The evidence base for an excellent educational and clinical placement

Transcription

The evidence base for an excellent educational and clinical placement
Centre for Health Research
School of Health Sciences
The evidence base
for an excellent
educational and
clinical placement
Mapping support for
Newly Qualified Practitioners (NQP)
across
Kent Surrey and Sussex
Commissioned research
• Health Education Kent Surrey & Sussex (HE KSS)
• £100,000
• March 2014 - March 2015
Project aims were to:
• Scope range of activity undertaken to support
NQP across region;
• Identify outcomes of NQP support programmes
and how these differ;
• Collate data from different programmes to
determine what works for whom and under what
circumstances.
The Research Team
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Professor Julie Scholes (Nursing) Principal Investigator
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Dr Nikki Petty (AHP)
Dr Inam Haq (Medical Practitioner)
Dr Tania Mcintosh (Midwifery)
Dr Anita Green (MH Nursing)
Dr Jane Morris (Clinical Education)
Lisa Hodgson (Research Officer)
Mirika Flegg (Research Officer & Artist)
Ruth Chandler (PPI Consultant)
Laura Lee Wilson (PPI Consultant)
Glynis Flood (Administration)
PGR Support
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Ben Hodgson, Simon Booth, Celia Stamper, Liz Blackburn, Louis Buckley
Professions represented
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Dietetics
Medicine
Midwifery
Nursing
Occupational therapy
Pharmacy
• Podiatry
• Physiotherapy
• Speech and language
therapy
Mapping current support for
newly qualified practitioners
• Telephone Interviews (n=24) June – Sept 2014
Kent (n=7) Surrey (n=8) Sussex (n=9)
primary secondary or tertiary care
in
acute adult, mental health and community services
• 41 documents related to support for NQP
Literature review
• Nursing, midwifery & AHPs
47 publications between 2000 and 2014 26
nursing; 9 midwifery, 12 AHPs
• Medicine between
• 7 papers between 2007 and 2014
Deepening knowledge of current
support for NQP
• Case studies
Two site visits to Trusts
Deepening knowledge of
current support for NQP
• Knowledge Exchange Conference in
December 2014
45 delegates
Knowledge exchange
conference
mutual understanding
deepen values
you
different perspectives
flush out ideas that need to be aired
each break out session had a:
artist
concept catcher
you
Note taker
facilitator
Visual techniques
…..art enhances the process of discovery in science
by its responsiveness to the unexpected
(McNiff 1998 p 39)
Artwork was created by MF and PPI participant to
visually represent entirety of group discussions and
were captured onto a single page while the
discussion occurred.
Data analysis
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Individual interviews
Documentary evidence from Trusts
Case Study site visits
Literature
Knowledge exchange conference: notes
and visual representations of discussions
Findings from literature
• Reality shock – learning the role;
• NQP gain competence and confidence from programmes;
• Wide variety of programmes within professions and across Trusts:
– 6/9 months and 2 yrs F1s.
• Little consensus on ideal form or content of programme
• Need to meet local needs;
• Preceptors need training
• Inter-professional programmes not evident
• No PPI involvement
Interprofessional Education
Management
NQP
Health
Provision
• Increased commissioning focus on this interprofessional
learning causing tension;
• Sense that there is an ‘eye for the approach, but no clear
vision’;
• Connecting the ‘interprofessional dots’ at a Trust or
profession level leads to a chaotic image when viewed
strategically;
Findings from other data
• Wide variation in NQP support across disciplines and across and
within Trusts; medicine most uniform
• Variation in provision due to needing local flexibility;
• Wide variation in protected time: from 18 study days to 0 (fully
integrated into work). Normally 6-12 mths;
• Uni-professional; little appetite for multi-professional;
• Competence skill development more valued than ‘softer’ skills;
• Want clear direction on how to implement support and minimum
standards so greater consistency;
• Two agendas: ecology model and corporate induction model;
• PPI involvement under-developed;
Patient and Public Involvement
• PPI is the connection
point where NQP,
Professional and
Organisational areas
intersect;
NQP
Professional
support
PPI
Organisational support
System
support
Findings cont’d
• More support needed for NQP in community, smaller trusts;
• Timely (immediate) support from appropriate person valued;
• Want minimum standards for NQP;
• Career pathway for those supporting NQP, need investment;
• External independently rated reference to confirm support of high
quality;
• Little use of outcome measures to determine impact of support on
NQP;
Making it happen-What works for whom
and under what circumstances
• Need to provide holistic
support;
• Deficit Model- NQPs who
are failing to thrive receive
the most attention;
• Time and recognition is
needed to balance the
support needs of NQP and
ensure patient safety;
Time Limitations
Patient & Public Perception
NQP
Findings cont’d
Ecology model - individual
Corporate induction model –
organisation
up-skilling (competencies)
skills amnesty
confidence building
Trust standards
professional autonomy
learning needs
resilience
patient safety
improving patient experience
induction: corporate agenda
quality assurance
appraisal and progression
reward and promote
Retention
What needs to happen to make the
support for NQP sustainable
• Need for increased
understanding of the
needs of NQP;
• Sharing platform
suggested;
Health System
Tendency to lump the
needs of NQP together
via the ‘weight of red
tape’
Share & Strengthen NQP voices
Breakout session
• What benefits do NQP receive when PPI
is included in training?
• How do we involve PPI in NQP
programmes?