Professional values and attitudes

http://hee.nhs.uk/wp-content/blogs.dir/321/files/2014/10/VBR-Framework.pdf

I have now begun a bit of work comparing the first year and final year responses to the professional values exercise  (I have so far analysed 10 presentations in each year, representing the work of around 70 students. I am about 1/3 of the way through) and there are some interesting differences emerging.

It appears for instance that the mentions of Social Justice are considerably more frequent in the final year students' work than in that of the first years' - 61 mentions in this category as opposed to 26. The other categories are noticeably more evenly balanced, although the "attitudes" section gets around 50% more mentions overall amongst the final year students.

For the final year students, the order in which categories feature is: social justice, attitudes of the care giver, skills of the care giver, outcomes for the service user, management and teamwork. The first years' focus, in order, is on skills then attitudes of the care giver, followed by the outcomes for the service user, social justice and finally management and teamwork.

The most frequently mentioned values out of all the categories in the first year are (in order of number of times referred to) Equality and Diversity, Respect, Supportiveness, Teamwork and Relationships. For the final year students these are: Equality and Diversity, Respect, Person Centredness, respecting the service user's  individuality and Empowerment. Although Equality and Diversity are top in each year, this aspect is mentioned twice as many times by the final year students as it is by the first years.

In terms of the care giver's personal attitudes, the top five in each year are remarkably similar :
Respectful, Compassionate, Enthusiastic and Committed and Approachable, are in the top five for each year. The final year students then have Genuineness and Honesty whilst the first years have Supportiveness.

There were however some interesting issues raised by the first year students which did not appear on the final year students' agenda at all. An awareness of isolation and loneliness, particularly amongst the elderly, and of the need for service users (again mainly the elderly) to be cared for within their own communities, stood out for me. The other main difference is that the first year students seem to emphasise the building of a trusting and supportive relationship where the care giver is enriching lives whilst final year students celebrate the individuality of the service user, aim to empower them and encourage independence whist identifying the care giver's most important qualities as empathy, committment and genuineness.

So how do these emerging attitudes and values compare with what health and social care organisations require of their staff? The link below explains the NHS' Values Based Recruitment programme:
http://hee.nhs.uk/wp-content/blogs.dir/321/files/2014/10/VBR-Framework.pdf with its emphasis on compassion, respect and dignity and improving lives.

Here also is BASWs values and ethics code http://cdn.basw.co.uk/upload/basw_112315-7.pdf focusing on human rights and social justice.

There is a greater overlap between the BASW values and the final year students' whilst the NHS values are wholly embraced by both years. Those BASW values which appear very little in either groups' work are the more political goals of redistribution of resources and working in solidarity.

One way of looking at the students' values statements is to assume they reflect their growing knowledge and experience and in particular their developing understanding of professional practice and the evidence base for effective interventions.

They may, for example, represent the difference between an understandable naivety (in a good sense) on the part of the first year students who, lacking both work experience and knowledge base, enter the course with an as yet undefined urge to help, care for and support others. This was noticeable in an unembarrassed use of the words love and passion in some groups' work as well as the expression of a desire to serve others and to make a change in the world. 

After three years of study, having had opportunities to work in the health and social care field, and with a more nuanced understanding of the needs of service users, values around empowerment, personal responsibility, advocacy and removing stigma are foregrounded by final year students.

Another interpretation is that the values expressed echo the social and psychological stage of the students themselves - from a more dependent, relationship-based perspective which perhaps reflects the first year student's need for belonging, to a more self-confident, independent and individual identity, which mirrors the final year undergraduate's readiness to "fly the nest" and embark on their career. Obvioulsy that is a bit of a generalisation especially as we have a number of mature students with existing health and social care careers behind them - but it's certainly worth considering.

Clearly there is more to be done - firstly to finish the analysis to see if the differences really are as marked as they currently appear and then perhaps to follow up on this through further dialogue with the students themselves and a review of their final reflective assessments.

Professional Identities - analysing the data

The values held by future health and social care professionals are something about which we should all care deeply. We may one day be very grateful if we or our partners, parents, or children find ourselves in the hands of people who have a keen sense of social justice and a compassionate nature.

Values are certainly at the heart of current  NHS quality improvement programmes  - see this interesting project involving "values based interviewing": The Health Foundation.

When I started on the Photopeach project I had some preconceptions about the sort of values our health and social care students would portray in their videos.... even after assessing them, I tended to have the impression that the number of different categories of values was very few and had been often repeated. If pressed I would have said Respect, Dignity, Caring would come out on top as key values (as ones we had actually discussed in class). Respect did indeed come joint top (along with with tolerance) but second was valuing the uniqueness of the individual.

Half way through the analysis of the videos, I have been surprised at the diversity of values, skills, professional attitudes and knowledge that the students have selected.

There are over 70 individual values mentioned and I have grouped these into five main categories: Social Justice, Personal Qualities, Professional Skills, Teamwork and Management, and the Desired state of the Service User.

Under Social Justice, such issues as anti-discriminatory practice, promotion of human rights, liberation from oppression and promoting the service user's voice are prominent (this category actually comes top with 47 mentions) whilst the desired state of the service user (comfort, happiness, dignity, independence etc) gets 30 mentions. Leadership and Teamwork gets 22 mentions (fulfilling goals, multidisciplinary working, accountability, leadership, co-ordination etc) which given that the module is called Leading Teams is unsurprising (in fact I'd have been disappointed if these had not materialised).

The two biggest categories (most values mentioned) are Personal Qualities and Professional Skills.
Qualities include attitudes such as altruism, compassion, responsibility and sensitivity, which I would have expected. Surprises included creativity, optimism, honesty and loyalty.

The inclusion of these values or qualities leads me to conclude that students had given this exercise quite a bit of thought and were not simply replicating what they could find on the NHS or SCIE websites that we looked at.

Professional Skills included safeguarding, problem-solving, being an advocate, ethical and reflective practice and managing relationships with service users. Confidentiality was actually the most mentioned attitude in this category.

I guess this demonstrates on one level that we have been doing something right as teachers for the past three years if our soon-to-be graduates are able to articulate these values and qualities so clearly. I think though it also highlights the type of student who comes on the course. I did the exact same exercise with first year students just a few weeks into their studies and the results are not a million miles away from these - a little less diverse perhaps but certainly demonstrating that students come on to the course already espousing beliefs in social justice and the importance of respect and dignity in the care of vulnerable people.

This in turn reflects the diversity of our student body - one third of our incoming students are over 21, 20% over 25. A number of these have already worked in the care sector. Around 10% of our students originate from outside Europe - some of these are refugees. Over half have not come to University straight from school but through a mixture of FE/access routes. We don't have the exact figures but I know anecdotally that a good number of our students are carers already - for children, parents and other family members - or themselves have a disability or chronic illness.

Concern for social justice and compassion appear to be well formed in our students even before they arrive. Developing knowledge of the subject area, engagement with the sociological and philosophical arguments presented on the course  - and of course, work experience - do the rest. Its good to know we'll be safe in their hands.

Free online course to promote peace, reduce violence in Health Care Settings

Medical Peace Work - free online course

http://www.medicalpeacework.org/?q=node/230

No tweets please, we're British health workers

http://4glengate.net/node/448

This blog post pretty much sums up the experience I - and my NHS based students - have had in trying to explore social networking sites for learning, newtworking, team communication and even health promotion. I agree that the potential threats to a hospital's vital information systems are not to be taken lightly, but the draconian tone taken in the forbidding of such networking sites does really demonstrate how little actual experience and understanding there is of their potential benefits.....

see my previous post about NHS and social media - clearly some people are using it (officially that is) and to good effect