Training the workforce following a serious case review: lessons learnt from a death by fabricated and induced illness

In England, when a child dies as a result of suspected maltreatment, the Local Safeguarding Children Board is required to establish whether lessons can be learnt about collaborative working to safeguard children. These reviews usually include recommendations for both inter and intra‐agency training. In this paper, the authors argue that it is crucial, when planning and delivering training in this situation, to recognise the emotional impact on the workforce of the death of a child from maltreatment. This is particularly important when the child has died as a result of fabricated and induced illness (FII) by a carer and professionals may have inadvertently contributed to the child's suffering. Drawing on a case example of training following the death of a child from FII, this paper considers the challenges encountered by those responsible for commissioning and providing training. Attention is given to managing logistics, such as time delays between the death of the child and the eventual publication of the serious case review. The particular knowledge and skills required by trainers, not only in relation to the subject matter but also in managing complex group processes, are discussed. The support required by course participants and the trainers themselves is explored. The paper concludes with a checklist for those commissioning and providing training. Copyright © 2009 John Wiley & Sons, Ltd.     

Child protection training for primary health care teams: making a difference?

The role of health professionals in child protection is central to effective interagency working, yet there has been in the past criticism of their contribution to the process and recognized difficulty in engaging some health professionals in relevant training. In 2001 the author, working as Child Protection Adviser for an NHS Trust in Scotland, obtained funding to deliver child protection training to 23 primary health care teams across the region. Participants included those seen as having a key role in child protection and those often overlooked such as clerical and reception staff. Learning outcomes were established in response to the identified needs of the target group, national recommendations and the requirements of the funding body. A number of methods of evaluation, both planned and opportunistic, were used during the 1‐year project. All evaluations indicated that, in the short term, the training had been effective and the learning outcomes had been achieved. Results of an internal audit suggested that the training had resulted in a significant increase in awareness and knowledge. Further audit and evaluation will, however, be required to establish the extent of any lasting changes in practice. Copyright © 2005 John Wiley & Sons, Ltd.     

Child protection: a survey of psychiatrists' knowledge and attitudes

The aim of the study was to examine psychiatrists' knowledge of the child protection process and their attitudes toward child protection training. An anonymous questionnaire survey was sent out to all psychiatric staff in a large psychiatric hospital. The response rate was 72 per cent. Fifty‐seven per cent of respondents had never attended child protection training and 16 per cent thought that it was of no relevance to their position. Significant differences in self‐rated knowledge were identified between those who had attended training and those who had not. Variations in the availability and quality of child protection training may result in psychiatrists not attaining the core knowledge required in order to work effectively as part of the child protection process. Hospital management should work towards prioritising and disseminating local child protection policies and procedures more effectively and consider routine child protection training as part of any new staff induction. The Royal College of Psychiatrists should consider inclusion of child protection in junior staff education programmes and as part of the MRCPsych examination curriculum. Likewise, consideration should be given to enhancing the status of child protection training in continuing professional development programmes for career‐grade psychiatric staff. Copyright © 2010 John Wiley & Sons, Ltd.     

Preservice Teachers’ Sources of Information on Mandatory Reporting of Child Sexual Abuse

Teachers in many countries are mandated by law, professional codes, or education authorities to report child abuse and neglect, including child sexual abuse. However, teachers may not receive adequate preparation for such sensitive interventions, as preservice teacher education degrees provide very few or no compulsory courses on child protection and crucially related, lifelong health and well-being issues. So, where do preservice teachers source their information regarding the mandatory reporting of such abuse? This research examines preservice teachers’ professional university education for their sources of information about mandatory reporting and child sexual abuse. A sample cohort of 56 final 4th-year university bachelor of education (primary school) student teachers in Australia identified the sources they used regarding 10 important aspects of child protection. The results suggest that most did not learn about mandatory reporting or child sexual abuse, and others cited sparse and sporadic public media as their primary information source. These findings, building on previous evidence about inadequate or nonexistent preservice mandatory intervention courses in primary teacher education, may guide the design of appropriate training responses enhancing educational professionals’ knowledge, competencies, skills, and efficacies as mandatory reporters of child sexual abuse.     

The experience of teaching and learning in social work. The teaching of young child observation: A historical overview

This paper describes the setting up in 1989 of the Tavistock/CCETSW course in young child observation for social work tutors and practice teachers, against the background of the immense pressures on social workers, particularly in the field of child protection. The paper summarises the potential learning from young child observation, and its contribution within social work training. It outlines the issues which faced the social work trainers as they went on to introduce and teach observation on their courses, and draws on an evaluative study in which the members of the course participated, giving their views on the value of observation training.     

Translating messages from research on child development into social work training and practice

Social work training should equip students with both the knowledge and the skills required for good practice. Although research messages are available through books and papers, they may more easily be conveyed through the repeated use of practice tools which have been developed from research findings. The Looking After Children Assessment and Action Records have been used in formal social work training to help students develop competencies, but their value as a means of conveying a knowledge basis of key issues in child development has yet to be exploited. The Children and Families Assessment Programme has a similar potential, to help practitioners set child protection issues within a developmental framework and further their understanding of those factors that impede children's satisfactory progress. New requirements to provide routine data on children's progress for aggregation and analysis can both improve practitioners' skills and understanding of the purpose of management information, as well as providing evidence of the effectiveness of services.     

Prevention of child sexual abuse: implications of programme evaluation research

Thirty child abuse prevention programme evaluation studies were selected according to a set of methodological criteria following an extensive manual and computer literature search. Targets for intervention in 17 studies were children; in three parents; in four teachers; and in six studies multisystemic programmes were evaluated where some combination of children, parents and teachers was targeted for intervention. From a review of the 30 studies, it was concluded that child abuse prevention programmes can lead to significant gains in children's, parents' and teachers' safety knowledge and skills. Best practice guidelines arising from the review include the use of multisystemic programmes; child‐focused curricula which cover a wide range of safety skills and concepts; and the use of didactic instruction and discussion, video modelling and active behavioural skills training techniques in programme delivery. The curricula for parents' and teachers' programmes should cover child protection issues and local child protection procedures along with an overview of the children's programme lesson plans. Longer programmes conducted by trained staff are preferable and such staff may include teachers, parents, mental health professionals and law enforcement officers. Copyright © 2000 John Wiley & Sons, Ltd.     

Piloting online WellnessRx learning modules: Demonstration of developmental evaluation

WellnessRx is a health initiative focusing on healthy living through education, knowledge translation, and community engagement. Stakeholders of WellnessRx identified web-based education learning modules on nutrition and physical education as a priority to be integrated into existing health sciences curricula, as well as adapted for use by health professionals. Five learning modules were created with essential knowledge, skills, attitudes and resources or tools for health professional students and practitioners. As part of the ‘developmental evaluation framework’ for WellnessRx, two of these modules were piloted within two health professional student programs. This paper describes the pilot-evaluation experience involving student surveys, focus groups and interviews, and faculty perspectives. For both modules, student pre-post knowledge assessments indicated some improvements in post-module knowledge. Post module evaluations by students indicated benefits with the online delivery being flexible for access, self-health, case-based assessments and useful nutrition and physical activity guides. Challenges for students included their time to do the modules and the activity expectations. Instructors felt each module could be better targeted to different years within an undergraduate program. Through developmental evaluation, the pilot results along with recommendations and lessons learned provided the direction needed to further develop the WellnessRx logic model and proposed learning modules.     

Cultivating knowledge of resiliency and reintegration among military youth through a national youth leadership program

Youth in military families are frequently challenged by the adjustment demands associated with the deployment and reintegration of a parent. A positive youth development approach was undertaken by the Boys and Girls Clubs of America to develop and implement a Military Teen Ambassadors (MTA) training for youth in military families that would facilitate knowledge of resiliency and reintegration and foster leadership skills to build assets for themselves as well as their peers within their local communities. To determine if MTA was functioning as intended and to refine future programming, this preliminary formative study assessed perceived participant learning outcomes associated with MTA on variables pertaining to knowledge acquisition, perceived skill acquisition, and community needs awareness. Data were collected prior to the training, immediately following the training, and 6 months after the training. Repeated measures analysis indicated significant mean increases over time in knowledge and awareness of resiliency and reintegration; perceived leadership skills; and community awareness. Qualitative findings provided triangulation in the aforementioned areas. These findings strengthen the body of knowledge on resiliency by demonstrating that the 7 Cs model may be an effective strategy to incorporate into leadership development programs seeking to build knowledge of resiliency among military youth. Study limitations, lessons learned, and recommendations for further research are delineated.     

From Chaos to Safe Transformation: The Emotional Intelligence Learning Environment Model

Self-awareness is a necessary foundation for those seeking to develop emotional intelligence (EI). Yet, the process of developing self-awareness can be deeply disturbing, creating inner turmoil and chaos which EI trainers need to take into consideration and manage in the learning environment. This article describes the nature of this chaos and proposes a learning environment model to assist EI trainers in the design of their EI training programmes, helping trainers to create safe learning environments in which learners can pursue EI training, thereby leading to transformational change. A review of the literature defines EI, constructivism, and chaos theory, as well as exploring elements of a safe learning environment. The literature is considered along with data gathered from a recent study of twenty-one EI trainers in New Zealand, in an effort to identify key characteristics of a safe learning environment, and positive and negative qualities of the trainer and learners which can contribute to creating a safe learning environment. Based on these findings the Emotional Intelligence Learning Environment Model was developed. The article discusses the implications of the model and concludes with suggestions for future research.     

The prevailing cultures and staff dynamics in children's homes: implications for training

This paper is about training, and the learning needs of residential child care staff that training should address. It takes as its starting point research that focused on what happens in children's homes, as described by residential staff themselves. It depicts the tasks which staff carry out in relation to their overall goal of benefiting the children and young people in their care, and considers the ways in which staff work to develop and maintain viable and effective teams. Distinctive cultures emerge when working in staff teams, and the paper shows how these are related to the kinds of practice that can be achieved in residential settings. The knowledge base, practice skills, and personal qualities required to work within residential child care are detailed. The paper closes by addressing the implications which this research has for training residential staff to work effectively in group settings. It argues that fundamental to training competent residential staff is a commitment to developing an ongoing culture of learning in workplace settings.     

Training Graduate Social Work Students for Child Advocacy in Community Mental Health

A project aimed at training graduate social work students for child advocacy in Community Mental Health was developed and implemented through the cooperation of the School of Social Work, the Children's Treatment Center, and the Rock County Guidance Clinic. The training model was the practicum or field work experience approach. The training was concerned with providing students with knowledge and skills in child advocacy, for the treatment of severely disturbed children, and for providing services to a Black and disadvantaged population. The primary objectives were training professionals for the mental health field and to provide mental health services to children.     

Child sexual abuse: from prevention to self‐protection

There are a growing number of child abuse prevention and education programmes, including primarily group‐based parent and child education, which are taught by teachers within the school system. This article reviews some of the existing sexual abuse education and/or body safety programmes, as well as the research surrounding them. Advantages as well as criticisms of such programmes are reviewed. Issues such as target populations (i.e. children, teachers, parents), programme components and methodological limitations are addressed. Major findings include: children as young as three can be effectively taught self‐protection skills, parental and family involvement in training is important, and repeated exposure helps children maintain knowledge gains. The components of successful programmes include teaching children to identify and resist inappropriate touching, reassuring children that it is not their fault and learning the proper names of their genitals. Finally, future directions for programme development, research and policy are explored. Copyright © 2008 John Wiley & Sons, Ltd.     

The role of narrative in public relations ethics pedagogy

Competence in ethical decision making is one of the most important issues in the industry and practice of public relations, yet professionals entering the discipline overestimate their knowledge and skills related to ethical principles. This article features a pedagogical approach to strengthen ethics education in public relations through the use of collaborative student-professional ethics narratives. This technique attempts to move beyond a traditional case study approach and transcend traditional classroom boundaries through the development of narratives featuring real ethics situations experienced by public relations professionals. The project involved the development, implementation and assessment of the pedagogical approach that required students to interview local communication professionals (mostly in public relations) and to craft narratives that explore ethical dilemmas these professionals faced. Pre- and post-test surveys and group feedback helped explore the impact of narrative inquiry in helping students internalize ethical lessons.     

Inter‐professional working in child protection with families with long‐term and complex needs

Within the United Kingdom there is growing awareness of the need to identify and support the small number of children who are living in families experiencing multiple problems. Research indicates that adverse experiences in childhood can result in poor outcomes in adulthood in terms of lack of employment, poorer physical and mental health and increases in social problems experienced. It is acknowledged that most of these children are known to child welfare professionals and that some are referred to social services, subsequently entering the child protection system. This paper reports research conducted with 28 experienced child welfare professionals. It explores their views about families known to the child protection system with long‐term and complex needs in relation to the characteristics of children and their families; the process of intervention with families; and the effects of organisational arrangements on practice. The research indicates that these families are characterised by the range and depth of the problems experienced by the adults, such as domestic violence, mental health difficulties and substance misuse problems, and the need for professionals to have good inter‐personal skills and access to specialist therapeutic services if families are to be supported to address their problems. Copyright © 2008 John Wiley & Sons, Ltd.     

Infant and child observation as preparation for social work practice

This paper argues that infant and child observation is not only valuable as part of social work training for work with children and families but that it has a wider value in equipping workers with assessment skills relevant in all areas of social work, including care management. It describes the introduction of infant and child observation as a required component of the BA/Diploma in Social Work at The University of Reading and the effect on students' learning and their practice skills. It shows how child observation festers the development of reflective practice, enabling workers to look beyond the presenting problem and to understand the situation as a whole. The resulting intervention is then more likely to be appropriate in meeting a client's needs.     

Practice Learning and the Development of Professional Practice

The development of professional practice is based on practice learning, yet there is no consensus about its definition. The currently evolving use of the term ‘practice learning’ provides us with an opportunity to consider the nature of learning for professional practice at initial entry through to post qualifying stages of development. A number of streams of thought are influencing the understanding of practice learning and we aim to consider some of these and how they inform those involved in supporting and guiding practice learners at different stages of their professional development.

In presenting our conceptualisation of practice learning we argue against oversimplified dualities of classroom‐based academic learning concerned with theory and workplace‐based practice learning concerned with practice. Additionally we make explicit the career‐long nature of practice learning which is as embedded in continuing professional development as it is in the requirements for qualifying programmes.

Having established what we mean by ‘practice learning’ we consider the impact of organisational learning theory on the management of practice learning. The consideration of the characteristics of organisations which learn leads to a brief examination of approaches to teaching and learning which promote knowledge creation in a way which is meaningful to practitioners. We will argue that the development of understandings of organisational learning and knowledge creation should become part of the knowledge base for those supporting and guiding practice learners, in addition to the traditional knowledge base of adult learning theory.

Before exploring the nature of practice learning it would be helpful to consider briefly what we mean by professional practice for which practice learning is preparing people.

Professional practice in social work is a complex set of activities which involve direct work with service users, and their families, as well as work with other professionals and agencies. A range of knowledge and skills are used with a firm value base which recognises diversity and oppression as key elements in UK society.

Such professional practice is learned and developed in a range of ways over time through training, practice, understanding, analysis and reflection. However, the nature of just what practice learning is and where it occurs has become a focus of debate in the UK as a result of recent developments in initial professional education and training for social work.     

THE CONTRIBUTION OF PSYCHOANALYTICAL OBSERVATION IN CHILD PROTECTION ASSESSMENTS

In this paper I describe my role in undertaking child protection assessments for children in my work for a Family Centre managed by a national voluntary child care organisation. I explore how psychoanalytical observation provides additional knowledge informing assessments of risk for children. In an example that I discuss in some detail, I show how observation provides a means for assessing relationships between children and parents which leads to informed recommendations to court. In a second example I show how observation can be linked with a therapeutic approach to generate necessary change in parenting capacity. I conclude that observation is an important and effective training for professionals responsible for protecting children from harm.     

Einsatz von Simulationspatienten im Kommunikations- und Interaktionstraining für Medizinerinnen und Mediziner (Medi-KIT): Bedarfsanalyse — Training — Perspektiven

Communication skills are of central importance within daily medical life providing effective treatment. In the modern high-tech field of medicine, trustful conversations play a prominent role. In order to help students of the Heidelberg Medical Faculty to be ready for their highly responsible role as communication partner, training is carried out in the framework of HeiCuMed (short for Heidelberger Curriculum Medicinale) using specially trained simulation patients. The communication and interaction training program (referred to as Medi-KIT) enables to practice conducting conversations with challenging communication partners and grave conversational content in difficult situations. Feedback from the standardized patients, as well as from peers and tutors represents a central didactic element.In order to secure knowledge transfer into daily clinic life and as well to build a relation to cognitive knowledge transfer, all medical students are assigned, alongside Medi-KIT lessons, to a ward, and training units are coordinated in terms of content to correspond with symptom-oriented lectures and parallel POL-groups (problem-oriented learning groups). In addition, communication learning objectives are examined at the end of the semester in the form of a clinical practical exam (OSCE: Objective Structured Clinical Examination) and at patient’s bedside (Mini-CEX: Mini Clinical Examination). The goal in imparting communication skills within medical education is that the longitudinal communication curriculum be maintained and continued in subsequent medical specialization studies.