The impact of the Experts by Experience Group (ExE) at the University of Derby on student mental health nurse practice

Alison Kilduff
University of Derby
Patient and Public Involvement

Summary

Evaluating the Impact of patient and public involvement groups – (Expert By Experience Groups) on student mental health nurse practice using a student focus group.

The role of patient and public involvement in partnership working is an approach which requires a patient centred culture to be embedded within health and social care programmes to be successful.  There is clear evidence that recently graduated students are supportive of patient and public involvement (O’Donnell 2012), particularly in mental health nursing where it is a field learning outcome (Terry 2011).   Within the University of Derby’s College of Health and Social Care, this is demonstrated strategically through the development of our Expert by Experience Group and individually through the application of patient centred care focusing on recovery, which is respectful, compassionate and responsive to individual patient need, values and preference.

Patient and Public Involvement is interwoven through all the College’s health and social care  programmes in collaboration with our ExE group.  The group work alongside academics in a range of roles as advisors, presenters and consultants in our admissions process, teaching and learning, programme and curriculum development and assessment. It is suggested that there is positive impact on the quality of provision and the student experience and furthermore; there can be a range of practical and ethical benefits for the service users and carers themselves, when collaboration with service users and carers is fully collaborative and embedded into the programme in an informed manner (McLaughlin 2009)

As part of the HEI challenge a focus group was held with 3rd year Mental Health student nurses to enable them to reflect on how the impact of our ExE had impacted on the quality of their student experience and enhanced their clinical practice.

What are the Aims?

Our aims are to:

  • Gain further understanding of positive or negative impacts of PPI on the student experience
  • Establish good practice for further dissemination within the College of Health and Social Care and wider communities of practice
  • Provide clear understanding and feedback to our ExE colleagues in relation to their contribution to our programmes

Who was/is involved?

Experts by Experience from the University ExE group and 3rd year student Mental Health Nurses and an academic facilitator – Alison Kilduff

What has changed/will change?

Outcomes

Overall students suggested that working alongside the ExE made them less likely to use jargon in those sessions but also in their clinical practice.  Students identified that using “real people” rather than paper based case studies enhanced their understanding and empathy and that they were more likely to take an individual, person centred approach in practice as the examples discussed by ExE were “real” practice scenarios.

Outputs

Student publication of the positive Impact of Experts by Experience on her student experience and clinical practice

Positive Impact on “small things” in practice which builds and influences the culture of practice in the work place

Development of a student feedback form for ExE to enable them to receive feedback directly from students

The students joined up with our practice partners and ExE in an event to reduce stigma and respect dignity for World Mental Health Day.

What lessons have we learnt?

The theme of discovering how students learn within a public and patient involvement partnership is complex, however, all students reported specific examples of how they had gained new knowledge and values and adapted this into their clinical practice.  This concurs with Rush’s (2008) study regarding transformative learning which has most benefits when students are emotionally engaged with the ExE in order for attitudes and values to be challenged which result in positive changes to clinical practice.

Quotes from the 3rd year student nurse focus group

“Listening to XXXX made me realise how unsafe he feels when unwell and in hospital and how we make it worse by moving his bed to another area when he is in a group because we have an admission.  He comes back to the ward and wants to rest and all his things have been moved without us even mentioning it to him.  It adds to his feelings of being powerless”

 “I understand better the need to support service users users regain their unique story and collaborate with them in their personal journey to recovery”

“I’ll never be able to walk in her shoes or live her life, but I will always recall her words and how it made me feel.  The effort and courage it took for her to stand in a room full of strangers and talk about herself and her illness and her family was selfless”

“I remember being particularly moved listening to the story of a girl who lived with an eating disorder talking about her parents, it was probably the bravest thing I had ever heard. I was haunted afterwards by images of her parents at home struggling to cope. I suppose on reflection it taught me that we are all interconnected and mental distress happens within systems of people not merely individuals. In practice I look outwards now and always dedicate time to spend with families and carers”

“Learning from academic resources is really important. However, narratives provided by expert by experience service users provides a unique insight into a persons world:  an emotional connection with the persons story is formed; which supports the growth of empathy and compassion in values based nursing practice”

“Working and hearing from the Experts by Experience was very touching and inspiring for me as a nurse. It is evident that we, as nurses, should focus our care on supporting recovery and building the resilience of people with mental health problems, Experts by Experience teams are also an effective tool to fight stigma associated with mental health”

“The involvement of service users/ experts by experience has been hugely influential in my development throughout my nurse training, it has allowed me to develop my understanding of what it means to live with a mental illness and enabled me to challenge stereotypes and assumptions surrounding mental illness”

“It’s the “small stuff” that matters – talking, being kind, listening and valuing individuality”

Contact details

Alison Kilduff a.kilduff@derby.ac.uk – Acting Head of Mental Health, University of Derby

Links to further information and resources

Deeming, W.E. (2000). The Economics for Industry, Government and Education. Cambridge. MA. The MIT Press.

O’Donnell, H. (2012). Service User Involvement in nurse education: perceptions of mental health nursing students.  Journal of Psychiatric and Mental Health Nursing. Vol 20, pp 193-202.

Langley, G.L., Nolan, K.M., Norman, C.L., Provost, L.P. (2009). The Improvement Guide: A Practical Approach to Enhancing Organisational Performance. (2nd edition). San Francisco. Jossey-Bass Publishers.

McLaughlin H. (2009). Service User Research in Health and Social Care Research. London. Sage Publications.

Rush, B. (2008). Mental Health Service Users in nurse education: A catalyst for transformative learning.  Journal of Mental Health. Vol 17, pp531-542.