Mental health consumer participation in undergraduate occupational therapy student assessment: No negative impact

Learning from lived experience: Outcomes associated with students' involvement in co-designed and co-delivered recovery-oriented practice workshops

INTRODUCTION

Learning from individuals with lived experience is considered an important element of developing recovery-oriented practice capabilities in mental health contexts. Additionally, service user involvement in the education of occupational therapy students is a requirement in accreditation standards. Despite this, many barriers to meaningful inclusion of Lived Experience Educators have previously been identified.

METHOD

This study evaluated the outcomes achieved by students who were involved in a unit of study that incorporated four recovery-oriented practice workshops that were co-designed and co-delivered by Lived Experience Educators and an occupational therapy academic. Change over time was measured using the Recovery Knowledge Inventory (RKI) and the Capabilities for Recovery Oriented Practice Questionnaire (CROP-Q). Change over time was evaluated using paired t-tests. Students also provided qualitative feedback at the conclusion of the workshops. These comments were analysed using interpretive content analysis.

RESULTS

Students' scores on the RKI and CROP-Q both demonstrated statistically significant improvements from the beginning of the semester to the end of semester (RKI: 53.6-57.7, t = 6.3, P < 0.001; CROP-Q: 75.6-77.0, t = 2.4, P = 0.019). The most common categories included in the qualitative comments were: "Learning from real experiences"; "Learning about how to be a better clinician"; "See the strength and resilience of the educators, reduce stigma"; "Learning about the negative aspects of the mental health system"; and "More effective than other types of learning".

CONCLUSION

This study has demonstrated that students who engaged with the co-designed and co-delivered workshops improved their recovery knowledge and recovery-oriented capabilities over the course of the semester. Qualitative feedback also suggests that students' attitudes and skills for future practice were also influenced in positive ways by engaging with Lived Experience Educators.

The impact of face-to-face mental health consumer-led teaching on occupational therapy student empathy levels: Two group comparison design

INTRODUCTION

Australian and New Zealand accreditation standards for occupational therapy courses mandate consumer involvement in the design, delivery, and evaluation of courses. Consumer involvement in medical, dental, and nursing education has been evidenced as a factor for increasing student empathy. To date, there has been no known research on the impact of mental health consumer involvement on occupational therapy students' empathy. The aim of this study was to investigate if occupational therapy students who receive teaching from a mental health consumer demonstrate higher levels of empathy compared with students who receive teaching delivered by occupational therapy academics.

METHODS

Pre-post, quasi experimental, two group comparison design was used to measure second-year student empathy pre and post a consumer-led teaching tutorial. Students (N = 217) were randomised into two groups across three university campuses: 'teaching as usual group' (control) or 'consumer-led' group (experimental group). The Jefferson Scale of Empathy was used to measure student empathy.

RESULTS

N = 138 matched scales were returned. Little difference in empathy scales was detected between groups. The 'consumer-led' group increased for the empathy scale by 3.4(95% CI: 0.7,6.1, p = 0.014) but was not statistically significant compared to 1.3(95% CI: -1.0,3.5, p = 0.267) for the control group. Both groups scored highly on empathy.

CONCLUSION

This study found that occupational therapy students had pre-existing high levels of empathy. The challenge for future research is to identify appropriate ways to measure the impact of mental health consumer involvement on occupational therapy curriculum and students.

Describing consumer involvement, recruitment, retention in Australian occupational therapy university education: A cross sectional survey

Introduction

Consumer involvement in occupational therapy programmes is one of the accreditation requirements of the Occupational Therapy Council in Australia. Consumers are direct recipients of occupational therapy services. Current knowledge about consumer involvement within occupational therapy education is minimal and mostly in mental health. This study identifies the trends for involvement and methods for recruitment and retention of consumers in Australian occupational therapy university education programmes.

Methods

Twenty-one occupational therapy programme directors in Australian universities were directly invited by email to participate in an online questionnaire. Prior to distribution, the questionnaire was piloted and the content validity tested. Analysis of closed-ended questions occurred using frequencies and percentages and content analysis occurred with open-text responses.

Results

Nine programme directors completed the questionnaire. Consumers were mainly involved in delivering lectures, sharing stories and having discussions in small groups. Consumers were recruited to programmes through collaboration with organisations and/or by direct approach. The main retention strategies included employing consumers as university educators and providing support before/during involvement.

Conclusion

Consumer involvement in curricula addresses university programme requirements and aims to prepare students for consumer-focussed practice. The findings inform educators about diverse ways of recruiting, retaining and involving consumers in their programmes.

Embedding lived experience expertise across the mental health tertiary education sector: An integrative review in the context of Aotearoa New Zealand

WHAT IS KNOWN ON THE SUBJECT?: An important step towards improving mental health outcomes is the realignment of tertiary mental health education and research in a way which places strategic value on experience-driven involvement in mental health and addiction-related care. One of the most widely recognized ways of achieving this is by increasing representation of individuals with first-hand experience of mental health and addiction distress (also known or referred to as Experts by Experience or EBE) within the tertiary sector. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Benefits of tertiary EBE representation such as improving student's preparedness for practice and the empowerment of mental health consumers are consistently reported throughout the literature. In striving towards these outcomes, it is crucial we remain mindful of relevant and often-reported hurdles such as stigma and improper implementation. By using Aotearoa New Zealand as a case study, the need for approaches to increasing EBE representation which is conscious of diverse cultural contexts, perspectives and identities is highlighted. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This review draws together a broad range of factors associated with improving clinical practice. These include the potential for EBE representation to improve outcomes for trainee clinicians, and the incorporation of consumer-driven perspectives into evidence-based practice. This review further highlights the need for EBE representation to be implemented in a way which is responsive to the cultural needs and nuances of mental health education and practice in Aotearoa New Zealand, and, similarly in other countries. ABSTRACT: Introduction There is potential value in increasing representation of expert by experience (EBE) involvement in mental health education sectors. This approach to improving mental health outcomes is here explored in the context of Aotearoa New Zealand's tertiary education sector. Aim/Question This review sought to identify potential outcomes, benefits and barriers associated with EBE representation in tertiary institutions, whilst critically analysing these strategies in the context of Aotearoa New Zealand's mental health education sector. Method Data retrieved from electronic databases were subjected to critical appraisal and thematic analysis. The integrative review drew from a final data set of 113 articles. Results An integrative review of our search results indicated that moving towards a tertiary mental health model in which lived experience plays a central role has the potential to benefit both teaching and research in the tertiary sector. Discussion The interplay between contemporary perspectives on tertiary EBE representation and the cultural needs and nuances of Aotearoa New Zealand's tertiary sector highlights the need for critical and careful approaches to EBE representation. Implications for clinical practice Findings surrounding tertiary EBE representation have direct implications for the training of mental health practitioners and the evaluation and development of clinical practice outcomes and procedures.

Consumer involvement in university education programs in the nursing, midwifery, and allied health professions: a systematic scoping review

BACKGROUND

Incorporating consumers' voices in tertiary education curricula is an ongoing initiative of educators of health professions in order to facilitate students' readiness for consumer-based practice and to meet accreditation standards. Consequently, educators within these professions use a range of different strategies to involve, recruit and retain consumers. To date, no study has attempted to consolidate the different strategies used by nursing, midwifery and allied health educators to involve, recruit and retain consumers. Consolidating these strategies will lead to a sharing of ideas, which would be of benefit to educators looking for ways to involve consumers in their programs.

OBJECTIVES

This scoping review aimed to identify how consumers are involved, recruited and retained in nursing, midwifery and allied health curricula, as reported within research from these professions.

DESIGN

The scoping review was carried out and reported according to the PRISMA Extension for Scoping Reviews.

DATA SOURCES

Eight electronic databases were searched on 8^th January 2019 for English, peer-reviewed primary literature without limiting publication date. The databases were: Cochrane Library, Embase, Emcare, ERIC: Educational Resources Information Center database, Joanna Briggs Institute EBP database, Medline, Scopus, and Web of Science.

REVIEW METHODS

The screening of studies was based on selection criteria and involved a two-stage process conducted by two independent reviewers. Once the studies were identified, two reviewers were involved in the charting process of each study. A form was developed to extract information regarding types of consumer involvement and strategies to recruit and retain consumers. Key concepts were then identified across the charted data and categorised and synthesised based on common characteristics or keywords.

RESULTS

From 2334 studies, a total of 58 articles were included. Four main areas for consumer involvement types and eight strategies for recruitment and retention were identified and mapped across the studies.

CONCLUSION

The collated findings allow idea sharing among educators from these professions on the various types of consumer involvement, recruitment and retention strategies. Enriching tertiary education programs with consumer input enhances student learning and assists these professions to meet accreditation standards.