Developing Education in Learning Disability for Adult Pre Registration

Nursing Students

Cathy BernalAndy Nazarjuk

Andrew Southgate

OverviewBackground

Evaluation of the simulation

Principles and Simulation Framework

National Context

Professional Context

Local Context

University Response

University Response

SIMULATED HOSPITAL ADMISSIONS:

How effective are they?

Simulated Hospital AdmissionObjectives were for students to be able to: • identify and discuss the key

challenges involved • reflect personally on what they have

learned from the session and about themselves

• to set some personal developmental goals for the future

(Nazarjuk, Southgate & Bernal 2013)

Discussion of Key Challenges

“Made me more aware of the issues that could arise from assessing patients with learning difficulties.”

“Made me more aware to not take everything at face value and think outside the box.”

“Initially dubious how the session would work in a ‘forced environment’ however worked well, and was an enjoyable experience.”

Personal Learning“it has made me really look at someone with learning disabilities in a different way, showing me how much of a valuable asset to society they are.”

“My knowledge to date is inadequate….need more knowledge on how to communicate”

“By working with people with learning disabilities I believe I have gained more knowledge about how to communicate effectively and appropriately”

Personal Goals“It has made me realise that you do have to explain things more as not everyone will understand.”

“I found the day rewarding and enlightening – it was useful and beneficial to meet/ greet our visitors…I will certainly show the respect they deserve, just as I would with anyone else I meet – I will also make sure others do the same.

“I have lots to take back into practice and ideas for the future.”

Service User Feedback

The students were “relaxed and calm”, “reassuring” and “friendly”

“I wasn’t nervous”

“It was brilliant!”

Practice Development 1Lessons learned 2011 -12 & implemented

in 2013:Session moved to year 2 (Benner 1984)Importance of students spending social

time & sharing informal activities with service users (Speed et al 2012)

Preparatory visits to the university by service users are not always necessary

Principles of Simulation

Represent reality

Utilise experiential learning

Foster a safe learning environment

(Nunn, 2004; Prescott & Garside, 2009; Hope, Garside & Prescott, 2011, Stables, 2012)

Simulation Framework

Time

Simulation Framework

Remuneration

Practice Development 2 Lessons learned in 2012-13, to be implemented if

possible in 2013-14:Students and service users to share lunchtimeGreater preparation time for students – 2 day

session incorporating directed study Trial two opposing approaches

Senior students as peer facilitators (Stables, 2012)

Simulation in Year 3Simulated experience for all Adult nursing

students

ReferencesBenner P (1984) From Novice to Expert: Excellence and Power in Clinical Nursing Practice. New Jersey: Prentice Hall HealthDepartment of Health (2012) Strengthening The Commitment: The Report of the U.K Modernizing Learning Disabilities Nursing Review Edinburgh Scottish GovernmentFrancis, R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry http://www.midstaffspublicinquiry.com/sites/default/files/report/Executive%20summary.pdfHope, A, Garside, J & Prescott, S (2011) Rethinking theory and practice: Pre-registration student nurses experiences of simulation teaching and learning in the acquisition of clinical skills in preparation for practice, Nurse Education Today, 31, p. 711–715 Mencap (2007) Death by Indifference London: Mencap. London: DoHMichael, J (2008) Healthcare for All: Report of the Independent Inquiry into Access to Healthcare for with Learning Disabilities http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_099255Mencap (2012) Death by Indifference: 74 Deaths and Counting London: MencapNazarjuk, A, Bernal, C & Southgate, A (2013) Involving Service Users in Student Education, Learning Disability Practice, 16, 5, p. 14-18Nunn, A (2004) Almost the real thing, Nursing Management, 11, 7, p. 14-18Nursing and Midwifery Council (2010) Standards for pre-registration nursing education. Available at: http://standards.nmc-uk.org/PreRegNursing/statutory/background/Pages/introduction.aspxPrescott S, Garside J (2009) An evaluation of simulated clinical practice for adult branch students, Nursing Standard, 23, 22, p.35-40Southgate, A (2013) Confounding expectations: reflection on simulation with learning disability service users, International Practice Development Journal 3 (1) [8] p. 1-7Speed S, Griffiths J, Horne M & Keeley P (2012) Pitfalls, perils and payments: Service user, carers and teaching staff perceptions of the barriers to involvement in nursing education. Nurse Education Today 32 (7), 829 – 834Stables, I (2012) Development of Clinical Skills: The Contribution of Peer Learning, Learning Disability Practice, 15, 8, p. 12-17