Theorising about service user and carer involvement in nurse education

The simple process of inviting a patient to give a presentation can be informed by a wide range of theoretical and conceptual perspectives. Just a few of these ideas are listed below, to help readers who wish to ground their activities in a conceptual framework. The issues and theories are in no particular order.

• 4PI is a set of principles that apply to all kinds of involvement activities in all settings, and was developed by service users and carers at the National Involvement Partnership, hosted by NSUN – the National Survivor User Network for mental health.  See details and sign up to show your support here.
• BNIM – The Biographic-Narrative Interpretive Method explores how the internal world of sense-making and storytelling by a person interacts with the external world of circumstances and events. Sometimes a personal story can shed light on social norms or national policies.
• Patient Simulation – the use of actors or manikins to recreate, perhaps in a standardised, repeated way, a particular clinical situation.
• Consumerism – service users comment on the services they are offered, but have little opportunity to design them.
• Democratisation – identify the points in an organisation were decisions are made and ensure that service users and carers have a real voice and opportunity to contribute to each decision.
• Integration –  Chambers & Hickey (2012) suggest that service user involvement can be positioned along an integration continuum, from piecemeal integration where involvement is confined to a small number of specific interventions, through to systemic integration where people are involved in every stage and aspect of the design and delivery of education.
• Engagement – Chambers & Hickey (2012) also offer an engagement continuum, where service users and carers are involved actively (in challenging stereotypes and delivering thematic teaching) or passively (as a body to be practised on).
• Engagement in the community – an alternative use of the term ‘engagement’. At Kingston University, student nurses volunteer in social action projects located in the community (such as the Baked Bean Company), thus creating a reciprocal relationship in which the community both contributes to nurse education and is benefited by student nurses too.
• Power – Chambers & Hickey (2012) call this a ‘participation continuum’. It captures the extent to which power is transferred from academic and clinical staff to service users and carers.