The Health and Well-being of Service User and Carer Educators: a Narrative Enquiry into the Impact of Involvement in Healthcare Education

Service user and carer involvement is increasing in health and social care educationas a result of UK policy directives and Professional Statutory and Regulatory Body requirements. The study aimed to elicit the accounts of service user and carer educators' experiences in practice-based healthcare education in the UK. The overall aim was to illustrate the impact this has had on their health and well-being. A narrative inquiry approach was adopted in order to give a clearer and stronger voice to service users and carers by making their experience the primary focus of enquiry.Narratives were collected from five service users and carers who had extensive experience of involvement in healthcare education. The individual narrative material obtained was distilled into key points following a naturalistic perspective, ensuring that the findings and final story were a re-presentation of the narrator's experience.Participating in the research enabled the service users and carers to articulate specifically how involvement had positively affected their health and well-being. An additional outcome included the personal artefacts that can be utilised in teaching and learning in order to bring the service user and carer voice to life.This study contributes to the emerging knowledge and understanding that service user and carer involvement in health education can be a truly collaborative, enriching experience,producing profound personal change, with improvements in health and well-being. Effective involvement is dependent upon appropriate support networks whereby service users and carers develop connections with staff and other service users and carers that result in a sense of belonging

A randomised controlled trial of patient led training in medical education: protocol

<p>Abstract</p> <p>Background</p> <p>Estimates suggest that approximately 1 in 10 patients admitted to hospital experience an adverse event resulting in harm. Methods to improve patient safety have concentrated on developing safer systems of care and promoting changes in professional behaviour. There is a growing international interest in the development of interventions that promote the role of patients preventing error, but limited evidence of effectiveness of such interventions. The present study aims to undertake a randomised controlled trial of patient-led teaching of junior doctors about patient safety.</p> <p>Methods/Design</p> <p>A randomised cluster controlled trial will be conducted. The intervention will be incorporated into the mandatory training of junior doctors training programme on patient safety. The study will be conducted in the Yorkshire and Humber region in the North of England. Patients who have experienced a safety incident in the NHS will be recruited. Patients will be identified through National Patient Safety Champions and local Trust contacts. Patients will receive training and be supported to talk to small groups of trainees about their experiences. The primary aim of the patient-led teaching module is to increase the awareness of patient safety issues amongst doctors, allow reflection on their own attitudes towards safety and promote an optimal culture among the doctors to improve safety in practice. A mixture of qualitative and quantitative methods will be used to evaluate the impact of the intervention, using the Attitudes to Patient Safety Questionnaire (APSQ) as our primary quantitative outcome, as well as focus groups and semi-structured interviews.</p> <p>Discussion</p> <p>The research team face a number of challenges in developing the intervention, including integrating a new method of teaching into an existing curriculum, facilitating effective patient involvement and identifying suitable outcome measures.</p> <p>Trial Registration</p> <p>Current controlled Trials: <a href="http://www.controlled-trials.com/ISRCTN94241579">ISRCTN94241579</a></p

The Service User and Carer Working Group's Journey Through the ALPS Programme

The ALPS operational plan includes a specific aim related to service user and carer involvement: To enhance the role of service users and carers in assessment and learning in practice settings. This led to the advent of the Service User & Carer Working Group. This workshop will explain more about the work of this group. This will be supported by a case study from an ALPS funded project piloting an innovative assessment process involving service users and students in mental health nursing. The group were given responsibilty for taking forward this aim either as a group, in liaison with other ALPS groups, or through developing, influencing, advising and /or overseeing activity at each partner site. Membership includes representatives from all five partner institutions and two service users. As the programme nears completion the group has agreed areas where ALPS has made an impact in terms of service user and carer involvement. These are: • ALPS has provided a structure through which local universities could further sustain their involvement ‘community of practice’ and so is contributing to an overall cultural shift and institutional leveling in terms of involvement practice • ALPS has funded valuable research into involvement in research and what matters to service users and carers when it comes to shared care and decision making • A shared policy on payment of service users across institutions for ALPS work has been an unprecedented development • ALPS has funded the development of an online involvement good practice resource • Seeking service users and carer feedback has been more clearly legitimized through the assessment tool and so should have some sustainability as a practice The objectives of this workshop will be: To share some of the successes, challenges and lessons learnt by the service user and carer working group about the preparedness (or not) of the overall health and social care economy for involvement. To demonstrate the groups agreed areas where ALPS has made an impact in terms of involvement as above. To highlight the effective collaboration of the group that is seen as one of it's key strengths. Case Study The case study project is in the field of mental health, proposong new ways of using the ALPS suite. This will include a group of service users working closely with an academic to develop realistic case based scenarios for student assessment and feedback. Planning will be comprehensive and include design of learning materials, understanding the feedback process, dealing with sensitive issues, planning and preparing role-plays, ethical issues, group and student logistics and student learning outcomes. Each student will then undertake a simulated assessment with a service user. The purpose of this assessment is to develop and improve the student’s communication skills, when working with service users and carers. The assessment will use the ALPS suite. Each assessment will be broken down into three 15 minute phases. Assessments are planned to take 15 minutes each, with each assessment observed by an academic and a student peer. In the next 15 minutes the student will reflect and write up their individual reflection. The three observers will discuss and prepare for feedback. In the final 15 minutes of the session the student will receive feedback from the service user, student peer and academic. Feedback will be provided to the student in a timely manner that is individual, tailored, improvement focused. All feedback will be recorded using a PC or existing devices. Following this simulation, students will take the communication ALPS Assessment tool with them into their next placement, thereby embedding into their practice portfolio. Outcomes from this will post-date the embedding project, but will contribute to the overall ALPS programme

Patient-led training on patient safety:a pilot study to test the feasibility and acceptability of an educational intervention

BACKGROUND: Training in patient safety is an important element of medical education. Most educational interventions on patient safety training adopt a 'health-professional lens' with limited consideration on the impact of safety lapses on the patient and their families and little or no involvement of patients in the design or delivery of the training. AIMS: This paper describes a pilot study to test the feasibility and acceptability of implementing a patient-led educational intervention to facilitate safety training amongst newly qualified doctors. METHOD: Patients and/or carers who had experienced harm during their care shared narratives of their stories with trainees; this was followed by a focused discussion on patient safety issues exploring the causes and consequences of safety incidents and lessons to be learned from these. RESULTS: The intervention, which will be further tested in an NIHR-funded randomised controlled trial (RCT), was successfully implemented into an existing training programme and found acceptance amongst the patients and trainees. CONCLUSION: The pilot study proved to be a useful step in refining the intervention for the RCT including identifying appropriate outcome measures and highlighting organisational issues

What matters to US (Users of Services) in shared care and decision making

Successful collaborative work in 4 West Yorkshire Universities related to service user & carer engagement in higher education led to a successful bid for research funding to the Assessment & Learning in Practice Settings (ALPS) Centre for Excellence in Teaching & Learning (CETL). ALPS is a collaborative programme between five Higher Education Institutions (HEI’s) with a proven track record for excellence in learning and teaching in health and social care. This includes the University of Bradford, University of Huddersfield, the University of Leeds, Leeds Metropolitan University and the University of York St John. Further information about the programme can be found at the central website www.ALPSCETL. leeds.ac.uk . The aim of ALPS is to ensure that students graduating from courses in health and social care are fully equipped to perform confidently and competently at the start of their professional careers and so improve patient care. The aim and method of the research was to establish a collaborative inquiry process with service users and carers to explore what professionals need to do to help patients/ clients and carers play their part in shared care and decision making. Action learning groups were held with service users and carers that informed the development of a Delphi type survey which was circulated to a wider group of service users and carers, students and academics related to a number of health and social care courses. The strengths of this research are: • That it was service user led/focused 82 • Dialogue with service users and carers that followed at iterative, reflective process. • The collaborative, inter disciplinary nature. • Development of reusable learning objects - podcasts relative to all health and social care professions

Patients as teachers:a randomised controlled trial on the use of personal stories of harm to raise awareness of patient safety for doctors in training

BACKGROUND: Patient safety training often provides learners with a health professional's perspective rather than the patient's. Personal narratives of health-related harm allow patients to share their stories with health professionals to influence clinical behaviour by rousing emotions and improving attitudes to safety. AIM: This study measured the impact of patient narratives used to train junior doctors in patient safety. METHODS: An open, multi-centre, two-arm, parallel design randomised controlled trial was conducted in the North Yorkshire East Coast Foundation School (NYECFS). The intervention consisted of 1-h-long patient narratives followed by discussion. The control arm received conventional faculty-delivered teaching. The Attitude to Patient Safety Questionnaire (APSQ) and the Positive and Negative Affect Schedule (PANAS) were used to measure the impact of the intervention. RESULTS: 142 trainees received the intervention; 141 the control teaching. There was no evidence of a difference in post-intervention APSQ scores between the groups. There was a statistically significant difference in the underlying distribution of both post PA (positive affect) and post NA (negative affect) scores between the groups on the PANAS (p<0.001) with indications of both higher PA and NA scores in the intervention group. CONCLUSIONS: Involving patients with experiences of safety incidents in training has an ideological appeal and seems an obvious choice in designing safety interventions. On the basis of our primary outcome measure, we were unable to demonstrate effectiveness of the intervention in changing general attitudes to safety compared to control. While the intervention may impact on emotional engagement and learning about communication, we remain uncertain whether this will translate into improved behaviours in the clinical context or indeed if there are any negative effects. TRIAL REGISTRATION NUMBER: Grant reference no. RP-PG-0108-10049