‘This Adds Another Perspective’: Qualitative Descriptive Study Evaluating Simulation-Based Training for Health Care Assistants, to Enhance the Quality of Care in Nursing Homes

Catherine Aicken, Lisa Hodgson, Kay De Vries, Iain Wilkinson, Zena Aldridge, Kathleen T Galvin

    Research output: Contribution to journalArticlepeer-review


    Much of the UK’s ageing population lives in care homes, often with complex care needs including dementia. Optimal care requires strong clinical leadership, but opportunities for staff development in these settings are limited. Training using simulation can enable experiential learning in situ. In two nursing homes, Health Care Assistants (HCAs) received training in clinical communication skills (Situation-Background-Assessment-Recommendation Education through Technology and Simulation, SETS: group training with an actor simulating scenarios); and dementia (A Walk Through Dementia, AWTD: digital simulation, delivered one-to-one). In this qualitative descriptive study, we evaluated the potential of this training to enhance HCAs’ clinical leadership skills, through thematic analysis of 24 semi-structured interviews with HCAs (before/after training) and their managers and mentors. Themes were checked by both interviewers. HCAs benefitted from watching colleagues respond to SETS scenarios and reported greater confidence in communicating with registered healthcare professionals. Some found role-play participation challenging. AWTD sensitised HCAs to the experiences of residents with dementia, and those with limited dementia experience gained a fuller understanding of the disease’s effects. Staffing constraints affected participation in group training. Training using simulation is valuable in this setting, particularly when delivered flexibly. Further work is needed to explore its potential on a larger scale.
    Original languageEnglish
    Article number3995
    JournalInternational Journal of Environmental Research and Public Health
    Issue number8
    Publication statusPublished - 10 Apr 2021

    Bibliographical note

    Funding Information:
    Funding: This research was funded by the Burdett Trust for Nursing, through its 2017 Strengthening Nursing Leadership grant programme. This manuscript was an invited contribution and incurred no APC.

    Funding Information:
    Acknowledgments: We are grateful to the care home organisation for their collaboration, and to staff and managers for their support and participation in our study. SETS was developed and delivered as part of a collaborative project between Sussex Community Trust and Surrey and Sussex Healthcare NHS Trust, and funded from a grant by Health Education Kent, Surrey and Sussex with the aim of reducing admissions to hospital by using technology enhanced learning. The professional actor’s fee was paid by the research grant. No authors received any additional funding to deliver the training. AWTD was developed by Alzheimer’s Research UK and is available for free download from http://www.awalkthroughdementia.org/ (accessed on 6th April 2021).

    Publisher Copyright:
    © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

    Copyright 2021 Elsevier B.V., All rights reserved.


    • Implementation science
    • Long-term care
    • Nursing homes
    • Quality improvement


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