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The impact of educational research from the Rothschild Centre for Clinical Simulation and Education Research (RCSER) at Imperial College London has progressed from the development and validation of simulators and skill assessment, through to shaping guidelines for training curricula and continued professional development in the NHS and beyond. This body of multidisciplinary research brings together Imperial's contributions in simulation science, skills assessment, performance-shaping factors, educational theory and surgical practice to contribute to national and international healthcare education and policy. The work impacts upon clinical practice at regional, national and international levels, with far-reaching implications for the quality and safety of patient care.
Beneficiaries of this research are patients in intensive care and healthcare staff. This research has had impacts in two distinct but related areas:
These advances are informed by our synthesis and application of rigorous, innovative methodologies relating to questionnaire development and real-time data collection.
Research by the University of Nottingham's Education and Technology for Health team has benefited healthcare students, professionals, users, carers and institutions both in the UK and internationally by establishing a participatory methodology for high-quality, sustainable multimedia Reusable Learning Objects (RLOs). These learning tools are now used in 50 countries globally to facilitate individual access to knowledge, enhance learning within curriculums and deliver continuing professional development, with feedback showing satisfaction of up to 100% in some nations. They are also being used to train healthcare professionals in resource-poor countries, further strengthening the University of Nottingham's role as a global education provider.
The emergency care team at Warwick Medical School has a strong track record of high-quality health sciences research encompassing evidence synthesis, health-services research and clinical trials. Our trials of a 03b2-agonist (salbutamol) in acute respiratory distress syndrome (ARDS) have influenced therapeutic recommendations in the International Sepsis Guidelines (2013), reducing the use of this potentially detrimental therapy. Our cardiac arrest research informed the 2010 international guidelines on cardiopulmonary resuscitation (CPR) led to the generation of new intellectual property, and prompted industrial collaborations to build new technologies, such as TrueCPRTM (2013). These have led to improved CPR practice and improved patient survival. Furthermore, our research has led to major policy changes and to a redesign of UK emergency healthcare, improving cost efficiency, the patient experience and clinical outcomes (e.g. 95% of patients were treated within 4 hours - up from 65%; and people leaving without been seen reduced to less than 5%).
Research conducted at the University of Manchester (UoM) has shaped the design of national systems of accreditation for general practice in the UK, Europe and beyond. Accreditation systems set standards that reflect key aspects of the organisational systems and processes in general practice that are needed to ensure delivery of good quality care. Accreditation systems also provide a kite mark of quality assurance and act as a platform for supporting continuous quality improvement. UoM developed indicators of quality in general practice structure and organisation and demonstrated how they could be used effectively to improve quality. Working in partnership with health professional organisations, governmental organisations and other universities, UoM used knowledge from the research to develop systems for general practice accreditation now used in the UK and across Europe.
Outcomes of the research conducted at the University of Edinburgh (2001 to 2007) that have had the most far-reaching impact are a strong conceptualisation of the whole learning environment (including curricula, teaching, learning support, and assessment and feedback) and its influence on the quality of undergraduates' learning. What gave these outcomes added resonance was a concern for disciplinary distinctiveness as well as more generic features; an alertness to the pervasive implications for day-to-day teaching-learning practices of mass 21st-century higher education; and a focus on enhancing as well as evaluating the student experience.
The reach of the impact extends to university teachers, middle and senior academic managers, local and national bodies with responsibilities for surveying quality and standards and, albeit less directly, students. Staff in at least 21 universities in 12 countries have used the Experiences of Teaching and Learning Questionnaire (ETLQ). The National Student Survey questionnaire was influenced by the ETLQ, and has continuing UK-wide impact on teaching through students' retrospective ratings of their experience. Project outputs were directed towards teaching staff through workshops, publications and invited presentations, followed by detailed advice on assessment and feedback of coursework.
The World Health Organisation's (WHO) Surgical Safety Checklist is the culmination of over 5 years of concerted research effort to better understand, model and intervene in human factors that affect clinical performance and patient safety in operating theatres and surgical care. Imperial researchers were instrumental in the set up and implementation of the WHO `Safe Surgery Saves Lives' working group, launched in 2006, from which the Checklist was a primary outcome. Subsequently, we were co-investigators, and UK-lead, in a global study the implementation of the Checklist in 8 pilot hospitals across 7 continents. The Checklist was demonstrated to significantly improve patient outcomes and was modified and mandated for use in all NHS surgical procedures in England by the National Patient Safety Agency. We have since lead a national study that evaluated the implementation of the Checklist within the NHS and successfully delivered a team training programme aimed at optimising use of the Checklist in our hospitals.
Improving patient experience of health services is a policy priority worldwide. The University of Manchester (UoM) has conducted research on patient experience since 1995, leading to the development of a series of validated measures for assessing patient experience of quality of care in primary care, including access to care and the degree to which services are patient-centred. Our measures have been in routine use in the NHS since 2004, sent to samples of several million patients. The data have been used to provide incentives for the highest quality practices, and to inform policy makers about current care throughout the UK.
Impact in this case study focuses on developing an inclusive culture; changes in academic development programmes; and influencing national policy on inclusive learning and teaching in higher education. While student diversity has increased over the last twenty years or so, teaching methods have changed little in response. This has had a knock-on effect on student engagement and success. Research outlined here has influenced how university teachers reframe their understandings and practices of teaching and engaging diverse students. This work has reshaped continuing professional development in university teaching in the UK and internationally and has influenced national policy on inclusive learning and teaching.
Research at the university of ulster into the theory and practice of person-centredness has resulted in:
i. the development of person-centred practices that lead to better outcomes for patients, staff and teams.
ii. the influencing of policy for the development of person-centred services.