Saturday 8 July 2017

Co-delivered #meded with technology - a joint blog with @TrevorKet

There is a drive in healthcare education to use technology and involve patients and service users in teaching sessions. Combining these two important agendas, I collaborated with a healthcare sciences lecturer, Trevor Kettle (@TrevorKet). to co-deliver two teaching sessions using the Meetoo app (and Skype). This a blog of two halves, with my reflections and Trevor's reflections (so do make sure you read both bits!)





These were students on two different courses at the Faculty of Health Sciences at Southampton University – both post-graduate, qualified health and social care professionals. The sessions were both 1.5 hours, and the first was co-delivered in person, while the second was co-delivered with Trevor Kettle in the room, and me Skyping in. 

The Meetoo App is a platform for real-time polling and discussion that allows students to share their thoughts and reflections, opinions and ask questions.

This blog is a collection of reflections on these experiences. These are twofold:
-       the process of using technology and collaborative teaching as a process to educate
-       the content of the conversation we had with the students.

Underpinning all of this was a strong equal partnership to co-produce the teaching sessions, the content and process between Trevor Kettle and myself – for which I am very grateful. Far from being onerous, this collaboration to coproduce the two teaching sessions required only a preliminary Skype meeting of about an hour and one or two iterations of the PowerPoint slides being shared via email. We had a short reflective debrief afterwards. Trevor’s perspective on it all in included below...

N.B. This isn’t formal research, so the data from the polls isn’t definitive but interesting none the less!

Establishing an understanding

Both sessions started with open-ended questions about the students thoughts and understanding of patient and public involvement. Whilst there was empathy with what patients, service users and carers might experience when receiving care, the majority of responses showed that their thinking on this subject was limited to people being involved directly in the care that the professionals were providing, rather than people influencing care provision at strategic level. When professionals were wearing their ‘care provider’ hat, involvement seemed to come naturally to them, but it wasn’t initially transferable to when the professionals were wearing their ‘leadership or management or strategic’ hats. A&E was the example raised in both sessions that highlighted this. In an emergency setting, a patients’ involvement in their own care is clearly limited, but people who have used A&E can be involved in planning patient pathways through A&E for example, which is at a strategic level.

This is reflected in two polls that were done in the first teaching session:

Who had heard of PPI before?
16.67% Yes, I am really familiar with it
53.33% Yes, I think so but don’t really know much about it
30% No, not heard of it before

Who sees involving and engaging patients and carers in partnerships as part of their role?
Yes, certainly, 54.57%
Yes to a degree, 46.43%
No 0%

And a third poll, in the second session:
How important do you think PPI is for research and service improvement?
Very important
14
77.78
Somewhat important
3
16.67
Unsure
1
5.56
Not really important
0
0.00
Not important at all
0
0.00

This suggests that in these sessions, there was a basic concept and understanding of the importance of involving people, but a degree of confusion or lack of confidence about what that means in practice. This was clear through some of the very enlightening questions that were later asked through MeeToo.

Questions and points of discussion

The MeeToo app allowed for questions that were very honest and quite hard-hitting, and allowed exploration of some of the most sensitive aspects of PPI.

The issue of motivation and bias was raised multiple times, as it feels like something the students are concerned about. Understandably, these are issues that important for their professional regulation.

What are the intentions of those involved in [PPI]?....is it always positive? Constructive?

[Their] agenda clouded by previous treatments?

Whilst I believe that patient/public interaction is important, there is the risk that there is a strong bias based upon experience and belief that may have the 'stronger voice'.  Obviously, there may be the same bias amongst the 'professionals'. However, those professionals may have a better ability to see the other view based upon their own academic learning and previous research experiences.

Does paying participates not create bias as well? Participating only to get paid?

The intentions of individuals getting involved can be very important in determining how they find the experience of involvement. Good recruitment, role explanation and expectation management can help with this. The payment question was interesting, as clinicians are often paid for additional roles, and the payment is actually very low in real terms, as the work is very sporadic. Again, recruitment processes can clarify this. It did prove a good opportunity to emphasize the importance of meaningfully valuing contributions from patients, carers and service users through different models of reciprocity. The bias of previous experiences was fascinating, as using previous experiences is what clinicians do as they become more senior to inform their practice. The key difference was that patients and carers might not have the academic and professional rigor to balance that. This is where ongoing support and debriefing from sessions and meetings can be important for patients involved, so they can reflect on their own processing of experiences. The conversations that people have when they are involved are often at a more general level of service improvement, research or education, and should be suitably facilitated so this doesn’t become an issue.


I’d feel awkward if not able to meet their requirements… Promise the world, not delivering it!

Faith that the organisation will support the input and feedback and allow involvement....I don't believe this exists therefore difficult to fully engage in PPI as feels a little fraudulent if cant act with best intentions

PPI can be difficult on the front line due to lack of resources and time. We want to do it!

These were both positive remarks, showing that the students appreciated how important the experience for the individual involved is, but highlights lack of confidence and support they receive in order to deliver that.

We have strategic knowledge which aids decision-making, service users do not. They may have great ideas for change management but financially and realistically we cannot provide.

Representatives aren't necessarily representative

No discussion on PPI would be complete without the representation debate, where we want people to be representative of an average patient, but bemoan their lack of greater understanding of the NHS. Many patients and carers and service users are interested in getting involved in PPI because they have a capacity for strategic thinking. Even if that isn’t obvious, the fresh perspective they bring can greatly aid decision making too. Part of the conversation is for the professionals at the table to be open and honest about the boundaries so there is shared understanding.  One student described this well on an post:
“Sometimes patient expectations can be unrealistic. The partnership should encourage a common understanding on both sides of the spectrum. I think only then we can create real solutions.”


Highlighting their understanding

There were some very good quotes from the students that helped us see what PPI means from their perspective…

Often organisations use [PPI] as tick box through easy methods such as patient survey.... so they look good that they appear to have done it but often find in reality feedback is ignored. Definite room for improvement!

Axe to grind people are often only around short term the true transformational patient leaders remain long term

We use [PPI] to enhance , improve and shape our services :)
It is striking that these students acknowledge imperfections in the system and the room for improvement and feel the potential in this approach, but it is challenging and they feel the pressure to do this  in a meaningful and appropriate way, while being unsupported.


The added value of the MeeToo app

Across the two sessions, there was an average of 90 posts per session, and several polls. There was a very high level of engagement with the app, and the feedback was overwhelming positive. The key points the students made about the benefits of the app in the session were:
-       Helpful if not someone who is comfortable speaking out in class
-       Interesting to hear more of what others think
-       Good for questions that might be ‘silly’
-       Gauge how others are feeling through polls
-       Useful to share links to websites and resources discussed
-       Helped the conversation stay honest
-       Anonymous comments
-       Good balance of face to face and technology

The only point for consideration in the future is about the challenge of listening to the discussion and following questions on the app. It might be that a follow-up session via the app could allow for further exploration of other questions not answered, and allow students time to process other questions while focusing on the discussion at the time in the session.

The graphs were very visual and normalized how they felt about PPI.

Being able to add polling questions enabled us to respond to the direction of conversation in the room and ask questions in a non-confrontational way to test the students approaches.

From a delivery perspective, it made the preparation easier as discussions could take care of themselves and slides needed to be simplified to just the key points of models to refer to in discussion.


PPI Co-delivery
As a non-academic ‘lay’ educator, these sessions felt very comfortable, for a range of reasons.

It was a very easy platform to use, and enable me to pick questions I felt most comfortable answering and that were the most important. This was real time ‘patient’ influence of the teaching agenda in collaboration with students!

It changed the dynamic from a lecturer knows best preaching to students to a more equal relationship of mutual interest and appreciation. This felt important as it directly models the behavior shift central to person-centred care and patient partnerships at all levels.

It enabled the student to ask questions of my experience comfortably, which meant they were acknowledging the assets I brought as a patient, and allowed me to acknowledge tier assets by hearing their experiences, again modeling an assets based approach which they might be unfamiliar with in a safe way.


Trevor’s Reflections…

I am a full time academic working in the Faculty of Health Sciences, university of Southampton. I have had the pleasure of working in partnership with Anya on a number of occasions in different ways, particular on jointly delivered teaching sessions. Anya has explained previously how we have begun to work with a new audience participation system called ‘Meetoo which has in my opinion enabled students to be connected with PPI in the lecture room to a much richer degree than has been possible up to now. Traditionally, in education we have used the tried and tested ‘raise your hand if you have a question’ format to allow students to communicate with the speaker. This can be successful in some contexts although it is easy to fall into the illusion that you are giving full opportunity to all students to ask questions and express their views. This is not so. Some students can be anxious about asking questions on such a public stage as they can perceive to be judged by their fellow students and also by the lecturer in case they are criticised for asking a ‘silly’ question. This usually results in the same few more confident students asking questions and giving comments. Meetoo (and other similar systems) offers the opportunity for ALL students to use web-based devices (Smartphones, etc) to send text questions/comments directly, in real-time, to the session presenter completely anonymously.  If a patient expert is leading the session, they will receive the questions on their own device and can choose the questions they would like to answer and comment on. All users see all questions. An added feature is the students can ‘like’ each other’s questions and the patient can order the comments in order of ‘most likes’, very useful if a large number of questions are received and there is not time to answer all. However, all comments can be downloaded after the session to be answered via text if required.

This system can be enhanced further by utilising Skype as a way of connecting patients geographically distant from the university campus. I have worked with Anya on developing this now to a fine art! In order to eliminate travel time and expense, Anya has more than once skyped her presence into the lecture room directly from her home location. By using Meetoo on her tablet device, next to her computer, she has access to all student comments as they are typed by the students. She is therefore have control over which questions to answer as explained previously.

What implications are there for PPI in healthcare education?  Combining technology in creative ways to enhance and enable a deeper level of patient involvement within a lecture environment can enhance a deeper learning within students, in my opinion. This have implications however to how academia interfaces with patients. My relationship with Anya is based on mutual trust, partnership and collaboration. I never consider myself to have a higher or more important knowledge level, even though I have a list of professional and academic qualifications. As a patient leader, I fully respect the experience and knowledge Anya brings to our projects. We are equals. I bring another kind of knowledge which includes teaching experience that enables me to construct learning environments described above that enhance and enable a deeper level of engagement between patients and learners.


Patient involvement in healthcare education is here to stay. As educators, we must move away from the model of wheeling a patient onto the lecture stage to ‘tell their story’ and be metaphorically ‘prodded’ by students. Using technology we can enhance the ability of patient leaders such as Anya to question and ask students to think about the issues that matter to patients and to take PPI into more strategic levels where real change can occur.  I want to thank Anya for her commitment to being involved with our student’s education and look forward to many more collaborations.

19 comments:

  1. Programming Assignment help
    In online mode, you can customize your assignment anytime and make desirable changes. But in offline mode, there is a limitation of time and place. Hence, you will have to think twice before customizing your order. I hope this article helped you to know that online Programming Assignment Help is far better than the offline mode. Not only it saves your time and effort but also gives a high quality of work.

    ReplyDelete
    Replies










    1. Just wanna say a big thank you cythia for introducing me to Dr Sayo the great HERBALIST that helped me prepare home remedies that cured my herpes simplex virus (HSV1&2)
      I was infected with herpes for the past two years and i was not happy all day so i was desperate to get a cure so that i can live normal and get healthy.One day i was less busy so i decided to make latest research on herpes  cure  and i found a site were everyone was talking about Dr Sayo and has ability to cure Herpes, HIV, HPV, Cancer, ALS, COPD, Anthrax, genital wart, cold sore, Arthritis skin tag and all manners of diseases and virus.So i discussed with cythia and she explained to me that its very easy working with Dr sayo  so i contacted Dr Sayo via email  dr.sayoherbalhealer@gmail.com and he helped me just as he has helped others now I am  now cured from herpes am very happy now.and i can also assure you that he can also help you. so if you need the service of Dr Sayo kindly contact him visit his websites website; http://sayoherbalhealer.website2.me/ Or check FB Page https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ check blog: https://sayoherbalhealer.blogspot.com/ 

























      Just wanna say a big thank you cythia for introducing me to Dr Sayo the great HERBALIST that helped me prepare home remedies that cured my herpes simplex virus (HSV1&2)
      I was infected with herpes for the past two years and i was not happy all day so i was desperate to get a cure so that i can live normal and get healthy.One day i was less busy so i decided to make latest research on herpes  cure  and i found a site were everyone was talking about Dr Sayo and has ability to cure Herpes, HIV, HPV, Cancer, ALS, COPD, Anthrax, genital wart, cold sore, Arthritis skin tag and all manners of diseases and virus.So i discussed with cythia and she explained to me that its very easy working with Dr sayo  so i contacted Dr Sayo via email  dr.sayoherbalhealer@gmail.com and he helped me just as he has helped others now I am  now cured from herpes am very happy now.and i can also assure you that he can also help you. so if you need the service of Dr Sayo kindly contact him visit his websites website; http://sayoherbalhealer.website2.me/ Or check FB Page https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ check blog: https://sayoherbalhealer.blogspot.com/ 


















      Just wanna say a big thank you cythia for introducing me to Dr Sayo the great HERBALIST that helped me prepare home remedies that cured my herpes simplex virus (HSV1&2)
      I was infected with herpes for the past two years and i was not happy all day so i was desperate to get a cure so that i can live normal and get healthy.One day i was less busy so i decided to make latest research on herpes  cure  and i found a site were everyone was talking about Dr Sayo and has ability to cure Herpes, HIV, HPV, Cancer, ALS, COPD, Anthrax, genital wart, cold sore, Arthritis skin tag and all manners of diseases and virus.So i discussed with cythia and she explained to me that its very easy working with Dr sayo  so i contacted Dr Sayo via email  dr.sayoherbalhealer@gmail.com and he helped me just as he has helped others now I am  now cured from herpes am very happy now.and i can also assure you that he can also help you. so if you need the service of Dr Sayo kindly contact him visit his websites website; http://sayoherbalhealer.website2.me/ Or check FB Page https://www.facebook.com/Sayo-Herbal-Healer-100145798345000/ check blog: https://sayoherbalhealer.blogspot.com/ 














      Delete
  2. I'm 15 years old. I was born with HIV my mother passed away because of the HIV infection And I regret why i never met Dr Itua he could have cured my mum for me because as a single mother it was very hard for my mother I came across Dr itua healing words online about how he cure different disease in different races diseases like HIV/Aids Herpes,Parkison,Copd,Epilepsy,Shingles,Cold Sore,Infertility, Chronic Fatigues Syndrome,Fibromyalgia, Diabetes Hepatitis even Cancer I was so excited but frighten at same time because I haven't come across such thing article online then I contacted Dr Itua on Mail drituaherbalcenter@gmail.com I also chat with him on what's app +2348149277967 he tells me how it works then I tell him I want to proceed I paid him so swiftly Colorado post office I receive my herbal medicine within 4/5 working days he gave me guild lines to follow and here am I living healthy again can imagine how god use men to manifest his works am I writing in all articles online to spread the god work of Dr Itua Herbal Medicine,He's a Great Man.

    ReplyDelete
  3. I am so glad that I found an interesting and informative post like yours. Several of the blogs that I’ve seen in these previous days did not please me due to insufficient substance.

    ReplyDelete
  4. The lead of the key with his educators is amazingly basic for the enhancement of the school. Every educator will instruct from heart in the wake of try this one seeing the better lead from the key which is indispensable for any foundation's brilliance.

    ReplyDelete
  5. Most likely, banks are tremendous for parentless understudies if agents give them the workplace of getting money. Financial specialists can offer money http://www.residencypersonalstatement.biz/ophthalmology-residency-personal-statement-writing-tips/ to parentless understudies on part returning which will change the whole world very soon.

    ReplyDelete
  6. Everyone's heart says to value the life yet everyone's heart doesn't state to lock in understudy life period. The understudies who lock find this in value the coming life well and the understudies who don't lock in face issues in future and fight a lot to get fulfillment in practical life.

    ReplyDelete
  7. Hiv disease for the last 3 years and had pain hard to eat and cough are nightmares,especially the first year At this stage, the immune system is severely weakened, and the risk of contracting opportunistic infections is much greater. However, not everyone with HIV will go on to develop AIDS. The earlier you receive treatment, the better your outcome will be.I started taking ARV to avoid early death but I had faith in God that i would be healed someday.As a Hiv patent we are advise to be taking antiretroviral treatments to reduce our chance of transmitting the virus to others , few weeks ago i came on search on the internet if i could get any information on Hiv treatment with herbal medicine, on my search i saw a testimony of someone who has been healed from Hiv her name was Achima Abelard and other Herpes Virus patent Tasha Moore also giving testimony about this same man,Called Dr Itua Herbal Center.I was moved by the testimony and i contacted him by his Email.drituaherbalcenter@gmail.com We chatted and he send me a bottle of herbal medicine I drank it as he instructed me to.After drinking it he ask me to go for a test that how i ended my suffering life of Hiv patent,I'm cured and free of Arv Pills.I'm forever grateful to him Drituaherbalcenter.Here his contact Number +2348149277967...He assure me he can cure the following disease..Hiv,Cancer,Herpes Virus,Lyme Disease,Epilepsy, ,Bladder Cancer,Colorectal Cancer,Breast Cancer,Kidney Cancer,Leukemia,Lung Cancer,Non Hodgkin Lymphoma,Skin Cancer,Lupus,Uterine Cancer,Prostate Cancer, fibromyalgia ,ALS,Hepatitis,Copd,Parkinson disease.Genetic disease,Fibrodysplasia disease,Fibrodysplasia Ossificans Progressiva,Fluoroquinolone Toxicity Syndrome,Liver/Kidney Inflammatory,Men/Woman infertility, bowel disease ,Huntington's disease ,Diabetes,Fibroid...

    ReplyDelete
  8. Most prostate cancers are adenocarcinomas, cancers that arise in glandular cells of the prostate’s epithelial tissue. Prostate cancers usually progress slowly and produce no symptoms in the initial stages. Eventually, the tumor may enlarge like mine use too, the prostate gland, pressing on the urethra and causing painful or frequent urination and blood in the urine. So I was so uncomfortable with this prostate cancer diseases then I decided to do online search on how to cure cancer because I well have read a lot about herbal medicine,I came across a lot of testimony how Dr Itua cure HIV/herpes then Cancer was listed below the comment.with courage I contacted Dr Itua and he sent me his herbal medicine through Courier service then I was asked to pick it up at my post office which i quickly did. I contacted Dr Itua that i have received my herbal medicine so he instructs me on how to drink it for three weeks and that is how Dr Itua Herbal Medicine cure my prostate Cancer, The treatment takes three weeks and I was cured completely. Dr Itua is a god sent and I thank him every day of my life. Contact him now On:Email:drituaherbalcenter@gmail.com/Whatsapp:+2348149277967.
    He listed to that he can as well cure the following diseases below.... Cerebral Amides. Lung Cancer, Alzheimer's disease, Adrenocortical carcinoma. Alma, Uterine Cancer, Breast Cancer, Allergic diseases. Kidney cancer, Love Spell, Colo rectal cancer, Lottery Spell, Bladder Cancer, Skin Cancer, HIV /Aids, Herpes, Non-Hodgkin lymphoma, Inflammatory bowel disease, Copd, Diabetes, Hepatitis

    ReplyDelete
  9. I am Alecia,from what I can read. It has been sad news and scam to everyone about Voodoo casters or so. But to me they are so real cause one worked for me not quite two weeks.i met this man on a blog his name is Dr Abalaka is a very powerful man.I traveled down to where his shrine his and we both did the ritual and sacrifice.he had no website site, and now me and my ex are living very ok now.I don't know about you but Voodoo is real;love marriage,finance, job promotion ,lottery Voodoo,poker voodoo,golf Voodoo,Law & Court case Spells,money voodoo,weigh loss voodoo,diabetic voodoo,hypertensive voodoo,high cholesterol voodoo,Trouble in marriage,Barrenness(need a child),Luck, Money Spells,it's all he does. I used my money to purchase everything he used he never collected a dime from. He told me I can repay him anytime with anything from my heart. Now I don't know how to do that. If you can help or you need his help write him on (dr.abalaka@outlook.com) i believe that your story will change for better,or if you have any question you can contact me here as 1001madonado@gmail.com if you have any question Thank you.

    ReplyDelete
  10. *Greetings to the general public, i want to inform the public how i was cured of HIV Simplex Virus by Dr. Bello. I visited different hospital but they gave me list of drugs like Famvir, Zovirax, and Valtrex which is very expensive to treat the symptoms,i was browsing through the Internet searching for remedy on HIV and i saw comment of people talking about how Dr Bello cured them. When i contacted him he gave me hope and send a Herbal medicine to me that i took and it seriously worked for me, i am a free person now without problem, my HIV result came out negative. I pray for you Dr. Bello God will give you everlasting life, you shall not die before your time for being a sincere and great man. Am so happy, you can also contact him if you have any problem Email (bellospelltemple@gmail.com) or whatsApp him +2348147271779 or call +1 (917) 979-6387.

    ReplyDelete
  11. Hello, I'm the first visit here and quit impress with your post. This is very useful and attractive. Many Students need CDR Report Help but they don't know how to get the best quality assignment help. so don't worry we have here My expert team providing high-quality assignment help for Students you have simply contact our expert team we have available 24*7. You have also visited our website MyAssignmentHelpAu.

    ReplyDelete
  12. Welcome to Emiran HealthCare Our services are aimed at ensuring that our clients can remain at home, receiving the highest care standard, yet without having distortion or disturbance in their comfort ability.

    Domiciliary Care
    Community Care
    HealthCare Provider
    Support living care
    Live in care


    Contact us:

    Call: 01908299170

    Email :info@emiranhealthcare.co.uk
    Website: https://emiranhealthcare.co.uk/

    ReplyDelete
  13. Very informative and useful post! Thank you for providing such information. Checkout here for more info about
    Best Clinic Management Software for Doctors

    ReplyDelete
  14. i am very grateful sharing this great testimonies with you, The best thing that has ever happened in my life is how i win the lottery. I am a woman who believe that one day i will win the lottery.finally my dreams came through when i email Dr Padman . and tell him i need the lottery numbers. i have come a long way spending money on ticket just to make sure i win. But i never know that winning was so easy until the day i meant the spell caster online which so many people has talked about that he is very great in casting lottery spell, so i decide to give it a try.I contacted this man and he did a spell and he gave me the winning lottery numbers. But believe me when the draws were out i was among winners. i win 1.900.000 million Dollar. Dr Padman truly you are the best, with these man you can will millions of money through lottery. i am so very happy to meet these man, i will forever be grateful to you. Email him for your own winning lottery numbers padmanlovespell@yahoo.com. OR Whatsapp or WhatsApp +19492293867 Website: https://padmanspell.com

    ReplyDelete
  15. Useful blog on technology. Thank you for providing such information. Looking for the best dentists/doctors in Jabalpur or top physiotherapy in Bhopal, Check out here for more info about
    Physiotherapy in Bhopal
    Best Dentists in Jabalpur
    Best Doctors in Jabalpur

    ReplyDelete
  16. I started on COPD Herbal treatment from Ultimate Life Clinic, the treatment worked incredibly for my lungs condition. I used the herbal treatment for almost 4 months, it reversed my COPD. My severe shortness of breath, dry cough, chest tightness gradually disappeared. Reach Ultimate Life Clinic via their website www.ultimatelifeclinic.com . I can breath much better and It feels comfortable!

    ReplyDelete
  17. Jó honlap : One Piece
    Jó honlap : Sinopsis Film
    Jó honlap : Zonahobisaya
    Jó honlap : Zonahobisaya
    Jó honlap : Zonahobisaya
    Jó honlap : Zonahobisaya
    Jó honlap : Zonahobisaya
    Jó honlap : Resep

    ReplyDelete