Medical school develops an education programme that allows students to visit dementia patients regularly, imbibing better understanding in undergraduate students about long term conditions

Challenges

•Traditional healthcare education often fails to build the understanding, compassion patient-centred empathy needed to help those with long-term conditions, such as dementia, which are a growing issue for healthcare systems.

•Typically, education focuses on short block clinical placements often in acute settings emphasising crisis and technical aspects of diagnosis and treatment

•This does not provide students with a true understanding of long-term conditions.

•Health professionals’ value systems and beliefs are set in undergraduate learning and undervalue care for people with long-term conditions in general and dementia in particular.

•It is difficult to teach understanding and compassion compared with imparting facts.

Actions

 Our ambitions for Time for Dementia (TFD) are high. Our long term vision is for people affected by dementia and other long-term conditions to feel the effect of better trained healthcare professionals, across the UK and internationally.

•Our solution was to develop, deliver, evaluate and roll-out the TFD programme, an educational initiative complementary to existing undergraduate training in which medical, nursing and paramedic students visit a person with dementia and their family in pairs for two hours every three months for two years as a compulsory part of undergraduate education.

•TFD is designed to:

(i) provide all students with a longitudinal experience of how individuals and their families are affected by long-term conditions using dementia as an exemplar.

(ii) improve students’ attitudes and knowledge of long term conditions in general and dementia in particular.

(iii) provide the opportunity for students to learn from the experiences of people with dementia and their family carers, hearing their stories and building relationships with them

(iv) provide interdisciplinary opportunities for students studying different courses to learn from each other.

•TFD’s development was a true collaboration between the Alzheimer’s Society, two universities and two NHS foundation trusts. The meaningful engagement of people with dementia and family carers was integral to all stages of the programme.

•We were successful in making TFD a core element of the curriculum for medical students at Brighton and Sussex medical school and adult nursing, mental health, and paramedic students at the University of Surrey.

•We started in the 2014/15 academic year. The programme consists of a plenary initiation meeting after which students visit a person with dementia and their family in pairs regularly for two years. Three cohorts of students have been recruited and two evaluated.

•A comprehensive mixed method evaluation is underway to capture the effectiveness of the programme, to support its iterative development, and to help make the case for wider uptake. This includes looking at student and family outcomes over a three year period. We have recruited three comparison cohorts (n=400) from other medical and nursing schools with which to compare the data of students undertaking the programme.

•The cost of the TFD programme and its evaluation was met by Health Education England Kent Surrey and Sussex. The cost per site to deliver TFD was £70k pa. The evaluation has shown improvements in qualitative and quantitative outcomes, including statistically significant improvements in attitudes, understandings and knowledge.

Results 

1.Development of TFD curriculum

2.TFD made a core part of undergraduate education at BSMS and UoS

3.Overall statistically significant one-year improvements in medical, nursing and paramedic students in knowledge and attitudes to dementia

4.Compared with controls, medical students have statistically significant one-year improvements in knowledge and attitudes to dementia scores

5.Positive qualitative evaluation from students, qualitative interviews and focus groups identified: increased awareness of the family perspective of dementia, skills development, increased knowledge of dementia, and a positive impact on practice

6.Positive qualitative evaluation from people with dementia and their family carers

7.Detail of outcomes in attached presentation

Spread

•Funded secured from Health Education England to roll out TFD in Kent, Surrey and Sussex

•2017/18 to physiotherapy and occupational therapy students University of Brighton

•2018/19 to nursing and paramedic students at University of Brighton

•2018/19 to nursing, paramedic, physiotherapy radiography OT and speech and language therapy students at University of Greenwich and Canterbury Christ Church University

•With this roll-out, a further 1,600 new students per year (on top of the existing 400 students per year at BSMS and UoS) will benefit from TFD