Development of nurse training programs for psychosocial interventions:  differences between the research and clinical environments. — ASN Events

Development of nurse training programs for psychosocial interventions:  differences between the research and clinical environments. (#223)

Sibilah Breen 1 2 , Penelope Schofield 1 2 3 , Sanchia Aranda 1 2 3
  1. Nursing & Supportive Care Research, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
  2. Department of Nursing, University of Melbourne, Parkville, VIC, Australia
  3. Division of Cancer Services & Information, Cancer Institute NSW, Alexandria, NSW, Australia

Background: Delivery of psychosocial interventions for research requires development of detailed training/assessment programs. Where interventions are implemented into routine care, training programs need to be expanded to larger numbers of clinicians and maintained over-time.

Aims: To describe three psychosocial intervention training programs and highlight the issues/changes which occur when intervention and training programs are implemented into routine care.

Program descriptions: The programs include training nurses to: 1)undertake screening of patients for unmet psychosocial needs; 2)deliver a pre-chemotherapy education/follow-up intervention (ChemoEd) to reduce distress and common side-effects and; 3)deliver an intervention to remotely monitor chemotherapy side-effects/psychological status remotely via mobile phone (PRISMS).

Training for all interventions includes: communication skills (eliciting/responding to emotional cues); role-plays; how/when to refer; use of referral protocols; intervention documentation; development of training manuals/exercises and use of audio/video resources to illustrate good vs poor interventions.  Application of good communication skills tailored to specific interventions are developed alongside example phrases, strategies and delivery techniques (eg reflection, describing typical day). In addition, the evidence behind each intervention to improve patient outcomes is presented. Training sessions are 8 hours with ChemoEd andPRISMS having sessions recorded for QA/feedback by researchers.

Research versus clinical environments: Implementing research into the clinic requires minimum time is spent on both training and the intervention. Training times are commonly cut by half and interventions reduced in duration and/or frequency. QA of intervention integrity is rarely implemented even when tools are supplied. High levels of staff turnover mean that ‘trainers’ may not be replaced.

Conclusions: It is vital to develop interventions that fit with routine clinical care and to sustain adequate numbers of trained staff to support a train-the-trainer model. Limited training times and reduced, if any, QA of intervention integrity mean that staff under-training is likely and the effectiveness of such interventions compromised in the longer-term.

Abstract submitted for planned symposium entitled, "Translating Training in to Practice: Examining the Process From Training to Implementation."