Enhancing student
learning through
Service User
Involvement
Simon Horton, Kathleen Lane, Becky Baker
University of East Anglia
Centre for the Advancement of Interprofessional Education
CAIPE Chair’s Event
Friday, 7th November 2014
Introduction
• Service Users and the public
• the health-care professions and regulatory bodies
• government policy aiming to create a more “patient-led”
NHS
• Involvement in the education of health and social care
professionals
• Service Users and carers provide invaluable insights
• educating current and future professionals to be responsive
to the needs of those they serve
Enhancing student learning
through Service User involvement
|| CAIPE Chair's Event
• The drive for Service User involvement has come from
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Service User involvement at
UEA
• Involvement of Service Users in the design, delivery,
assessment and evaluation of health care education
• There is evidence of involvement and good practice at
UEA …but
• Evidence for impact on the quality of student experience
and performance is limited and inconsistent
• Our paper adds to the context of what is happening in
our institution and in institutions elsewhere
Enhancing student learning
through Service User involvement
|| CAIPE Chair's Event
• required for accreditation of health and social care
programmes (HCPC; NMC etc.)
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Aims and Methods
• School of Rehabilitation Sciences
• School of Nursing Sciences
• Norwich Medical School
• Methods: focus groups with students (N=15) and staff (N=8)
from the three FMH Schools and with Service Users (N=6) with
experience on teaching programmes in the Faculty
Enhancing student learning
through Service User involvement
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• Teaching Fellowship awarded 2012-2013 to investigate
the impact of Service User Involvement on preregistration student learning in the Faculty:
• Analysis: themes were drawn from the data
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Main Findings
• UNDERSTANDINGS OF THE TERM, “Service User”
• PREPARATION FOR PRACTICE
• CHALLENGES IN SERVICE USER INVOLVEMENT
• SUGGESTIONS FOR CHANGE
Enhancing student learning
through Service User involvement
|| CAIPE Chair's Event
• IMPACT OF SERVICE USER INVOLVEMENT
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“Service User”
• different definitions
We’re still referring to them as patients… (Student)
We refer to people as Service Users because they’re not
necessarily ill but they’re accessing treatment (Student)
• student sensitivity to the vocabulary they employed
If you talk to people you can generally get a feel of
whether they want to be referred to as a patient or [a
Service User] (Student)
Enhancing student learning
through Service User involvement
|| CAIPE Chair's Event
• understandings of the term varied among student groups
I’d actually never heard of “the Service User” before
today. (Student)
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Making learning effective
Exposure to the lived experience
Diminishing stigmas and stereotypes
Developing empathy
Inspiring and motivating students
Contributing to development of
professional identity
Enhancing student learning
through Service User involvement
|| CAIPE Chair's Event
IMPACT of SERVICE USER
INVOLVEMENT
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Making learning effective
[Service Users’ stories] always stimulate more interest and
more engagement… it’s what makes learning memorable.
If you teach somebody right from the start, at grass-roots
level, then hopefully they will grab it and take it in and
digest it for life.
(Service User)
It’s not enhancing learning; I think that it is integral to
learning.
(Student)
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through Service User involvement
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(Student)
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Making learning effective,
cont’d
I’m a practical learner, a visual learner, [didn’t] learn from
books very well.
I feel that [students] meeting people who represent the
people they’ll be helping later in life illustrates that
textbook.
(Service User)
It’s more effective to talk to people and find out things in
your own way and in your own learning style.
(Student)
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through Service User involvement
|| CAIPE Chair's Event
(Student)
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Exposure to the lived experience
It makes it more real when you’ve actually got a live
patient in front of you.
When Service Users come in and talk about their life, you
get a bigger understanding that it is wider… it affects their
family, their home life.
(Student)
Service Users provide students with powerful, authentic
experiences.
Enhancing student learning
through Service User involvement
|| CAIPE Chair's Event
(Student)
(Staff)
[Students realise] we are real people, not just a case.
(Service User)
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Diminishing stigmas and
stereotypes
(Student)
Then you meet the person and they’re not as bad as you
think; …they’re people.
(Student)
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through Service User involvement
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It brought home to me that anyone could get breast cancer
and I think I’d always thought it was a lifestyle thing.
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Developing empathy
[You] get an insight of what a patient would be feeling in
that position through talking to someone who has been
through it.
You can learn all the EBL [Enquiry-Based Learning] you
like… but you don’t understand about how people feel.
(Student)
The stories of coping and living with illness and disability…
make a shift in the way that students view the theory that
we teach. It helps them put themselves into another’s
shoes.
(Staff)
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(Student)
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Inspiring and motivating
students
[Interacting with Service Users] helped reaffirm my love for
nursing.
A Service User’s testimony was inspirational; it helps you
understand the person… rather than the straightforward
facts.
(Student)
Students actually want to hear what Service Users have got
to say and Service Users sense that it reinforces the
students’ commitment.
(Staff)
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(Student)
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Developing professional identity
It’s very empowering for us to understand what our roles
are from Service Users.
[I gained] a very good insight into what is expected from us
as nurses.
(Student)
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(Student)
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Enhancing student learning
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PREPARATION for PRACTICE
Safe environment
Practising with Service Users
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Safe environment
You know you are not going to do any harm because the
Service User has been brought there for you to learn.
You’d make more serious mistakes if you weren’t allowed
to make the silly mistakes.
(Student)
It’s about giving people permission… to ask questions.
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(Student)
(Service User)
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Practising with Service Users
It improves your skill as a therapist… you need to know
how to hold a conversation with a real person.
It makes us just more confident in everything, confident to
give it a go.
(Student)
It’s really challenging to have to think on the spot.
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(Student)
(Student)
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Practising with SUs, cont’d
(Student)
Service User involvement is a good way of finding out what
it [the NHS] really is like at this moment because it’s very
different from a year or two years ago.
(Staff)
Enhancing student learning
through Service User involvement
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If you don’t start in uni by listening and asking patients
how you’re doing, what can we improve, how can we make
things better, then it’s going to be a massive shock when
you start working.
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CHALLENGES in SERVICE USER
INVOLVEMENT
It’s about keeping an open mind [that each patient’s
experience is individual].
…just because the person has a label, they don’t respond in
the same way [as someone else].
(Service User)
Sometimes a Service User might be pushed to be involved
or do things out of being nice.
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(Student)
(Student)
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CHALLENGES, cont’d
Supporting and preparing Service Users must include
finding out what Service Users want to get out of whatever
they’re doing.
After a learning session, it can be quite traumatic to go
away unsupported. Even a phone call a few days later. It’s
just about how you look at supporting Service Users.
(Service User)
Both Service Users and students have a role to play in
preparing for the learning that takes place.
(Student)
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(Staff)
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SUGGESTIONS for CHANGE
If we can be treated not as a case study… but as an
individual.
Small groups go down very well for the students to learn
about real people and you can throw ideas around, discuss it.
(Service User)
Bring five examples [of people who have experienced a
brain injury] and let us see different perspectives.
(Student)
We need feedback about how to make intimate
examinations as acceptable as possible to a patient.
(Student)
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(Service User)
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REFLECTIONS
Service User involvement is like gold dust. We don’t get
enough of it… [and there should be] more involvement.
It’s not about just wheeling in our Service Users… but giving
their involvement equal weight to other providers of
education.
(Staff)
Being able to co-develop, co-produce and co-deliver learning
is definitely the way forward.
(Service User)
We need to give time and priority to these experiences,
because unless we do, the students won’t.
(Staff)
Enhancing student learning
through Service User involvement
|| CAIPE Chair's Event
(Student)
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DISCUSSION
Cultural and attitudinal changes needed to
further embed Service User involvement across
the curriculum
Service Users as the “centre of the curriculum”
or equal partners in an Interprofessional team?
Enhancing student learning
through Service User involvement
|| CAIPE Chair's Event
Reflective practice is essential in maximising
the impact of Service User involvement on
student learning
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ACKNOWLEDGEMENTS
We acknowledge the input of our colleagues Susanne
Lindqvist, Laura Bowater and Steve Wilkinson.
Thank you for attending our session.
We welcome your thoughts, questions and discussion.
Enhancing student learning
through Service User involvement
|| CAIPE Chair's Event
This study was supported by a UEA-funded Teaching
Fellowship.
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