35,99 €
Mehr erfahren.
- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
Behavioural science to develop effective health professional education serves as a practical guide in the cutting-edge area of health professional education and behavioural science. This textbook will provide practical evidence-based guidance to enhance the real world impact of your health professional training, To aid in seamless reader comprehension, chapters work through clear step by step stages, with boxes to verify understanding, along with examples to work through and links to further reading if readers want to understand more about underlying theory. The book also contains a series of templates which can be adapted for use by the reader. Sample topics covered in Behavioural Science to develop effective health professional education include: * Education and training as a behaviour change intervention, covering language of learning and behaviour change, with examples of behaviour change intervention approaches * Defining the behaviours that you want to change, intended behavioural outcomes (IBOs), and specifying your IBOs * Exploring the influences on behaviours, covering Influences on practice, and how to explore influences on each IBO * Developing training to change behaviour, covering active ingredients of behaviour change activities, and the process of creating behaviourally informed training For postgraduate and undergraduate health professional courses, continuing professional development providers, and providers of health professional training in medicine, nursing, dentistry, and allied health professions, Behavioural Science to develop effective health professional education is an essential resource on the subject that helps make education and training more effective.
Sie lesen das E-Book in den Legimi-Apps auf:
Seitenzahl: 161
Veröffentlichungsjahr: 2023
Ähnliche
Training to Change Practice
Behavioural Science to Develop Effective Health Professional Education
Jo Hart
Professor of Health Professional Education University of Manchester, UK
Lucie Byrne-Davis
Professor of Health Psychology University of Manchester, UK
Wendy Maltinsky
Health Psychology Senior Lecturer University of Stirling, UK
Eleanor Bull
Senior Health Psychologist, Manchester University NHS Foundation Trust, UK Highly Specialised Health Psychologist, Derbyshire County Council, UK Honorary Senior Lecturer, University of Manchester, UK
This edition first published 2023
© 2023 John Wiley & Sons Ltd
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.
The right of Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky and Eleanor Bull to be identified as the authors of this work / the editorial material in this work has been asserted in accordance with law.
Registered Office(s)
John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA
John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
Editorial Office
9600 Garsington Road, Oxford, OX4 2DQ, UK
For details of our global editorial offices, customer services, and more information about Wiley products visit us at www.wiley.com.
Wiley also publishes its books in a variety of electronic formats and by print-on-demand. Some content that appears in standard print versions of this book may not be available in other formats.
Limit of Liability/Disclaimer of Warranty
The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.
A catalogue record for this book is available from the Library of Congress
Paperback ISBN: 9781119833482; ePub ISBN: 9781394172214; ePDF ISBN: 9781119833499; oBook ISBN: 9781119833505
Cover Image: © beanimages/Shutterstock
Cover Design: Wiley
Set in 10.5/13 pt STIXTwoText by Integra Software Services Pvt. Ltd, Pondicherry, India
Contents
Cover
Title page
Copyright
Foreword
Acknowledgments
CHAPTER 1 Education and Training as a Behaviour Change Intervention
What Is Continuing Professional Development?
The Purpose(s) of CPD
The Challenges of Changing Practice through CPD
Important Concepts and Theories
Miller’s Pyramid
Figure 1: The interaction of capability, opportunity, motivation and Miller’s Pyramid
A Shared Theoretical Language
Why Think about Behavioural Theory?
The COM-B Framework
Figure 2: Influences on behaviour mapped to capability, opportunity and motivation
A Focus on Motivation
Why Is Behavioural Science Important?
Effective and Enjoyable Training
Principles for Effective Training
Principle 1. Starting from Where Learners Are
Principle 2. Working in Partnership
Principle 3. Interactive/Active Learning
Principle 4. Communication
Principle 5. A Collaborative Learning Environment
Principle 6. Individual and Group Voices
Principle 7. Time for Reflection
Check Your Understanding and Reflect
Useful Links and Further Reading
Behavioural theories and types of behaviours
Dual processing
The COM-B Framework
PRIME Theory and other briefings on behaviour change
References
CHAPTER 2 Defining the Behaviours That You Want to Change
Introduction
Developing a Theory of Change
Tips and examples
Intended Behavioural Outcomes (IBOs)
Tips and examples
How to Develop IBOs
Tips and examples: Topic guide and cues for a behavioural specification focus group
What Does the Evidence Say?
Choosing the IBOs on Which to Focus
Whose IBOs Are They?
Check Your Understanding
Useful Links and Further Reading
Developing A Theory of Change
References
CHAPTER 3 Exploring the Influences on Behaviours
Influences on Practice
Figure 3: The COM-B framework
Capability
Tips and examples
Opportunity
Tips and examples
Motivation
Tips and examples
How to Explore Influences on Each IBO
Before Developing CPD
Tips and examples
Tips and examples
During CPD
Check Your Understanding and Reflect
Further Reading
More About Exploring Influences on Behaviour
References
CHAPTER 4 Developing CPD to Change Behaviour
The Active Ingredients of Behaviour Change Activities
Reminder: What is COM-B Again?
BCTs and Communication Skills in Education and Training
Tips and examples
How to Develop Your Training Activities
Capability
What Does the Evidence Say?
Figure 4: The Johari Window
Tips and examples
Figure 5: Post-it notes to illustrate an effective practitioner
Building Psychological Capability
Tips and examples
Building Physical Capability
Figure 6: A cycle for physical capability improvement (learning a skill)
Tips and examples
Opportunity
Building Physical Opportunity
Tips and examples
An Appreciative Inquiry Approach
Building Social Opportunity
Tips and examples
Tips and examples
Figure 7: Comic book strip
Motivation
Building Reflective Motivation
Tips and examples
Building Automatic Motivation
Tips and examples
Planning the ‘How’ of Your Training
Consider Space
Consider Numbers
Consider Acoustics and Visuals
Consider Time
Consider Dynamics
Consider Technical Equipment and Skills
Consider Administrative Support
Consider Refreshments
Consider Culture/Contexts/Countries
Online
Blended Learning – Synchronous and Asynchronous
Figure 8: Considerations for a blending learning course
The Building Blocks of Your Training
Figure 9: Overview of training structure
Introductions
Welcoming
Introductory Activities
Trainee Introductions
Create Name-Plates
Introductory Bingo
Introduce Your Neighbour
Throw the Soft Toy
Group Agreements
Course Expectations, Hopes and Fears
Balancing Training Energy
Endings: Reflection, Action Planning and Evaluation
Check Your Understanding and Reflect
Further Reading
References
CHAPTER 5 Assessing and Evaluating
Process vs. Outcome
Why Are You Evaluating?
Theories and Frameworks to Help Us Evaluate
The Kirkpatrick Model
Tips and examples
Evaluation of Complex Interventions
Assessing Behavioural Influences
Topic guide
Figure 10: Topic guide example for interviews about the impact of a course on practice at follow-up
Assessing Behaviour
Check Your Understanding
Further Reading
References
Guides
Sample Training Plans
Aims
Tips and Examples: Setting up A Session
Cards for Change
Index
End User License Agreement
List of Tables
CHAPTER 04
TABLE 1 Examples of how...
Guides
TABLE 2 Setting up the session.
TABLE 3 Session outline.
TABLE 4 Session outline.
TABLE 5 Session plan, activities...
List of Illustrations
CHAPTER 01
FIGURE 1 The interaction of...
FIGURE 2 Influences on behaviour...
CHAPTER 03
FIGURE 3 The COM-B framework...
CHAPTER 04
FIGURE 4 The Johari Window.
FIGURE 5 Post-it notes to...
FIGURE 6 A cycle for...
FIGURE 7 Comic book strip...
FIGURE 8 Considerations for a...
FIGURE 9 Overview of training...
CHAPTER 05
FIGURE 10 Topic guide example...
Guide
Cover
Title page
Copyright
Table of Contents
Foreword
Acknowledgements
Begin Reading
Guides
Cards for Change
Index
End User License Agreement
Pages
i
ii
iii
iv
v
vi
vii
viii
ix
x
xi
xii
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
Foreword
This first edition of Training to Change Practice is a jewel for educators, psychologists and scientists. The four co-authors – the JEWeL of Jo, Eleanor, Wendy and Lucie – have drawn upon their domestic and international experiences to identify and propose practical solutions to one of the most salient issues in health and care systems worldwide: the market failures in the conceptualization, development, delivery and impact of education and training for health and care workers.
The authors rightly open chapter 1, and inform the book throughout, with an appreciation of health professional’s education and training as an economic sector, an industry, a market: with its inherent strengths and weaknesses and highly susceptible to internal and external factors. Their evidence from Canada and the United Kingdom strongly resonates with reviews and commissioned studies from the World Health Organization that conservatively estimate global expenditure in lifelong learning in the health and care economy in the range of US$12-15 billion per annum. A market that – when subject to scrutiny, evaluation and scientific review – demonstrates limited effect on practice and patient outcomes, irrespective of whether training is delivered in low-, middle- or high-income settings.
This global market within health and care systems has grown decade by decade: heavily influenced by two factors. A belief among many that “in-service training” was the primary solution to address quality of health services through improving the skills and knowledge of the health and care workforce, and secondly the expansion of official development assistance to health in the period from 2000.
Fortunately, the increased spending on in-service training has also generated additional analysis and scrutiny. In particular, multi-disciplinary teams of behavioural, education and health systems’ specialists are increasingly combining their respective sciences to reveal the conceptual flaws in the theory of change and bring new thinking to the fore. This contemporary logic includes moving beyond the transfer of knowledge, the assessment of time allocated to study, or the measurement of learners’ satisfaction with the training experience to one of how adults learn, their behaviour in teams and institutions, and how to develop competencies that will be routinely applied in practice. Assessment and learning transfer evaluation models likewise focus on the demonstrable application of learning.
Similar concepts are very much evident in this book, where the authors’ collective wisdom – channelled convincingly through “we believe”, “we find”, “we argue” and “we propose” statements – focuses on practical techniques, measures and theories of behavioural science to impact change in the workplace.
The book opens with a short overview of applicable concepts and theories, and the simple COM-B framework (capability, opportunity, motivation -> behaviour) that underpins subsequent chapters, before introducing seven key principles to develop and inform effective training. Chapters 2, 3 and 4 then guide the reader through a step-by-step approach to how to apply behavioural science techniques before Chapter 5 sets out a pragmatic approach to assessing and evaluating change, drawing upon process and outcome measurement. Many readers will particularly enjoy the topic guides, tips and examples and sample training plans across the book.
Beyond presenting the complexity of the field in an informative and instructional format, the co-authors challenge and nudge the reader to learn, think and act differently in their practice. Whilst drawing upon a rich, collective experience of the United Kingdom’s National Health Service with some examples from less resourced settings it is a public good for international application.
The book is particularly timely given the global health challenges arising from three years of the COVID19 pandemic. Many health and care systems are facing reductions in government health expenditure in real terms, new demands to recover, ‘build back better’ and expand preparedness in health security, and increasing political and financial pressure on health providers to optimize existing resources in pursuit of effective, quality services. Inevitably these demands will be transferred to the millions of health and care teams around the world to solve; requiring concerted efforts to invest in competency-based, behaviourally informed training that targets changes in practice.
All parties involved in the commissioning, subsidy, development and delivery of lifelong learning targeted to health and care professionals’ can learn much from this book. The application of the principles, tools and approach would do much to accelerate the use of behavioural science in the training of the world’s health and care workforce, address existing market failures and impact learning, practice and patient outcomes.
Jim Campbell
Director, Health Workforce
World Health Organization
Acknowledgement
We would like to thank Association for the Study of Medical Education for their support in the development of this book. Also, we would like to thank all the wonderful clinical educators we have worked with and particularly our colleagues at Health Education England, Tropical Health & Education Trust and Advanced Life Support Group.
We are very grateful to our supportive health psychology community, in particular The Change Exchange, Chris Armitage, Justin Presseau, Nicola McCleary, Jeremy Grimshaw and Marie Johnston.
With thanks to Paul Davis for expert proof reading.
CHAPTER 1 Education and Training as a Behaviour Change Intervention
Jo Hart1, Lucie Byrne-Davis2, Wendy Maltinsky3, Eleanor Bull4,5,6, Nicola McCleary7 and Chris Armitage8
1 Professor of Health Professional Education, University of Manchester, UK2 Professor of Health Psychology, University of Manchester, UK3 Health Psychology Senior Lecturer, University of Stirling, UK4 Senior Health Psychologist, Manchester University NHS Foundation Trust, UK5 Highly Specialised Health Psychologist, Derbyshire County Council, UK6 Honorary Senior Lecturer, University of Manchester, UK7 Senior Implementation Research Fellow, Ottawa Hospital Research Institute, Canada8 Professor of Health Psychology, University of Manchester, UK
Learning Points
Education and training can be an intervention to change healthcare practice
Clinical practice is composed of multiple behaviours, such as diagnosis, treatment and management, monitoring and supporting self-management
Practice behaviours are influenced by capability, opportunity and motivation
There are theory- and evidence-based methods to increase the likelihood of clinical practice change
WHAT IS CONTINUING PROFESSIONAL DEVELOPMENT?
Continuing professional development (CPD) is an umbrella term, covering all kinds of activities that help health professionals learn and develop throughout their careers (e.g., Peck et al. 2000). Among the most widespread CPD activities are the structured education opportunities that we will describe in this book as CPD training courses, although they are also called educational meetings or workshops (Forsetlund et al. 2021). As long ago as 2002, the UK NHS was estimated to directly spend approximately £1 billion annually on workforce CPD (Brown et al. 2002). CPD is seen as crucial to developing the more flexible, multidisciplinary health workforce envisioned in the recent NHS Long Term Plan (Karas et al. 2020). Given how much is invested in CPD, it is even more important that CPD is designed to maximise practice improvement, so the benefits of investment can be fully realised in terms of improving care delivery and ultimately health outcomes.
THE PURPOSE(S) OF CPD
In healthcare (and social care) settings, the main aim of CPD is to maintain and improve standards of safe and effective care. For instance, the Health and Care Professions Council, one of the nine regulators of the UK health professional workforce, define CPD to ensure practitioners ‘keep their skills and knowledge up to date and are able to practise safely and effectively’ (HCPC 2022). CPD may also aim to increase staff motivation, well-being and retention (Brown et al. 2002) through supporting staff to form new networks, feel valued, meet their personal development needs and benefit from reflective time away from their usual roles. This all sounds fantastic in theory, but as educators ourselves working to organise a wide range of CPD in the UK and internationally, we have found that developing training that changes hearts and minds, and most importantly, practice, is not all that easy. Research agrees: a recent Cochrane review combining 215 studies of educational meetings for healthcare professionals found these to only slightly improve professional practice compared to no intervention, with even fewer effects on patient outcomes (Forsetlund et al. 2021). Indeed, despite the aim of CPD being to improve and maintain safe and effective care, a review of accredited CPD activities offered to health professionals in Canada showed that 96% of the learning objectives targeted changes in cognition, i.e. were not designed to promote practice change (Légaré et al. 2015).
