Transcript Slide 1
The Impact on Practice (ImP) Project:
A framework to maximise the impact of
continuing professional education on
practice
Liz Clark, Jan Draper and Shelagh Sparrow
Self-report data on the impact of
learning on practice
‘I’ve developed an end-of-life care package for patients in my clinical area.’
‘Improved practice in our deep vein thrombosis service has impacted on patient care and
this has been a result of my learning.’
‘Undertaking this module has enabled me to demonstrate to my employer that I am
knowledgeable practitioner who is able to offer some new-found knowledge into workbased situations.’
‘I now find it much easier to approach my ward manager about implementing a change in
the ward environment.’
‘My learning has made me challenge and question my nursing style.’
‘I’ve got my dream job, thanks to the support, confidence and the amazing degree you
helped me achieve. I still find it hard to believe that I’m actually doing what I’ve only
dreamed about doing for so long. It’s a brilliant feeling to be able to go home at night with my
head still buzzing with ideas of ways to improve older people’s care.’
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Background and context (1)
Project funded by the Higher Education Funding Council for England
(HEFCE) as part of the Higher Education Innovation Fund (HEIF3)
Rhetoric of the benefits of lifelong learning on patient care
‘Every aspect of healthcare delivery and strategies for health depends
on the education and skills of individual staff. Investment in their
learning and personal development is, in a real sense, spending on
patients and is essential to the future quality of the health service.’
Funding learning and development for the healthcare workforce (Department
of Health, 2002, p.7)
‘The delivery of high quality education and training is an essential part
of delivering high quality patient care.’
A high quality workforce: NHS next stage review (Department of Health, 2008,
p.13)
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Yet little evidence of direct impact of continuing professional
education (CPE)
Limitations of existing evidence base. Studies tend to:
– be programme-specific, typically confined to a single locality;
– be short-term and small-scale;
– be over-reliant on self-perception (learner satisfaction) and
focus on teaching and learning strategies rather than on changes
in behaviour;
– use retrospective methods (errors of recall and bias);
– assume or imply benefits to patients/service users rather than
assess them directly.
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Background and context (2)
In-depth conversations with employers, patients and postregistration students prior to the project:
Employers: important, timely issue; any approach must be manageable
and not programme-specific; should not involve formal research activity
Patients/Service users: want reassurance that health professionals
have the necessary knowledge and skills to provide good care
Students: keen to articulate and demonstrate benefits of their learning
following registration
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Methods used to develop the framework
Structured literature review (health and social care and education
literature); emerging themes:
– organisational culture, including support for change
– role of the manager
– link between the education provider and organisation
Contributions from an expert Advisory Group
Two interactive conference presentations (Vancouver and
Dundee)
Conversations with stakeholders to develop/refine the framework:
– commissioners of education
– managers
– health and social care educators
– service users/representatives from patient organisations
– learners
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Characteristics of the ImP framework
It is underpinned by theoretical insights from the education and
health and social care literature
It is easy to understand
It is user friendly
Key stakeholders were involved in its development and refinement
Its usage does not involve research activity
It is sufficiently flexible to be applicable ultimately to health and
social care
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The ImP framework (1)
The four core domains of the ImP framework are:
education provider
learner
manager
organisation
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The ImP framework (2)
Impact on Practice
Manager
Time
Learner
CPE
Time
Pre-selection
Selection
During CPE
Organisation
Post CPE
Education provider
Impact on Practice
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© The Open University 2008
Feedback on the ImP framework
‘I think that it is a sophisticated tool ... I like its simplicity. I could
use this and would not be intimidated or put off from using it.’
Commissioner of education
‘It isn’t going to be a framework that sits on a dusty shelf and
gets referenced – it has the potential to be a really useful tool.’
Educator
‘I don’t feel that I have anything other than admiration and
excitement about this. ... I do not have anything else useful to
contribute except having the added leverage of people being aware
and being able to ask how this is being implemented.’
Patient organisation representative
An online version is currently being developed and will be widely disseminated
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Next steps…
Assess the usefulness of the ImP framework in practice
– longitudinal research
– participative approach
– a range of different organisations (using organisations as cases)
Explore the possibilities of realist evaluation (Pawson and Tilley)