Innovation
The innovation concerns a unique MSc programme in Clinical Leadership in Cancer, Palliative and End of Life Care. This programme aims to enable emerging and established clinical leaders in these specialties to critically champion compassionate and informed care of a high quality, and to create learning environments that promote excellence. Specifically, to achieve these aims this programme has three outstanding and interdependent features.
- All core modules incorporate experiential rehearsal and formative assessment of the inter-relational skills underpinning clinical leadership – advanced communication skills related to patient care, service design and policy implementation, and skills in educating others, brokering and networking.
- The programme is closely aligned to our research group – the students share research scholarship opportunities (seminars and master-classes) with the research group. In addition each student is coached by an active researcher throughout their programme so that they learn about research from researchers and have the opportunity to develop clinical research networks.
- The programme is aligned to the student’s practice and work place. For each core module students are expected to undertake some self-directed work-based learning in relation to the module focus in negotiation with their manager and academic tutor. It is expected that this will inform their assignment. In turn they are expected to negotiate an assignment that is of an appropriate form and focus to their development and workplace needs. As an example, students have undertaken policy reviews, developed business cases, presented at conferences, held a local teaching session or facilitated a network meeting or reference group, prepared position papers and evaluative reviews for publication.
What prompted innovation?
Several factors prompted this innovation. Feedback from our stakeholders identified that whilst we had previously prepared specialist nurses in cancer, palliative and end of life care there was a need to enhance the leadership capability of practitioners who were clinically engaged in a variety of roles in order to take forward service development. The rapidly changing policy context and demographics of cancer, palliative and end of life care supported this need and reinforces the role of clinical leadership in the provision of excellent care and healthy organisations. Additionally, we were encouraged by a University initiative to consider the ways by which we could integrate our postgraduate provision in the workplace and by a Faculty initiative that our educational provision should be research-led.
What makes innovation different?
- The focus on relational leadership and therefore the incorporation of skills rehearsals of leadership skills and formative assessment of these skills.
- The integration with our Cancer, Palliative and End of Life Care research group, and the coaching provided by researchers to foster an understanding of the relationship between research and clinical practice and care delivery.
- The close alignment between the programme and the work-place through the process and outputs of the programme.
Changes in practice
Changes in practice have included:
- Implementation of a comprehensive medicine management strategy within a hospice at home service. This includes clinical guidelines, modification of the organisation’s operational strategy, risk assessment processes and an educational strategy and framework to support the policy.
- Informing advance care planning (ACP) strategy across a health region for children at the end of life.
- Establishing processes and strategies for achieving the preferred place of care of hospitalised adults at the end of life.
- Instigation of end of life care education for members of the public in a health region (part of compassionate cities initiative).
- Instigating a sexual health service for people with sexual function difficulties following cancer treatment.
- Design and initiation of a holistic health assessment for people with cancer within a specialist cancer centre.
- Design and planning of a respite service for people with palliative care needs.
Impact
Our evidence includes student evaluation, evidence from discussions with students’ managers, external review and our internal review processes. Externally at programme review the innovations were commended as being ‘ahead of their time’ and ‘cutting edge’. From student evaluations and our internal regulation processes we know that students find these innovations difficult at first because they vary so much from their experience of education, which has predominately been didactic and more traditional. However, they rapidly grasp the opportunities offered so that by the second core module we begin to see initiatives that will benefit both students and their workplace.
Dissemination
Some of the features of the innovation have been disseminated – other programmes in the Faculty have adopted our assignment processes to enable students to negotiate an assignment that is of benefit to their workplace and students on other programmes follow our model of research training and benefit from a research coach.