Symposium 9: Competent to care A train-the-trainer method of teaching as a way of implementing the correct use of the ‘Malnutrition Universal Screening Tool’ in Norfolk: is it effective?

Abstract

Malnutrition is frequently undetected in care homes. It is recommended that residents are screened on admission and at suitable intervals thereafter. It is aimed to implement the 'Malnutrition Universal Screening Tool' ('MUST') in all care homes in Norfolk in order to fulfil this recommendation. Following a pilot of successful (but time-consuming) 'MUST' training a train-the-trainer package was developed as a practical way of achieving this goal. Courses were held in 2007, each comprising a study day and an assessment of each trainer delivering training. Trainers were provided with a dossier of training support materials. Data were collected at the study day and 3 months after the course to evaluate its effectiveness. Sixty-seven trainers were trained, all of whom rated the course as effective in preparing them to deliver training. At their assessments 96 % were able to explain 'MUST' accurately. Of the new trainers 44 % returned follow-up questionnaires and copies of sample care plans. The majority of care plans showed 'MUST' scores had been calculated accurately and appropriate nutrition care plans had been set up and evaluated. The train-the-trainer model is an effective method of training large numbers of care-home staff to use 'MUST'. One of the unexpected benefits observed was the ownership taken by the trainers, which was demonstrated by the enthusiasm and confidence with which they subsequently trained their colleagues. Malnutrition: Nutritional screening: 'MUST' training

An evaluation of a community dietetics intervention on the management of malnutrition for healthcare professionals

“…The high turnover of staff suggests that frequent and repeated education programmes are required to maintain high levels of nutritional knowledge, which has considerable implications for manpower planning for community dietetics services as the providers of such training. Recently, the use of a ‘train‐the‐trainer’ method for educating nursing home staff in the use of ‘MUST’ was reported as successful (Lee & Scott, 2009); this may offer a possible solution to training needs in the nursing home setting.…”

Focus on Undernutrition in Care Homes: A Retrospective Service Evaluation

“…Comparing FoU's impact (Table 10, Fig. 6) on undernutrition is limited because other UK studies using "MUST" [17,51,85,87] did not report on prevalence change; and foreign studies [61,68,69,[88][89][90][91] used alternative outcomes or non-comparable nutritional screening tools (NST). Similar studies [83,92] implementing education and care pathways identified both a reduction [92] and no impact [83] in prevalence.…”

Using the Cascade Model to Improve Antenatal Screening for the Hemoglobin Disorders

“…3,4,14 Research and the Cascade Model. 16,17 The literature is dominated by descriptions of how the cascade model has been applied 3,7,9,10,[12][13][14]18 and tends to report initiatives that were considered successful, suggesting publication bias. 15,16 There appear to be no trials to test whether cascading results in transfer of knowledge and skills to trainees, few attempts to compare it with other educational modalities, 15 and no initiatives where it has been combined with other approaches such as e-learning that are frequently employed in settings where direct access to continuing professional development (CPD) is limited.…”

“…Introduced in the 1940s, the cascade model is used to develop capacity in the commercial sector, 2 general education, 7 public health, 3,[8][9][10] and continuing medical education (CME). 11 Cost-effectiveness is assumed because small numbers of trained facilitators disseminate information to a wider population.…”

“…15,16 There appear to be no trials to test whether cascading results in transfer of knowledge and skills to trainees, few attempts to compare it with other educational modalities, 15 and no initiatives where it has been combined with other approaches such as e-learning that are frequently employed in settings where direct access to continuing professional development (CPD) is limited. 16,17 The literature is dominated by descriptions of how the cascade model has been applied 3,7,9,10,[12][13][14]18 and tends to report initiatives that were considered successful, suggesting publication bias. However, a number of shortcomings have been identified, with practical suggestions for improving the transfer of knowledge and skills during cascade training.…”