Assistive Technology (AT) Training for Healthcare Professionals - - PowerPoint PPT Presentation

The ADAPT Research Team, CCCU

Prof Eleni Hatzidimitriadou Sharon Manship Dr Maria Stein Dr Rachael Morris Dr Gayaneh Szenkovits

Assistive Technology (AT) Training for Healthcare Professionals

Luncht ime Research S eminar, Facult y of Healt h and Wellbeing, CCCU 15t h January 2020

CONTEXT

• Ageing societ ies and chronic disabilit ies are

irrevocable t rends in EU, leading t o loss of aut onomy and a breakdown of social relat ions

• Key role of innovat ive Assist ive Technologies

(AT), including S

• cial Assist ive Robot ics (S

AR) and smart EPW as effect ive t ools t o empower disabled and aged people and improve social inclusion

• Exist ing barriers in t he upt ake of AT

(st andardizat ion, int eroperabilit y, limit ed involvment of users, lack of healt hcare professional t rainings)

ADAPT

• Call for project : INTERREG VA FMA
• Duration : 48 mont hs
• T0 : January 01st 2017
• TEND : June 30t h 2021
• Budget : ≈8,7M€
• Lead partner : ES

IGELEC

• Partnership
• 16 partners : 8 FR / 8 UK
• Large scale of competencies:
• Universities
• Hospitals
• Health networks and economic clusters
• SMEs and Charity

MAPPING OF THE P ARNTES HIP

Université PJV INS A Rennes University of Kent University College of London Canterbury Christ Church University ERGOVIE ES IGELEC

S ME and Charity

Breizh PC Kent S urrey S ussex Academic Health S cience Network

Academics Hospitals Health networks and economic cluster

Plymouth Hospital CHU de Rouen / IFE Pôle TES Kent Canterbury Hospital + Health and Europe Center Cornwall Mobility Pôle S t Hélier

OUR PROJECT S TRATEGY

• 1. Framework of innovation for making the

deployment of the solutions easier, including :

• Development s from TRL 4 t o 8 int egrat ing indust rials

requirement s

• Cost effect ive product s
• S

t andardizat ion issues

• 2. A set of training materials to cover a large

scale of healthcare professionals

• 3. Co-construction and continuous integration

process to improve the solutions to meet the user’s/ stakeholder’s needs

• 1. EPW S

imulat or plat form using virt ual realit y

• Immersive experience to the user of the smart

EPW

• Train the users to drive in everyday life
• Professionals will

assess the suitability of the EPW for particular patients and environments and gain understanding from the user perspective

• 2. S

mart EPW t o compensat e for user disabilit ies t hrough driving assist ance t echnologies and report users’ healt h

• Benefit to severely disabled users
• Enable health professionals to monitor changes in

user health

WHAT WE ARE DOING

• 3. Training of healthcare professionals in AT
• Address a gap in the current healthcare education.
• Proj ect platforms (EPW simulator + smart EPW) will be

captured in training protocols for t he benefit of users and healthcare provider

• 4. Formalized

agreements between research institutions and companies built through 20 events ranging from local to international meetings

• Promoting and disseminating ADAPT’s result s, creating

synergies, identifying points

• f

convergence for common studies

• Boost R&D and favour the spread of innovative ADAPT's

AT to the market

WHAT WE ARE DOING

WP T1

INS A RENNES / UCL

EPW S imulat or Virt ual Realit y Plat form WP T2

UPJV / EKHUFT

S mart and Connect ed Robot ic EPW WP T3

CCCU / BREIZH PC

Training of Healt hcare Professionals in Assist ive Technologies WP T4

CORNWALL MOBILITY

Economic Development in t he Cross Border Area –Technology Transfer

WP M : PROJECT MANAGEMENT

ES IGELEC – IRS EEM / HEC

WP C : COMMUNICATION

ES IGELEC – IRS EEM

ADAPT Project Work Packages

9

WP #T3 – LEAD: CCCU

ACTIVITY LEADER DELIVERABLES DATE START / END T3.1 Crossborder benchmarking AT service training and S urvey of Needs of health prof. regarding AT CM Benchmarking and Literature Review Report Report on results from the survey of knowledge, attitudes and training needs of healthcare professionals 01.2017 / 01.2018 T3.2 Development of the AT training programmes for healthcare professionals CCCU 4 Training packages for different qualifications of healthcare professionals 08.2017 / 06.2018 T3.3 Development of ‘ Train the Trainer’ Package IRS EEM ‘ Train the Trainer’ package 01.2018 / 06.2019 T3.4 Delivery of Training S essions CHU Number of students/ professionals trained in UK/ France (680) Training hours in UK and France (576) 08.2018 / 04.2020 T3.5 Evaluation of Training EKHUFT Evaluation Reports for Training 08.2017 / 03.2021

Literature Review: Challenges Encountered in the Adoption of Assistive Technology (AT) and Training of Healthcare Professionals

Purpose of the Literature Review

 To understand the challenges encountered by

professionals in adoption/use of Assistive Technology (AT) in healthcare practice in UK and France

 To explore if/how training of healthcare professionals

(HCPs) in AT practice takes place in UK and France

 To inform the relevant work package activities

(WP3.2.1 and WP3.2.2) of ADAPT project:

• Online survey of HCPs in relation to their knowledge,

experiences and training needs of AT

• Development of AT training materials for HCPs

Literature Review Methodology

 Narrative literature review approach  Search of databases in UK/FR

• Academic Search Index, BDSP (Base de données en Santé

Publique), Cairn, CINAHL, Documentation EHESP/MSSH (Ecole des Hautes Etudes en Santé Publique/Maison des Sciences Sociales et Handicap), Google Scholar, Pubmed, Social Sciences Citation Index

 Inclusion criteria:

• Search terms: assistive technology, AT provision, training,

healthcare professional/s, health, technology autonomy, gerontechnology, electric powered wheelchairs, socially assistive robotics, virtual reality, simulation

• Language: English/French; Date of publication: 1990 onwards

 Thematic analysis undertaken to elicit key points

Summary of Literature Review Sources (n=79)

Country N Type of Research N Type of Source N Key focus N

UK 20 Practice report/ perspective 18 Journal article 48 AT training/ education 29 France 19 Evaluation/ survey 10 Report 11 Barriers in use of AT 15 US A/ Canada 27 Qualitative 9 Online source 11 Background 12 Europe* 7 Guest Editorial 2 Book 6 Evaluation of AT 10 Australia 3 S ystematic Review 2 Conference paper 3 AT principles/ practice 6 Unknown 2 Literature Review 2 Abandonment of AT 3 UK/ France 1 Case S tudy 2 Opportunities/ access to AT 2 RCT 1 Impact of AT 2 Action Research 1 *Papers were from S weden, Italy, S witzerland, Netherlands

Findings from the Review – Overall themes

• 1. Barriers to adopting AT solutions
• 2. Training of HCPs
• 3. Barriers to training in AT practice

Barriers to adopting AT solutions

 Inadequate information about

appropriate AT solutions

 Complexities relating to

financing/funding, acquisition and prescription/ recommendation of devices

 Obtrusiveness and stigmatisation

experienced when using AT

 The above challenges contribute

to abandonment of AT

Training of healthcare professionals

 Need for HCPs to be aware of

availability and application of AT devices

 Lack of knowledge of healthcare

regarding AT solutions

 Shortfalls in communication

amongst professional groups and between HCPs/users

 Strong need for evaluation and

assessment tools regarding the benefits of AT

Barriers to training in AT practice

 Different AT terminology/definitions across

disciplines

 Inconsistent provision and quality of AT

training

 Lack of evaluation of training  Lack of access to professional help in area of AT  Lack of resources and funding  Shortage of qualified professionals to teach  Increasingly rapid development of technologies

Conclusions

 Technology that enhances reablement/rehabilitation

will increase in future - growing need for HCPs to be aware of availability and application of AT devices

 Challenges in availability, assessment and provision of

appropriate AT leads to isolation of users, loss of independence, abandonment of devices

 Support, training and education for HCPs/AT users is

vital in adoption and use of devices

 Need for comprehensive education, ongoing

assessment and evaluation in AT field

 Paucity of studies examining content and impact of AT

training and longer term outcomes – further research and evidence required

An Online Survey of AT Knowledge and Experiences of HCPs in the UK and France

Background to Survey

 Literature Review Findings

• Review t hemes informed survey t hemat ic areas

 Benchmarking Exercise

• Mapping of relevant healt hcare services and t raining of

key professional groups in UK and French survey regions  Purpose of the Survey

• To inform t he development of t he t raining programme t o

be designed for t he purposes of t he ADAPT proj ect

Survey Development



S urvey Design:

• Existing studies
• Proj ect Team Expertise



Pilot of draft survey t o refine cont ent and present at ion

• Arthanat, S., Elsaesser, L.J. and Bauer, S. (2016) ‘A survey of assistive

technology service provisions in the USA’, Disability and Rehabilitation: Assistive Technology, 12(8), pp 789-800.

• De Joode, E.A., Van Boxtel, M.P.J., Verhey, F.R. and Van Heugten, C.M. (2012)

‘Use of assistive technology in cognitive rehabilitation: Exploratory studies of the

• pinions and expectations of healthcare professionals and potential users, Brain

Injury, 26(10), pp 1257-1266.

• Long, T.M., Woolverton, M., Perry, D.F. and Thomas, M.J. (2007) ‘Training needs
• f paediatric occupational therapists in assistive technology’, American Journal of

Occupational Therapy, 61, pp 345-354.

• Nieboer, M.E., van Hoo, J., Van Hout, A.M., Aarts, S. and Wouters, E.J.M. (2014)

‘Professional values, technology and future health care: The view of health care professionals in The Netherlands’, Technology in Society, 39, pp 10-17.

• Somerville, N.J., Wilson, D.J., Shanfield, K.J. and Mack, W. (1990) ‘A survey of

the Assistive Technology Training Needs of Occupational Therapists’, Assistive Technology, 2, pp 41-49.

Survey Methods



Survey structure:

• 37 open/ closed/ multiple-

choice questions

• 4 main sections



Circulation – June-November 2018

• UK: 237 emails (mapped organisations),

plus 56 NHS trusts (portfolio study)

• FR: 1180 professionals/ institutions



Ethics Approval:

• UK (Local / NHS

HRA)

• FR (Not required)



Online Delivery:

• Bristol Online S

urvey (BOS ) (UK)

• Google Forms (FR)
• Age / Gender / Profession / Qualifications /

geographical location / work remit (e.g. hospital) / years qualified / AT organisation membership Demographics

• Overall AT knowledge on AT service provision

Knowledge

• Current experience and how AT is used in practice

Experiences of working with AT

• Current level of training and training requirements

Training needs

Survey Participant Demographics

Total sample within ADAPT regions = 429: UK* =167 / FR = 262

* Tot al S ample in UK = 965 (findings from overall UK sample t o be report ed elsewhere) 46.6% 6.5% 2.3% 22.1% 7.6%

FR Professions

OT Physio S LT Nurse Audiologist Ort hot ist Prost het ist Doct or Counsellor S cient ist Technologist Education Manufact urer Researcher Other 34.1% 16.8% 16.8% 10.8% 11.4%

UK Professions

OT Physio S LT Nurse Audiologist Ort hot ist Prost het ist Doct or Counsellor S cient ist Technologist Education Manufact urer Researcher Other

Survey Participant Demographics

82.8% 17.2%

FR

Female Male 89.2% 10.8%

UK

Female Male 17.4% 21.3% 31.1% 26.3%

UK

18-29 30-39 40-49 50-59 60-69 70+ 17.9% 32.8% 23.3% 21.4%

FR

18-29 30-39 40-49 50-59 60-69 70+ 29.3% 48.5% 11.4%

UK

Doct orat e Mast ers Bachelors Diploma Other 13.0% 75.2%

FR

Doct orat e Mast ers Bachelors Diploma Other

Gender Years of Qualification Age Level of Education

66.5%

UK

<2 2-4 4-6 6-8 8-10 10+ 62.2%

FR

<2 2-4 4-6 6-8 8-10 10+

Survey Participant Demographics

30.5% 14.1% 7.3% 27.1%

FR

Hospital Communit y Charit y Privat e Education S elf-employed

Membership of AT Organisat ion:

• Percentage of professionals who are members of AT organisations

is higher in France (10.3%) than the UK (2.3%) Type of Health Care Service

9.0% 66.5%

UK

Hospital Communit y Charit y Privat e Education

Findings – Knowledge of AT

86.2% 7.8% 6.0% 94.3% 3.8% 1.9% S t rongly Agree/ Agree Don't Know S t rongly Disagree / Disagree

AT helps people complete difficult tasks

UK France 52.7% 42.5% 3.0% 1.2% 82.4% 15.3% 1.9% 0.4% Always/ On a regular basis S

• met imes

Don't Know No

Use of AT relies on support from carers, family and professionals

UK France

Findings – Knowledge of AT

93.3% 6.0% 0.6% 42.8% 3.4% 53.8% S t rongly Agree/ Agree Don't Know Disagree

AT provides more autonomy

UK France p<.001 p<.001 45.5% 20.4% 34.1% 84.7% 11.8% 3.4% S t rongly Agree/ Agree Don't Know S t rongly Disagree / Disagree

AT is provided by trial and error

UK France

Findings – Knowledge of AT

p<.001 28.8% 18.5% 52.7% 71.8% 13.4% 14.9% S t rongly Agree/ Agree Don't Know S t rongly Disagree / Disagree

AT refers exclusively to technologically- advanced electronic devices

UK France

Findings – Experiences of AT practice

Those who can prescribe AT include:

UK France

Findings – Experiences of AT practice

13.2% 46.7% 6.6% 33.5% 21.2% 75.5% 2.1% 1.2% Yes, in dept h To a lesser degree Don't know No

Knowledge to compare and choose AT

UK France



A third of all HCPs did not know if AT users had access to adequate resources/ support (UK 35.5% ; FR 27.5% )



A third of HCPs felt capable of monitoring continued effective use of AT (UK 38.9% ; FR 34.8% )



HCPs in both countries would benefit from interdisciplinary clinical standards (UK 80% ; FR 77.1% )

Conclusions



Knowledge and application of AT was varied between UK and France - possibly due to differences in health care provision and support mechanisms



S urvey findings suggest HCPs recognised value of AT for users’ improved care but had low confidence in their ability to choose appropriate AT solutions and monitor continued use, and would welcome AT interdisciplinary clinical standards.



Inevitable challenges for workforce development – need to:

• Explore further reasons for variations between countries
• Implementation of training in response to training needs

Training Needs and Development of Online AT Training for HCPs in UK and France

Background

 Part of the ADAPT Proj ect is the development of

AT training for HCPs to enable them to use AT effectively in practice.

 The focus of the presentation is twofold:

• Present survey results that refer to training

needs of HCPs in both UK and France who indicate their training needs for AT

• Present the process of development of online

AT training for health care professionals in UK and France

Education and Training Needs



Access to AT specific training – Big issue!

• Maj ority of survey respondents had no specific AT

training or in-service in both countries

12.6% 65.9% 21.6% 16.4% 46.9% 36.6% Yes No Don’ t know

In-service AT training

UK France 6.6% 93.4% 18.7% 81.3% Yes No

AT training qualifications

UK France

Tot al sample = 429; UK =167, France = 262

Barriers to AT training

 More than half of survey respondents identified

• rganisational barriers to AT training including lack
• f local training funding constraints in both

countries

27.5% 19.2% 36.5% 22.8% 61.7% 62.9% 25.6% 33.6% 38.5% 22.9% 50.0% 55.7% Online resources Published resources Ongoing CPD Nat ional t raining Local t raining Funding for t raining UK France

Tot al sample = 429; UK =167, France = 262

AT Education and Training Priorities

Priority needs Specific detail UK France Knowledge of AT devices & services Different types of AT, availability, suitability & operation 94% 81.3% Customisation of AT Adaptation of devices, EB applications 30.1% 65.3% Holistic assessment of client needs How to assess comprehensively to increase client satisfaction , reduce abandonment? Follow-up assessment? 25.3% 53.4% Client/carer/family education about AT Client/user interface, carer involvement, support & training 28.3% 56.5%



To bridge gaps in knowledge and ident ified t raining needs of healt hcare professionals in Assist ive Technologies



ADAPT AT t raining is an online int eract ive programme which st art s by int roducing Foundat ions of AT and moves on t o specialist Unit s, e.g. AT for Mobilit y, Communicat ion, Evidence-Based Pract ice.

Purpose of ADAPT AT Training

UNDERPINNING FRAMEWORK:

• The biopsychosocial model of World Healt h Organisat ion’s (WHO)

International Classification of Functioning, Disability and Health (ICF) framework underpin development of cont ent .

• ICF shifts focus from disability to health and functioning, in line

wit h a social model of rehabilit at ion.

Contextual Factors

Underpinning Framework of Training Units

Biopscyhosocial Model of Disability

(Engel 1977)

Conceptual Interaction International Classification of Health and Disability

(WHO 2001)

embedded

 Pilot of Unit 1 – analysis of feedback and furt her refinement of

cont ent , present at ion and mode of delivery

 Launch of Unit 1 in April 2019 in UK – CCCU st udent s and HCP

academics.

 Embedded evaluat ion quest ionnaire in each Unit  6 mont h follow-up evaluat ion quest ionnaire – find out usefulness &

applicat ion of t raining in workplace

Process of development of Training Units

• Learning

Outcomes – Content layout

• Format -

Evaluation Development

• f Content
• Interactive Text –

short presentations

• Self-Reflection

points Delivery and e-learning tools

• Workshops with

partners

• Advisory

Stakeholder Group Feedback

process

Aim 75 part icipant s - 59 signed up for t raining, 35 complet ed

ADAPT A T Training – UK & French Advisory Groups

• East Kent Hospitals University NHS

Foundation Trust

• Cornwall Mobility
• University of Kent
• Centre for Independent Living Kent
• Chailey Clinical Service
• Service Users
• Family Carers/Personal Assistants
• CCCU Staff Disabilities Network
• Kent Physical Disability Forum

UK Adapt group members

Unit 1: Foundations of AT

Coursesites e-learning platform Moodle e-learning platform

Unit 1: Foundations of AT

Powtoon Microsoft Sway

ADAPT AT Training Units

Knowledge of AT Devices & services Customization of AT Holistic Assessment

• f client needs

Client/carer/family education around AT

Identified training needs

Overview of Units

Work in progress

 Concentrating on developing content for other units in collaboration

with the French – similar main content adjusted to suit UK/French training needs

 Upcoming meeting with French in UK to discuss/finalise content for

unit 2 and 3.

 Transfer all training content to Moodle