Convergent themes
| Quantitative | Qualitative | |
| Theme: Transferring learning into practice | Over-riding themes | |
| Confidence (p<0.003) Increases in: Skills to have conversations; managing own emotions, being able to discuss relevant issues. | Feelings of confidence to hold conversations. Improved confidence in practice to signpost and liaise with other professionals and organisations. | Empowerment |
| Expectations and beliefs Less concerned about: Getting too close to a patient. (p=0.012) Talking to them would damage how they cope. (p=0.027) Making matters worse. (p=0.051) Less likely to believe that: A patient would raise concerns on their own. (p=0.036) | Greater awareness of the importance of being non-judgemental, especially where patients were reluctant to engage. Appreciation of the importance of mirroring the patient’s energy, pausing, listening, providing cues and responses at appropriate times, and readiness to employ these strategies in conversations. | Tolerance and open-mindedness Increased sensitivity |
| Perceptions of usefulness and intentions (Scale mean. Total=100) More satisfied. Mean=82 Motivated to seek more knowledge. Mean=92 More able to support parents. Mean=93 Intension to use. Mean=94 | Strong intentions to use learning in practice. More awareness of timing, questions to ask, the need to check in with patients, explore cues, use listening skills, ‘be alongside’ and to use resources. Consciously looking at patient notes to identify children, greater efforts to document presence of children, ensuring time for talking and resources. | Determination Changing personal practice |
| Attitudes to influencing change in practice % Participants Sharing learning with colleagues. (90%) Influence change in the workplace. (89%) Influence wider practice. (71%) | Sharing learning and making organisational changes—reviewing and updating documentation systems, building stronger networks with other professionals, developing workshops to be offered to parents. Support provided is influenced by settings and roles. In acute settings: heavy caseloads, limited time and scarce resources hindered relationships and proactive conversations/finding a quiet space for sensitive discussions. Difficult to build rapport when only contact is in a patient’s final days of life. In community-based settings: lack of control over context and conversation flow. | Influencing wider practice Barriers/challenges to implementing learning |
| Theme: Reactions to the training experience | ||
| Participants consistently positive. N=28/28 agreed/strongly agreed the facilitators worked well together and were knowledgeable, and the topics covered were relevant to them. N=21/28 agreed/strongly agreed that role-play was authentic and realistic. N=2/28 provided negative feedback—not clear about the objective, not enough time, support materials not helpful, role-play not comfortable. | Delivery style and range of content were appreciated and relevant. Training considered suitable for all levels of roles and experience. Face-to-face format facilitated relationship building and support. | Content and style |
| Opportunities to share experience invaluable, new ideas, validated experiences. Learning together with mixed professional backgrounds brings other perspectives and expands knowledge and understanding. | Interactive training | |
| Role-play with a professional actor brings realism/authenticity. New insights experienced whether engaged in role-play or observing. Risk of evoking recent experiences, generating emotional responses and increasing feelings of inadequacy. Suggestions that role-play might be better when face to face so that appropriate support can be offered. | Realism and authenticity | |
| Resources introduced were welcomed and useful, but more practical guidance on how to work with these in practice is required. Understanding diversity in response to illness, death and dying across different patient populations. How to talk to children directly. | Resources and additional learning |