Innovation
The essential innovation is based on the principle of enhancing students’ ability to understand and provide compassionate care. This is done through exposure of students to ‘real’ service users in the early part of their course in order to highlight the importance of effective and caring interactions as well as provide effective opportunities to develop those skills.
In year one, within our interprofessional education programme, students across a range of health disciplines undertake initial development of skills in communication and base competences, such as moving and handling. This is done using our volunteer patient group who grade the students on key skills in these areas. This ensures that students receive authentic feedback from those on the receiving end of their care and helps to ensure a clearer patient focussed perspective. Related to this is an emerging initiative to provide video feedback on interactions in order that students can actually witness their interactions and reflect on relevant aspects.
In Diagnostic Radiography, students participate in a placement experience that has two main facets; in year one, they attend a placement in a care home setting and in year two they each spend a day with a profoundly disabled child (known as the ‘Day in the Life’ experience). In both settings they are required to contribute to the care needs of these individuals in a context entirely separate from their specific disciplinary priorities. This helps to induce a broader understanding of the needs of service users that encourages a more empathetic and compassionate approach to practice. The care home placement experience has been recently piloted and will in due course be formalised as a more extensive placement component.
What prompted innovation?
In recent years across the UK-wide health and social care landscape, there has been frequent adverse comment regarding the effectiveness of communication, and the care and compassion shown by health professionals in their interactions with service users. Although these qualities are generally considered to be inherent in the content and structure of educational programmes, the issue has been a matter of concern within the School, prompting consideration of how these matters may be addressed in a manner that is realistic, effective and not tokenistic.
This viewpoint pre-empts by some time, recent events in Staffordshire and also the outcomes of the Keogh report, all of which vindicate the stance that has been taken. Although it is recognised that these events do not relate solely to the actions of practitioners, it is evident that where possible, students are exposed to appropriate values and experiences that might enhance future care delivery. This innovation sets out to achieve that aim.
What makes innovation different?
The essential element in this innovation that would be considered different is that of authenticity of experience. The divide between theory and practice can be difficult to bridge in the early stages of educational courses and the absence of immediate feedback from interactions with service users particularly hampers the application of theoretical knowledge. Providing students with these authentic scenarios enables them to develop a clearer understanding of the user perspective on a number of levels that they can then apply more effectively in the clinical setting.
Changes in practice
The nature of this initiative and its stage of implementation make it difficult to quantify the effect on practice in the wider sense. The intention is to enable more effective practice in certain activities as well as behavioural change that will in due course lead to a more empathetic culture in clinical settings. It is therefore inevitable that such change will be more clearly recognised in the longer term.
Nevertheless, provisional feedback from the practice setting indicates a high level of satisfaction with students’ abilities in these areas in initial placements. Student feedback has given a clearly positive indication of the perceived value of the experiences, including a stated belief in the way in which they have influenced patient interactions. This information provides a good level of confidence in the longer term value of this innovation.
Impact
In the periodic review of the BSc(Hons) Diagnostic Radiography held in September 2012, which is the only Health Science course to be recently reviewed, the review panel commended the course team on their approach to the development of caring and empathetic skills through the use of patient volunteers and care related placements. This may be seen as wider vindication of the approach taken within the School.
Student feedback has been extremely positive and as mentioned, there has been a clear indication of the perceived impact on practice. This has been obtained through normal feedback channels and also through a more formalised data gathering process that will be further disseminated in due course.
Dissemination
Dissemination has been undertaken both internally and externally, although some work remains in the process of preparation for publication. Internally, outcomes have been conveyed primarily through informal fora and staff development events, although the broad based engagement with some of this work has meant that many staff within the Faculty particularly have been aware of, or involved in the work and its progress.
Externally, outcomes have been presented at a variety of events related to clinical simulation, either at conferences such as the Association for Simulated Practice in Health Care, or for example through events arranged by NHS Education Scotland who have strongly supported some elements of the initiative, particularly the care home and ‘Day in the Life’ placements where they have been instrumental in facilitating aspects of placement organisation.