Evaluation of Online Simulated Scenarios for Nursing

Mike O’Driscoll,  Professor Michael Traynor

Report published: July 2021.

Introduction

In April 2020 the adult child midwifery (ACM) department at Middlesex University started using online screen-based simulation (OSBS) software sourced from Oxford Medical Simulation[1] (OMS). OMS was originally designed to be used with virtual reality hardware and delivered in the classroom setting. However, due to COVID-19 restrictions the delivery of the programme was remote and online only i.e. students participated in these simulations on their own computers, and mostly at home.

This simulation platform places students into a virtual ward or single bedded area, students are then able to control their environment and interact with the surrounding equipment as in clinical practice. There is a usually a support worker present in the room who the student can interact and communicate with. Each of the simulations features a patient presenting with a specific medical condition with certain scenarios also involving patients presenting with a variety of social or psychological issues. The student is then required to undertake a clinical assessment of that patient, using their clinical knowledge to draw conclusions and make decisions regarding patient care within a safe environment.

Evaluation

The independent evaluation of this OSBS initiative was commissioned by the ACM department in April 2020 and data collection was carried out between June and September 2020. The mixed methods evaluation was led by Mike O’Driscoll and Prof. Michael Traynor, incorporating an online survey and online focus groups with students who had participated in the OSBS initiative as well as an online focus group with staff. Relevant secondary data (such as the number of times students participated in each scenario), which was available via the OMS system, was also analysed.

Learning Objectives

Learning objectives for 3rd Year (adult and children and young people) nursing students who were to go into practice earlier than anticipated (through an opt in ‘extended placement’) because of the increased need for staff as a result of the COVID-19 pandemic: included  

  • To develop knowledge and understanding of the physical assessment of an acutely unwell patient and reflect on their practice.
  • To develop the technical and non-technical skills required when assessing and intervening with the acutely unwell patient and reflect on their practice.
  • To upskill current third year adult and children and young people nursing students to prepare them for being deployed as a result of the COVID-19 pandemic.

The OSBS initiative was also aimed at adult and children and young people third year nursing students who did not opt for the ‘extended placement’ and with adult and children and young people second year students; mental health nursing students (2nd and 3rd year); nursing associates (2nd year); third year midwifery students and PG Dip 2nd year students. For these groups there were slightly different learning objectives:

  • Enable healthcare students to develop knowledge and understanding of the physical assessment of the acutely unwell patient.
  • Enable healthcare students to develop technical and non-technical skills required when assessing and intervening with the acutely unwell patient.

Evaluation Findings

The response rate to the online survey was 25% (617 students invited, 154 wholly or partially completed questionnaires obtained). 13 students took part across two online focus groups. Seven members of staff took part in an online focus group and one took part in a one to one interview (as they had been unable to attend the focus group).

There is strong evidence of the OSBS learning objectives having been met, particularly from survey evidence regarding which skills students perceived they had gained which could be transferred into practice and learning outcomes or objectives they felt they had achieved, and this is supported by focus group evidence. A very large majority of respondents felt that they had gained skills in making clinical decisions based on their observations and prior knowledge; escalating issues to senior members of staff and using time effectively across different activities.

Respondents were very positive (mean ratings above four on a scale of 1 to 5 about the last scenario participated in, on a range of measures including realism, usefulness and overall satisfaction. Most respondents did not consider  there were serious barriers to their participation in OSBS and there were no statistically significant differences in perceived barriers to participation by scenario, age, learning style, programme or year of programme and few differences on gender. However, a considerable limitation of the evaluation is that those who took part in the evaluation had participated in the OSBS (i.e. those who experienced barriers  (or did not like OSBS for whatever  reason) were under-represented in the evaluation).

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If you have any queries about this research or would like to discuss a research project please contact Mike O’Driscoll (m.odriscoll@mdx.ac.uk) or Professor Michael Traynor (m.traynor@mdx.ac.uk).


[1] See http://oxfordmedicalsimulation.com

CCRNM researchers evaluate new work-based healthcare apprenticeship models

The Learn and Earn career pathway (LECP) was established in 2017 following a pilot by Islington, Haringey and Camden community education provider networks (CEPNs) and is managed via Community Matters. It attempted to address some of the perceived barriers to employers’ engagement with apprenticeships by means of administrative assistance, financial incentives and the development of a bespoke ‘apprenticeship-plus’ model where additional training, particularly clinical skills, are included within the offer. Specifically, it was set up to promote the career pathway towards nursing and to explore the viability of using apprenticeships as a sustained funding source for training required to progress along the pathway.  

The central ‘offer’ on the pathway was a Healthcare Assistant (HCA) programme, adapted to accommodate both newcomers to the HCA role (e.g. admin or reception staff) as well as experienced HCAs who want to gain the level 3 Diploma in Clinical Healthcare Support, and to develop additional clinical skills. The programme was based on a traditional apprenticeship model but with  additional clinical skills classrooms that reflect the tasks typically undertaken by HCAs in General Practice. 

Evaluation commissioned
In 2019 a research team from the Centre for Critical Research in Nursing and Midwifery Education in Middlesex University led by Mike O’Driscoll was commissioned to carry out an independent evaluation of the Learn and Earn project. The evaluation aims included understanding the take up of each course on the Learn and Earn pathway (numbers of employers/learners, profile, progress, outcomes, reasons for take up and barriers to take up);comparing progress against targets; understanding what worked well and what did not work well and evaluating the impact of project activities at individual/business and project level.

Evaluation methods
The mixed methods process evaluation which was completed in early 2020, involved an online survey, focus group and telephone  interviews with all stakeholders  (learners, training providers, employers, CEPNs and the project managers). It also included a ‘business case’ analysis of the project, providing  a tool to inform and support employer decision-making regarding placing learners on the LECP. The business case tool, developed by Dr Wendy Knibb, provides a structure around which employers can develop their consideration of key aspects of the decision-making process such as benefits and potential non-monetary benefits of training; costs and potential non-monetary costs to training; perceived risks/challenges of training and comparing the apprenticeship model to other training options.
The evaluation also provided an evaluation toolkit, to facilitate future evaluations.

Key evaluation findings included:
Learner’s main reasons for taking part in courses were  career development (86%), followed by wanting a role which involves more healthcare expertise (83%) and job satisfaction (72%). 62% said that they had taken part in course/s because they wanted to improve their employability and just over half (51%) chose ‘get a better salary or working arrangements’ and 38% did the course/s because they ‘want a role with more contact with public’.

Level 2 HCA Apprentices

Overall satisfaction with courses, which may have been negatively impacted by some initial teething problems, was moderate – however the vast majority of current learners  (84% ) reported feeling very or fairly confident about taking part in their current course and satisfaction with current course was high for peer interaction and support (79% very or fairly satisfied), employer support (74% very or fairly satisfied) and timing / pattern of course (68% very or fairly satisfied).

Many learners felt that their course would have a positive effect on their career and their current employing organisations (or had already done so) and that their course had had a positive effect on the level of service provided to patients (especially in increasing capacity and the range of services which are offered in a GP practice).

Employers were, on the whole positive about their experiences of Learn and Earn courses and recognised benefits such as the ability to ‘grow their own’ primary healthcare workforce, i.e. to increase skills and capacity in their existing staff and to gain specific skills which the employer needed and which could be tailored to the needs of the employing organisation and to provide a better service for patients.

If you would like to commission an evaluation please contact Mike O’ Driscoll (m.odriscoll@mdx.ac.uk)

For more details of the evaluation findings please contact Community Matters (training@communitymatters.co.uk)

Report title:
Learn and Earn Project – Evaluation Report
O’Driscoll, M., Traynor, M. and Knibb, W. (2020). Middlesex University, Centre for Critical Research in Nursing and Midwifery.



Helen Allan Secures Visiting Scholarship at De Montfort University

Helen Allan has secured a Visiting Scholarship to the Centre for Reproduction Research at De Montfort University from January to March 2019. Helen will be working on papers with Professor Nicky Hudson and her team which arise from the Early Parenthood after IVF study. Helen’s collaborators on this study have been Professor Olga van den Akker (MU), Professor Lorraine Culley (DMU), Dr Ginny Mounce (University of Oxford), Jo Killingley, Lindsay Ahmed and Therese Bourne (MU) and Ruth Hudson (Surrey & Borders NHS Trust).

Sharing our research on student volunteering, critical pedagogy and compassion in nurse education

Research by Professors Sue Dyson and Olga van den Akker, Dr Liang Liu  and Mike O’Driscoll uniquely draws together three important concepts for the first time:  namely student volunteering, critical thinking skills for nurses, and caring and compassionate nursing practice and shows how these relate to critical pedagogy in the nurse education.  The programme of research has so far resulted in three conference papers, one peer-reviewed publication, a book and international collaboration with Dr Kwadwo Korsah  at the University of Ghana School of Nursing in Accra and the establishment of academic networks in Canada, Australia, and Latvia.

Conference papers Mike O’Driscoll, a researcher in CCRNM, presented findings of research into the role that volunteering  can play in developing critical pedagogy within nurse education at the AITNER Sociology conference in Athens in May  and at the National Council of Voluntary Organisations Research Conference in Nottingham, in September. Also in September, Professor Sue Dyson presented findings from the research at the World Congress on Nursing & Nurse Education Conference in Rome.

The presentations were very well received and led to many interesting discussions around volunteering in health professional education and how critical pedagogy relates to compassionate care.

The presentation titled The extent, variability and attitudes towards volunteering among nursing students: Implications for pedagogy in nurse education’  presented by Mike O’Driscoll at the AITNER conference in Athens can be downloaded here AITNER 2017 PRESENTATION.

Peer-reviewed publication Findings from this research have also been published in the peer reviewed journal Nurse Education in Practice.

Book The research is the subject of the book by Professor Sue Dyson to be published on October 7th. 2017: Critical Pedagogy in Nursing: Transformational Approaches to Nurse Education in a Globalized World (Palgrave Macmillan).

The programme of research continues and for further information please contact Professor Sue Dyson (s.dyson@derby.ac.uk).

 

Professor Helen Allan and colleagues – Action Research on Guyanese women living with diabetes

Professor Helen Allan, Professor Tina Koch and PhD student Dr Ann Mitchell have published their research ‘Guyanese expatriate women ask: Is it a touch of sugar?’ examining the experiences of expatriate Guyanese women living with diabetes.

The article was published in Action Research Journal which seeks to disseminate research findings to practitioners and health service users through social media.  Read online using link below (time limited access) or download the pdf here is it a touch of sugar

Would you like to start a chronic illness participatory action research group?  For further information contact:

 ann.mitchell@open.ac.uk

h.allan@mdx.ac.uk

tinakoch24@gmail.com

 

Is it a Touch of Sugar?

 

New research highlights delegation as key skill for nursing students

Middlesex’s Prof Helen Allan collaborates on ground-breaking study revealing importance of delegation training for nurses

A new study carried out by researcher Helen Allan, Professor of Nursing at Middlesex, and colleagues at the University of Surrey, University of Salford and UCL Institute of Education sheds light on the practice of delegation in NHS nursing roles.

The research – which followed newly qualified nurses in four hospital trusts across England over a three year period – found increased educational and organisational support is needed to develop nurses’ delegation skills.

The team identified five styles of delegator among the nurses they followed. These ranged from the ‘do-it-all’ nurse who felt unable to delegate anything, to the ‘inspector’ who delegates but constantly checks the work of others for fear of being held accountable for mistakes.

Professor Allan’s work highlights an immediate concern as the most recent Nursing and Midwifery Council Code of Conduct states registered nurses should be accountable for their decisions to delegate tasks.

“Our research focuses on a little understood area of nursing – the delegation of key nursing tasks to untrained and unregistered care staff,” she says.

“Delegation falls into the category of essential nursing task which has for many years gone unacknowledged and unvalued.

“It is important because patients’ safety rests on effective delegation between nurses and care assistants. In fact, delegation is important across the whole health care team.”

The research findings will feed directly into Middlesex’s undergraduate nursing and midwifery courses to ensure students graduate with the necessary skills to delegate effectively.

“It’s important to act according to your Code of Conduct, which for the first time specifically stipulates that effective delegation is a key role for registered nurses,” explains Helen.

“Always feel confident that you know how to do what’s expected of you – and that anybody you ask to do something is competent too.”

Read the full study on delegation styles among newly qualified nurses here.

(content from Middlesex University web team http://www.mdx.ac.uk/news/2017/02/new-research-highlights-delegation-as-key-skill-for-nursing-students)

Professor Helen Allan to give seminar on infertility, at the Royal College of GPs

Professor Helen Allan has been invited to give a seminar at the Royal College of
General Practitioners on the topic of ‘Infertility’ at an RCGP Learning, One
Day Essential CPD for Primary Care Event on Men’s Health.

This is an important step forward for Professor Allan who hopes to recruit
GPs to work with her on a funded research project about early parenting in
infertile couples and the role of primary care professionals in identifying
the needs of parents following IVF.

For further information please contact Professor Allan: h.allan@mdx.ac.uk 

Professor Helen Allan of CCRNM and colleagues win grant to investigate fertility treatments

Congratulations to Professor Helen Allan of the Centre for Critical Research in Nursing and Midwifery Education and colleagues who will investigate early parenthood experiences of infertile couples after successful fertility treatment as part of winning a development grant award.

The research group, which includes Professor of Health Psychology Olga van den Akker and Professor of Nursing Helen Allan, won the Society for Reproductive and Infant Psychology (SRIP) grant award to run a workshop to develop a collaborative team for investigating the implications on IVF/ICSI conception and delivery of a baby for couples’ lives in early parenthood.

Full story here:

http://www.mdx.ac.uk/news/2016/05/researchers-win-grant-to-investigate-fertility-treatments