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Celia Woolf Institute of Health Sciences Education Research Afternoon QMUL 9 th June 2010

Training students to obtain informed consent from patients with a communication disability Evaluation of an interprofessional education programme. Celia Woolf Institute of Health Sciences Education Research Afternoon QMUL 9 th June 2010. Informed consent and communication disability.

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Celia Woolf Institute of Health Sciences Education Research Afternoon QMUL 9 th June 2010

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  1. Training students to obtain informed consent from patients with a communication disabilityEvaluation of an interprofessional education programme Celia Woolf Institute of Health Sciences Education Research Afternoon QMUL 9th June 2010

  2. Informed consent and communication disability Health professionals must involve patients / clients in decision making (e.g. DoH 2001, 2004) Obtaining informed consent from people with communication disabilities (PWCD) can be challenging

  3. Background Health professionals often don’t involve PWCD properly in decision making (Byng et al, 2003; Law et al, 2005) • lack of knowledge • communication strategies • professional responsibilities • negative attitudes and assumptions (Fox & Pring, 2005)

  4. Background • Communication disability is common • estimated 20% of population at some stage in life (Law et al, 2007) • Importance of interprofessional collaboration SLT role to assist other health professionals to communicate with patients (DoH, 2001; DoH, 2004)

  5. Background Exposure may not improve ability to communicate with people who have communication disability Training improves communication facilitation skills (Kagan et al, 2001)

  6. Study Design • 3 interprofessional groups of final year students • Speech & Language Therapy • Nursing (Adult, Child, Mental Health) • Medicine • Radiography • Midwifery (n = 26) • Two training sessions for each group (2 x 2 hours) • Led by a facilitator and co-trainers with communication disabilities

  7. Evaluation • Pre- and post-training questionnaires • knowledge • confidence • Focus groups • Students • Co-trainers • Written feedback from students • Observation of training sessions

  8. Training content • Session 1 • Patient experiences • Ethico-legal context • Communication disability • Communication strategies • Allocation of informed consent scenarios

  9. Training content • Session 2 • Informed consent simulations • Orthopaedic surgery • Change of drug treatment for epilepsy • Barium swallow • Feedback & discussion

  10. Evaluation results

  11. Questionnaire Results • Explored changes in confidenceand knowledge about informed consent and communication disability • 5 point response scale Strongly disagree -------------strongly agree • Administered pre and posttraining

  12. Questionnaire Results Compared pre- and post-training responses Repeated Measures ANOVA Highly significant increases in confidence and knowledge

  13. Focus group recordings transcribed verbatim Thematic analysis using Framework approach Overwhelmingly positive experience Students particularly valued meeting and working with co-trainers simulation and hands on approach mix of theory and practice Focus group results

  14. Examples of written feedback Excellent overall. Really enjoyable and a great learning experience. Feeling considerably more confident! Many thanks! (Adult Nursing) Thank you! I hope this course is offered to as many healthcare practitioners / students as possible. (Medicine) The training sessions have given me an insight on how to communicate with people with communication difficulties and the importance of simplifying medical terminology. (Diagnostic Radiography)

  15. Examples of written feedback [I enjoyed] the chance to work in an interprofessional context and discuss issues which might come up in future practice. Great chance for practical involvement. (SLT) Admirable co-trainers whose participation in the programme was paramount. Exceptionally wonderful and open people. (SLT) This was a very positive and constructive experience that proved to be completely relevant to my practice and personal development and I enjoyed meeting people that face difficulties when interacting and communicating with health care professionals. (Adult Nursing)

  16. Conclusions • knowledge about informed consent • knowledge of communication strategies • confidence about obtaining informed consent • attitudes towards people with communication disabilities

  17. Acknowledgements CETL for project funding Project Team: Celia Woolf, Tom Penman, Mary Rogers Co-trainers: Carole, Catriona, Kim, Collette CONNECT the Communication Disability Network Westminster Learning Disability Partnership Student participants Statistical advice: Fiona Warburton, City University

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