Student nurse training to assess, support and manage patients with learning disabilities and autism has recently become mandatory for all nursing and care staff following the inclusion of specific role-appropriate training in the Health and Social Care Act. These measures are also to be supported by ensuring that people with learning disabilities receive better and more focused community care as part of plans to reduce the number of specialist inpatient care admissions. Nurses report receiving insufficient training in caring for people with learning disabilities, and many patients within this group experience health inequalities and unmet needs (Ford, 2020).
The mandated training is named after Oliver McGowan, whose death highlighted the need for improved training for all health and social care staff. It has been developed with expertise from people with learning disabilities and autism, their families and carers. It has also been created in partnership with Health Education England, the Department of Health and Social Care, Skills for Care and NHS England. Tier one is a 90-minute e-learning session followed by an interactive online session with a service user and facilitator. Tier two is a 90-minute online learning session followed by a 1-day face-to-face session with a service user, facilitator, and subject specialist.
To supplement the delivery of this training the University of West London has developed learning disability simulations in collaboration with the Baked Beans theatre company. These simulations were delivered to third-year nursing students from all fields at the beginning of this academic year. The purpose of these sessions was to create awareness, understanding and an appropriate level of knowledge to enable students to care for people with learning disabilities and ensure positive health and social care outcomes. Using simulation in nursing education allows participants to interact with realistic patient scenarios (Jeffries, 2020; Bowden et al, 2020). It creates a safe learning environment where participants can practice and improve their knowledge, communication, teamwork, critical thinking, and clinical reasoning skills. The facilitator can observe how a learner performs in a controlled environment, allowing repetition when necessary and promoting reflection on thoughts and actions.
The scenarios were simulated in an authentic environment using experienced learning disability actors/service users. Students attended in groups of up to 10, which were facilitated by academics, subject specialists, and clinical staff. At the start of the simulation, the facilitator gave students a handover for each scenario. Students were empowered to direct their own learning by taking turns to assess the patients, give peer advice when not directly participating and reflect in action to make appropriate changes during the simulation. Subject specialists and practice supervisors were present to role model safe, effective, and inclusive care, providing feedback and giving students additional support when needed.
Overall, the students really enjoyed the learning opportunity and 90% felt more confident assessing the needs of service users with learning disabilities following the training. The students felt that the training had enhanced their knowledge and understanding of working with people with learning disabilities, and improved their assessment, communication skills and understanding of what is required to enable fair and equal treatment. This included the importance of taking time to build a relationship with the service user, allowing them to feel comfortable talking about their health needs, and heightened awareness of the extra support needed.
Learning disabilities training is an important educational requirement, which can be enhanced using simulation. Students are able to practice, rehearse and try out complex communication and assessment skills in a safe and authentic environment. This could lead to improved quality of care and patient outcomes in the future.