Involving people with intellectual disabilities in the formal assessment of psychiatrists’ skills

2016 ◽  
Vol 33 (S1) ◽  
pp. S16-S16
Author(s):  
S. Soni ◽  
I. Hall ◽  
P. Doulton ◽  
P. Bowie
Keyword(s):  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Healthcare Professionals ◽  
Quality Of Healthcare ◽  
Simulated Patients ◽  
Formal Assessment ◽  
People With Intellectual Disabilities ◽  
Competing Interest ◽  
Training Programmes ◽  
The Uk

PurposeIt is widely recognised that people with intellectual disabilities receive a poorer quality of healthcare than their non-disabled counterparts. Training for healthcare professionals in intellectual disability is often scant or non-existent. The purpose of this work is to explore the usefulness of employing actors with intellectual disabilities as simulated patients in the assessment of trainee psychiatrists.Design/methodology/approachThe development of a structured clinical exam “station” designed to assess the ability of trainee psychiatrists to communicate with a simulated patient played by an actor with an intellectual disability is described. The paper also assesses the potential benefits of this kind of assessment and the experience of actors and examiners taking part in this process.FindingsThe station was found to perform well in discriminating between candidates of various abilities and was well received by actors, examiners and observers. The station is now routinely used in the formal assessment of trainee psychiatrists in the UK.Practical implicationsThe use of people with intellectual disabilities in training and assessment appears to be advantageous in terms of improving knowledge, attitudes and skills amongst healthcare professionals and gives increased opportunities for people with intellectual disabilities to undertake valued social roles.Originality/valueFew institutions currently employ actors with intellectual disabilities as simulated patients as part of their training programmes and as a result there is little in the way of literature on this subject. This paper describes an alternative approach to teaching and assessment which falls in line with recommendations from the UK Department of Health to involve service users in the training of healthcare professionals.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Involving people with intellectual disabilities in the assessment of healthcare professionals

2014 ◽  
Vol 8 (6) ◽  
pp. 362-369 ◽  
Author(s):  
Sujata Soni ◽  
Ian Hall ◽  
Phill Doulton ◽  
Peter Bowie
Keyword(s):  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Healthcare Professionals ◽  
Quality Of Healthcare ◽  
Simulated Patients ◽  
Content Type ◽  
Department Of Health ◽  
Potential Benefits ◽  
People With Intellectual Disabilities ◽  
Training Programmes

Purpose – It is widely recognised that people with intellectual disabilities receive a poorer quality of healthcare than their non-disabled counterparts. Training for healthcare professionals in intellectual disability is often scant or non-existent. The purpose of this paper is to explore the usefulness of employing actors with intellectual disabilities as simulated patients in the assessment of trainee psychiatrists. Design/methodology/approach – The development of a structured clinical exam “station” designed to assess the ability of trainee psychiatrists to communicate with a simulated patient played by an actor with an intellectual disability is described. The paper also assesses the potential benefits of this kind of assessment and the experience of actors and examiners taking part in this process. Findings – The station was found to perform well in discriminating between candidates of various abilities and was well received by actors, examiners and observers. The station is now routinely used in the formal assessment of trainee psychiatrists. Practical implications – The use of people with intellectual disabilities in training and assessment appears to be advantageous in terms of improving knowledge, attitudes and skills amongst healthcare professionals and gives increased opportunities for people with intellectual disabilities to undertake valued social roles. Originality/value – Few institutions currently employ actors with intellectual disabilities as simulated patients as part of their training programmes and as a result there is little in the way of literature on this subject. This paper describes an alternative approach to teaching and assessment which falls in line with recommendations from the Department of Health to involve service users in the training of healthcare professionals.

Simulation training to support healthcare professionals to meet the health needs of people with intellectual disabilities

2016 ◽  
Vol 10 (5) ◽  
pp. 284-292 ◽  
Author(s):  
Grégoire Billon ◽  
Chris Attoe ◽  
Karina Marshall-Tate ◽  
Samantha Riches ◽  
James Wheildon ◽  
...  
Keyword(s):  
Intellectual Disabilities ◽  
Health Inequalities ◽  
Simulation Training ◽  
Healthcare Professionals ◽  
Health Needs ◽  
Simulated Patients ◽  
Free Text ◽  
Content Type ◽  
People With Intellectual Disabilities ◽  
The Impact

Purpose The purpose of this paper is to discuss the role of education and training in addressing health inequalities in intellectual disabilities, before examining innovative approaches to healthcare education. Preliminary findings of a simulation training course to support healthcare professionals to work with people with intellectual disability are then presented. Design/methodology/approach This study employed a mixed methods design to assess the impact of the simulation course. Quantitative data were collected using the Healthcare Skills Questionnaire and a self-report confidence measure; qualitative data were collected using post-course survey with free text responses to open questions. Findings Healthcare skills and confidence showed statistical improvements from pre- to post-course. Qualitative analyses demonstrated that participants perceived improvements to: attitudes, communication skills, reasonable adjustments, interprofessional and multi-disciplinary working, knowledge of key issues in working with people with intellectual disabilities. Practical implications Encouraging findings imply that simulation training to address health inequalities in intellectual disabilities is a valuable resource that merits further development. This training should be rolled out more widely, along with ongoing longitudinal evaluation via robust methods to gauge the impact on participants, their workplaces, and people with intellectual disabilities. Originality/value The authors believe this paper to be the first to assess an interprofessional, high-fidelity simulation course, using actors as simulated patients to address the mental and physical health needs of people with intellectual disabilities. The rigorous use of co-production and co-delivery, alongside promising findings for this training method, represent a useful contribution to the literature.

scholarly journals Oxford Handbook of Learning and Intellectual Disability Nursing

2018 ◽  
Keyword(s):  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Community Services ◽  
Physical And Mental Health ◽  
Republic Of Ireland ◽  
Active Involvement ◽  
Authoritative Text ◽  
People With Intellectual Disabilities ◽  
The Republic ◽  
The Uk

The Oxford Handbook of Learning and Intellectual Disability Nursing, 2nd edition, has been comprehensively updated throughout and brings together the contributions of leading practitioners and academics from the UK, the Republic of Ireland, and further beyond, in an authoritative text that provides essential facts and information on nurses working with people with intellectual disabilities. A unique aspect to this Oxford Handbook is the continuing attention given to differences in legislation and social policy across the jurisdiction of the constituent countries of the UK, as well as the Republic of Ireland. The landscape for the practice of nursing has never been so complex, and given this complexity of context and practice, the Oxford Handbook of Learning and Intellectual Disability Nursing continues to offer students and newly qualified practitioners alike up-to-date and concise, practical applied knowledge, as well as theoretical information, about working in a person-centred way with people with intellectual disabilities and their families/carers in order to promote their physical and mental health, improve their quality of life and their active involvement in decisions about their care, and support their access to general healthcare and community services. This handbook will be of use in the very many areas where nurses for people with learning/intellectual disabilities are located. It will also be of use to a wider range of other health and/or social care professionals, who often seek an authoritative text that provides essential facts and information on working with people with intellectual disabilities.

scholarly journals Short-term PsychoEducation for Carers To Reduce Over Medication of people with intellectual disabilities (SPECTROM): study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e037912 ◽  
Author(s):  
Shoumitro Deb ◽  
Bharati Limbu ◽  
Mike Crawford ◽  
Tim Weaver
Keyword(s):  
Intellectual Disabilities ◽  
Field Test ◽  
Complex Interventions ◽  
Training Programme ◽  
Care Staff ◽  
Related Information ◽  
Relevant Stakeholder ◽  
People With Intellectual Disabilities ◽  
Training Programmes ◽  
The Uk

IntroductionPsychotropic medications that are primarily licenced for the treatment of psychiatric disorders are used widely (32%–85%) among people with intellectual disabilities (ID) often for the management of problem (challenging) behaviour in the absence of a psychiatric disorder. Care staff play a pivotal role in the prescribing process. Currently, no staff training programme exists to address the issue of overprescribing of psychotropic medication in people with ID, thus highlighting an urgent need for developing a psychoeducational programme (PEP) specifically designed to address this issue. We propose to develop a PEP for care staff using the methodology described in the UK Medical Research Council guide for complex interventions.Methods and analysisThe development of the PEP will involve (1) gathering information on available relevant training programmes, (2) running four focus groups with care staff and other professionals to establish the content and format of the PEP, and (3) organising a co-design event involving all relevant stakeholders to discuss the format of the PEP. A core project team will develop the PEP under guidance from the PEP Development Group which will consist of 10–12 relevant stakeholder representatives. Feedback from selected stakeholders on a draft PEP will allow us to refine the PEP before implementation. The PEP will have web-based modules supplemented by face to face training sessions. When the final draft is ready, we will field test the PEP on six to eight care staff from community care homes for people with ID. After completing the field test, we will run a focus group involving participants in the PEP to get feedback on the PEP.Ethics and disseminationEthics approval for this study was waived by the UK Health Regulatory Authority as the study does not collect any patient related information and only include care staff outside the UK NHS. This will be the first ever such universally freely available PEP supported by training manual and slides.

Improving healthcare for people with intellectual disabilities: the development of an evidence-based teaching programme

2016 ◽  
Vol 10 (6) ◽  
pp. 333-341 ◽  
Author(s):  
Lance Vincent Watkins ◽  
Robert Colgate
Keyword(s):  
Intellectual Disability ◽  
Medical Students ◽  
Intellectual Disabilities ◽  
Educational Intervention ◽  
Educational Programme ◽  
Student Feedback ◽  
Simulated Patients ◽  
Attitude Questionnaire ◽  
Content Type ◽  
People With Intellectual Disabilities

Purpose To develop and implement an educational programme to improve medical students’ attitudes towards intellectual disabilities. The purpose of this paper is to improve the healthcare outcomes for individuals with intellectual disability. Design/methodology/approach The development of an educational programme involving actors with an intellectual disability as simulated patients. Scenarios were developed involving basic healthcare interactions. The programme was piloted in three sessions with 45 students. A qualitative analysis of student feedback was then used to develop a student attitude questionnaire for completion pre- and post-educational intervention. Findings The student attitude questionnaire was completed by 23 different medical students. Two domains were analysed: affect and understanding domain scores, mean difference (95% CI) 3.17(2.41-3.94) p<0.001, knowledge and skills domain scores, mean difference (95% CI) 4.22(3.3-5.14) p<0.001. Social implications Student feedback reveals significant positive changes in affect and understanding, and an improvement in knowledge and skill levels when interacting with people with an intellectual disability following the educational intervention. Some major institutions now offer comprehensive programmes involving people with intellectual disabilities as tutors, and in the role of simulated patients. However, more needs to be done to encourage the increased participation and good practice for all of tomorrow’s doctors to benefit. Originality/value Following the publication of recent enquiries into the deaths of people with intellectual disabilities. We know that many of these deaths are premature and potentially preventable. The main failing identified repeatedly is that healthcare staff lack of awareness of the needs of people with intellectual disabilities. This emanates from poor quality and limited curricula time dedicated to intellectual disabilities. There is a need to drastically change the approach to teaching about intellectual disabilities to medical students. All the evidence promotes the involvement of people with intellectual disabilities and their careers in designing and delivering this teaching.

A practical example of an open disclosure process for people with intellectual disabilities in the Republic of Ireland

2021 ◽  
pp. 174462952110189
Author(s):  
Feabhra Mullally ◽  
Deirdre Corby
Keyword(s):  
Intellectual Disabilities ◽  
Service Providers ◽  
Republic Of Ireland ◽  
Open Disclosure ◽  
The Usa ◽  
People With Intellectual Disabilities ◽  
Adults With Intellectual Disabilities ◽  
The Republic ◽  
Communication Needs ◽  
The Uk

Literature pertaining to open disclosure predominantly refers to acute care settings; this is the case in, for example, the UK, Republic of Ireland, Australia, Korea and the USA. There is, however, a dearth of literature regarding open disclosure related to people with intellectual disabilities. A practice example of open disclosure is presented here, following a serious adverse event in an organisation supporting adults with intellectual disabilities. The aim of the process was to openly disclose in a meaningful way to adults with significant intellectual disabilities and communication difficulties. An apology pathway was developed by a multidisciplinary team based on individual communication needs. A suite of resources was developed including easy read-picture agendas and sign language to support increased understanding of the apology. Service users received the apology first, followed by meetings with their families. This practice example has positive implications for service providers for people with intellectual disabilities.

Coping With Criticism and Praise

2015 ◽  
Vol 120 (3) ◽  
pp. 258-268 ◽  
Author(s):  
Lynn Esdale ◽  
Andrew Jahoda ◽  
Carol Pert
Keyword(s):  
Intellectual Disability ◽  
Positive Affect ◽  
Intellectual Disabilities ◽  
The Self ◽  
Self Perceptions ◽  
Stigma And Discrimination ◽  
People With Intellectual Disabilities ◽  
Study Participants

AbstractThrough experiencing stigma and discrimination, people with intellectual disability may become more sensitive to criticism from others and be less likely to believe praise. This study compared how people with and without intellectual disability viewed praise and criticism, using a vignette task developed for the study. Participants were asked to imagine someone saying something praiseworthy or critical and were then asked about their emotions, beliefs, and thoughts. People with intellectual disability were more likely to believe and be distressed by criticism. Contrary to predictions, this group were also more likely to believe praise and experience positive affect. The results suggest that the self-perceptions of people with intellectual disabilities is more dynamic and reliant on the views of others.

Pregabalin use in adults with intellectual disabilities

2017 ◽  
Vol 41 (S1) ◽  
pp. S597-S597 ◽  
Author(s):  
K. Courtenay ◽  
S. Jaydeokar ◽  
B. Perera
Keyword(s):  
Anxiety Disorder ◽  
Intellectual Disabilities ◽  
Dose Range ◽  
Case Series ◽  
Generalised Anxiety Disorder ◽  
Anti Epileptic Drug ◽  
Mental Health Difficulties ◽  
People With Intellectual Disabilities ◽  
Adults With Intellectual Disabilities ◽  
Competing Interest

IntroductionPregabalin is a well-established anti-epileptic drug in the treatment of epilepsy. It is also indicated for the treatment of generalised anxiety disorder and neuropathic pain. In addition, it has mood modulating properties. In people with intellectual disabilities it is used to treat epilepsy. There is little evidence of the use of pregabalin in managing mental health difficulties in people with intellectual disabilities.ObjectivesTo describe the use of pregabalin in adults with intellectual disabilities.MethodA descriptive case series of adults with intellectual disabilities living in the community, under the care of a community psychiatrist, who are prescribed Pregabalin. Outcomes of treatment were measured using the health of the nation outcome scale for people with intellectual disabilities (HoNOS-LD).ResultsFourteen cases were identified in the community service of adults with Intellectual Disabilities. Twelve were men and two were women. The average age of the sample was 29 years. The range in duration of using pregabalin was from 3 to 72 months. Thirteen adults had a diagnosis of Autism of which three also had ADHD. The indications for using pregabalin and numbers were : anxiety (12); liability of mood (2); generalised anxiety disorder (1); epilepsy (1). The daily dose range was from 150 mg to 300 mg The mean change in HoNOS-LD scores was 32%.ConclusionsPregabalin is a useful treatment in people with intellectual disabilities who experience anxiety. It is especially effective among adults with ID and autism to modulate mood and anxiety symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Audit of patients with intellectual disabilities accessing a specialist neuropsychiatry service for epilepsy management

2017 ◽  
Vol 41 (S1) ◽  
pp. S352-S352
Author(s):  
A. Adetoki
Keyword(s):  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Total Sample ◽  
Best Interest ◽  
Nice Guidelines ◽  
Specialist Services ◽  
Co Morbidity ◽  
Planning Processes ◽  
Competing Interest ◽  
Equity Of Access

IntroductionEpilepsy is a frequent co-morbidity in patients with intellectual disabilities, some of whom require specialist services. The National institute for health and care excellence (NICE) has recommended that there should be equity of access to high quality of care regardless of the existence of a diagnosis of intellectual disability.ObjectivesTo observe current practice with regards to NICE guidelines for epilepsy care in patients with intellectual disability.AimsTo identify the level of compliance with NICE guidelines and provide evidence which may inform care planning processes.MethodsA retrospective review of the electronic and paper-based records of a total sample of intellectually disabled patients who accessed a specialist neuropsychiatry service for the management of epilepsy during a six-month period was carried out.ResultsThe records of 21 patients whose ages ranged from 20 to 58 years were audited. The waiting period ranged from 4 weeks to 46 weeks. There was evidence of Carer involvement in the management of 100% of the patients and seizure improvement since referral was documented in 66%. Non- medication treatment was offered in 67% of cases. Evidence of special considerations in view of patient's intellectual disability was recorded in 24%, best interest considerations in 24% and capacity assessment in 19%.ConclusionsThere is a significant improvement in the symptoms of 66% of patients in this audit. However there is room for improvement and a more specific plan for patients with intellectual disabilities should facilitate this.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Intellectual Disability, Identity, and the Internet

2013 ◽  
pp. 198-223
Author(s):  
Darren D. Chadwick ◽  
Chris Fullwood ◽  
Caroline J. Wesson
Keyword(s):  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Internet Use ◽  
Computer Mediated Communication ◽  
The Internet ◽  
Mediated Communication ◽  
Disability Identity ◽  
Computer Mediated ◽  
Online Behaviour ◽  
People With Intellectual Disabilities

This chapter provides insight into the nature of online engagement by people with intellectual disabilities, the extent and quality of this engagement in terms of the access that people have, and how people with intellectual disabilities present themselves in the online world. The authors of this chapter provide an overview of the extant literature on intellectual disability, identity, and the Internet. The chapter begins by outlining issues around Internet use and access by people with intellectual disabilities, including potential barriers. It then moves on to address online behaviour and the potential benefits of Internet use for people with intellectual disabilities. The chief focus of the chapter follows, describing the manner in which computer mediated communication affects how people with intellectual disabilities present themselves in the online world as well as considering the role that family members and supporters play in the development and management of people’s online identities. Finally, the chapter introduces future directions for research into intellectual disability, identity, and the Internet.

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