Developing interprofessional cohesion: a multidisciplinary approach to child and adolescent mental health learning and teaching for pre-registration nurses

The drive to deliver cost effective, efficient, innovative and multidisciplinary methods of teaching is now, more than ever before, firmly at the forefront of curriculum design (Glenn and Leiba, 2010). Two departments at the University of Huddersfield have joined forces to implement what we believe is an unusual and unique initiative, not only in the subject matter but also the way it is delivered. Nursing and social work students are brought together in the classroom, in a bid to engender positive and realistic expectations of multidisciplinary working in the field of child and adolescent mental health. The Nursing and Midwifery Council’s vision for nurse education includes the need for pre-registration nursing programmes to address the mental health needs of children and adolescents (NMC, 2010; CAMHS Review, 2010). For several years now, two departments at the University of Huddersfield have been working side by side to deliver a comprehensive module which aims to address the key issues related to identifying and meeting the mental health needs of children and young people (DoEd, 2005). This module takes a broad stance in identifying the ways in which child and adolescent mental health and problems are understood, drawing on previous learning related to human development and examining the influences that affect these processes to create difficulties, problems and disorder (Rutter and Taylor, 2002; Sutton, 2006). Methods of assessment and intervention at individual, group and family level are also examined, and current patterns of service delivery to children, young people with mental health needs are outlined. At the end of the module it is expected that students are familiar with methods of assessment, intervention and evaluation used in identifying and addressing mental health issues and are able to describe the nature and range of service delivery available. The module cohort consists of students from child nursing, mental health nursing and social work routes. Faculty staff and practitioners from the field of child and adolescent mental health (CAMH) take an active role in multidisciplinary teaching delivery for an initial period of six weeks. For the final hour of each session, students are subdivided into smaller multidisciplinary groups and asked to review a case scenario. They are encouraged to devise ecograms/ecomaps (DH, 2000) to both enable visualisation of the specific circumstances surrounding the child and stimulate discussion of their initial thoughts. Throughout the following weeks more information is given to enable the students to build upon or disregard their initial impressions of the case scenario and they are encouraged to feedback to one another within their multidisciplinary micro-groups. The second half of the semester is profession specific and looks in greater detail at some of the issues, conditions, scenarios considered in the initial teaching period and students are taught in their individual professional cohort groups. Thanks to the involvement of grassroots practitioners throughout the module, the content reflects current practice and is based on actual experience. The link of theory to practice is clear, and recent case examples illuminate the application of 'in vivo' of models of working (Grant, 2010). Similarly the assessment strategy requires students to relate the content of the module to their own experiences of working with patients/clients (Stickley and Bassett, 2008; WHO, 1992). The aim is that their practice will be confident and patient/client-focused whenever the mental health needs of children require care (Dogra, 2001; Dwivedi, 2004; Hill and Maughan, 2000). Child nursing student feedback regarding the module as a whole is positive and whilst some students acknowledge they find the initial interdisciplinary work challenging, the majority state that this is due to preconceived ideas as to the work that social work or mental health professionals undertake. In conclusion, this presentation will offer a critical appraisal of the utility and effectiveness of interprofessional learning and teaching strategies

Capturing 'what works' in complex process evaluation research: the use of calendar instruments

Calendar or timeline techniques have developed in parallel and are used in life course research, and health behaviour and treatment studies. Both types of research seek to reconstruct histories or events in order to understand phenomena. Unsurprisingly a research strategy that seeks to represent events from memory is fraught with recall error thereby influencing consistency, completeness, and accuracy of data. Strategies can be employed to improve data quality so informants can more accurately access long term memory. One such strategy involves producing a graphical timeframe against which historical information can be represented. This is said to stimulate memory facilitating accuracy of recall and fidelity of data. There are minor variations in the application of calendar techniques, unsurprising given the different methodological heritage, nevertheless there are common characteristics. These include: graphical display of the dimension of time, use of one or more thematic axis (representing the data domains) and event or landmark cues that temporally bound the research. The Department of Health (England) in 2008 funded a series of public health initiatives in nine ‘Healthy Towns’. These initiatives were targeted on facilitating healthier lifestyles in local populations and importantly learning from projects about “what works”. One “Healthy Town” – Healthy Halifax – funded ten embedded project streams all designed to encourage adoption of health lifestyles by the population living in four wards with poorest health outcomes. The challenge presented to the local evaluation team was capturing which, if any, of the projects made a difference to health lifestyles of local populations. Calendar technique were incorporated in research design to accurately represent the life history of each project and capture the antecedents, attributes and consequences of project delivery that might illuminate ‘what works’. This presentation will offer a critical appraisal of the utility of calendar technique as a methodological approach for capturing process evaluation