Transcript Slide 1

Training students to obtain informed consent
from patients with a communication disability
Evaluation of an interprofessional education
programme
Celia Woolf
Institute of Health Sciences Education
Research Afternoon
QMUL
9th June 2010
Informed consent and
communication disability
Health professionals must involve patients / clients in
decision making
(e.g. DoH 2001, 2004)
Obtaining informed consent from people with
communication disabilities (PWCD) can be challenging
Background
Health professionals often don’t involve PWCD
properly in decision making
(Byng et al, 2003; Law et al, 2005)
• lack of knowledge
– communication strategies
– professional responsibilities
• negative attitudes and
assumptions (Fox & Pring, 2005)
Background
• Communication disability is common
– estimated 20% of population at some
stage in life
(Law et al, 2007)
• Importance of interprofessional
collaboration
SLT role to assist other health professionals to
communicate with patients (DoH, 2001; DoH, 2004)
Background
Exposure may not improve ability to communicate with
people who have communication disability
Training improves communication facilitation skills
(Kagan et al, 2001)
Study Design
• 3 interprofessional groups of final year students
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Speech & Language Therapy
Nursing (Adult, Child, Mental Health)
Medicine
Radiography
Midwifery
(n = 26)
• Two training sessions for each group (2 x 2 hours)
• Led by a facilitator and co-trainers with
communication disabilities
Evaluation
• Pre- and post-training questionnaires
– knowledge
– confidence
• Focus groups
– Students
– Co-trainers
• Written feedback from students
• Observation of training sessions
Training content
• Session 1
– Patient experiences
– Ethico-legal context
– Communication disability
– Communication strategies
– Allocation of informed consent scenarios
Training content
• Session 2
– Informed consent simulations
• Orthopaedic surgery
• Change of drug treatment for epilepsy
• Barium swallow
– Feedback & discussion
Evaluation results
Questionnaire Results
• Explored changes in confidence and knowledge
about informed consent and communication
disability
• 5 point response scale
Strongly disagree -------------strongly agree
• Administered pre and post training
Questionnaire Results
• Compared pre- and post-training responses
Repeated Measures ANOVA
• Highly significant increases in confidence and
knowledge
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Student Confidence
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Focus group results
Focus group recordings transcribed verbatim
Thematic analysis using Framework approach
Overwhelmingly positive experience
– Students particularly valued
• meeting and working with co-trainers
• simulation and hands on approach
• mix of theory and practice
Examples of written feedback
Thank you! I hope
this course is offered to
as many healthcare
practitioners / students
as possible.
(Medicine)
Excellent overall. Really
enjoyable and a great
learning experience.
Feeling considerably more
confident! Many thanks!
(Adult Nursing)
The training sessions have given me
an insight on how to communicate
with people with communication
difficulties and the importance of
simplifying medical terminology.
(Diagnostic Radiography)
Examples of written feedback
[I enjoyed] the chance to
work in an interprofessional
context and discuss issues
which might come up in
future practice. Great chance
for practical involvement.
Admirable co-trainers
whose participation in
the programme was
paramount.
Exceptionally wonderful
and open people. (SLT)
(SLT)
This was a very positive and constructive
experience that proved to be completely
relevant to my practice and personal
development and I enjoyed meeting people
that face difficulties when interacting and
communicating with health care professionals.
(Adult Nursing)
Conclusions
 knowledge about informed consent
 knowledge of communication strategies
confidence about obtaining informed consent
attitudes towards people with communication
disabilities
Acknowledgements
• CETL for project funding
• Project Team: Celia Woolf, Tom Penman, Mary Rogers
• Co-trainers: Carole, Catriona, Kim, Collette
• CONNECT the Communication Disability Network
• Westminster Learning Disability Partnership
• Student participants
• Statistical advice: Fiona Warburton, City University