Category: Education

Multiple Mini Interviews

Over the weekend I was sorry to learn that Inspector Michael Brown’s much-respected, and award winning, MentalHealthCop blog and twitter account have been suspended. I hope he is able to get back to both in the very near future.

Meanwhile, back at base I spent pretty much all of today helping select future students of nursing using multiple mini interviews (MMIs). Not sure about MMIs? Neither was I until recently. Here’s what we’re saying about them in the School of Healthcare Sciences at Cardiff University:

The interviews at Cardiff University School of Health Care Sciences for Nursing involve the use of a Multi Mini Interview procedure which is based on the Objective Structured Clinical Examination format that is commonly used by Health Sciences programmes to evaluate clinical competence.

The interview process is an opportunity to assess interviewees in person and assess information, such as personal qualities, that is not readily forthcoming in traditional application processes. The majority of these interviews will take place the week commencing 17 February 2014. 

The MMIs are made up of a series of short, carefully timed interview stations which provide information about applicants’ ability to think on their feet, critically appraise information, communicate ideas and demonstrate that they have thought about some of the issues that are important to the nursing profession. There are six stations in total. Each mini interview lasts a maximum of 5 minutes.

The School assesses the ability to apply general knowledge to issues relevant to the culture and society in which students will be practising, should they be successful in gaining admission to (and ultimately graduating from) the School. Equally important will be an assessment of the ability to communicate and defend personal opinions.

That’s pretty much it in a nutshell. Sticking to time is clearly important, and there’s plenty of moving around for applicants as they shuttle from station to station. As a process I rather liked it. I’ll be back for another slice of the same tomorrow, but will spare a thought for my esteemed Mental Health Nurse Academics UK colleagues who will be meeting at Lincoln University.

End of week catch-up

This week I learnt a whole lot more about framework analysis, having made the trip to City University London to join others in the COCAPP team for a NatCen training event. This was also my first introduction to the use of NVivo (a computer-assisted qualitative data analysis software package), my experience having previously been with Atlas.ti.

Elsewhere the RiSC project team convened, via teleconference, for an important decision-making meeting. We’re entering the closing stages of this study, and it’s interesting stuff: about which I’ll be able to say more in time.

And, as planned, this was also the week I made the short hop to Cardiff Met (at the invitation of Lynette Summers in the University’s Library and Information Services) to meet with folk there to talk about my experiences in using this blog, and other things, to bring my research and writing to a wider audience. That was fun, and I hope useful, too.

Along with some classroom teaching, marking, a committee meeting and reading a nearly-there doctoral thesis that just about sums up my recent workplace activities. Varied, as always. Looking ahead, I realise that (unusually) I’ll be missing the next meeting of Mental Health Nurse Academics UK due to take place at Lincoln University on February 18th. Other commitments have won out on this occasion.

Activity based funding and student research in the NHS

Yesterday I spent time with a group of MSc students, talking about research review processes. I’ve written on this blog in the past about my experiences of seeking approvals for my PhD, and in Monday’s session I urged people to be exceptionally cautious about planning NHS-related research in pursuit of their Master’s degrees.

Preparing for and securing NHS research ethics committee and R&D office approvals takes time. In this part of the world at least, some healthcare organisations are also likely to ask researchers to cover the costs to the NHS of supporting studies which are not portfolio adopted. Here I’m thinking of, for example, the costs arising when staff leave the workplace to participate in interviews or join focus groups, or suchlike.

The relatively new practice of directly seeking payment from research teams for the costs of studies which are not eligible for portfolio registration has appeared with the shift to activity-based funding. Here in Wales, the National Institute for Social Care and Health Research (NISCHR) has published criteria for entry to its portfolio, which are summarised here and are elaborated on here. It is from this second document that I have snipped the following:

A research study is a structured activity which is intended to provide new knowledge which is generalisable (ie of value to others in a similar situation) and intended for wider dissemination.

Studies eligible for the NISCHR portfolio should involve face to face contact with NHS patients, social care service users or people involved with their care. Studies must be led from and/or recruiting participants from Wales. All studies must already have research funding before they can be included in the Portfolio.  Research Costs cannot be provided by NISCHR CRC.

The following types of study are not eligible for inclusion in the NISCHR Portfolio:

  • audit,
  • needs assessments,
  • quality improvement projects,
  • directly commissioned studies,
  • secondary research such as systematic reviews,
  • purely laboratory based studies,
  • routine biobanking of samples would not be eligible but a hypothesis based sample collection would be if appropriately peer reviewed and funded,
  • own account funded studies,
  • studies closed to recruitment.

MSc projects invariably do not meet these criteria, meaning that numbers of taught postgraduate students get to cut their dissertation teeth on non-NHS research studies or (where academic regulations allow) on other types of project altogether. Examples are service or quality improvements, service evaluations and systematic reviews. And, in my view, these are sufficiently testing options for students working at MSc level, with some (like local quality improvements) having the added advantage of immediately and obviously benefiting the NHS and those who use its services.

However, a problem arises in the case of postgraduate research degrees. In some disciplines, including nursing, these are often undertaken part-time and are carried out with limited or no external grant income. Opportunities for studentships are relatively rare, and where they are available may be financially unattractive to practitioners who have already built careers in the health service. As with MSc projects, ‘own account’ doctorates will struggle to get onto the portfolio. They therefore run the risk (in some circumstances) of not being supported by organisations within the NHS unless their associated costs are explicitly met. One way of achieving this may be for local NHS managers to agree to carry the costs of non-portfolio studies which it is planned will take place within their services. But securing this kind of support is not straightforward, and for would-be research students the added challenge of finding a means of paying costs is hardly an encouragement. And, where MSc students can usually opt for non-research projects this is not so for those aiming for PhDs or Professional Doctorates. These are awards made only to those who generate new knowledge using sound and defensible research methods.

So what does all this mean? It’s early days, but one likely outcome may be a reduction in small-scale research projects within the NHS, along with an increase in the preparations and negotiations which precede data generation. Another may be the proliferation of non-portfolio projects which are explicitly designed to meet ‘research’ criteria for academic award purposes, but which are constructed to be something else (typically ‘service evaluation’) within the context of NHS research governance. A reasonable, longer-term, concern is that research capacity-building in fields like nursing may falter as potential students rethink their plans. And that, in my view, would be a big step backwards.

Education for community mental health work

This week brought a COCAPP meet-up in Bristol, where we had the chance to plan our work for the immediate period ahead. The RiSC team also met, albeit in teleconference rather than face-to-face fashion. I’ve had pre-registration student nurses’ assignment work to begin marking, and this afternoon will be taking part in a joint Cardiff University/Local Health Board discussion on the future provision of post-qualification modules for community mental health practitioners.

This afternoon’s meeting has given me pause for thought, and a chance to reflect a little on my long involvement in post-registration mental health education. It was explicitly to lead a full-time, one-year, programme for actual or intending community mental health nurses (CMHNs) that I was recruited into what was then the University of Wales College of Medicine in 1997. Education, and my role, have changed considerably in the period following. In Wales there is no longer a fully funded, full-time, course of this type. Like pretty much everywhere else, here education for health care workers beyond registration has increasingly become part-time, and modularised.

I once wrote about the CMHN course we ran in Cardiff in the journal Nurse Education Today. The article was titled ‘Specialist practice in community mental health nursing‘, and had an abstract which went like this:

Community mental health nurses (CMHNs) work in an increasingly complex health and social care environment. Over recent years, the evolving direction of general health service and specific mental health policy has directed CMHNs towards: the provision of clinically-effective interventions; a closer attention to meeting the needs of people experiencing severe and long-term mental health problems; the simultaneous provision of services to meet the needs of people experiencing a wide range of mental health problems presenting in primary care settings; greater collaboration with workers representing other disciplines and agencies; and the development of active partnerships with mental health service users. This paper explores the context within which CMHNs practise, and within which education programmes preparing specialist practitioners in community mental health nursing have been developed. One recently-validated specialist practice course for CMHNs is described in detail, with the intention of stimulating discussion and debate surrounding the practice of, and the educational preparation for, community mental health nursing.

I can’t claim that this paper did actually trigger any particular debate, but at least I tried.

I also had the chance, during the time that I ran Cardiff’s full-time CMHN course, to survey the leaders of other programmes of this type offered elsewhere in the UK. A paper called, ‘Specialist practice for UK community mental health nurses: the 1998-99 survey of course leaders‘ appeared in the International Journal of Nursing Studies. This was co-written with Philip Burnard, Debs Edwards (who, I am delighted to say, is now project manager for the RiSC study already mentioned in this post) and Jackie Turnbull. In the paper’s abstract we said:

Surveys of the leaders of the UK’s post-qualifying education courses for community mental health nurses have taken place, on an annual basis, for over 10 years. In this paper, findings from the survey undertaken in the 1998–99 academic year are reported. These findings include: that most course leaders do not personally engage in clinical practice; that interprofessional education takes place at a minority of course centres, and that course philosophies and aims are characterised by an emphasis on both outcomes (in terms of, for example, skills acquisition, knowledge development and the ability to engage in reflective practice), and process (adult learning).

And then there was a paper called, ‘Education for community mental health nurses: a summary of the key debates‘ which Steve Trenchard, Philip Burnard, Michael Coffey and I wrote for Nurse Education Today. Here we said:

A wide range of post-qualifying education courses exist for community mental health nurses (CMHNs) working in the UK. ‘Specialist practitioner’ courses emphasize shared learning between CMHNs and members of other community nursing branches. These programmes typically include course content drawing on the social and behavioural sciences, as well as on material more tailored to the clinical needs of practitioners. Such courses and their predecessors have been subject to criticism, however. Courses have been described as anachronistic, and failing to take account of recent advances in treatment modalities. In addition concerns about the generic focus of some programmes have also been raised. Educational alternatives, such as programmes preparing nurses and other mental health workers to provide ‘psycho-social interventions’ have, correspondingly, become increasingly popular. In this paper we explore some of the debates surrounding the education of CMHNs, and explore the context in which CMHNs work and in which educational programmes are devised. We consider the multidisciplinary environment in which CMHNs practise, the differing client groups with which CMHNs work, the developing policy framework in which mental health care is provided, demands for more user-responsive education, and the relationship between higher educational institutions and health care providers. We conclude the paper with a series of questions for CMHN educators and education commissioners.

And there are other papers and book chapters, too, which I won’t refer to now. But I am reminded that I once spent large parts of my working life running programmes for community mental health workers, and managed to research and write a fair bit about the same. Perhaps today’s meeting will lead to a modest rekindling.

Catching up post

Plenty going on in the last week or so. I had the chance to join pre-registration mental health nurses and occupational therapists for a second day as they made preparations for an interprofessional event scheduled for early December. Some of these students have also been giving me drafts of assessed work to comment on, but as the deadline for receipt of these is first thing next week I expect a deluge then. ’twas ever thus.

Elsewhere there has been RiSC reviewing to crack on with, assignment marking, and peer review reports to both consider and write. I’ve also put myself in the frame to act as a reviewer for another university’s proposed new MSc mental health programme, this being the kind of curriculum work I haven’t had the chance to do for a while.

I’m not normally one for formal, suit-and-boot, events, but made an exception last Wednesday (November 27th) to join a posse of colleagues from the School of Healthcare Sciences at the RCN Wales Nurse of the Year awards. These took place at Cardiff City Hall, and the overall winner was Cardiff and Vale UHB ward sister Ruth Owens. Congratulations, Ruth. Congratulations, too, to the individual category winners: including Andy Lodwick (also from Cardiff and Vale) for picking up the Mental Health and Learning Disabilities award and Dr Carolyn Middleton, doctoral graduate from what was the Cardiff School of Nursing and Midwifery Studies, for winning the Research in Nursing award.

This week also brought me to a meeting of the MHRNC Service User and Carer Partnership Research Development Group and, yesterday morning, to the Cardiff City Stadium for an open meeting to discuss NISCHR’s infrastructure and programme funding review. Both were lively events, and on the NISCHR front I see big changes ahead from 2015.

And to close this summary post: via the twitter grapevine I see that the RCN is now giving early notification of the Network for Psychiatric Nursing Research 2014 conference. This will take place at Warwick University on the 18th and 19th of September. I’ll post a link to the call for abstracts once this appears, but for now will reproduce this extract from the event website:

This year [2014] is the 20th international NPNR conference and it’s going to be a celebration.

We wish to celebrate and promote some of the outstanding mental health nursing research that shapes mental health policy and nursing practice across the world. We will also acknowledge some of the best psychiatric and mental health nursing research that helped create the strong foundation for our work today. And we will invite delegates to look ahead to map out the future for mental health nursing research, education and practice.

Postgraduate symposium

Tomorrow I’m off to the School of Healthcare Sciences’ first-ever Postgraduate Research Student symposium, taking place in the grand surroundings of Cardiff University’s Glamorgan Building.

This has given me the perfect excuse to find out, once and for all, the particular meaning of the word ‘symposium’ (as opposed to ‘colloquium’, for example). So for those interested (which won’t be many of you, I’m sure), the Collins English Dictionary defines ‘symposium’ thus:

  1. a conference or meeting for the discussion of some subject, esp an academic topic or social problem
  2. a collection of scholarly contributions, usually published together, on a given subject
  3. (in classical Greece) a drinking party with intellectual conversation, music, etc

A ‘colloquium’, on the other hand, is:

  1. an informal gathering for discussion
  2. an academic seminar

I’m glad that’s sorted. Looking at the third definition of ‘symposium’ above, and then at the organising committee’s Socratic quotation reproduced in the flyer at the top, I now realise I ought to prepare for an event in the ancient Greek style. I may bring my guitar, all the better to join in with.

Standard professions?

The Times Higher Education reports this week on comments made by Vince Cable at an event hosted by the Sutton Trust. According to the THE, the Business Secretary:

[…] has criticised the “qualification inflation” that means entrants to “very standard” professions such as nursing require a degree.

In truth I find the THE‘s report a little disjointed, as elsewhere it quotes Vince Cable on a host of other matters including private schooling, support for postgraduate study and the promotion of social mobility.

But I understand enough of it to take issue with the Business Secretary’s side-swipe at graduate nurses. On what grounds might we distinguish ‘standard’ from ‘elite’ professions, or sustain the argument that only those joining the latter must of necessity possess degrees? We await an explanation. In the meantime, for a considered review of nursing education I refer readers to the report of the Willis Commission, which I wrote about on this blog last year. For a research-oriented post on the division of labour in health care (and particularly, on professions in the mental health field), try this post.

Classroom time

This morning I’ll be in a classroom urging a group of post-registration community nurses to embrace the idea that mental health is everybody’s business. It’s a session I regularly get to do on the School of Healthcare Sciences’ Fundamentals of Community Practice module. We’ll be looking at rates of mental ill-health within populations, and at the National Institute for Health and Care Excellence (NICE) guidelines on depression. We’ll also get to think about what district nurses, health visitors and others can do to promote mental health in their day-to-day work.

This is a session where I additionally get to introduce people to Healthtalkonline. This is an excellent resource for everyone: teachers, practitioners, service users and carers. Here’s how it describes itself:

People’s stories: see, hear and read their experiences…

Healthtalkonline is the award-winning website of the DIPEx charity. Healthtalkonline and its sister website, Youthhealthtalk, let you share in more than 2,000 people’s experiences of over 60 health-related conditions and illnesses. You can watch video or listen to audio clips of the interviews, read about people’s experiences if you prefer and find reliable information about specific conditions, treatment choices and support.

The information on Healthtalkonline relies on external funding and is based on qualitative research into health experiences, led by experts at the University of Oxford. These personal stories of health and illness will enable patients, families, carers and healthcare professionals to benefit from the experiences of others.

Healthtalkonline has a repository of clips in which people talk about their personal experiences of mental health difficulties. I have it on good authority that there is more on the way, too, so this is a site to keep coming back to.

Supporting doctoral students in mental health nursing

Over on the Mental Health Nurse Academics UK blog, Julia Terry from Swansea University has written a post introducing the new Mental Health Nurse Doctoral Students’ Network which she has worked so hard to convene. The group met, for the first time, as part of an NPNR conference fringe at Warwick University last month.

Here’s what Julia has to say:

Welcome to the first official blog post for the:

paperchain people

 Mental Health Nurse Doctoral Students’ Network

At the NPNR in Warwick this year 10 Mental Health Nurse Doctoral Students came forward and agreed that a network was a good idea.

This network can work in a number of ways:

  • Meeting up for occasional face to face discussions
  • Using an email group to contact like-minded people
  • And using this blog

You may have questions, tips to share, events and books to recommend, the possibilities are wide.

As you’re reading this we’ve now increased the network to 24 interested doctoral students already, so the interest seems to be there. Thanks for your support.

Top tip:

2 great books I read from start to finish and keep going back to –

Petre, M., Rugg, G. (2010) The unwritten rules of PhD research. 2nd ed. Berkshire: Open University Press

Phillips, E., Pugh, D. (2010) How to get a PhD: a handbook for students and their supervisors.  Berkshire: Open University Press

I found them very easy to read, and good to dip in and out of. Tips about writing, planning your time, supervision, etc..Well worth a read.

Bw, Julia Terry

Great work, Julia: I hope people get involved.

Whilst I’m on the topic of postgraduate research, I note that the European Academy of Nursing Science (of which I am a Fellow) runs a doctoral student summer school for nurse researchers. There’s also the Academy of Nursing, Midwifery and Health Visiting Research with its mentorship scheme.

Teesside story

So here’s a brief post from a train, as I make my way home from Mental Health Nurse Academics UK‘s meeting at Teesside University. The journey is long, but the company is good: next to me is Michael Coffey, and in front are Linda Cooper and Julia Terry.

The day has been an interesting one. Len Bowers reprised findings from his Safewards trial (and very important they are, too). Ian Hulatt and Joy Duxbury led a discussion on positive behavioural support. PBS? Not something I know much about, I have to confess. The possibility of establishing research priorities for mental health nursing was also explored. I now realise, as I type, that a discussion on Twitter is taking place on what these priorities might be. A similar round is taking place on themes for future MHNAUK meetings. Time to dive in, perhaps?