Who's challenging who training for staff empathy towards adults with challenging behaviour: cluster randomised controlled trial

Hastings, Richard P.; Gillespie, David; Flynn, Samantha; McNamara, Rachel; Taylor, ZW; Knight, Rosie; Randell, Elizabeth; Richards, Leisa; Moody, Gwenllian; Mitchell, Alex; Przybylak, Phillip; Williams, Ben; Hunt, Paul

doi:10.1111/jir.12536

Cited by 25 publications

(38 citation statements)

References 29 publications

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“…Fifteen studies did not specify a timeframe for postintervention measurements or were unclear. 31–33 35–38 40 41 43–52 For example, Hastings et al 37 reported measuring empathy 6 weeks post-randomisation but were not clear how long after the intervention had ended that this measurement was taken. For studies that were explicit, postintervention measures varied between 2 days and 6 months, with the majority of measures taken within 2 weeks of the intervention.…”

Section: Resultsmentioning

confidence: 99%

Assessing the effect of empathy-enhancing interventions in health education and training: a systematic review of randomised controlled trials

et al. 2020

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ObjectiveTo estimate the effect of empathy interventions in health education and training from randomised controlled trials (RCTs).MethodsMEDLINE, PsycINFO, EMBASE, CINAHL and Cochrane databases were searched from inception to June 2019 for RCTs investigating the effect of empathy-enhancing interventions in medical and healthcare students and professionals. Studies measuring any aspect of ‘clinical empathy’ as a primary or secondary outcome were included. Two reviewers extracted data and assessed the risk of bias of eligible studies using the Cochrane Risk of Bias Tool. Random effects meta-analyses of the impact of empathy training on participants’ empathy levels were performed.ResultsTwenty-six trials were included, with 22 providing adequate data for meta-analysis. An overall moderate effect on participant empathy postintervention (standardised mean difference 0.52, 95% CI 0.36 to 0.67) was found. Heterogeneity across trial results was substantial (I2=63%). Data on sustainability of effect was provided by 11 trials and found a moderate effect size for improved empathy up until 12 weeks (0.69, 95% CI 0.23 to 1.15), and a small but statistically significant effect size for sustainability at 12 weeks and beyond (standardised mean difference 0.34, 95% CI 0.11 to 0.57). In total, 15 studies were considered to be either unclear or high risk of bias. The quality of evidence of included studies was low.ConclusionFindings suggest that empathy-enhancing interventions can be effective at cultivating and sustaining empathy with intervention specifics contributing to effectiveness. This review focuses on an important, growing area of medical education and provides guidance to those looking to develop effective interventions to enhance empathy in the healthcare setting. Further high-quality trials are needed that include patient-led outcome assessments and further evaluate the long-term sustainability of empathy training.Protocol registration numberPROSPERO (CRD42019126843).

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Section: Resultsmentioning

confidence: 99%

Assessing the effect of empathy-enhancing interventions in health education and training: a systematic review of randomised controlled trials

et al. 2020

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“…They have been assessed mainly in studies focusing on co-delivery training for mental health staff. Among the validated scales adopted, Staff Empathy for people with Challenging Behaviour Questionnaire (SECBQ, [97]) can be mentioned, as well as Borderline Personality Disorder-Cognitive/emotional Attitudes Inventory (BPD-CAI/FAI, [98]). Self-efficacy, defined as the belief in one's ability to succeed in specific situations or accomplish a task, has been measured through other reliable tools and adapted instruments.…”

Section: Outcomes For Professionalsmentioning

confidence: 99%

Co-Production Performance Evaluation in Healthcare. A Systematic Review of Methods, Tools and Metrics

Marsilio

Fusco

Gheduzzi

et al. 2021

IJERPH

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Co-produced practices and publications in the healthcare sector are gaining momentum, since they can be a useful tool in addressing the sustainability and resilience challenges of health systems. However, the investigation of positive and, mainly, negative outcomes is still confused and fragmented, and above all, a comprehensive knowledge of the metrics used to assess these outcomes is lacking. To fill this gap, this study aims to systematically review the extant literature to map the methods, tools and metrics used to empirically evaluate co-production in health services. The search took place in six databases: Scopus, Web of Science, Psych INFO, PubMed, Cochrane and CINAHL. A total of 2311 articles were screened and 203 articles were included in the analysis, according to PRISMA guidelines. Findings show that outcomes are mainly investigated through qualitative methods and from the lay actor or provider perspective. Moreover, the detailed categorisation of the quantitative measures found offers a multidimensional performance measurement system and highlights the impact areas where research is needed to develop and test new measures. Findings should also promote improvements in empirical data collection on the multiple faceted co-produced activities and spur the consciousness of the adoption of sustainable co-productive initiatives.

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“…Following the further development work on WCW, a large-scale RCT (Hastings et al, 2018) was undertaken. The primary aim was to assess the effectiveness of WCW to increase the empathy of staff working in residential homes for people with LD compared with a waiting list control group, using a cluster randomised controlled trial design.…”

Section: Evaluation Of Who's Challenging Who?mentioning

confidence: 99%

“…Findings indicated a small positive (but statistically non-significant) effect on increased staff empathy at 20 weeks, and small to moderate effects for staff reported secondary outcomes (e.g., positive empowerment attitudes towards people with LD and CB, increased personal accomplishment at work, and positive work motivation), in favour of the intervention group. Referring to the small change in empathy following the WCW training course, Hastings et al (2018) noted that the study "was not powered to detect such small effect sizes." (p. 807).…”

Section: Evaluation Of Who's Challenging Who?mentioning

confidence: 99%

Who’s Challenging Who?: a co-produced approach for training staff in learning disability services about challenging behaviour

Flynn¹,

Hastings²,

McNamara³

et al. 2019

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Purpose The purpose of this paper is to outline the development, piloting and evaluation of the Who’s Challenging Who? (WCW) training intervention for social care staff to improve their empathy and attitudes towards people with learning disabilities (LD) and challenging behaviour (CB). Design/methodology/approach A phased approach was taken to the development and testing of the intervention. Initially, the existing literature was reviewed, the theoretical background of the intervention was developed, and then the intervention was designed. A pilot study was undertaken, followed by further development, and a large-scale randomised controlled trial (RCT). Findings WCW had a small positive effect on staff empathy 20 weeks after the intervention, and small to moderate effects for other staff reported outcomes (e.g. positive empowerment attitudes and positive work motivation). Being trained by people with LD and CB encouraged staff to reflect on the impact they have on the people they support. The trainers with LD valued their role, and saw benefits beyond this (e.g. friendships). Research limitations/implications It is possible to carry out high-quality RCT evaluations of social care practice, and research should continue to generate evidence in this way, as in healthcare settings. However, there were difficulties in retaining participants. Practical implications People with LD can be actively involved in the co-production and delivery of social care training. Social implications Employment and a fair wage can increase the confidence and empowerment of people with LD. Originality/value This is the first large-scale RCT of an intervention that aimed to improve empathy/change attitudes in social care staff who work with people with LD and CB.

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Who's challenging who training for staff empathy towards adults with challenging behaviour: cluster randomised controlled trial

Cited by 25 publications

References 29 publications

Assessing the effect of empathy-enhancing interventions in health education and training: a systematic review of randomised controlled trials

Assessing the effect of empathy-enhancing interventions in health education and training: a systematic review of randomised controlled trials

Co-Production Performance Evaluation in Healthcare. A Systematic Review of Methods, Tools and Metrics

Who’s Challenging Who?: a co-produced approach for training staff in learning disability services about challenging behaviour

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