1. Institute of Health Sciences Education
Training students to obtain informed consent from patients with a communication disability Evaluation of an interprofessional education programme
Celia Woolf
Institute of Health Sciences Education
Research Afternoon
QMUL
9th June 2010

2. communication disability
Informed consent and
communication disability
Health professionals must involve patients / clients in decision making (e.g. DoH 2001, 2004)
Obtaining informed consent from people with communication disabilities (PWCD) can be challenging

3. Background
Health professionals often don’t involve PWCD properly in decision making (Byng et al, 2003; Law et al, 2005)
lack of knowledge
communication strategies
professional responsibilities
negative attitudes and
assumptions (Fox & Pring, 2005)

4. Background Communication disability is common
estimated 20% of population at some stage in life
(Law et al, 2007)
Importance of interprofessional collaboration 
SLT role to assist other health professionals to communicate with patients (DoH, 2001; DoH, 2004)

5. Background Exposure may not improve ability to communicate with
people who have communication disability
Training improves communication facilitation skills
(Kagan et al, 2001)

6. Study Design 3 interprofessional groups of final year students
Speech & Language Therapy
Nursing (Adult, Child, Mental Health)
Medicine
Radiography
Midwifery (n = 26)
Two training sessions for each group (2 x 2 hours)
Led by a facilitator and co-trainers with communication disabilities

7. Evaluation Pre- and post-training questionnaires knowledge confidence
Focus groups
Students
Co-trainers
Written feedback from students
Observation of training sessions 7

8. Training content Session 1 Patient experiences Ethico-legal context
Communication disability
Communication strategies
Allocation of informed consent scenarios

9. Training content Session 2 Informed consent simulations
Orthopaedic surgery
Change of drug treatment for epilepsy
Barium swallow
Feedback & discussion

10. Evaluation results

11. Questionnaire Results
Explored changes in confidence and knowledge about informed consent and communication disability
5 point response scale
Strongly disagree strongly agree
Administered pre and post training

12. Questionnaire Results
Compared pre- and post-training responses
Repeated Measures ANOVA
Highly significant increases in confidence and knowledge 12

14. 14

15. Focus group results Focus group recordings transcribed verbatim
Thematic analysis using Framework approach
Overwhelmingly positive experience
Students particularly valued
meeting and working with co-trainers
simulation and hands on approach
mix of theory and practice

16. Examples of written feedback
Excellent overall. Really enjoyable and a great learning experience. Feeling considerably more confident! Many thanks! (Adult Nursing)
Thank you! I hope this course is offered to as many healthcare practitioners / students as possible.
(Medicine)
The training sessions have given me an insight on how to communicate with people with communication difficulties and the importance of simplifying medical terminology.
(Diagnostic Radiography)

17. Examples of written feedback
[I enjoyed] the chance to work in an interprofessional context and discuss issues which might come up in future practice. Great chance for practical involvement. (SLT)
Admirable co-trainers whose participation in the programme was paramount. Exceptionally wonderful and open people. (SLT)
This was a very positive and constructive experience that proved to be completely relevant to my practice and personal development and I enjoyed meeting people that face difficulties when interacting and communicating with health care professionals. (Adult Nursing)

18. Conclusions knowledge about informed consent
knowledge of communication strategies
confidence about obtaining informed consent
attitudes towards people with communication disabilities

19. Acknowledgements CETL for project funding
Project Team: Celia Woolf, Tom Penman, Mary Rogers
Co-trainers: Carole, Catriona, Kim, Collette
CONNECT the Communication Disability Network
Westminster Learning Disability Partnership
Student participants
Statistical advice: Fiona Warburton, City University 19