I work in the Me first team as the project coordinator and I am also a freelance medical role player (actor) in various NHS medical education communication training settings for exams and communication skills practice. My experience in medical education (from the perspective of playing a patient) has been quite illuminating. I was surprised to discover an apparent lack of what I considered to be rather basic and obvious communication practice among health professionals: simple things like introducing yourself properly with your name and professional role, addressing the patient by their name and avoiding medical jargon by using appropriate language that a lay person can easily understand.
At Me first, I keep a record and follow up on goals set by candidates who attend a Me first training day . Providing a ‘good introduction’ is a recurring theme and one that some candidates set as their goal. E.g. ‘Improve the way I introduce myself’ or ‘Introduce myself and explain what I do in simple easy to understand terms’.
Me first introduced goal setting as a training tool to help implement a small change in practice one step at a time. There is growing evidence that shows goal setting increases motivation, improves performance and helps people make positive changes.
Everyone who attends a Me first masterclass is asked to set a goal to help them bridge the theory to practice gap and make a change. By the end of a Me first training day, participants will have heard first-hand accounts from young people about their experiences in healthcare and discussed and explored their own practices of communication with children and young people through various activities. Goal setting happens at the end of the training day. The Me first team keeps a record of it and follows up 6-8 weeks later for any feedback.
Other common goals regularly set include:
- Try to see the child or young person alone
- Give time to the parent and the child or young person separately
- Don’t just address the parents
- Speak directly to the child
- Offer the child or young person choices
- Introduce visual tools or diagrams to help describe a procedure
- Suggest the child or young person makes a list of questions to ask the health professional
- Give the child or young person space and time
- Allow a child’s silence.
Generally feedback does vary – often there is a very positive experience as was the case with this one workshop participant, whose goal was to: ‘Improve the way I introduce myself, to explain my role’.
After several weeks we received the following feedback:
‘I feel I achieved my goal. Putting it into practice seems to put the child or young person at ease more quickly. It has also inspired me to encourage others to do the Me first course’.
Goal achievement is not always possible or straightforward and Me first acknowledges this and emphasises that this is absolutely OK! There may be unforeseen obstacles but the underlying idea of goal setting is to encourage, motivate and inspire, keeping in mind that learning comes from the process of goal setting, trying out and upon reflection about it, not just in achieving the goal.
The following goal and feedback from a Clinical Nurse Specialist illustrates this well:
‘ My goal was to talk about a difficult situation out loud; suggest that the young person keep a private diary as a coping strategy; liaise with school to arrange for classmates to do a scrapbook project to keep her included with school life …. I was unable to achieve all of my goals but I did find the Me first masterclass very helpful with talking to this withdrawn young person. I felt as if the masterclass facilitators were sitting with me in the room the following day. The main thing I gained was the ability to sit with the teenager’s silences and continue to engage despite her lack of response.’
This difficult situation required adaptation and flexibility but ultimately it seemed like a kind of breakthrough that had been helped by a change in approach. It also highlights that you may not always be able to apply your set goal but as Joanna Reid, Me first project lead emphasises:
‘The reminder of one’s goal is a useful prompt to examine barriers and obstacles to changing your practice’
It is clear to me that there are still some issues that are helped by remembering to apply the basics, such as a clear and friendly introduction. However it is also apparent that there are many complex communication challenges with children and young people in healthcare, such as managing parents and breaking down barriers when communicating directly with a child. Me first encourages using the #hellomynameis campaign.
From the emails we have received on goal setting and feedback, my sense is that goal setting is a motivating and empowering tool that can act as a reminder to try new approaches to help the child or young person have a better healthcare experience. Me first masterclass participants report feeling inspired, enthusiastic and confident when setting goals and then implementing new ideas in practice to achieve them. Clearly there are benefits all round, for children and young people and those health professionals that are working with them.
Me first Project Co-ordinator.