences of treatment, promote survival, health and wellbeing” (DH, Macmillan Cancer Support, NHS Improvement, 2013). This definition will be used for the purposes of this review

Creating and supporting clinical academic careers in the NHS

Aim of the Poster: To provide an overview of three distinct but related activities in the East Midlands region to support the development of Clinical Academic Careers in Nursing, Midwifery and Allied Health Professions

An Exploration of Rural–Urban Residence on Self-Reported Health Status with UK Cancer Survivors Following Treatment: A Brief Report

Objective: To explore the effect of rural–urban residence on the self-reported health status of UK cancer survivors following primary treatment. Design: A post-positivist approach utilizing a cross-sectional survey that collected data on demographics, postcode and self-reported health status. Methods: An independent samples t test was used to detect differences in health status between rural and urban respondents. Pearson’s χ2 was used to control for confounding variables and a multivariate analysis was conducted using Stepwise linear regression. Setting: East Midlands of England. Participants: Adult cancer survivors who had undergone primary treatment in the last five years. Participants were excluded if they had recurrence or metastatic spread, started active oncology treatment in the last twelve months, and/or were in receipt of palliative or end-of-life care. Main outcome: Residence was measured using the UK Office for National Statistics (ONS) RUC2011 Rural–Urban Classifications and Health Status via the UK ONS self-reported health status measure. Ethics: The study was reviewed and approved (Ref: 17/WS/0054) by an NHS Research Ethics Committee and the Health Research Authority (HRA) prior to recruitment and data collection taking place. Results: 227 respondents returned a questionnaire (response rate 27%). Forty-five percent (n = 103) were resident in a rural area and fifty-three percent (n = 120) in an urban area. Rural (4.11 ± 0.85) respondents had significantly (p < 0.001) higher self-reported health statuses compared to urban (3.65 ± 0.93) respondents (MD 0.47; 95% CI 0.23, 0.70). Conclusion: It is hoped that the results will stimulate further work in this area and that researchers will be encouraged to collect data on rural–urban residency where appropriate