Personally, this blog post for me is part of an on going challenge as I try and embed a culture of involvement within a Healthcare education Faculty. How will I measure success and achievement? Do I use quantitative (numbers) or qualitative (words) measures? Using a hierarchy measurement such as the ladder of involvement is one way of measuring involvement success. This ladder, clearly heavily influenced by Arnsteins citizen participation ladder, was developed by Tew to enable a closer examination of how institutions were allowing true service user/carer involvement within mental health professionals education. Therefore higher-order involvement activities that go beyond the so-called ‘face to face’ patient/student session that may include recruitment, programme and module design and student assessment amongst others will be reflected in the higher steps of the ladder. A condensed version of the ladder is as follows:
Step 1: No involvement
Step 2: Limited involvement (“tell their story” sessions, etc)
Step 3: Growing involvement (at least two of: Module/curriculum planning, stud selection, student assess, etc)
Step 4: Collaboration(Full team members re step three, payment for teaching at full visiting lecture rates, etc
Step 5: Partnership (All key decisions made jointly, PPI funding strategy, statement of values, etc).
See page 54 of this document for a beeter explanation of the ladder of involvement: http://www.mhhe.heacademy.ac.uk/silo/files/learning-from-experience-whole-guide.pdf
It would appear at first glance this ladder would be useful in allowing an institution to reflect on its growing involvement work. However, looks can be deceiving. For example, an institute could have a policy of including patients/carers within their recruitment activities for students and ‘claim’ they do this from the perspective of measuring themselves against the ladder of involvement (see steps 2 and 3). However, having a policy is one thing, frequency of achievement is another. I would argue that unless patients/carers were present on the majority of recruitment events it could not be claimed that this has been achieved from a ‘registering on the ladder’ perspective. This observation is valid in my view for all hierarchical measurement structures. Anyway, should we be solely using a quantitative (numbers) system of measuring involvement success? This blog is called the experts by experience blog and perhaps therein lies a possible solution. Why not use a qualitative (words) measurement approach to supplement use of the ladder and ask some ‘experts by experience’ who are involved within educational institutions if they truly feel involved? Do they feel overawed and outnumbered by academics at meetings? Do they feel listened to? Do they feel they make a difference? These issues are crucial as institutions start to grapple with the issue of patient and public engagement and how we can measure their effectiveness to our student learning. Ultimately, success is about ensuring that our students become better people centred practitioners who are prepared to listen to expert patients and facilitate empowering, collaborative relationships which encourages shared decision making and effective self management skills that will ultimately benefit everyone. I will explore my thoughts as to how we measure the student experience of patient/carer involvement in education in a later blog.
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