Evaluating the impact of training clinicians to learn motivational interviewing, psychological support skills and promote self-management of mental health for cancer patients
Why the research is needed
Cancer has damaging consequences on mental health and suicide risks. However, cancer patients are less likely to seek or receive help for these problems. Poor identification and management of common mental health problems can result in poorer quality of life, lower treatment concordance and increased care costs. Therefore, a training programme was developed to support cancer care staff with psychological skills and mental health problems assessment, aligned with current practice guidelines. This pilot project aims to deliver ‘Level 2’ psychological skills training and implement supervision for East Midlands cancer care staff in areas under-resourced for psychological support amongst cancer patients. Despite the need for cancer care staff to be trained in psychological skills, clear evidence for training effectiveness and training implementation into practice is lacking.
What is already known about the subject
Current evidence also indicates that staff who are more psychologically skilled may be at lower risk of burnout. This is particularly important at a time when there are large numbers of NHS doctors and nurses leaving the profession due to burnout. Psychological skills training and supervision therefore presents the double-benefit of improving psychological skills in the cancer care workforce and potentially preventing burnout as a by-product. However, training evaluations rarely assess the impact of training on these important factors, despite their effect on service quality and staff retention.
Therefore, this evaluation will provide evidence on the degree to which psychological skills training translates to changes in clinical practice amongst cancer care staff in being able to provide patients with additional low intensity psychological interventions. It will also provide evidence of the impact on staff wellbeing and burnout, which are not commonly evaluated.
Who we will be working with
The East Midlands Cancer Alliance Board and specifically the Living with Cancer working group all contributed to the design development and specification of the training to be evaluated.
The EMCA-funded training and supervision project team has been working with patients with lived experience of cancer diagnosis.
Aside of the level 2 training and supervision, Dr Tim Anstiss of Virtual Health Labs, will provide training in motivational interviewing for cancer care staff. The training, involving three cohorts of 20 participants each is part of the overall project and included in the evaluation.
The identification of relevant staff and integration of training and supervision into work plans is led by Lead cancer nurses in Lincolnshire, Derbyshire, Nottinghamshire, and Leicestershire.
How patients and the public are involved
Patient advisors with lived experience of cancer diagnosis and treatment were involved in the development and refinement of the training programme. In addition, patient feedback about the benefits of the psychological skills acquired by staff has informed improvements of the training to be provided in this project.
The EMCA-funded training and supervision project will develop a patient advisory panel for the project as a whole, members of which will contribute to the design and development of the evaluation project and its processes.
What we will do
As part of the evaluation, those attending training will be asked to fill in surveys before and after the training session, and three months later. The surveys will cover work engagement, work-wellbeing, capabilities to recognise and assess mental health problems, and ability to use the taught skills.
In addition, participants will be invited to participate in a telephone interview to discuss their experience of the training sessions and supervision, and the implementation of the psychological tools and skills into their practice. Interviews will also explore improvements to the training programme.
What the benefits will be
Evaluation of the training acceptability, its effectiveness with reference to implementation of psychological skills into practice, and its effects on staff wellbeing (work engagement, burnout). The evaluation will also identify barriers and facilitators to implementing taught skills into practice to develop adequate support during training whilst increasing the benefits to practice.
The training evaluation will contribute to improve access to psychological skills training and supervision for cancer care staff.
When the findings will be available
The final findings will be available by 1st of March 2023.
How we are planning for implementation
The projects being evaluated were funded with a view to long-term adoption of psychological skills training processes in cancer care services beyond project completion. With motivational interviewing, psychological assessment and intervention skills, this evaluation will help shape a model for dissemination with the largest clinical impact. Overall, this evaluation will offer more comprehensive evidence of the training impact, and ways to improve training through the important focus on implementation of skills into clinical practice.
Contact
Clem Boutry, mszcob@exmail.nottingham.ac.uk.