Enhancing Nursing Education Through Service User Involvement in Interprofessional Learning

1. Service Users’ Involvement in Interprofessional Learning and Higher Overall Pass Rate. Paper Presented at the 2nd Global Nursing and Healthcare Conference, UK, 13-15 August 2018 By Dr Vincent Icheku Senior Lecturer in the Department Adult Nursing and Midwifery, London South Bank University

2. Background *We know from Barwell, et al. (2013) that students from different nursing fields often have little idea of what each other’s roles entail. *Our students’ feedback showed that Interprofessional learning (IPL) increase this knowledge, as well as giving students an understanding of the interpersonal skills needed for interprofessional working in practice.

3. Service user involvement in Interprofessional Learning • For decades, curriculum planners in nursing education in the UK have been expected to involve service users in Interprofessional Learning (IPL) (DH, 2006; NMC 2010, HPC 2011).

4. Involvement of service users in IPL at level 4 BSc nursing programme • Involvement of service users in IPL at level 4 BSc nursing programme has been introduced successfully at the London South Bank University in 2017. • According to Gutteridge and Dobbins (2010), there is a need to discover how or why learning is enhanced through service user involvement in classroom teaching.

5. Presentation Aim • This presentation focuses on discussing the involvement of service users in the IPL at level 4 culminating in overall pass rate of 85 per cent consecutively for two years (2017 and 2018).

6. Context • At IPL level 4, first year students from all nursing fields (Mental Health, Child and Adult) are introduced to the value of Interprofessional and collaborative working in health and social care delivery. • There are expected to develop the necessary communication, collaborative and team working, reflective and other practice skills required to meet the needs of clients/patients and diverse populations who are at the centre of Interprofessional health and social care delivery. • They are also expected to work collaboratively on-line to explore and develop understanding of the purpose, scope and range of Interprofessional and collaborative working.

7. Teaching Methods • Blended Learning • Main Hall Lectures • Seminars

8. Blended Learning • A component part of the IPL is a blended learning that starts before the seminars begins. • Example - Students are encouraged to watch a video, read book chapter, article etc. on relevant topics. • They are asked to reflect on particulars issues or questions to be identified in the material and write down their responses. EXAMPLE: • How do professionals communicate with service users? • What ways do the professionals communicated with the service users? • How do they feel when the professional started to shout at the service user? • How  would they engage with service users? ETC.

9. Lecture and seminar Examples • Face to face lecture lead by a lecturer on the Power and meaning of Co-production within teams: Service Users’ Perspective • Small Group Seminar facilitated by a lecturer and service user aims to: • Reflect on experience of co-production within professional practice. • Understand co-production from a user and professional perspective - aims to show that in practice, ‘it involves people who use services being consulted, included and working together from the start to the end of any project that affects them’

10. Involvement of service users in Lectures • Service users sit in lectures and provide the opportunity for students to listen to the health care experiences of patients and their carers. • Listening to the service users’ experience in the classroom encourages the students to reflect on the care they are giving.

11. Prep for lectures and seminars • Service users received materials for both lectures and seminars in Advance. This allows them the opportunity to study and familiarise themselves with the contents in anticipation of the sessions. • Co-lead lecturers arranged 10 minutes meeting with Co-lead service user before each session to check for understanding and to agree on delivery methods.

12. Involvement of service users in seminars • For seminar based sessions, students were divided up into small interdisciplinary seminar groups. • This offered the opportunity for moving beyond some of the more conventional 'teaching from the front' approaches to involving service users in the learning process . • Each Seminar group is facilitated by a Service and co-lead lecturer – This allows both offering their own disciplinary expertise based on their lived experience and also acting as a facilitator for the groups learning process.

13. Service user involvement in assessment Students were assessed using both: • Formative and • Summative methods

14. Formative Assessment • Students from different fields of nursing were divided into learning group (of about six students) • Within a learning groups, students work together on a project to consider service user perspectives and the roles and relationships of Health and Social Care Professionals. • The project will be presented in the 5th week in the second semester.

15. Formative Presentation • Students are required to consider – Roles and responsibilities of those working with the patient / service user and their family • The students are required to demonstrate communicationbetween professionals and user Feelings / perspectives of those involved -patient safety -and discuss what could enhance the healthcare experience for the user, their family and others involved in their care

16. Summative • Students are required to submit a 3, 000 words reflective account of the experience of working in the learning group using Gibbs reflective cycle (Model). • They should relate the learning set experience to what they have seen in clinical practice, applying relevant theories. • They need to consider how research literature can be translated into their experience within the learning group e.g. managing difficulty situations, service users involvement, communication issues etc. 

17. Higher Pass Rate • IPL at level 4 has been running for two years and recorded 85 per cent pass rate consecutively. • The module’s evaluation forms was completed at the end of the module last year contained positive comments from students. 

18. Evaluation data

19. Result of Evaluation • As demonstrated by the above table, the module received positive evaluation: • Students liked the use of service users as co-facilitators and found method beneficial. • This is in-line with Costello and Horne (2001) research finding that having service user involvement in education enables students to gain insight into the experience of service users.

20. Challenges and barriers of service user involvement • A number of challenges and barriers to service users’ involvement in the IPL at level 4. • The two main challenges were faced; funding and timetabling: • The involvement of an average of 12 service users across two sites on different days and over 12 weeks incurs substantial cost. A recent cut in funding meant that Service users stopped attending team meetings. • The IPL involves large cohorts of over 400 students that were divided into 14 seminar groups of about 30 students. • Provision of appropriate rooms including wheel chair accessible rooms posed major challenges

22. Conclusion and recommendations • Gutteridge and Dobbins (2010) stated that challenges and barriers to service user involvement needed to be addressed to make service users involvement in IPL successful and meaningful. • In-line with the above statement, efficient system of room booking, securing finances and making sure service user payments happen, disseminating information and managing tensions that arise from delivering IPL to a large cohort of students are recommended.

23. References • Barwell, J. et al (2013): How interprofessional learning improves care, Nursing Times; 109: 21, 14-16, www.nursingtimes.net/studying. • Costello, J., Horne, M., 2001. Patients as teachers? An evaluative study of patients `involvement in classroom teaching. Nurse Education in Practice 1, 94-102 • Department of Health, 2006. Our Health, Our Care, Our Say: A New Direction for Community, Services. Cm. 6737. London, The Stationary Office • Department of Health (2003), Laming Report: The Victoria Climbié Inquiry-Report of an Inquiry by Lord Laming. London: Stationery Office. • Department of Health (2001) Learning from Bristol: the Report of the Public Inquiry into Children’s Heart Surgery at the Bristol Royal Infirmary. London: Stationery Office.

24. References • Gutteridge R, Dobbins K. 2010. Service user and carer involvement in learning and teaching: A faculty of health staff perspective, Nurse Education Today 30: 509-514 • Health Professions Council. 2011. Service user involvement in the design and delivery of education and training programmes (Education and Training Committee, 10 March 2011. London, HPC • Nursing and Midwifery Council, 2010. Standards for pre-registration nurse education. London, NMC • World Health Organization (1988), Learning Together to Work Together for Health, World Health Organisation.