Drawing on the work of Chambers & Hickey (2012), there are a number of models to conceptualise and explain the current status of service user involvement. These models are often expressed as ladders or continuums.
The ‘integration continuum’: from ‘systemic user involvement’ to ‘piecemeal user involvement’.
The former refers to where service users are involved in all aspects of the design and delivery of education from programme development, selection of students, delivery, assessment, through to evaluation. The latter involves service users in certain aspects of education and training (usually teaching delivery). The closer to ‘systemic user involvement’ the more integrated is involvement. There are some examples in the literature of ‘systemic user involvement’ (e.g. McKeown et al 2010) but the vast majority of publications suggests a more ‘piecemeal’ approach.
The ‘engagement continuum’: has ‘active’ and ‘passive’ involvement at its polar ends.
This continuum refers to the level of engagement or demands made of the service user role. Service users have traditionally had a ‘passive’ role in clinical practice, where students develop their skills by practising on patients. However, there are also examples of more active roles where service users are engaged in classroom teaching and even student assessment.
The ‘participation continuum’ or ladder: Many authors have developed such a continuum (or ladder) (see McKeown et al 2010) and all aim to help explain the level of user involvement and degree of power transferred from teaching staff/educational institution to service users. Some are briefly outlined below:
Information/Explanation – Consultation – Partnership – User Control
(The participation continuum, Hickey and Kipping 1998)
No involvement – Limited Involvement – Growing – Involvement – Collaboration – Partnership
(Ladder of Involvement, Tew et al 2004)
No control Information – Consultation – Participation – Sharing Power – Full control
(Service user involvement best practice guide, Supporting People 2012) http://www.serviceuserinvolvement.co.uk/whatisit_laderOfP.asp?id=1