title: Introducing service improvement to the initial training of clinical staff.
abstract: BACKGROUND
  It is well recognised in healthcare settings that clinical staff have a major influence over change in how services are provided. If a culture of systematic service improvement is to be established, it is essential that clinical staff have an understanding of what is required and their role in its application.
  
  
  METHODS
  This paper describes the development of short educational interventions (a module of 6-8 contact hours or a longer module of 18-30 h) for inclusion in the initial training of future clinical staff (nursing, medicine, physiotherapy, occupational therapy, dietetics, social work, operating department practice, public health and clinical psychology) and presents the results of an evaluation of their introduction. Each module included teaching on process/systems thinking, initiating and sustaining change, personal and organisational development, and public and patient involvement.
  
  
  RESULTS
  Over 90% of students considered the modules relevant to their career. Nearly 90% of students felt that they could put their learning into practice, although the actual rate of implementation of changes during the pilot period was much lower. The barriers to implementation most commonly cited were blocks presented by existing staff, lack of time and lack of status of students within the workforce.
  
  
  CONCLUSIONS
  This pilot demonstrates that short educational interventions focused on service improvement are valued by students and that those completing them feel ready to contribute. Nevertheless, the rate of translation into practice is low. While this may reflect the status of students in the health service, further research is needed to understand how this might be enhanced.
authors.affiliation: Institute of Clinical Education, University of Warwick, Coventry CV4 7AL, UK. p.n.johnson@warwick.ac.uk
authors.forename: Neil
authors.initials: N
authors.lastname: Johnson
authors.forename: Jean
authors.initials: J
authors.lastname: Penny
authors.forename: Robinson
authors.initials: R
authors.lastname: Dilys
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Cooke
authors.forename: Sally
authors.initials: S
authors.lastname: Fowler-Davis
authors.forename: Gillian
authors.initials: G
authors.lastname: Janes
authors.forename: Sue
authors.initials: S
authors.lastname: Lister
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004501:Education, Medical; D004506:Education, Nursing; D040381:Education, Public Health Professional; D017598:Efficiency, Organizational; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007388:Internal Medicine; D009936:Organizational Innovation; D010865:Pilot Projects; D013222:State Medicine / Q000458:organization & administration*; D013997:Time Factors; D006113:United Kingdom