title: Service user involvement in giving mental health students feedback on placement: A participatory action research study.
abstract: BACKGROUND
  Although the drive to engage service users in service delivery, research and education has mainstream acceptance, it is not easy to achieve meaningful involvement. The contribution that could potentially be made by users whilst accessing services is often overlooked.
  This study involved stakeholders (mentors, service users and a lecturer) working together to design, evaluate and refine a system enabling students to seek feedback from service users. The feedback concerned mental health students' interpersonal skills and occurred whilst on practice placement. This research aimed to explore the experiences of those concerned when nine students attempted to learn from rather than about service users.
  
  
  METHODS
  A 2-year study, encompassing five cycles of participatory action research (PAR).
  
  
  METHODS
  A small island community in the British Isles, adopting UK standards for pre-registration nurse education.
  
  
  METHODS
  Data came from interviews with service users and mentors and a series of reflective group discussions with students who volunteered to try out the feedback mechanism. The deliberations of the PAR stakeholder group informed the research cycles and added to the data, which were subject to thematic analysis.
  
  
  RESULTS
  Findings indicated that service users volunteering to give feedback had unanimously positive experiences. Students' experience lay on a continuum: those with a stronger sense of self were more willing and able to ask for feedback than less confident students. Cultural adjustment to the role change needed was challenging, requiring self-awareness and courage. Over time, all students achieved deep learning and, for some, learning appeared transformative.
  
  
  CONCLUSIONS
  Although contextual, the study concluded that the feedback initiative encouraged the development of more equitable relationships, in which mental health nurses respected the expertise of service users. This potentially benefits student development, recovery-orientated practice, service users and HEIs searching for meaningful ways to involve service users in learning and formative assessment.
authors.affiliation: Institute of Health and Social Care Studies, Guernsey, GY4 6UU, UK. Electronic address: jspeers@hssd.gov.gg.
authors.forename: Janey
authors.initials: J
authors.lastname: Speers
authors.affiliation: Faculty of Health Sciences, University of Southampton, SO21 1BJ, Southampton, UK. Electronic address: J.Lathlean@soton.ac.uk.
authors.forename: Judith
authors.initials: J
authors.lastname: Lathlean
mesh_terms: D002983:Clinical Competence; D004508:Education, Nursing, Baccalaureate; D005246:Feedback; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D008605:Mental Health Services / Q000592:standards; D008611:Mentors / Q000523:psychology; D009726:Nurses; D015402:Nursing Education Research; D010358:Patient Participation; D011568:Psychiatric Nursing / Q000193:education*; D013338:Students, Nursing / Q000523:psychology; D006113:United Kingdom
keywords: Feedback; Mental health; Service user; Student nurse; User involvement