Brief training in psychological assessment and interventions skills for cancer care staff: a mixed methods evaluation of deliberate practice techniques

Abstract

Objective: Unaddressed anxiety and depression is common among cancer patients and has significant adverse consequences. Cancer staff training is recommended for psychological assessment and interventions to address depression and anxiety, to increase access to psycho-social oncology care. However, psychological skills training has a poor track-record for improving clinical effectiveness. "Deliberate practice", receiving feedback on therapeutic micro-skills and rehearsing modifications, can enhance clinical effectiveness. This study applied deliberate practice to maximise benefits of brief psychological skills training for cancer care staff. Methods: Seventeen one-day training workshops were provided to 263 cancer care staff, aiming to improve confidence in assessing anxiety and depression, and delivering problem-solving therapy. Training used deliberate practice methods at the expense of didactic lecturing. Staff confidence was assessed in key teaching domains using pre-post confidence ratings. Anonymous comments from 152 training attendees were examined using thematic analysis. Results: One-day psychological skills training significantly improved cancer staff confidence in assessment of anxiety and depression, and delivery of brief psychological interventions. Thematic analysis indicated that focusing on practical skills was valued by participants and contributed to staff commitments to change practice. However, some participants felt the one-day training was over-filled and would be better delivered over more days. Conclusions: Similar results can be achieved by providing psychological skills training on a single-day, as compared to an established five-day programme, by abbreviating didactic teaching and focusing time on deliberate practice of skills. Training may increase the likelihood of changes in practice, but more training time may be required for maximum benefit.

Outcomes of psychological support skills training for cancer care staff: Skill acquisition, work engagement, mental wellbeing and burnout

“…The training offered was a development of Barrett Naylor et al.’s 20 deliberate practice model. An initial training day was offered with half the day focused on assessment skills and half focused on intervention skills.…”

“…Previous studies of similar training have been unclear about durability of effects in routine practice (e.g., 20 ). This study suggests that effects can be retained for several months, but also indicates that a 1-day training may not be sufficient for longer-term skill acquisition.…”

“…18 However, use of deliberate practice with coaching or supervision has been variably applied in training. 19 More recent studies have either had smaller pilot samples, little training follow-up, or have measured only skills or wellbeing outcomes (e.g., 20 ).…”

An apprenticeship model in the training of psychotherapy students. Study protocol for a randomized controlled trial and qualitative investigation

“…theravue.com. The notion that DP might help improve trainees' therapy skills has received some experimental support [22][23][24][25][26][27] but the evidence for an impact of DP on client outcomes is, to date, indirect [e.g., 28]. Indeed, meta-analyzing DP in diverse fields, Macnamara and colleagues [29,30] found that DP had a limited influence on performance in low-predictability environments, that is, performance settings in which the range of possible actions is high and…”

The last chapter (but not the last word) on deliberate practice.

“…True, the current evidence shows DP is more effective than traditional approaches for teaching and training therapists (Barrett-Naylor et al, 2020;Newman et al, 2022;Westra et al, 2021). Still, much remains unknown and subject to revision; for example,…”