Shared learning database

University of Birmingham
Published date:
April 2012

The CLI is a joint learning program involving students from different professional backgrounds, specialising in mental health. The focus of the CLI is on interdisciplinary working and applying different theoretical perspectives, including service user and carer perspectives. Service users and carers work as integral members of the teaching team meaning they were involved in the design, delivery, evaluation and dissemination of the fully interdisciplinary teaching.

Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?


Aims and objectives

To develop an interdisciplinary dialogue on improving service delivery of mental health care. This is delivered during health professional training thus professionals should adopt a multidisciplinary way of working at the start of their professional lives. Service users and carers are involved in the design delivery and evaluation of this program which instils that service users and carers should be involved. - To explore roles and values within the interdisciplinary team as part of the training;
- To explore how different theoretical perspectives may be helpful to practitioners, service users and carers in making sense of mental distress;
- To involve service users in the training of health and social care professionals;
- For students to explore the different perspectives and meaning of different mental health conditions from an interdisciplinary perspective;
- Developing an understanding of the experience of Mental Health in-patient care, and the social implications thereof.

The CLI is a five day program comprising of case study exercises regarding the differing professional perspectives, an exploration of personal and professional values, first person narratives of in-patient care, wiki work around theoretical perspectives on mental illness and a lecture on self harm.

Reasons for implementing your project

For the first two years the students participating in the CLI were from Nursing and Social Work backgrounds, in the third year they were joined by Clinical Psychology students and from the fourth year (2011) onwards were joined by second year core trainees (medics) from local mental health trusts. There were a maximum of 130 people attending.

Service users and carers work as integral members of the teaching team meaning they were involved in the design, delivery, evaluation and the dissemination of the interdisciplinary teaching. Service user and carer involvement is becoming more widespread in mental health teaching and there are various models of service user and carer involvement in education being used across the UK (Levin, 2004; Tew et al., 2004; Tew et al, 2011). Central to the CLI is the promotion of opportunities for dialogue, both between the participants from different professional disciplines and also between the participants and the service user and carer facilitators. To enable dialogue, much of the learning took place in small groups facilitated by either a service user or a carer. The service users and carers contribute to key decisions and discussions and the value of that contribution is integral to the CLI.

How did you implement the project

For both e-based and classroom-based work the participants were divided up into small interdisciplinary groups, culminating in the preparation and delivery of joint presentations to the wider learning group. This offered the opportunity for moving beyond some of the more conventional 'teaching from the front' approaches to involving service users and carers in the learning process (Levin, 2004; Tew et al, 2004). Service users or carers facilitated the small groups for all of their classroom-based learning sessions - both offering their own disciplinary expertise based on their lived experience and also acting as a facilitator for the group learning process. The small group work is generally in relation to case scenarios which are based on real situations. It has proved very successful to show video case scenarios to the whole group and then for the participants and facilitators to break off into small groups to do the related exercises.

A component part of the CLI is a wiki that starts before the face-to-face teaching begins. Participants are given the opportunity to meet each other virtually before they meet in person to extend their learning opportunities. Using the wikis students are asked to comment on a series of trigger videos. These custom made videos show a service user or carer interviewing an expert about a particular perspective on mental distress. Participants are assigned a role to answer questions related to the specific videos they have viewed thus engaging in learning through collaborative discussion and debate.

The number of participants in the initiative was: 19 Mental Health Nursing students; 22 Clinical Psychologist students; 15 Social Work students (UG); 20 Social Work students (PG); 30 2nd year core trainees (medics); 20 service users & carers.

The CLI incurs costs of around £5500 annually, various funding streams are accessed to cover this. These costs all relate to the salaries for service users and carers.

Key findings

The first two years of the CLI the participant and the service user/ carer experience were independently evaluated and these evaluations indicated that the opportunities for dialogue had been much valued. But, where a particular service user or carer had stayed with the same group for more than one session, a deeper rapport was established. Therefore from the second year onwards the model was revised, with a designated service user or carer staying with each small group throughout the initiative - including reading and commenting on their e-based discussions and their classroom based learning.

The pre/ post evaluation forms were revamped for the fourth year using the original evaluation forms as a template and these were distributed amongst the professional cohorts.

The evaluations indicated that whilst a small, but significant, number of social work, clinical psychology and nursing participants felt that they did not benefit from involvement in the CLI, the majority of students learned from this shared experience and felt that it would have a major impact on their professional development.

The main themes apparent in the qualitative evaluation provided by the professional groups and the service user and carers were:
- General appreciation of the work done in the CLI;
- Importance of listening;
- Value of contribution by service users/ carers;
- Despite having potential, a lack of educational value to the wikis.

In the future the Medics and the Clinical Psychologists will become more involved and will participate in three of the five days. In conclusion, the CLI meets important criteria of contemporary HEI education; the use of blended learning, high levels of carer & service user input and is interdisciplinary in its design and has consistently been positively evaluated.

Key learning points

The four main struggles that the CLI have faced have been finances, space, timing and staff time. Now that the CLI uses up to 20 service users/ carers across the different days this incurs a substantial cost. We have used grants, seed funding, external lecturer budgets, school managers creating special one off budgets and, most recently, ECQ funding from the SHA. However, every year there is uncertainty and difficulty into how the CLI will be funded. For institutions attempting to replicate the model we imagine they will face similar difficulties.

The CLI deals with large cohorts of people, up to 130 in a room together simultaneously. These participants and facilitators are divided into groups of about 7 to work together. Therefore, not only would institutions looking to replicate this imitative need to provide large rooms they also need to be large, flat rooms that can facilitate small group learning.

We have five different programs running simultaneously-each programme being organized in different ways and students being available for classroom teaching at different times. Whilst e-learning overcomes some barriers, it is not a panacea. The only way we can get five cohorts of students in the same room at the same time is by lecturers and course administrators showing flexibility and allowing students to attend CLI sessions when they should be elsewhere.

The two lecturers who are the driving force behind the CLI invest an inordinate amount of time in it - organizing, recruiting, booking rooms, securing finances, making sure service user/ carer payments happen, disseminating information and managing tensions that arise. Without key individuals wanting the CLI to be a continued success it would not continue.

We have a core of 7/8 service users and carers who are committed to the values of the CLI and we return to them on an annual basis for their input. This stability is very helpful and important to the success of the CLI.

Contact details

Chris Wagstaff
University of Birmingham

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