1. Welcome & Introductions
Practitioner Development Programme Training for Trainers Programme (T4T)
Welcome & Introductions

2. Welcome and Introductions
Tutors
House keeping;
-Manage self
-Toilets
-Fire alarm & exits
-Refreshments
-Mobile phones

3. Introductions
Everyone introduces themselves, together with their role and where they work and one thing they would like the group to know about them.

4. Aims of T4T - overview
To introduce clinical and lay tutors to the content and skills required to deliver the CCH Practitioner Development Programme (PDP)
To increase confidence and competence to deliver PDP
To support new trainers to develop individualised goals and action plans
To develop strategies for integrated partnership working between lay and clinical co-facilitators
To be the first step on the journey of continual development for PDP trainers

5. Baseline questionnaire
Please complete the pre training questionnaire and return to the facilitator.
This questionnaire will be repeated at the end of the Programme and will enable you to assess your development and will contribute to the programme evaluation
Thank you

6. Aims for facilitation team
Increase confidence in ability to present to clinicians
• Increase understanding of the clinician’s journey to support self-care and
develop empathy for clinicians at all levels in the journey
• Increase understanding of the specific skills and techniques taught in the PDP
• Increase confidence to tell story of journey of self-management
highlighting concepts of Importance, Confidence, and use of Problem-Solving
• Increase confidence to present the techniques of Problem-Solving, using example real life examples
• Increase confidence to present ambivalence as a normal experience for a person living with a long-term condition using real life examples
Increase confidence in ability to facilitate skill rehearsal with actor
• Develop a plan for continued co-facilitator skill development

7. Role of the Facilitators
Work in small mixed groups of three or four
Share your experiences of your own self management journey or your experiences of supporting self management
Consider how these experiences may impact your role as a tutor
Consider how you might reflect on your experience and describe these to delegates within a PDP training programme.
What support and strategies might you need to deal with your personal frustrations and emotions to enable you to use this experience in a training environment?
Debrief as a large group

8. Experiences of the PDP and skills
Work in [different] small mixed groups of three or four
Discuss your successes and challenges of using the PDP approach
Agree and record your top 5 successes and your top 5 challenges
Discuss your successes and challenges of using the PDP skills
Whole group debrief then;
Identify your learning goals for the skills revision session

9. Individual learning agenda
Individual learning agenda to inform skills revision

10. Skills revision session
Key revision session for ensuring all delegates are confident with the PDP skills (in the communication skills descriptor list), how to use them, linkages and flow

11. Practitioner Development Programme Training for Trainers Programme (T4T)
Coaching & feedback

12. Key tools for supporting behaviour change
Good quality coaching and feedback are key tools for supporting individuals to develop confidence and competence in self management support skills.
All new skills develop over time, becoming easier with practice.
Interactive exercise;
Split into smaller groups and explore ways that you have received feedback in the course of your personal and professional lives.
How did these methods make you feel and what was their impact?
What are the key qualities of constructive feedback, what should be avoided?
Come back & debrief as a large group

13. Coaching; definition
Relationship and rapport is part of the process, safety is key
Focus on enabling and empowering the learner
Goal is reaching a higher level of performance

14. Coaching; the challenge
Coaching and giving coaching feedback is a new skill for many of us
We may need to give coaching feedback to a range of workforce groups
Coaching and feedback from lay facilitators may be a new experience
We need to be confident SMS practitioners, facilitators and coaches
Consider your own learning needs and goals
Making sure you use and model the skills and approaches in PDP will increase your confidence for skill spotting and to give constructive coaching feedback
Having lots of examples from your own practice will build credibility

15. Coaching; the process outline
Set learner agenda and invite goal
Assess level of importance and confidence
Agree process & negotiate time outs and duration
Goal is reaching a higher level of importance
Continual process of improvement in skills and confidence
Support handout available

16. Coaching; the process steps
Pre –performance : seek learner agenda & set goals
Performance (negotiate time-outs and time)
Post-performance (feedback)
Refine learner agenda
Re-rehearsal
Summarisation, next steps

17. Coaching; the detail Clarify process Establish learner’s goals
Assess Importance and Confidence
Set up the scenario
Have a go 
Pause
Feedback, use the feedback grid (handout 2) to record your observations
Have a second go and feedback again

18. Coaching
Demonstration
Small group practice

19. Coaching; Debrief & action plan
Whole group de-brief
Individual action plan

20. Practitioner Development Programme Training for Trainers Programme (T4T)
Workshop overview

21. The workshops Briefly describe the workshops with short summary
overview of key content
Elicit questions and learning agenda

22. Facilitators working in partnership
Practitioner Development Programme Training for Trainers Programme (T4T)
Facilitators working in partnership

23. Facilitators in partnership
Equal partnership
Part of integrated team
Joint responsibility
Team inputs and outputs
Value and respect
Utilise skills and experiences
Consider context of delegates
Consider context of facilitators

24. Facilitation interactive exercise
Split into pairs with one lay and one clinical facilitator.
Each pair takes an interactive exercise from the PDP and creates an action plan for delivery.
One group facilitates their interactive exercise with the whole group.
The participants in the exercise give constructive coaching feedback.

25. Coaching; More practice
Small group practice

26. Facilitation & Presentation Skills
Practitioner Development Programme Training for Trainers Programme (T4T)
Facilitation & Presentation Skills

27. Group discussion Essentials of good presentation
Essential of good facilitation
Flip chart responses

28. Skills grid Review the elements of the skills grid (T4T handout 5)
Explain each section
Consider you confidence for each section
Write your action plan to address areas of lower confidence
Use the grid to inform how your action plan for ongoing learning and continued development

29. Working with Simulated Patients
Practitioner Development Programme Training for Trainers Programme (T4T)
Working with Simulated Patients

30. Valuable resource
Develop rapport & relationship with your simulated patient(s).
Accept them as a valuable resource and as a part of your integrated team.
Provide adequate training and preparation time.
Include simulated patients for the part of the session debrief
and workshop evaluation that relates to their role and share the evaluation
Agree basic principles in advance such as feedback in role, no comment or
judgement on learners ability to use skill
Discuss any areas of concern on either side at the end of the workshop and agree action plan for next time

31. Culture of continuous Improvement
Practitioner Development Programme Training for Trainers Programme (T4T)
Culture of continuous Improvement

32. Personalised health/care planning, self management support and shared decision making
Activation

33. The knowledge, skills and confidence to manage your own health and healthcare

34. A supportive system Working in partnership Sharing decisions
Planning care
Activated patients
Prepared, proactive teams
Optimal functional and clinical outcomes

35. Living with a Long Term condition Usual care is self management
Self care / management = 8757 in a year
Hours with professional / NHS = 3 in a year

36. People who live with LTCs are the ultimate decision makers and risk takers
Decisions
About lifestyle
About medication adherence
About accessing services
About possible planned interventions

37. So it should be the job of the service to ensure that….
…People are supported to make informed and personally relevant decisions about managing their own health and healthcare
Should I take that pill today?
Am I going to stick to that exercise regime?
Do I really want that heart operation?

38. Personalised health/care planning, SMS and SDM
Shared decision making
Decision aids
Scheduled follow up appointments,
providing motivational support
Scheduled care
pathway, providing
specific interventions
Scheduled care planning appointments, providing proactive support through partnership working

39. Continuous Quality Improvement Is just a way of helping an organisation to consider and implement change

41. Act Plan Study Do Model for Improvement What are we trying to
Understanding the problem. Knowing what you’re trying to do - clear and desirable aims and objectives
Model for Improvement
What are we trying to
accomplish?
How will we know that a
Measuring processes and outcomes
change is an improvement?
What change can we make that
will result in improvement?
What have others done?
Act
Plan
Study Do
Langley G, Nolan K, Nolan T, Norman C, Provost L, (1996), The improvement guide: a practical approach to enhancing organisational performance,
Jossey Bass Publishers, San Francisco
What hunches do we have? What can we learn as we go along?

42. Patient Confident in Self Management Organisational Changes
Agenda Setting
Patient Confident in Self Management
Goal Follow Up
Goal Setting
Organisational Changes
Pre Visit Changes
During Visit Changes
Post Visit Changes
Patient / Clinician Engagement
The 3 Enablers
Primary Drivers
Secondary Drivers
Ideas for Change
Outcome

43. In your consultation today:
Appendix 2
Self Management Questionnaire
To help us to continually improve our services we would be grateful if you would kindly answer the following 6 questions.
HAVE YOU ATTENDED A SELF-MANAGEMENT PROGRAMME? YES/ NO (please circle)
In your consultation today:
(please circle)
1. Did you Discuss what was most important to You in managing your own health?
YES/ N0
2. Did you Get support to set a short-term goal for yourself?
3. Did you Arrange to discuss your progress on your short-term goal?
4. How supported did you feel in managing your health?
Totally Not at all
supported supported
“I am confident that I can manage my health condition”
Strongly Strongly
agree disagree

44. Continuous Improvement; interactive exercise
Work in groups of three or four
Record on a flip chart all your examples of continuous improvement
Consider how these examples will support the PDP workshop content
Feed back to the whole group one example per group of how you integrate this into the PDP workshops

45. Coaching; More practice
Small group practice

46. Practitioner Development Programme Training for Trainers Programme (T4T)
Competency model

47. Competency Individual timescales Review skills confidence grid domains
Set own continuing development action plan
One series observation co-facilitation with coaching feedback (using feedback grid and peer review form)
Negotiate with co-facilitator
Facilitator skill mix
Yearly peer review

48. Continuing development & support
Consider local training programmes
Facilitation skills accreditation
Presentation skills accreditation
Regional and national initiatives
Knowledge & skills framework
Appraisal
Peer tutor groups & Action Learning Sets
Regular tutor meetings

49. Individual action plan
Goal & action plan
Importance and confidence
Potential barriers
Problem solving
SMART
Confidence
Follow up plan

50. Free space
Collaborative agenda setting for using this time

51. End of training questionnaire
Please complete the post training questionnaire and return to the facilitator.
This questionnaire will be repeated at the end of the Programme and will enable you to assess your development and will contribute to the programme evaluation
Thank you

52. Acknowledgements
All logos of sites and phase 1 contributors required these also need to be on sheet inside front page