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Introducing service improvement to the initial training of clinical staff
  1. Neil Johnson1,
  2. Jean Penny2,
  3. Robinson Dilys3,
  4. Matthew W Cooke4,
  5. Sally Fowler-Davis5,
  6. Gillian Janes6,
  7. Sue Lister7
  1. 1Institute of Clinical Education, Medical School Building, University of Warwick, Coventry, UK
  2. 2NHS Institute for Innovation and Improvement, Coventry, UK
  3. 3Institute of Employment Studies, Brighton, UK
  4. 4University of Warwick, Coventry, UK
  5. 5York St John University, York, UK
  6. 6Teesside University, Middlesborough, UK
  7. 7Coventry University, Coventry, UK
  1. Correspondence to Dr Neil Johnson Institute of Clinical Education, Medical School Building, University of Warwick, Coventry CV4 7AL, UK; p.n.johnson{at}


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.

Conclusion 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.

  • Health services
  • quality of healthcare
  • research
  • education
  • medical
  • education
  • professional
  • education
  • nursing
  • health professions education

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  • Funding This project was funded by the NHS Institute for Innovation and Improvement, Coventry, UK.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.