Dr Amanda Miller, Dr Joan Livesley and Dr Angela Darvill Involving young people in the planning, facilitation and debriefing of simulation sessions with CYP nursing students Dr Amanda Miller, Dr Joan Livesley and Dr Angela Darvill

Background Adult service users and carers in the UK have been involved in nursing research and the education of student nurses for some time This is less evident with children and young service users Much of the published literature relates to asking CYP what makes a good nurse, involvement in curriculum design, recruitment/selection and the voices of parents When undertaking a review of the literature much of what was found pertained to the involvement of adult services users, in particular in the field of mental health and learning disability nursing

An exploratory interpretive study The aim of my study was to explore the impact of young people’s involvement in simulation with undergraduate students of children and young people’s nursing from the perspectives of the participants; young people, undergraduate students and lecturers Participants: 11 young people (16-18 years old) 21 nursing students (End of Year 2, CYP field of practice) 5 lecturers It was important to ascertain what impact this intervention would have on the education of students nurses and whether it would enhance their learning and this would be achieved through simulation 11 young people

Involving young people in simulation Involvement of young people in simulation Writing a scenario Developing a feedback tool Being the voice of the manikin Providing feedback to the UG students Interviews with study participants There were several stages involved in the study Developing a feedback tool that would be used in the debriefing – in simulation what tends to be done is to focus on the learning outcomes and the facilitators use an experiential cycle of learning to guide the process. I wanted the YP to devise something which was service user friendly and specific to the values/qualities which they felt a nurse caring for children should possess Writing the simulated scenario – this usually done by lecturers/practitioners. I wanted to create a scenario that was from the perspective of the young person The voice of the manikin – again usually done by a member of staff, I wanted to have a 'real' YP being that voice and responding and interacting with the student nurses Debriefing. – include the views of the YP, directly involved in the debriefing Interviews – eliciting the views from all of those participants about the experience

Working with the young people DAY VENUE ACTIVITY DAY 1 College Introduce the study, recruit participants & demonstrate SimJunior DAY 2 University Orientation to simulation ward & manikins Post-it exercise on qualities of a good nurse DAY 3 Development of feedback tool using diamond ranking exercise, meet lecturers & students DAY 4 Demonstration of a simulated scenario (with students), scenario writing DAY 5 Run through scenario/ role of the YP in giving feedback DAY 6 & 7 Simulation sessions & debriefing DAY 8 Interviews The training of the YP was an essential part of the study and involved several workshop type days and occurred over a period of 6 months. I had met with the curriculum leader initially to see if the college would be interested in taking part

Developing the feedback tool: Post-it note exercise – ‘what qualities do you think a children’s nurse should possess and what is important to you’? Privacy & confidentiality Taking time Being patient Asking for consent Being listened to Being informed Good communication skills Talking to me & not my parent Reassuring Having a positive attitude Caring The YP wrote down their thoughts on post-it notes, I transcribed and thematically analysed them and narrowed it down to 11 headings. Much of what the YP were saying was the same – what seemed very important was ‘being listened to’ and ‘talking to my parent instead of me’

Diamond ranking exercise Three groups ranked them slightly differently All important qualities Created three umbrella headings for the tool to be used in the debriefing

Writing the scenario Provided with a brief outline for the scenario – 15 year old attends Paediatric A&E with an exacerbation of asthma Using body maps & the dimensions of health created the social history, background & the characteristics of the individual I advised only on the clinical and technical aspects of the scenario

Being the voice

The observers

The debriefing

Two key research objectives To identify and explore lecturers’ and students’ insights into the benefits or drawbacks for all participants as a result of young people’s involvement in simulation sessions with undergraduate students To identify and explore young people’s accounts of their own involvement and any additional benefits identified by them from their engagement with a university  

Data collection & analysis Semi-structured interviews were conducted with the young participants and lecturers following the simulation days Focus group interviews were conducted with the nursing students Data analysed using the framework approach (Ritchie and Lewis, 1993)

Findings CONCEPT Meaningful involvement THEMES Meaningful involvement Finding voice Developing voice Sharing voice Challenging voice Personal development Creating a more authentic reality Realism of simulation scenarios Being the voice Learning to build relationships Learning from difficult situations Uncertainty Unfamiliarity Being prepared Being watched Being assessed Shifting relationships

Some key recommendations Undertake similar work with younger children and evaluate the outcomes of their involvement in simulation Analyse the written comments on the feedback tool and the verbal feedback that was delivered to the student nurses in the debriefings To involve children and young people as simulated patients To limit the number of people observing student nurses when participating in a simulation To adapt the NHS England (2016) Co-production model so that it can be specifically applied to co-production with children and young people

Thank you for listening – Any questions Thank you for listening – Any questions? Dr Amanda Miller Simulation lead & CYP nurse lecturer University of Salford a.miller@salford.ac.uk Twitter: @SUSimulation

References Blades, R; Renton, Z; La Valle, I; Clements, K; Gibb, J; Lea, J (2013) We would like to make a change. National Children’s Bureau: London Elo S, Kyngas H (2008) Qualitative content process. Journal of Advanced Nursing 62(1);107-115 La Valle I; Payne L; Gibb J; Jelicic H. (2012) Listening to Children’s views on health provision: A rapid review. National Children’s Bureau, London Randall, D, Brook, G and Stammers, P (2008) How to make good children’s nurses: children’s views. Paediatric Nursing. 20 (5): 22-25 Ritchie J, Spencer E (1994) Qualitative data analysis for applied policy in research In Bryman A, Burgess, R (Eds) Analysing qualitative data. London: Routledge Smith J, Firth J (2011) Qualitative data analysis: the framework approach. Nurse Researcher 18(2):52-62 Summers K (2013) Children’s nurse education. British Journal of Nursing. 22 (13): 747-750