1. Medical Students working as Healthcare Assistants
Dr Susanne Lindqvist
Learning and Teaching Day, May 2017

2. Background NHS values:
The NHS strives to employ staff with the necessary values required to care for patients and work collaboratively with colleagues to provide integrated care.
NHS values:
show respect and dignity
show commitment and quality of care
show compassion
improve lives
work together for patients
everyone counts

3. Response
An intervention was developed whereby medical students have the opportunity to learn about fundamental care needs and the role of the Healthcare Assistant (HCA) The HCA is a key staff member who each day needs to apply the desirable NHS values and behaviours as they provide care to patients

4. Pilot (n=31)
31 first-year medical students completed an HCA induction and three supervised shifts across three hospital trusts:
Norfolk and Norwich University Hospital, NNUH
James Paget University Hospital, JPUH
Queen Elizabeth Hospital, QEH

5. Content
Training
First two weeks of their Module 1 secondary care placement.
Some training were part of their “normal” Module 1 and some was specific to their role as HCA. Extra staff was recruited to provide the necessary HCA training (e.g. manual handling, washing, feeding, safe guarding).
Blended learning: face-to-face, online, workbook.
Shifts
Three six-hour HCA shifts in the company of a mentor during the week
14th - 18th December. First shift started 9am; second was late (finishing ~ 8pm or 10pm) and third early (starting ~ 7am).

6. Learning Outcomes
… to demonstrate knowledge and skills associated with care delivered by an HCA and thus gain an understanding of the contribution of an HCA to the care pathway.
… to describe how hospital wards “work” and how different staff members contribute to the care delivery of each patient.
… appreciate the stresses of shift work patterns.
… identify common challenges associated with the role and responsibilities of an HCA.
… describe interprofessional and professional-patient interactions and communications as an HCA within a real clinical environment.
… describe some differences and similarities between own future profession and that of an HCA, in providing high quality and safe care.
… appraise what knowledge, skills, attitudes, values and behaviours a doctor needs in order to enhance the contribution of all members of healthcare staff.

7. Evaluation of Learning Outcomes

8. Students feeding forward…
“It will help future doctors appreciate and understand the other members of their team more which will in turn mean closer relationships which will only help improve the patients care. It also allows students to become HCAs during which they can improve their consultation and people skills allowing them to become even more well rounded.”
“It’s an absolutely fantastic experience. Whilst it was hard work, I got so much out of it and have heard from so many people on the ward (esp. the nurses) that doctors who have trained as HCAs deliver yet another level of care for their patients. I loved being able to meet the patient’s individual needs and have grown so much with the experience and the challenges.”

9. Mentors (supervising shifts) feeding forward…
Hands on and enthusiastic
Excellent attitude & willingness to learn
Showed empathy
Helpful
Competent
Needs to be done sooner than later
Very shy when interacting with patients and staff
Awkward and/or embarrassed when providing care
Lack of understanding of what was expected

10. Educators feeding forward…
The project worked well and much better than they had anticipated
We can do this again, but not with more students
Students improved in their second week
Support and preparation was good
It will make a difference to future doctors
First week was rushed
Project may be better delivered during the summer
There was duplication of some teaching

11. Key points from pilot
The overall feedback from students taking part in the pilot (87% response rate), educators involved in the training, and mentors supporting students during the actual shifts was that:
this is a great learning experience
this should be offered to all medical students
the training needs to be more hands-on, more interactive, less repetitive
shifts are invaluable, but need to take place during term time and best if students can be mentored one- to-one

12. Extended Pilot (n=60)
35 first-year medical students and 25 Foundation Year students will complete an HCA induction and two or three supervised shifts across three hospital trusts, two nursing homes and three community trusts:
Norfolk and Norwich University Hospital, NNUH
James Paget University Hospital, JPUH
Queen Elizabeth Hospital, QEH
Holmwood House
Meadow House
Norfolk and Suffolk NHS Foundation Trust
Norfolk Community Health and Care NHS Trust
East Coast Community Care

13. HCA shift allocation for Foundation students and first year medical students 2016-2017

14. Overall Learning experience

15. Students likes…
The hands-on approach where I was not just watching, but actually taking part and doing everything. This made me appreciate the role of an HCA. Due to this experience, I am currently applying to be an HCA over the summer holidays.
Working with very friendly and inspirational healthcare professionals, seeing patients with a variety of conditions, hearing their journey and being able to help even in a small way. Getting to see how life on a ward is throughout the whole day.
Having responsibility on the wards. I felt like I was making a difference to the patients and providing care which was helping them. I enjoyed being placed on the same ward for the whole of the placement as this meant I built relationships with staff and patients on the ward

16. Students dislikes… Having to wake up at 5am for the 7am shift!
Changing patients’ pads or taking them to the bathroom; although this taught me a lot about compassion and being able to empathise with patients more.
The long [12 hour] shift
The duvet and pillows in the accommodation were not very comfortable
Having to stay on during Christmas week when everyone else got
to go home…

17. Way Forward
Meeting with Trust Partners Involved in July to share feedback and in particular discuss:
Training
Shifts
Timing
Cost
Numbers for
Sustainability

18. Thank you for listening
Any questions?
Thank you also to all Practice Partners making this project possible