Optimising service users and carers involvement in nursing and social work pre-registration degrees

Evaluating the introduction of Mad Studies into undergraduate mental health nursing curriculum through zine making: A co-produced qualitative study

BACKGROUND

Classification systems have been developed to identify a range of mental illnesses that can be labelled and treated within a biomedical framework. Whilst alternative understandings regarding the lived experience have emerged, a biomedical explanation still dominates public and professional thinking. This is reflected in mental health professional education nationally and internationally. This study reports on an initiative co-produced by a team of experts by experience and academic staff where Mad Studies was introduced into undergraduate nursing curricula. Mad Studies is an academic field and international movement that challenges the traditional view of mental illness.

AIM

The aim of the study was to examine mental health nursing students' perceptions of the impact of Mad Studies on their learning.

METHODS

A qualitative exploratory design was co-produced by a research team consisting of academics, experts by experience and mental health nursing students. Data was collected in the form of zines from 43 students. Visual data was analysed using a framework of interpretive engagement, thematic analysis was utilised for non-visual data.

RESULTS

Four overall themes emerged: making human connections, personal affirmation (of own mental health), transformed understanding and connecting differently.

DISCUSSION

Mad studies created a transformative experience for students related to a different way of knowing. There were notable shifts in perspectives of mental distress due to disruption in understanding. There was safety to engage differently with experts-by-experience allowing personal reflection and acceptance.

CONCLUSION

The mad studies delivery and voice of the experts by experience recontextualises learning as it repositions understanding of mental distress whilst creating authentic connections with self and others. It highlights the essentiality of co-production for making a difference and the potential to influence nursing practice.

It takes it out of the textbook: Benefits of and barriers to expert by experience involvement in pre-registration mental health nursing education

WHAT IS KNOWN ON THE SUBJECT?: Service user involvement in mental health nursing education is beneficial in terms of attitudinal change to reduce stigma, clinical skill development and enhancing understandings of recovery-oriented practice. Service users as experts by experience have not been embedded within pre-registration nursing programs. Consequently, they remain limited in number, ad hoc and frequently tokenistic. Nurse academics responsible for the design and delivery of pre-registration mental health nursing curricula have a potentially important role in facilitating expert by experience involvement in mental health nursing education.

WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE

Nurse academics teaching mental health nursing have generally favourable views about the importance of expert by experience involvement. Nurse academics experience significant barriers in supporting the implementation of academic positions for experts by experience, particularly in obtaining funding. The experts by experience could contribute to mental health nursing education does not appear to be clearly understood by nurse academics. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health services aspire to adopt a recovery-oriented approach to practice. Involving experts by experience in mental health nursing education can facilitate increased understanding and appreciation of recovery-oriented practice. Nurse academics could play an important role in supporting the implementation of experts by experience positions in nursing academia. To do so, they require an understanding of the benefits of EBE involvement in academia and the barriers that can be encountered when attempting to facilitate the implementation of such positions. Experts by experience contribute unique expertise, essential to the development of quality mental health services. Conveying this expertise through the educating the future nursing workforce in mental health is essential.

ABSTRACT

INTRODUCTION: Involving service users in mental health nursing education is ad hoc and minimal, despite growing evidence of its benefits. Insights and experiences of nurse academics teaching mental health to pre-registration students have been underrepresented in the research to date.

AIM

To seek insights and experiences of nurse academics involved in designing and delivering pre-registration mental health nursing education in Australian universities regarding involving service users in mental health nursing education.

METHODS

A descriptive qualitative study involving 19 nurse academics from 13 Australian universities, involved in pre-registration mental health nursing education. Data were analysed thematically.

RESULTS

Participants reported minimal service user involvement. Most sought an increase and identified barriers. Data analysis resulted in five identified themes: (1) value-rich, (2) resource-poor, (3) imperfect processes, (4) 'part, but not all' and (5) unrecognised worth.

CONCLUSIONS

Increasing meaningful involvement of service-users in mental health nursing education requires support and investment from multiple stakeholders. Nurse academics are crucial stakeholders in understanding the unique expertise service users bring.

IMPLICATIONS FOR PRACTICE

Service users being central to all aspects of mental health services requires their active participation in the education of health professionals. Nurse academics have an important role in realising this goal.

The patient involvement in nursing education: A mixed-methods systematic review

OBJECTIVE

To evaluate the effects patient involvement in nursing education has on students, patients and academic staff using a specific theoretical framework.

DESIGN

Mixed-methods systematic review based on Joanna Briggs Institute methodology (Prospero no. CRD42022327158).

DATA SOURCES

Seven databases (PubMed, Cochrane Library, Cinahl, PsychINFO, Scopus, ERIC, Embase), Google Scholar and reference lists were searched.

REVIEW METHODS

Qualitative, quantitative and mixed-method studies published from 2012 to 2022 were included. Two reviewers independently assessed the studies for eligibility and quality; any disagreement was discussed with a third reviewer. Data were extracted and analysed according to the Joanna Briggs Institute converged integrated approach.

RESULTS

Twenty-one qualitative, one quantitative and five mixed-methods studies met the inclusion criteria. Data were provided from three points of view: students, patients and academic staff. Student integrated findings included: (i) students' reactions towards patient involvement in education; (ii) students' views on the learning process and (iii) on ethical issue. From the patient point of view, the integrated findings addressed (i) patients' goals and effects on students' learning; (ii) how patients teach and get involved with students; (iii) how patients perceived their role; the patients' views on facilitators (iv) and barriers (v) in education; (vi) the perceived effects of being involved in education. Four integrated findings were derived from the academic staff's point of view: (i) academics' perceptions on patient vulnerability; (ii) perceived barriers to the efficacy of patient involvement in education; (iii) effects of patient involvement in nursing education; and (iv) methodological aspects of patient involvement in university curriculum.

CONCLUSIONS

This systematic review provides useful information from all stakeholders' perspectives on the effects of patient involvement in nursing education. It offers a broader view of the implications for implementation and for developing theoretical frameworks and hypotheses for future research.

Key stakeholder perspectives on expert-by-experience involvement in the values-based recruitment of student mental health nurses: A co-produced qualitative study

BACKGROUND

Values-based recruitment is a mandatory process for nursing programmes within UK higher education, with the Nursing Midwifery Council expecting that experts-by-experience are engaged in these recruitment and selection processes. The wider involvement of experts-by-experience in healthcare education is gaining momentum internationally with calls for engagement in all aspects of design and delivery; however, the impact of such involvement in recruitment of nursing students has received little attention, particularly in mental health nursing.

AIM

To understand the impact of expert-by-experience involvement in the values-based recruitment of mental health nursing students from the perspective of candidates, experts-by-experience, and academic staff.

DESIGN AND METHODS

This qualitative approach was co-designed and implemented by a research team comprised of academics, experts-by-experience, and student mental health nurses. Focus groups and an on-line survey were used to collect data, with Burnard's thematic analysis providing a framework for data analysis.

SETTING/PARTICIPANTS

This study took place at one UK university. Participants included nurse academics, experts-by-experience, and student nurses with experience of a values-based recruitment process.

RESULTS

Thematic analysis identified four themes: starting out, collaboration, rich assessment, and stakeholder gains. Whilst not without its challenges, the involvement of experts-by-experience in the recruitment of mental health nursing students was identified as delivering a robust recruitment process, encompassing academic abilities alongside the personal qualities required to make a 'good nurse'. Personal benefits for experts-by-experience, candidates, and academics were also reported.

CONCLUSION

This study provides insights into the impact of experts-by-experience in supporting values-based recruitment. The approach is identified as enhancing the selection process by drawing from academic and lived experience perspectives and highlights to potential candidates, at the outset of their career, the value of meaningful engagement. These findings support the Nursing Midwifery Council's position that experts-by-experience should be engaged in the recruitment and selection of student nurses.