Combining lived experience with the facilitation of enquiry-based learning (EBL)
Gemma Stacey & Rachel Oxley
University of Nottingham
Patient and Public Involvement
This educational development involved people who had lived experience of mental health problems developing their “story” into short triggers which acted as authentic prompts for pre-registration nursing students to engage in independent research and group based facilitated discussion. This pedagogical approach is known as enquiry based learning and is traditionally initiated by fictitious case studies and facilitated by academics. The alternative approach was based on the principles of co-production whereby people with lived experience of mental health problems work alongside academics to develop the triggers, acquire skills for EBL facilitation and engage in a reciprocal exchange of experience based and evidence based knowledge with the students. The initiative was evaluated through open ended questions and the desired outcomes where identified by both the lived experience and academic facilitators.
What are the Aims?
Curricula which incorporates high levels of EBL has been criticised in the literature where case studies are viewed as lacking authenticity resulting in surface learning and poor motivation amongst students known as EBL fatigue. Attempts to address this had included a service user reference group who reviewed the case studies and contributed to their revision. The lived experience approach attempted to further address this issue alongside meeting specific co-produced learning outcomes relating to knowledge, skills and attitudes:
- understanding of: the implications of diagnosis; the impact of stigma and discrimination on social participation and perception of self; the unique experience of mental distress and the importance of fundamental interpersonal skills;
- critically analyse preconceptions regarding hope, ability and potential to recover
Who was/is involved?
The initiative was led by Gemma Stacey (Assistant Professor in Mental Health) and Rachel Oxley (Person with lived experience of using mental health services and experienced educator working on behalf of Making Waves). Gemma and Rachel led the training for both the lived experience and academic facilitators and provided ongoing developmental/ organisational support throughout the process.
What has changed/will change?
Evaluation suggests students experienced the learning encounter as transformational. Evidence of the assimilation of new perceptions and understandings of people who experience mental distress was demonstrated: Their confidence in speaking about personal and traumatic experiences in front of large groups or people challenged some of my expectations about what people are capable of achieving even while still experiencing a lot of distress in daily life. (2nd year, Mental Health field student)
This experience was truly significant for me. Their account was truthful, moving and at times shocking. I t gave me an insight into how that person actually feels and their experiences which cannot be taught, in my opinion, in any text book. As an adult nurse, this will stay with me forever. Although in many ways a sad ‘story’ the main thing I have taken from this is how with love and compassion from both health professionals and family members, there is hope and life can be ‘lived well’ and enjoyed not just endured. (1st year, Adult field student)
Additionally, learning was motivated by the educational encounter and the wider application was recognised: It made situations more of a reality. It caused a greater desire to want to go and research topics. They had literally poured their hearts and soul out to us; a bunch of strangers – wanting to do their stories justice in a way by going and researching as much as possible. (1st year, Adult field student)
It challenged me to not just talk to/sit with the ‘easy’ patients, but to spend time with the more ‘difficult’ ones, acknowledging they may be lonely and would really benefit from someone listening to/caring for them. I was also challenged to think about the patient’s family, especially as I’m training to be a children’s nurse. To see that the patient has a mum and a dad who love them and are anxious and want to care for them and know what’s going on, and not just care for the child as an isolated patient with an illness that needs to be cured. I was challenged to really think about what’s going on in my patient’s life, what situation they’re in and what sort of person they are. (1st year, Child)
What lessons have we learnt?
The challenges of this initiative relate to its sustainability. The lived experience facilitators are paid for their time which presents a costlier approach than traditional EBL formats. In addition, the relationships built between the lived experience and academic facilitators are integral to the success of the educational encounter. This requires ongoing investment and commitment of a dedicated few.
Gemma Stacey (firstname.lastname@example.org)
Links to further information and resources
Stacey, G., Oxley, R. and Aubeeluck, A. (2015), Combining lived experience with the facilitation of enquiry-based learning: a ‘trigger’ for transformative learning. Journal of Psychiatric and Mental Health Nursing, 22: 522–528. doi: 10.1111/jpm.12228