Developing Technologically Enabled Remote Access to Recovery Colleges: A Co-Production Workshop.

On Thursday 16th of March at the Digital Exchange in Little Germany, Bradford, the  Digital Health Exterprise Zone (@DHEZ) hosted a workshop that brought together clinicians, recovery college students, users of services and technology innovators to consider the challenges of making recovery college sessions available for ‘remote participation’.

Professor Allan Kellehear, Academic Director @DHEZ, welcomes the delegates and introduces them to the challenge in hand.

Recovery colleges are meant to be health education communities where people can learn together, from each other and with educators developing personalised ways of improving their mental health, well-being and ability to work with distress. They should also offer opportunities to reforge identity, gain purpose and hope, hone life-skills and as desired work-skills without the latter being the necessary main focus of attention.

Steve Williams (@mhnurselecturer) and the lead for the @UoBRecoveryColl introduces what Recovery Colleges are and what the simulated college workshop will entail.

So why ‘remote participation’? The idea here is to consider developing technologies that enable people attending recovery education or psychological health sessions to join in from home if on that day they simply can’t get into college because they haven’t got enough money for travel, or they feel too distressed mentally or physically or for whatever reason that comes along with what health services typically refer to as ‘drop-out’ or reasons for non-attendance. Lots of advantages and lots of problems come along with this idea of remote participation. We feel it’s worth addressing these to help tackle, amongst other things, the ‘drop-out’ issue.

Drop-out is a massive problem in all forms of psychological health care, whether that’s situated in health or education. For example the most recent IAPT (Improving Access to Psychological Therapies) figures for 2015-2016 (from April 2015 to March 2016)  indicate that 33.9% of referrals end before entering treatment and of those referrals 92.1% did not attend any type of appointment. IAPT is the service aimed at providing psychological therapies for people with anxiety and depression. There were in total 1,399,088 referrals which equates to 1, 179, 328 people because there are sometimes multiple referrals, people being referred from one IAPT service to another and also people being stepped up from a lower intensity to a higher intensity service. 58.7% of referrals did not complete the course of treatment and ended participation for a variety of reasons and what ‘ending the referral’ means in IAPT terms  includes- declining to start, being deemed not suitable for IAPT or starting but not continuing. Given that IAPT aims to reach as an initial goal only 15% of those with anxiety and depression who need ‘evidence-based treatment’ and has a target of 50% reaching ‘recovery’ multiple approaches to addressing the reasons why treatment ends or is patchy are clearly urgently required. Using technology is one possible approach that we are exploring at Bradford.

Our delegates view, in another room, what is going on in the College Simulation and grasp the difficulties of current technology in providing ‘remote participation’ first hand.

Having run the workshop on the day our delegates left having worked together to form the skeleton framework of potential solutions. Problems were identified and discussed and ways to overcome them from an operational and technical perspective were raised. We now have potential partners who encompass user-experience, clinical and educator experience and technology expertise. We are looking forward to them joining with us on the next step to exploring how feasible, safe, and effective remote participation can be as a strand of delivering mental health care and to those struggling to find it and attend in our current education and care provision.

And here’s an interesting 360 degree image from one of our technology colleagues (David Renton) who participated on the day:

Interesting workshop in Bradford on Innovative tech to support Mental Health #MVPBuzz #MIEExpert #theta360 – Spherical Image – RICOH THETA

Some Thoughts on ‘Public Professionals’ on Social Media.

WeBlog
You can see the thoughts of other attendees to #WGT16 at the Live Blog.

I attended the fabulously well-organised #WGT16 (We Get Together 2016) event developed by the We Communities social media group. I’m not sure if ‘group’ is the right word – ‘network’ maybe? Anyway there was an Open Technologies discussion section towards the end where we were asked to think about “How Can We Improve the Lives and Services for Our Patients Through Social Media?”. This question prompted a range of strong reactions in me on the day, and still does. I blogged about it over at the We Communities site, and I’ve reproduced it here with some additional formatting.

Some thoughts from #WGT16. It was so nice to see lots of ‘tweeting’ nurses together in one place and spot people I knew in the community. I even got the chance to talk to some of them IRL and meet some new folk along the way. So the social aspect was good. Our table had an interesting discussion when it came to looking at how social media might be used to improve the lives of people we work with. I have some reservations about this and we acknowledged these within our group.

We discussed how we ‘curate’ our follows – that is our use of twitter depends on to a substantial degree (but not totally), on whom we choose to follow. So with my @mhnurselecturer account I naturally tend to follow a lot of folks who tweet about mental health and related issues. Therefore I think we are sometimes at risk of creating ‘networks of the likeminded’ to some degree and perhaps we need to think strategically about how we diversify our twitter network. Much was made of in the day about how diversity in our networks can be fruitful. We therefore thought that we don’t want to replace one sort of silo with another and that reaching out and following people in other walks of life, professions, with other interests and passions could be a helpful way of improving the diversity of what we experience through social media.

I work with people and work to improve the services that deliver care to people who are marginalised in many ways, stigmatised and also structurally disadvantaged in our society. They are also subject to damaging terrible experiences of abuse, coercion and control – socially and organisationally. They may well not wish to interact with me as I may well represent to them exactly the kind of thing they want to stay away from. So I find myself thinking that we must be attentive to the needs of people who for many good reasons may not wish to interact with professionals on social media. They could do without another form of imposition on top of what they have already experienced or are experiencing. Just as we would in other avenues of communication we must be attentive to the space and territory that we occupy in these virtual spaces. Not all will welcome the idea of professionals seeking to ‘improve their lives’ through social media, and may find this threatening and invasive.

An @WeNurses WebBlog Article on Digital Education in Nursing

EmbracingDigitalEducationforNursing

Embracing Digital Education for Nursing (An @WeNurses WebBlog Article).

Originally Posted on Sept 9, 2013 by mhnurse

This is the original article text for my @WeNurses WebBlog Article on Embracing Digital Education for Nursing. Teresa Chinn (@AgencyNurse) invited me to write this blog article for @WeNurses over at WeNurses.co.uk as she became aware of how we are developing the integration of social media use, and twitter chats in particular, in our pre-registration nursing curriculum at Bradford University (@BradfordUni). I chose to take a somewhat personal perspective and incorporate the story of my development as a ‘twittering’ nurse for want of a better phrase and how the project ensued.

Embracing Digital Education for Nursing

Earlier this year I did something quite major in terms of my twitter identity. Having reviewed the NMC’s SoMe (Social Media) guidelines (NMC, 2012) I changed my identity to a professional one on twitter. I’m now @MHNurseLecturer. From this moment on I shifted the emphasis  to largely tweeting about the needs of people with mental illness and how we can learn from their struggles. I wanted to get serious about helping liberate us from what I largely see as something of a mess that our society’s fear and lack of understanding has created. Twitter is a way of communicating and connecting with others who share your interests and also challenging the views of others who maybe don’t.

I became aware of other professionals, groups, service users and nurses in particular. I can’t recall how I stumbled upon @WeNurses initially as an organization. I honestly didn’t like the sound of it at first –“How could it include all of us?” I remember thinking. However, I resolved to give it a try and joined in on a few twitter chats. So I eventually found myself rather late at night in the University hunched over my computer as my colleague was giving a seminar on Diversity in the office via Skype. I was helping co-lead a nursing twitter chat! I had connected with some organizational development professionals I met over twitter in a previous @WeNurses chat when it became apparent that we shared the same kind of interest in resiliency and mindfulness. We led a twitter chat together having collaborated to put in our proposal and you can read the write up I put together for that here, and also here at WeNurses.co.uk (Williams, 2013).

At this time I was in the throes as a module leader  of putting together the first run of our Year Three, Semester One module for nurses. At this point of their training they are ‘developing proficiency’ and consolidating their skills. I’d also been charged with threading cognitive based talking therapies and their derivatives throughout the curriculum to bring our nursing training up to and beyond scratch in terms of delivering evidence-based interventions for serious mental illnesses. That’s my area of expertise from my own experience and on-going clinical practice since 2002. I’m currently a nurse-therapist part-time, so I just started weaving in what I do into the curriculum and developed the delivery of teaching sessions that focus on skills coaching, recovery and talking therapy interventions by nurses. I’ve also engaged nurse turned psychotherapist professionals in practice to come into education and co-teach sessions with us.

It occurred to me to join some of these things up. Why not, I thought, get the students to run a twitter chat? First let’s get twitter streamed in our school. I quickly got my learning resource team colleagues to stream @WeNurses chats on one of the displays as a trial. I say ‘quickly’ that was several months of e-mails and effort! Students could have their lunch and watch the tweets of professionals, carers, service-users and others on the current topics as they arose. This trial run quickly showed me that we need a dedicated display so that the screen can be rapidly controlled directly by an academic and not have to compete for space with other necessary university information. So my learning resource team colleagues figured out how to have a dedicated display page that we could switch from #hashtag to #hashtag according to what was topical and also control the time-parameters of the twitter stream so that it could be displayed retrospectively.

At present we have a business case for the screen being processed to have this dedicated display create a permanent social media presence in the school. The vision is that Academic Twitter Champions (ATC’s) will form a multi-disciplinary academic team that can seek out interesting SoMe users, dialogues and #hashtag streams. The ATC will then be responsible for ensuring  that they are of relevant interest and are suitable for student consumption so we can respond rapidly and safely to emerging debates. Naturally we are wanting as an organization to safeguard the quality of the content and minimise the risk of deleterious twitter activity from being displayed. Another knock on benefit we forsee from this is being able to role model the use of SoMe and NMC SoMe guidelines for nurses in training.

I took things a step further by making a twitter chat a vehicle for student learning.  So for example something we examine really closely at this stage of the nurses education is what they understand of ‘evidence’. As  a whole collection of nursing fields they come to grips with the nature of research informed evidence, evidence based practice and evidence informed practice. These are perhaps, to some, relatively subtle distinctions and are further complicated when you consider how these kinds of practice and evidence differ from say practice-based evidence! It may sound as if I’m merely shuffling the same words about but these are distinct relationships between kinds of evidence and types of practice.

I’d already planned on a whole field in class structured debate for the module. That is: there will be a student-led debate after a key lecture on the nature of evidence. This trigger lecture refreshes what they’ve already learned and sets out some of the pro’s and con’s of different kinds of evidence, efficacy vs effectiveness, mixed methods vs single methods and so on. They then have a whole field debate that we facilitate on whether NICE (National Institute of Health and Care Evidence) standards of evidence are sufficient for nursing practice.

From this the students will put together a small working party and use their initial debate to put together a @WeNurses twitter chat on what they found interesting about being ‘evidence based practitioners in nursing’. Everybody in the fields will be able to contribute to the discussion on twitter though and therefore the learning that comes from it. The elected group will make a full submission and lead a twitter chat and see what it is like to disseminate and discuss knowledge creation and sharing in this digital medium. This hopefully will help them draw upon a wider range of critical views, improve their own constructive critical thinking and show them the value of knowledge transfer in the digital age. It will hopefully also show them some of the pitfalls too.

The first run of this module is coming up in September. Part of the evaluation of learning will be the twitter chat transcripts and bits of work following on from the dissemination fed back into the module. I hope they put together a good submission for @WeNurses so that we end up with some healthy sharing of student nurse and professional perspectives on the nature of what we call evidence, and how we put it into our practice. If this would be of interest to the @WeNurses blog-o-sphere, I’ll come back with what we learned and ask some of my student nurse colleagues to give you their account of the process of getting involved in this kind of digital literacy in their nurse education and training. You can then be instrumental in the educational development of your upcoming colleagues who are getting ready to join you in improving and maintaining the delivery of high-quality, compassionate nursing care in our unfolding post-Francis world.

References:

Nursing and Midwifery Council (2012), Practical guidance for students, nurses and midwives using social networking sites [online], London:  Nursing and Midwifery Council. Available from: http://www.nmc-uk.org/Nurses-and-midwives/Regulation-in-practice/Regulation-in-Practice-Topics/Social-networking-sites/ [accessed 21st August 2013].

Williams, S. (2013), A Twitter Chat for @WeNurses on Resilience (Hosted 7th March 2013), The Inside Skinny Latte Blog, 8th March 2013, Available From: http://mhnurselecturer.co.uk/wp/?p=10, [accessed 21st August 2013].