Background and Policy Context
The Cancer Control Programme (2006) and the Framework for Cancer Prevention, Treatment and Care (2010) recognise the need for health and social care professionals to be skilled in communicating effectively and sensitively with people affected by cancer and life limiting conditions. Both documents stipulate that those professionals with responsibility for communicating significant news should undertake a programme of advanced communication skills training. This is in line with UK wide initiatives which have resulted in the development of an agreed programme of training.
Model of training
Coordinated by the Northern Ireland Cancer Network, the model chosen is aligned with the national (UK) course. It has been robustly evaluated and shown to change behaviours and enhance communication between professional and patients. It is an intensive quality assured course, designed and led by Dr Susie Wilkinson, involves six-eight participants. It lasts for three days (there is also a two day variant), and includes a variety of experiential learning approaches including the use of actors in role play, video recording, presentations, critical reflection and debate.
This programme has been developed, progressed and partially funded in partnership with Macmillan Cancer Support in NI.
ACST Core Principles
The original course is aimed at senior healthcare professionals working with adults in the areas of cancer and palliative care. It consisted of a three-day intensive, experiential, learner-centred course, where up to 12 participants worked with two facilitators on areas of communication they found personally challenging. The programme is usually delivered outside of the hospital setting, thus away from the workplace. Participants are bound by agreed ground rules and trained actors simulate patients in role play. The participants set the agenda for the three days by presenting complex communication scenarios they have found difficult in practice; they are then facilitated to work through their own scenario over the three-day period.
Development of the Northern Ireland ACST Programme
The initial ACST delivery in NI began in 2009 with the original three-day course. The programme has since undergone a process of evaluation and review in response to feedback from participants. One common theme arising from evaluations was the preference of participants to be able to access a two-day programme as opposed to the historical three-day version. In response to this feedback, the facilitators steering group agreed to trial a two-day programme throughout 2012/2013 with a maximum of six participants. This worked very well and was positively evaluated.
Thus, the current NI ACST model now comprises of a two-day programme containing the learning philosophy, core components, learning outcomes, and delivery methods of the original programme.