Medical Students working as Healthcare Assistants A collaborative project between CIPP & local Health Partners

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1 Medical Students working as Healthcare Assistants A collaborative project between CIPP & local Health Partners Susanne Lindqvist, Professor of Interprofessional Practice & Director of Centre for Interprofessional Practice

2 Background The NHS strives to employ staff with the necessary values required to care for patients and work collaboratively with colleagues to provide integrated care. NHS values: 1. show respect and dignity 2. show commitment and quality of care 3. show compassion 4. improve lives 5. work together for patients 6. everyone counts

3 Response An intervention was developed whereby medical students have the opportunity to learn about fundamental care needs and the role of the Healthcare Assistant (HCA) The HCA is a key staff member who each day needs to apply the desirable NHS values and behaviours as they provide care to patients

4 Pilot (n=31) 31 first-year medical students completed an HCA induction and three supervised shifts across three hospital trusts: 1. Norfolk and Norwich University Hospital (NNUH) Norwich, Norfolk 2. James Paget University Hospital (JPUH) Great Yarmouth, Norfolk 3. Queen Elizabeth Hospital (QEH) Kings Lynn, Norfolk

Content Training First two weeks of their Module 1 secondary care placement. Some training formed part of their normal Module 1 and some was specific to their role as HCA.

5 Content Training First two weeks of their Module 1 secondary care placement. Some training formed part of their normal Module 1 and some was specific to their role as HCA. Extra staff were recruited to provide the necessary HCA training (e.g. manual handling, washing, feeding, safe guarding). Blended learning: face-to-face, online, workbook. Shifts Three six-hour HCA shifts in the company of a mentor during the week 14 th - 18 th December. First shift started 9am; second was late (finishing ~ 8pm or 10pm) and third early (starting ~ 7am).

6 Learning Outcomes 1. demonstrate knowledge and skills associated with care delivered by an HCA and thus gain an understanding of the contribution of an HCA to the care pathway. 2. describe how hospital wards work and how different staff members contribute to the care delivery of each patient. 3. appreciate the stresses of shift work patterns. 4. identify common challenges associated with the role and responsibilities of an HCA. 5. describe interprofessional and professional-patient interactions and communications as an HCA within a real clinical environment. 6. describe some differences and similarities between own future profession and that of an HCA, in providing high quality and safe care. 7. appraise what knowledge, skills, attitudes, values and behaviours a doctor needs in order to enhance the contribution of all members of healthcare staff.

7 Evaluation of Learning Outcomes

8 Students feeding forward It will help future doctors appreciate and understand the other members of their team more which will in turn mean closer relationships, which will only help improve the patients care. It also allows students to become HCAs during which they can improve their consultation and people skills allowing them to become even more well-rounded. It s an absolutely fantastic experience. Whilst it was hard work, I got so much out of it and have heard from so many people on the ward (esp. the nurses) that doctors who have trained as HCAs deliver yet another level of care for their patients. I loved being able to meet the patient s individual needs and have grown so much with the experience and the challenges.

9 Mentors (supervising shifts) feeding forward Hands on and enthusiastic Excellent attitude & willingness to learn Showed empathy Helpful Competent Needs to be done sooner than later Very shy when interacting with patients and staff Awkward and/or embarrassed when providing care Lack of understanding of what was expected

10 Educators feeding forward The project worked well and much better than they had anticipated We can do this again, but not with more students Students improved in their second week Support and preparation was good It will make a difference to future doctors First week was rushed Project may be better delivered during the summer There was duplication of some teaching

11 Key points from pilot The overall feedback from students taking part in the pilot (87% response rate), educators involved in the training, and mentors supporting students during the actual shifts was that: this is a great learning experience this should be offered to all medical students the training needs to be more hands-on, more interactive, less repetitive shifts are invaluable, but need to take place during term time and best if students can be mentored one-to-one

12 Extended Pilot (n=60) 35 first-year medical students and 25 Foundation Year students completed an HCA induction and two or three supervised shifts across three hospital trusts, two nursing homes and three community trusts: 1. Norfolk and Norwich University Hospital (NNUH), Norwich 2. James Paget University Hospital (JPUH) Great Yarmouth 3. Queen Elizabeth Hospital (QEH) Kings Lynn 4. Holmwood House, Swaffham 5. Meadow House, Swaffham 6. Norfolk and Suffolk NHS Foundation Trust, Norwich 7. Norfolk Community Health and Care NHS Trust, Norwich 8. East Coast Community Care, Beccles

13 HCA shift allocation for Foundation students and first-year medical students

14 Overall Learning experience 100% 90% 80% Overall Score of Learning Experience Year 1 1=Very poor; 2=Poor; 3=OK; 4=Good; 5=Excellent % 60% 50% 40% 30% [VALUE] 45% % 10% 0% % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Overall Score of Learning Experience Year 1 1=Very poor; 2=Poor; 3=OK; 4=Good; 5=Excellent % 47% % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Overall Score of Learning Experience Foundation Year 1=Very poor; 2=Poor; 3=OK; 4=Good; 5=Excellent 0 0 5% 52% 43%

Student likes The hands-on approach where I was not just watching, but actually taking part and doing everything. This made me appreciate the role of an HCA.

15 Student likes The hands-on approach where I was not just watching, but actually taking part and doing everything. This made me appreciate the role of an HCA. Due to this experience, I am currently applying to be an HCA over the summer holidays. Working with very friendly and inspirational healthcare professionals, seeing patients with a variety of conditions, hearing their journey and being able to help even in a small way. Getting to see how life on a ward is throughout the whole day. Having responsibility on the wards. I felt like I was making a difference to the patients and providing care which was helping them. I enjoyed being placed on the same ward for the whole of the placement as this meant I built relationships with staff and patients on the ward

17 Student dislikes Some felt they weren t expected at the shifts. A few felt left out and/ or in the way. A few struggled to wake up at 5 am in the morning to get ready for a 7 am shift. Washing patients and dealing with intimate situations. The long [12-hour] shift Having to stay on when everyone else got to go home

18 Way Forward We had meeting with Trust Partners in July to discuss: o Training o Shifts o Timing o Cost o Numbers for o Sustainability We agreed to: o Continue expanding the project o Number of students involved ~90 o Cost included in tariff for year one and invoice for Foundation Year o Timing & shifts are kept the same as last year o Continue to share training models to make it more hands-on

19 Thank you for listening Any questions? Thank you to all Practice Partners - making this project possible Susanne Lindqvist, Professor of Interprofessional Practice & Director of Centre for Interprofessional Practice s.lindqvist@uea.ac.uk

20 References NHS values. Francis R (2013). Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationery Office. Frenk, J., Chen, L. Bhutta, Z., Cohen, J., Crisp, N., Evans, T., Fineberg, H., Garcia, P., Ke, Y., Kelley, P., Kistnasamy, B., Meleis, A., Naylor, A., Pablos-Mendez, A., Reddy, S., Scrimshaw, S., Sepulveda, J., Serwadda, D. and Zurayk, H. (2010). Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. [Online] Science Direct 376. p Available from [Accessed: 23rd January 2017] National Institute for Health and Care Excellence (2012). Patient experience in adults NHS services: improving the experience of care for people using adult NHS services. NICE Guidelines CG138. Available from [Accessed: 23rd January 2017]

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