GIN Programme Evaluation Report Wave 1 Prepared by: Libby Thomson Project Lead Nurse, National GIN Project January 2009 1
This report is an evaluation of the progress of the GIN programme. The programme consists of 3 training days: GIN for Facilitators Train the Nurse Trainers (TNT) course GIN course This Evaluation Report is based on the uptake figures taken from the GIN Website and from the Evaluation Forms that each delegate is requested to fill out after each course. Background Each acute endoscopy unit in England has been invited to participate in the programme which is being rolled out over 3 waves: Wave 1: September to November 2008 Wave 2: December to February 2009 Wave 3: March to May 2009 Aims The GI endoscopy for Nurses (GIN) programme was developed to improve access to training relevant to nurses and support workers in endoscopy in England. Its aim is to update the workforce on service developments in endoscopy and provide sustainability by equipping the workforce with the personnel and tools to ensure an ongoing structured approach to training, assessment and appraisal. Method Each endoscopy unit is asked to identify a Local Facilitator to be responsible for supporting the training and development of the local team and for providing evidence to support the development of the unit as part of the quality assurance process. The Local Facilitator is invited to participate in all 3 training days. Day 1 GIN for Facilitators course: Provides an overview of their role and developments affecting the endoscopy service. Introduces the facilitators to the on-line tools which will be used for individual and team training and development. Day 2 Train the Nurse Trainers (TNT): Provides a dynamic way of learning through individual and group participation. This course assists the Local Facilitators to identify ways in which they can influence change as individuals or as part of a team. It equips them with the skills to teach in a variety of settings with maximum benefit for both the trainer and the trainee. Each session is linked directly to day to day practice in endoscopy which makes learning practical and relevant. 2
Day 3 GIN Course: This course provides an opportunity for team training. Each unit is invited to send 5 endoscopy staff (including the Local Facilitator). The programme is similar to the GIN for Facilitators course, however the Local Facilitator leads their local group on table top discussions relating to training and assessment. This gives the Local Facilitators an opportunity to use the skills acquired on the TNT course and makes the training relevant to the local team. This course provides a useful networking environment as those invited are from the same geographical location. Marketing Each endoscopy unit was sent a written invitation to participate in the programme, with a follow up email. Information was sent to the Trust Head of Nursing, Endoscopy Clinical Lead and Endoscopy Manager. Each unit was sent an A3 poster advertising the programme. Each unit was contacted by telephone or by email by the Programme Manager who gave support during the booking process. GIN website The GIN website is proving to be a successful hub for the GIN programme. 627 individuals registered on the site in Wave 1 and a further 342 have registered as of 22 nd January, 2009. This has given us a database of unit profiles, email addresses and other useful contact details which will be an invaluable asset for monitoring the programme in the future. Course scheduling, bookings and evaluations are done on the GIN website. A Resource section and Notice board have been added to the site. These provide up to date information about the programme and the endoscopy service to those individuals registered. On-line tools On-line tools have been developed as an integral part of the GIN programme. Their aim is to support individuals and teams to achieve long term changes that will benefit the workforce, the service provided and the patients. These include: Responsibility & Delivery Matrix and Communication Plan Supports the Local Facilitator to carry out their roles and responsibilities effectively e-portfolio Interactive tool based on the Endoscopy Competence Framework. Provides the endoscopy team with an ongoing structured approach to training, assessment and appraisal. Can be used to provide a Passport of Knowledge and Skills for all staff working in the service. Tutorials via conference calling Web based booking system for conference call tutorials. Provides ongoing support to Local Facilitators and staff who have attended the GIN Programme. GIN Project Team The GIN Programme benefits from a GIN Project Lead, GIN Programme Manager and Event Organiser. 3
TABLE OF CONTENTS Page number SECTION 1 COURSE OVERVIEW. 5 Course breakdown by type 5 Course breakdown by region 5 SECTION 2 ATTENDEE REVIEW.. 6 Number of attendees. 6 Workforce breakdown 6 SECTION 3 QUALITY CONTROL. 7 Quality of Training Event.. 7 Quality of Trainers. 10 SECTION 4 COURSE OBJECTIVES / LEARNING OUTCOMES Core Knowledge 11 SECTION 5 IMPACT 15 Responsibility and Delivery Matrix. 15 e-portfolio.. 15 Global Rating Scale scores (GRS). 15 SECTION 6 FUTURE.. 16 Independent Sector.. 16 Community Sector 16 Wider UK interest... 17 SECTION 7 SUSTAINABILITY. 17 CONCLUSION. 17 4
SECTION 1 - COURSE OVERVIEW 74 acute endoscopy units in England were invited to participate in Wave 1. 9 units requested to be moved to an alternative wave leaving 65 units to participating. (A) Course breakdown by type There were 22 courses held in Wave 1 between September and December, 2008. One pilot TNT course was held in August. These were divided as set out in the chart below. (B) Course Breakdown by region Number of courses run by SHA GIN 1 TNT GIN 1 2 G.F TNT GIN 1 1 1 GIN 1 GIN 1 TNT GIN 1 1 TNT GIN 2 2 G.F GIN 1 2 GIN 1 GIN 1 G.F: GIN for Facilitators TNT: Train the Nurse Trainer GIN: GIN Course 5
SECTION 2 ATTENDEE REVIEW (A) Number of attendees The courses have been very well attended. We appointed a GIN Programme Manager in September 2008. The programme manager is responsible for managing the booking process including monitoring uptake to ensure we achieve the maximum attendance possible and for inputting the evaluation forms on-line. (B) Attendees per course (B) Workforce breakdown The courses are made up of a cross section of nursing and support staff from endoscopy units around the country. Faculty previously not involved in national training, observed a course as part of their development. 6
SECTION 3 QUALITY CONTROL (A) Quality of Training Events The feedback from the courses so far is very encouraging. All delegates seem appreciative of the opportunity to attend these courses. As well as the knowledge they gain from the courses, the courses also provide a good opportunity for networking. As a result of feedback to date, we have altered the programme to include more diverse teaching styles and have increased the time spent on the e-portfolio. We have also started tutorials via conference calling, covering the online tools which can be booked directly on the GIN website. Extracts from the GIN for Facilitators and GIN Course evaluation forms: I have learnt a lot, especially in how to achieve my goals/ competencies as an endoscopy nurse By far the most useful and interesting course I have done. I feel that this information will help me to develop and give me access to information/resources I never knew existed. Excellent course, up to date, well supported by speakers/trainers who know what they are talking about to a very high level. A structured, competence based approach to endoscopy training is long overdue. I feel that this framework, once implemented will support the provision of a local endoscopy training programme. The enthusiasm of the team was infectious and made the day enjoyable and informative. The networking opportunity is invaluable Thank you for the clear, concise day. Excellent initiatives which serve to value the nurse s contribution especially the Passport. 7
a) GIN Courses Overall rating for Content b) GIN Courses Overall rating for Course Materials c) GIN Courses Overall rating for Administration 8
Extracts from the TNT evaluation forms: Focused on the role of GIN facilitator and has made me feel more prepared for this role. Feel more empowered these strategies will help me to use limited resources to maximise training Excellent delivery, suitably tailored and relevant. This course will help the whole endoscopy team develop, improve skills and patient care. It is easy to feel negative, today made me feel that I can make a difference. Delegates were asked to score each session on a scale of 1 to 6 (6 Highest). Each session on the TNT course evaluated very well with over 90% of delegates scoring 5 or 6, a) See chart below 9
(B) Quality of Trainers GIN Trainers: Each SHA has a team of trainers led by a Lead Nurse. All GIN Trainers attended a GIN Faculty Training day. All trainers were invited to observe a TNT course. An experienced GIN Trainer was available to support the local trainers on all GIN locality courses in Wave 1. As a result of feedback from the trainers in Wave 1, a faculty handbook and CD rom has been developed to support the GIN trainers and was distributed in preparation for Wave 2. TNT Trainers: Each TNT course is led by a Training Lead and a Nursing Lead (as a minimum). All trainers were involved in the development of the course and observed a course prior to delivery. A comprehensive TNT Faculty book was distributed prior to the roll out in Wave 1. This has been updated for Wave 2. a) GIN Course Overall rating for Trainers b) GIN Course Overall Rating for delivery 10
SECTION 4 COURSE OBJECTIVES/LEARNING OUTCOMES CORE KNOWLEDGE GIN Courses: In order to evaluate the impact of the training, delegates were asked to score their knowledge on the topics before and after the training event. The objectives are split into 10 key areas. Each area demonstrates a beneficial shift in knowledge. 1) Understanding of the 4 domains within the GRS and how they relate to care provided within practice settings 2) Understanding of the role of the GRS and the JAG in accreditation of endoscopy units 11
6) Understanding and applying the current decontamination guidelines and standards to local practice to promote staff and patient safety 7) Understanding of the consent process and how to implement a nurse-led consent service 8) Understanding of the structure of the endoscopy competence framework 13
9) Understanding how to present valid evidence to demonstrate competence for different nursing roles 10) Understanding and applying the e-portfolio to training, assessment and appraisal 14
SECTION 5 IMPACT OF THE PROGRAMME The website has been developed to monitor the uptake of the on-line tools by individuals, teams and SHA s. This information, together with the unit s Workforce Domain GRS scores will provide us with the information needed to assess the benefit of the programme. We aim to measure the impact the programme will have on individuals attending the course, the wider team and the service including quality of patient care. For this purpose we will use 3 methods of evaluation: Completion of the tasks on the Responsibility and Delivery Matrix - this measures individual outcomes but completion of the matrix will have a wider effect on the team Number of staff who have accessed the e-portfolio per unit - this measures the individual, team and service outcomes. Utilising the e-portfolio brings structure to training and assessment which will benefit individual performance, enhance team working and improve quality of care. Global Rating Scale scores (GRS) this measures the service outcomes. We have linked the tasks in the Responsibility Matrix to the Workforce domain in the GRS. The Workforce GRS scores are available on the GIN website. Each Unit s scores will be monitored after each census. (It is not possible to measure this at this stage in the programme) Post course evaluations have been designed to measure the short term impact the course has had on individuals and teams. All delegates will be sent a link to complete an on-line evaluation which will be linked to the GIN website. a) The uptake of the on-line tools was slow to begin, however the tutorials have provided the necessary support to improve these figures. 15
b) Uptake Figures per SHA London, West Midlands and Yorkshire & Humber SHAs have the highest uptake to courses and of the on-lines tools. Support needs to be directed to other SHA s to engage the Local Facilitators and improve uptake. SECTION 6 FUTURE The GIN Programme has been centrally funded by the National Endoscopy Team for 12 months. The project has been very successful, however costs have been greater then expected. In order to complete the roll out plan, we have had to source alternative funding for Wave 3. Independent Sector The Independent Sector have expressed interest in the GIN programme and have therefore been invited to participate in Wave 3. To meet the additional demand, the faculty have agreed to delivery additional courses for the Independent Sector. GIN for Facilitators x 1 TNT x 3 GIN Course x 2/3 Our aim will be to integrate the Independent Sector into the planned roll out in Year 2. 16
Community sector The Community Sector will be invited to participate in the GIN Programme in Year 2. Wider UK interest Scotland, Northern Ireland and Wales have all expressed interest in the programme. A proposal to roll out the programme in Scotland is currently under review by NHS Education for Scotland. Similar proposals will be sent to Northern Ireland and Wales in due course. SECTION 7 - SUSTAINABILITY The programme roll out has been a success; however this is largely due to the ongoing input by the GIN Project Team. In order to reach a sustainable position, work will now focus on ways to devolve the administration of courses to the SHAs including the post course support and evaluation. The GIN programme will sit within the JAG where central support will be provided on course content, delivery and website developments. CONCLUSION Wave 1 has been extremely successful with maximum uptake to all courses. This is being followed by an equally successful Wave 2. The feedback from the courses has been excellent and we will continue to monitor completion of on-line tools and the GRS following the next census. 17
gingastrointestinal endoscopy for nurses