MHSMART Training Evaluation: Are we SMART enough

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MH-SMART Training EvaluationAre we SMART
enough?
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Introduction

• Context and framework of outcome collection in
  Aotearoa New Zealand
• Training
• Issues and challenges
• Benefits
• Key learnings

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Context and Framework

• MH-SMART
• Implementation with a focus on the dual
  requirements to
• link collection directly to supporting recovery
• responsiveness to Maori and other cultures
• The approach.aimed to provide the trainees with
  the knowledge and skills to enable them to
  incorporate the new outcomes approach into their
  practice

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Training
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Training Structure Process

• Team
• Consumer
• Clinical
• Maori
• TTT
• Regional approach
• Direct

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Resources

• Elva and Paki
• Vignettes
• Scenarios
• Training vignettes
• Key documents
• Principles to Guide Practice
• Implications for Service Users
• Tuituia
• Trainers Manual
• Rules

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Issues and Challenges

• Intense information overload and balance
• Information demand for information utility
• Dislocation just give us the tool leave the
  rest of it out
• Training - teaching and training skills for adult
  learners
• Cultural content opposition to cultural
  difference
• Suspicion
• Funding
• some audience members were unsure whether the
  training was cultural or HoNOS/ MH-SMART
  training
• Too strong a Maori focus. It can work against
  Maori
• Inclusion of recovery and cultural components
  patronising duplicating other training
• the fact no consumer was involved in the
  training in our DHB at a local level.
• Training model
• Train the trainer model
• Sustaining trainers and developing skills
• Not enough on training tips tools techniques
• No clear process for selecting participants for
  TTT

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Issues and Challenges cont.

• Consistent implementation - Modification of
  training package
• What is MH-SMART? no one has ever sat us down
  and said to us this is what MH-SMART is about.
• versus
• They could have come to the training with no
  knowledge of MH-SMART and HoNOS and come out
  with some.
• Beyond our Scope
• Technical issues information systems, paper
  collection etc.
• Workforce capacity issues computer literacy,
  who is prepared to be a trainer

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Successes ..mostly

• Approach and Content
• Consistent training package across country
• Set number of vignettes good so that trainers
  become familiar and confident
• The integrated approach was good, we had
  consumer and Maori
• representatives and there was someone from the
  clinical side, and it was
• well interwoven throughout.
• Useful components of training
• Clinical utility
• As a sort of newby nurse I found the training
  excellent. The information included in the
  training, i.e. integrated recovery etc. is
  excellent and it helped me to recap/refresh
  things that I already knew.

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Successes ..mostly
Confidence in using new knowledge and
skills very useful in daily practice .. good
way of thinking about clients, what you are
looking at and in discharge planning, setting a
structure for planning treatment Confidence in
using HoNOS Majority reported confidence after
training however some issues with clinicians
who did not value the tool I think probably one
thing that made going live easier was that we got
to practice, practice, practice with scenarios,
then we could go though and discuss each one and
get immediate feedback. It depends when you
get a new person coming in to the ward and doing
HoNOS, some one who is brand new, it is easier to
do. If you have someone who you knew previously
it is hard to shut down the information you have
about them from previously and only focus on the
last 2 weeks.
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Successes ..mostly
Impact of training on practice We have
decreased the waiting list here quite a lot,
getting earlier discharge and ease of discharge,
people are discharged with more trust in letting
go we have evidence to show the people have
moved on. got a better understanding of the
need to quantify what we do, made me aware of the
different bits/components of outcome, where
previously Id just concentrate on the clinical
issues. The training has broadened my own
perspectives and enhanced my focus on
collaboration and engagement.
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Successes ..mostly
Ability to deliver training Positive response to
training more preparation for extreme challenge
and criticism I thought the package was
awesome, having the booklet and the resources, we
have all of the stuff that we need to deliver the
training. Yes, I hit the floor with
confidence, but it was really through dealing
successfully with the withering criticism of
clinicians that I really came to understand what
this tool was really good for. Find the
teaching material very good, and it is well
utilised, staff have commented on how useful this
is and how they enjoy the vignettes. This style
of teaching has begun how we present other
training material.
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Future Considerations

• Training
• Consider formal trainer accreditation and
  competency development
• Ongoing support for DHB trainers
• Consider mechanism to review and refresh training
  package
• Amend or better present the comprehensive and
  complex information.
• Selection process for TTT
• Need for ongoing supply of vignettes
• Provision of clinical/information utility

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Future Considerations

• Training Sustainability
• Time available carrying training and clinical
  responsibilities
• Support continuous development of knowledge,
  FAQ
• High turnover, change of role, time demands
• Lack of recognition as part of work role i.e.
  not in PD
• Role of consumer advisors and cultural workers
  ensuring resource to ensure they are incorporated
  in training provision
• There is not the capacity in many consumer
  advisor roles to allow them to fully participate
  in all training sessions. Without this full
  participation, MH-SMART runs the risk of becoming
  another series of forms that clinicians have to
  complete and the opportunity for collaboration
  with consumers is lost.

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Key learnings

• Information utility
• Trainer support
• Review/refresh of training content
• Selection preparation of participants
• Monitoring training implementation on the ground

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Summary Conclusion

• You cant please all of the people all of the
  time
• ..the whole training was interesting, I didnt
  want to fall asleep, they kept our interest up
  the whole time.
• Excellent course, excellent trainers, excellent
  content.

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HEADING
Cmon Sylvia, wheres your spirit of adventure?