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									Service User Involvement:
Assessing the interpersonal skills
of Pre-Registration Mental Health
Nurses
        Sue Linsley & Jon Perry
     Faculty of Health & Social Work
         University of Plymouth
What we did
   This was an evaluative study
    focusing on an interpersonal skill’s
    module taught to second year
    mental health students
The novel features of this
module
   The involvement of service
    users in assessment
   The use of video taped
    interviews of standardised
    patients
The involvement of service users
   Mental health service users provide a unique
    perspective on mental health difficulty
   There is an increasing awareness of the need
    to validate and use this expertise
   There is much policy guidance and advice on
    the teaching of inter-personal skills and user
    involvement in teaching and assessment
    (Workforce action team 2001, DoH 2002,
    UKCC 1999, SCMH 2001).
Service user feedback

 Feedback from patients has been
 shown to make a statistically
 demonstrable difference in
 personal skills in GP training,
 (Greco et al 2001).
Assessment
   Took the form of a ‘collaborative conversation’
    with a standardised patient.

   The conversation was of 20 minutes duration
    and was video-taped .

   The standardised patients completed feedback
    forms immediately after their role play, before
    they were ‘debriefed’.
(All standardised patients had received prior training &
   were given a scenario on which to base the character
   role played)
Assessment
   Practitioners had a range of clinical
    experience and the service users had all
    experienced severe mental health problems.
   All the ‘users’ had received prior training &
    were familiar with the marking documentation
    before the assessment panel was convened
Assessment

   Detailed feedback incorporating all the
    comments from the panel and the final
    % mark was then given to the students.
   The assessment process was then
    evaluated using the nominal group
    technique
Study Methodology

 This study used nominal group
 technique to examine the student
 experience of the module and
 assessment of inter-personal skills.
Nominal Group Technique:

    This is a consensus method, which aims to
     determine the extent to which a group agrees
     about an issue/variety of issues.
    It overcomes the disadvantages of group
     domination by one individual or coalitions
     representing vested interests within the group
Results

     NGT results and questionnaire
            development
Good items: Role Play
   Good to use a stranger (to do the role play).
   Pressure (of assessment) was good, job is
    pressurizing.
   Exam important should not be changed good
    that it was practical.
Change items: Role Play
   Collaborative conversation not consistent with
    packing in three interventions (assessment requires
    demonstration of too many interventions).
   Situation was fake, felt uncomfortable due to people
    behind screen.
   Tutors should not role play assessment.
   Less emphasis on intervention, longer assessment.
   Nerves affected a true performance.
Good items: Course content
   Exercises were good enabled us to
    understand what the patient may be feeling
   Given me confidence and more self
    awareness as to how I am as a person
   Good to practice with videos
   Felt it was preparing me for job
   Toolkit very useful
   Whole module was fun enjoyable and I loved
    it
Change items: Course content
•   Learning models and starting to get our
    heads round them and then it moved on,
    better in blocks
Good items: User involvement
   Feedback from service users, actors etc. very
    helpful
Change Items: User involvement
   User involvement the marking scheme
    influences marking (negatively)
THE END
           Median rank and voter numbers and teaching style: Good catagories


         Group self disclosure brought group closer together.
                                                                              4


        This way of teaching beats normal / previous by miles
                                                                              2


Group learning enabled self discovery and increased bonding
                                                                              2


       Supportive and sensitive lecturers gave a chance for
      personal explanation, "like a personal therapy session"
                                                                                  2


All made to feel that we would achieve module and outcomes
                         successfully
                                                                                  2


Theory – practice links helpful. Better when more experienced
                      during placement.
                                                                                  2


                                                                0   0.5   1           1.5   2   2.5   3   3.5   4   4.5   5
                                                                                            Median Rank
           Median ranking and voter numbers course content: Good catagories


  Learning different models of
      interventions (good)
                                                 3


 Exercises were good enabled
   us to understand what the
     patient may be feeling                      3


Given me confidence and more
self awareness as to how I am
         as a person                                 3



Felt it was preparing me for job
                                                 3



             Toolkit very useful
                                                     3



        Whole module was fun
        enjoyable and I loved it
                                             2


             Median Rank           0   0.5   1           1.5   2   2.5   3   3.5   4   4.5   5
                                Median ranking and voter numbers for role play catagories: Change

                   Use assessment environment for mock exam with feedback from tutor.
                                                                                                                    4


  Fear plays too bigger part – Assess several assessments, not just one, more continual
                                       assessment.                                                                  4


                                       Less information regarding the client might be useful                        3


     (Using) different actors is unfair (as it is) inconsistent, (explore) ways of getting more
                                              consistent.                                                           3


                                                    Tutors should not role play assessment.
                                                                                                                    3


                                               I would like to observe more mock interviews
                                                                                                                    2


Collaborative conversation not consistent with packing in three interventions (assessment
                   requires demonstration of too many interventions).                                                   2


                       Situation was fake, felt uncomfortable due to people behind screen.
                                                                                                                    2


                                       Less emphasis on intervention, longer assessment.
                                                                                                                        2


                                                        Nerves affected a true performance.
                                                                                                                    2


                                     Different environment without mirror (would be better).
                                                                                                                    2


                More practice / demonstration (of inter-personals skills and interventions).
                                                                                                            2

                                                                           Median Rank
                                                                                                  0   0.5       1       1.5   2   2.5   3   3.5   4   4.5   5
                    Median rank and voter numbers for marking catagories: change

               5

              4.5

               4

              3.5
Median Rank




               3                  4

              2.5

               2

              1.5                                               3

               1

              0.5                                                                              2

               0
                        Quicker turn around of     Good to practice with videos   More emphasis on reflection
                    provisional mark and group de-                                        needed.
                                briefing.
                    Median rank and voter numbers for role play catagories: good

    Able to analyse self using
   video and improve on areas
                                                4



Good to see self as others see.
                                                4


 Good to use a stranger (to do
        the role play).                         4


 Pressure (of assessment) was
   good, job is pressurizing.
                                                3



  Good to practice with videos
                                                3


   To be videoed is a valuable
         learning lesson                        2


Look at them again to compare,
 later in the course (to check
       skills acquisition).                     2


   Assessment enabled you to
   see how you had changed /
   progressed since first year.                 2

                Median Rank       0   0.5   1       1.5   2      2.5     3         3.5   4   4.5

								
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