Perceptions of service user and carer involvement in undergraduate nurse education: rhetoric or reality?

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Abstract

Background: From a UK policy perspective, service user and carer involvement has followed an increasing focus on involving patients and the public in shaping and delivering healthcare (DH 2001; 2004, 2005a, 2006). From an educational perspective service user and carer involvement has become a major imperative not only in promoting the learning of patient-centred practice (Forrest et al. 2000; Towle et al. 2010) and assessment (Repper & Breeze 2007; Stickely et al. 2009), but also in recruitment (Rhodes & Nyawata, 2010) and developing undergraduate Nurse and Midwifery education (NMC 2010). Nurse education needs to develop and respond to the changing needs, developments, priorities and expectations in health and healthcare as well as developing innovative curricula and teaching methods to meet the challenges and changing needs of nursing (DH 2005b; NMC 2010). Nursing care provision and practice can be influenced and improved by developing the students’ understanding of the service user and carer experience, thereby helping to bridge the distance between theory and practice that exists within nursing education (Costello & Horne 2001; Jackson 2003). Service user and carer involvement in the education and assessment of social work and mental health students is well established (Repper & Breeze 2007). However, we need to identify the facilitators and challenges to involving service users and carers in undergraduate graduate nursing and midwifery curricula to develop and improve nurse education.Aim: The aim of this presentation is to discuss the findings from an exploratory qualitative study, and subsequent web based survey, that identified and explored nurse educator’s perceptions and experiences in engaging and involving service users and carers in teaching, interviewing, assessment of student nurses and curriculum development. Methods: An exploratory qualitative study using three focus groups (n = 16 in total) to identify areas of good practice and explore attitudes, beliefs, advantages and challenges with regard to engaging and involving service users and carers in teaching, recruitment and assessment of students, and in curriculum development within undergraduate nursing and midwifery programmes to develop and improve nurse education (Kreuger 2008). Data were transcribed verbatim and data analysis and classification followed the framework analysis approach (Richie & Spencer 1994). A web based survey of 80 nurse educators was then conducted to establish current level of service user and carer involvement, and to assess the strength of attitudes and beliefs about the advantages and challenges of involving service users and carers in under graduate and midwifery recruitment, assessment, education and curricula development at the University of Manchester. Survey data were transferred into SPSS and explored using descriptive statistical analysis. Findings: There are opportunities and difficulties when using service users and carers in the assessment of students and in designing and developing nursing curricula. However, much potential was seen in service user and carer involvement in interviewing and teaching. Participants identified that service user and carer involvement was useful for changing attitudes and developing empathy in students; they could make a useful contribution to the assessment process of student nurses and to the curriculum development process of student nurse education. Challenges were seen in how to involve them in large group teaching and how to use the experience of service users and carers effectively. Concerns were also raised about the ‘one perspective’ – an unrepresentative view, the ‘professional user’, tokenism and involving the ‘right sort’ of service user. Conclusions:Service user and carer involvement is an expectation and a growing necessity in nurse education (NMC 2010). Nurse educators need to harness the opportunities and overcome the challenges of how best to involve service users and carers. This needs to be based on nurse educators’ experiences and lessons learned to make such involvement a reality within nursing curricula and education. These findings have implications for undergraduate nurse and midwifery education both within the UK and internationally.Contribution to knowledge development within the theme• How and why nurse educators involve service users and carers to develop and improve nursing and midwifery curricula and education.• Nurse educators’ perceptions and experiences of factors that facilitate or hinder engagement with service users and carers in teaching, assessment, recruitment and curricula development.• Nurse educators’ views on how the relationship between service users and carers should develop to respond to and meet the challenges and changing needs of nursing and midwifery.

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Nurse education service user invovlement carer invovlement staff attitudes

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