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Developing training for clinical staff

Developing training for clinical staff to improve confidence and increase skills in facilitating personal health planning and self management

Background

The Centre for Self Management Support (CSMS) team was approached by the local community health services to develop and deliver training for clinical staff to increase their skills and confidence to facilitate personal health planning and self management support.

The service manager is responsible for seven multi-disciplinary clinical teams working with a range of patients living with a long term condition(s). These include diabetes, chronic respiratory disease, heart failure, tissue viability, Parkinson’s, community matrons and continence services. As part of the contracting process these teams are required to introduce personal health plans and to support patients to develop and progress these plans if they wish to. Importantly the service manager also has a strong commitment to developing staff skills and confidence to support patients to self manage and to adopting a collaborative partnership approach. Staff are based over a wide geographical area and cover both urban and rural populations

What we did

An exploratory meeting between the CSMS team and the service manager identified the key objectives for the training and also a set of meaningful outcomes measures including quality measures, service performance measures, training impact and importantly clinician confidence to support personal health planning. Clinicians completed a pre training questionnaire at the start of session 1 and a post training questionnaire at the end of the last session.  A further questionnaire is due to be administered three months after training. Delegates were also asked to complete an evaluation form for each workshop.

A series of four workshops was designed. Each workshop lasted two hours and incorporates the locally developed personal health plans and examples of application of the skills in this respect were reinforced. Opportunities for delegates to explore their beliefs, challenges and successes were provided

Impact

Outcomes from the training demonstrated the largest improvement in confidence was shown for personal health planning support. Participants rated these as the least confident areas pre-course and they showed the largest increases in confidence post-course. The increases were statistically significant. Following the training clinicians were also more likely to agree that health care professionals and patients are equals and experts and that they share responsibility. These increases were also statistically significant.

Small statistically significant increases were seen for domains relating to behaviour change skills. There were no significant changes for generic communication skills with participants rating their confidence reasonably high both pre and post course.

Clinicians often reported that prior to training they considered themselves to be confident with health behaviour change skills; however the training initiated an awareness that this was often based on their own agenda regarding what they considered was important for the patient, rather than collaboratively exploring what was important to the patient. They may therefore have over-reported their confidence regarding health behaviour change skills pre-training.

Learning

  • Beliefs, attitudes and behaviours of this group of staff were influenced by the clinician training.
  • Linking the application of self management support skills to the personal health planning process increased staff confidence to facilitate effective personal health planning.
  • Mandatory training ensured all staff had the opportunity to develop new skills and approaches.
  • Administrative support delivered high numbers of staff through the training in an efficient and robust manner.
  • Flexibility in training delivery (location, times) was crucial, and providing ‘mop up’ training sessions increased the number of staff who completed the whole programme.
  • Working collaboratively with teams and the service manager ensured that the training, evaluation and service improvement tools were contextually relevant and supported them to address their local challenges including performance indicators, quality and personal health planning metrics.