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Title: Transferring new skills and knowledge to practice : a mixed methods case study of Improving Access to Psychological Therapy (IAPT) in a single English region
Author: Mcgonagle, Ian
ISNI:       0000 0001 2414 0604
Awarding Body: University of Lincoln
Current Institution: University of Lincoln
Date of Award: 2015
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Background. This thesis examined facilitative and inhibitory issues in the transfer of new skills and learning to support implementation of national policy for Improving Access to Psychological Therapy (IAPT) in primary care services within the English National Health Service (NHS). The policy for IAPT had two principal implementation strands; a) development of new services in primary care and development of a new, national education and b) training programme to support delivery of effective evidence based psychological treatments for a specified range of common mental disorders; particularly depression and anxiety. There is a paucity of research on transfer of skills and learning from formal education programmes to application in healthcare practice. Methodology. A mixed methods case study design was developed to obtain quantitative and qualitative data on the experiences of IAPT therapists prior to commencing their training programme; on completion of their educational programme and again at a follow-up period. In-depth interviews were held with key policy leads that devised, developed and implemented the IAPT initiative to examine their expectations and reflections on the programme. Formal interviews were held with IAPT therapists; their managers and clinical supervisors from a single education cohort in an English region. Focus groups were also held with other IAPT therapists to examine emerging findings from the data. Results A number of themes emerged from the merged quantitative and qualitative data. Motivation to maintain fidelity to the work of being an IAPT therapist was seen as crucial. This motivation was highly related to the self-reported force of external pressures to adapt IAPT practice in line with changed NHS commissioning requirements. System feedback was seen as a unique feature of the programme and part of this feedback process centred on the role of clinical supervision in supporting the transfer of learning and continuous development of practice. Educational programmes were based on a prescribed competency model which was designed to provide core knowledge and skills to support new workers in new roles in new service providers within Primary Care. However, respondents reported high degrees of complexity, practice isolation and political and economic stressors that were not reflected in the curriculum. Therefore the role of the curriculum as a front end model to prepare practitioners for practice was questioned. Despite this, evidence existed of high levels of confidence and capability of IAPT therapists in the extension of their core educational skills. This transfer behaviour was a feature of practice when set within the context of supported supervision. Discussion on the implications from this research Implementation of new services and a new workforce (such as IAPT) within the NHS remains challenging with few significant successes. The IAPT programme has a number of unique features, such as a focus on feedback processes and clinical supervision. These enabling forces particularly those of supervision, were considered to be under threat from cost saving initiatives. Such financial pressures appear to have the potential to destabilise one of the major enabling building blocks of learning transfer. This thesis adds to the body of knowledge in workforce development and education and training in the NHS by offering a detailed case study analysis of a range of factors that can inhibit or enable transfer of learning and promote change in professional practice. There is little research in the mental health literature on the transfer of learning that takes such a comprehensive whole systems and long term perspective on this issue.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: C800 Psychology