Supporting nursing and midwifery students with dyslexia on clinical placements

Location Nursing and Midwifery Burton 141 Sandwell: 154 Wolverhampton 149 Dudley 168 Walsall 162 Social Work Approx 50 placements

Length of placement Nursing and Midwifery Equal value 50/50 Midwifery – up to 60/40 Nursing up to 300 hrs simulation Social Work 200 days –Yr 1 30 days –Yr 2 70 days UG –Yr days –Yr 1 80 days PG –Yr days

Key Drivers Concerns about managing failing students Suitability Panel Remit Legislation Local Research

“Dyslexia” is “A specific learning difficulty which mainly affects the development of literacy and language related skills” “Likely to be present at birth and lifelong in its effects” Information processing difficulties: working memory, phonological processing, processing speed, automatic skills development. Often resistant to conventional teaching methods, “but its effects can be mitigated by appropriately specific intervention”. (Ref: British Dyslexia Association dyslexia/faqs.html [accessed 07/03/11]. dyslexia/faqs.html

Study Aims: opening phase To identify -the main challenges to dyslexic student nurses in achieving the professional standards of competence relating to record keeping - how they can best be supported in the development of these skills -what interventions that would be most acceptable and effective -who should be involved in this process -where it should take place

Gaining perspectives and ideas Student nurses with dyslexia 10 individual semi- structured interviews Midwifery: 2 Mental Health:2 Adult: 6 Poster adverts / tutoring system Placement mentors Focus Group interviews Acute Hospital (4) PCT 2/6 have dyslexia PPMs as co-facilitators

Students: perceived strengths Practical tasks (8/10) Communicating with patients; putting at ease, extracting information, listening, people reading (10/10)

Disclosure Students 5 reported told all mentors irrespective of anticipated response 5 disclosed selectively General response: +ve A few less helpful responses and actions “Oh, but you have such a pretty face” Mentors Highest number of mentees with dyslexia reported by the 2 mentors with dyslexia All believed had mentored several students with dyslexia who had not disclosed Belief : willingness to disclose related to life stage

Key difficulties identified by students Knowing what to write and where to write it Visual stress: clinical forms Identifying key information and prioritising order Learning and using professional terminology / phrasing in different areas Recording handover information Admission forms: multitasking involved Interruptions Retaining information until time to document this Correct spellings Identifying “goalposts”

Key difficulties identified by mentors Varied with area and nature of clinical documentation used Learning of correct spellings of drug names and medical conditions Longer to complete records Handovers: speed and accuracy issues Identification, selection ad ordering of relevant information Short-term memory issues Sentence structuring

Intervention proposals Notion of a blank sheet Consider where interventions should take place What these should consist of Who should be involved Ideas raised for both university and placement settings

University based: students Clinical record writing introduction early in 1 st year Clarity on standards required: examples Introduction to common documents Generic skills development: e.g. writing succinctly, spelling strategies, identifying and documenting key information from scenarios, mock handovers Open to all, not just those with dyslexia

University based: mentors Provision of a mentor awareness sheet. Advance notice of students’ additional support needs to allow time for preparation and consultation.

Students: placement setting Lists of common terminology, key phrases, correct spellings Document templates for each area and useful phrases for each section Opportunity for repetition More time for completing records Better dyslexia awareness among mentors Provision of an awareness sheet to give out voluntarily

Mentors: placement setting A “specialist” mentor in every work area as a point of reference / adviser for other mentors in the area and students experiencing difficulties. Dyslexia awareness and support training for all mentors.

Actions so far to encourage disclosure Placement Awareness Sheet Baseline list of reasonable adjustments Option of adding further adjustments Fluid throughout course Decision to pass to placement mentor lies with the student.

Actions so far to encourage disclosure CAPD booklet statement to encourage disclosure make reasonable adjustments share placement awareness sheet

Actions so far to encourage disclosure Handbook to enhance support for students with dyslexia Tips for students Tips for mentors General information Signposts additional support

Dyslexia Champions Training Day Open initially to practice placement managers / supervisors Positive attributes of dyslexia Locating dyslexia in neurodiversity arena Information processing differences Strategies to enhance reading speed accuracy and confidence Strategies to aid clinical record writing Dyslexia simulations Posters to identify “Dyslexia Champions” in work areas

Actions in the pipeline Evaluation of Dyslexia Champions training Posters to advertise Dyslexia champions Follow up meetings Generic skills development Monitoring student disclosure through our ‘Suitability Panel’