Title: Evaluation of the Impact of care Experience Prior to Undertaking NHS Funded Education and Training
Funder: Department of Health and Social Care

Abstract: Concerns about nursing care quality in England have been raised by policy makers, patients, the public as well as some members of the nursing profession. Some of these concerns are also supported by published evidence. In its response to these concerns, the Government introduced a pilot project that gives people who are intending to study nursing hands-on care experience working in NHS Trusts, prior to training. However, there is little evidence that this response will resolve the concerns expressed, nor is there evidence suggesting which model of prior care experience will improve nursing students skills, values and behaviours, and service users experiences of care. Objectives To investigate the effect of prior experience of care on pre-registration students caring approach. To determine the longer-term benefit to students upon qualification of formal, paid, prior experience of care. To identify if, and how, the values and behaviours that students learn during prior care experience are sustained throughout their education and training. To elucidate which model of prior care experience best enhances the newly qualified workforces caring and compassionate behaviours. Research plan and methods of investigation Using a convergent parallel mixed methods design, the research team will conduct a systematic search and critical review of previously published literature. We will then collect measures of student nurses skills, values and caring behaviours using standardised measures at entry to the nursing degree, within the first semester of study at University, in years two and three of study, and in the first three months after graduation. We will compare and contrast the skills, values and caring behaviours of student nurses who participated in the pilot project with two other groups of student nurses who did not partake in the pilot, at the same intervals, sampling a total of 480 students. Using focus groups, we will explore students experiences of their prior care experience. We will assess patients experiences of care through a set of key questions and, via the use of audio recodings, we will analyse the quality of care interactions between students and patients. Finally, we will ask students mentors or clinical supervisers to assess the competency of students using a standard scale. Research team The study will be conducted by researchers from the Universities of Nottingham and Manchester, and Anglia Ruskin University, with expertise in mixed methods research and experience in evaluating national health and social care policy through research. Potential impact This research will provide systematically collected data that will inform policy makers, the NHS, clinicians and educators about the effect of prior experience on students skills, values and caring behaviours, and the best model of providing this experience. Providing evidence of this nature has the potential to improve the quality of care to people using health and social care services and reduce adverse events, thus improving patient safety, enabling services meet the needs of patients, and meeting regulatory standards. The findings may also help reassure the public regarding its concerns about nursing practice while also improving the education of nurses.

Lay abstract: Concerns about nursing-care quality in England have led to a pilot project that gives people who are intending to study nursing hands-on care experience working in NHS Trusts, prior to training. However, we do not know whether this will adequately address the concerns expressed. Therefore, we propose to study whether this experience of care prior to entering training improves nursing practice and patient care. This research will capture evidence that is critical in ensuring the delivery of the best possible NHS care. The research methods we will use include a systematic search and critical review of published evidence. After this, following ethical approval, and with students and patients consent, we will employ questionnaires and focus groups, and listen to students interactions with patients. These methods will allows us to compare the skills, values and caring behaviours of student nurses who participated in the pilot project with two other groups of student nurses who did not take part in the pilot, at different intervals over a four year period. We will also explore the patients experiences of care received from the different student groups. The outcomes used to assess success for the proposed research lie in capturing the required sample sizes, continued high participation/ response rates, high levels of completion of the questionnaires, and completing the study to the agreed timetable. The proposed research will benefit patients by informing policy makers on the best model for providing prior care experience to people wishing to train as nurses so that they can then deliver the best care upon graduation and beyond. The research team is well placed to carry out this study because of its expertise in the proposed methods and its extensive experience of conducting similar research.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE