What was required?
The simulated practice sessions are part of a two week period where the third year students are in university, get asked to read papers and others materials online and then take part in various discussion groups and often role-play around scenarios aimed at developing their skills and confidence in key aspects of clinical practice.
In mental health care, family members and friends or informal carers of people with mental illness/distress often feel ignored and isolated by healthcare professionals yet they often know a lot about the person requiring treatment and care and frequently provide high levels of support before, during and after contact with health services.
The aim of the sessions was for students to competently apply knowledge and skills in working in partnership with carers (family/friends of service user);. This included Working in partnership with carers: listening to carers; involving carers in assessment and planning; working with challenging issues; confidentiality and sharing information.
How did you address it?
Alan Simpson worked in partnership with two carers, June Hanshaw and Jay Hudson, to plan and develop the two one-day sessions, discussing key topics to be addressed and how we might best provide an engaging learning experience. We decide on a range of methods that include pre-session reading about the Triangle of Care policy and related materials on sharing information and confidentiality. We developed several case scenarios for the basis of role plays with students taking on the roles of carer, nurse and observer. June and Jay were video-interviewed about key topics and Alan edited this into 11 short clips (between 1 and 4 minutes long) which were used during the day. Finally, June and Jay each agreed to come in for two hours each during the simulated practice to provide feedback on the role plays and ask any questions for the students.
How did it go?
After outlining the aims for the day, the students were asked to work in groups to identify the essential role carers play and the importance of identifying and engaging with carers at first contact. They were asked to understand the need to be ‘carer aware’ and for a carer engagement approach for mental health services. They then identified questions they might ask a carer on first contact. The first video clips were shown with June and Jay talking about first becoming a carer and their first experiences of contact with mental health services.
The rest of the day was a mixture of role plays and feedback, interspersed with more video clips, as the students engaged with different scenarios to learn how to engage and listen to carers; deal with challenging and angry carers; involve carers in care and discharge planning; and share information and maintain confidentiality. Finally, they explored the support and resources available to carers in local communities.
What worked well? Any particular challenges?
The students engaged well throughout the day and got really stuck into the role plays, swapping roles, testing out different approaches and appreciating the carers viewpoint while developing confidence and skills. Ethical issues were discussed and challenges such as working with children and their parents identified. Having June and Jay come into the class and take part in feedback sessions and discussions was the highpoint of the day for most people.
Evaluations of the two days were very good. Average scores across the two days:
1.1 Helped understand subject: 4.9/5.0
1.2 Staff enthusiastic: 4.9/5.0
1.3 Available to respond to queries: 4.8/5.0
4.1 Overall satisfaction: 4.9/5.0
The many positive comments included:
“Content was engaging and it was very useful to hear carers’ perspectives in person and in videos. It encouraged me to form a plan re discussing confidentiality and sharing information on the ward”.
“Great to have a carer involved both through video and in person”
“Role Play: these were very useful! In the past I have found role play to be shoe-horned into sessions but these felt very well-rounded and ‘authentic’ and as they were grounded in carers’ perspectives this enhanced them further. Carer coming in to speak was great. YouTube Videos were great.”
“It was good to hear June and Jay’s perspectives as carers. It was helpful to be reminded to not only offer solutions but that reflection and summarising are important when dealing with carers’ (or patients’) worries/anxieties/issues.”
“Having a carer come and talk to us directly about their experience of mental health services was really useful. Videos were also a good medium to provoke discussion and thoughts.”
“Found the role play useful as I was put in a situation likely to happen in practice and was able to build my confidence.”
Refinements to the sessions need to include: scenarios on working with children and parents; and working with carers of people with dementia; more variation in role play scenarios; develop role plays to include service users as well as carers and nurses. More live involvement of carers would be welcomed.