Keeping it real, online

Macmillan Cancer Care Navigator communication skill training at Norfolk and Waveney ICB.

“The workshop was expertly designed to foster feelings of belonging between participants, something too many online workshops simply failed at during the pandemic. After the session, participants all reported an increase in confidence, as well as expressing how positive they had found it as a bonding experience.“

Maggie Tween, Senior Cancer Programme Manager NHS Norfolk and Waveney Integrated Care Board

Lockdown saw the need for communication skills training within the cancer transformation world accelerate, and the mode of delivery change. Read about how one Integrated Care Board Cancer Transformation team, with support from our actor coaches, helped newly recruited Macmillan Cancer Care Navigators bond and deliver exceptionally skilful support …

Summary

Taking on a new patient-facing role within the cancer transformation world during a pandemic requires a special kind of person. Recruiters knew this and knew what qualities to look for when recruiting. Commissioning training providers to help new colleagues learn role-specific skills during the pandemic required just as much care and attention to detail. What previously worked in face-to-face training, may not work in the virtual world.

Luckily for Norfolk and Waveney’s newly recruited Macmillan Cancer Care Navigators (CCNs), their local Clinical Commissioning Group (CCG) contracted The Communication Practice. Co-creating and delivering training which gave CCNs the opportunity to practise situation-specific, nuanced, communication strategies and skills gave new recruits the confidence to succeed. Cancer patients benefited too, from the skilful, empathetic signposting to support they received.

Situation

During the COVID-19 pandemic, Norfolk and Waveney ICB wanted to prepare their new Macmillan CCN recruits for the kind of difficult conversations with cancer patients and people affected by cancer that typically occur over the phone.

While they knew they had recruited well in terms of personal qualities needed in the role, many of those recruited had no previous healthcare experience. Even before the pandemic, this specialist non-clinical role required specialist communication skills training support. The additional layers of fear and anxiety that the pandemic brought, and the fact that training could not be delivered face-to-face, amplified these requirements.

The need was for an online solution that would equip CCNs to: 

• Feel confident and competent in having difficult conversations with patients with a new cancer diagnosis
• Practise empathic listening, questioning and responding
• Manage difficult emotions.

Solution

Aware of practice conversations we had delivered for the East of England Cancer Alliance, Maggie Tween, Senior Cancer Programme Manager at NHS Norfolk and Waveney Integrated Care Board, invited us to work with her team. Together we co-produced a conversation practice-based training programme that could easily integrate into the organisation’s wider communications training programme.

Evidence-based communication skills training

“It was designed to very much mirror the two key insights from Cancer Alliances’ national work regarding what people with a new cancer diagnosis want: an acknowledgement that something significant is happening to them; and empathy about the impact this is having on their lives,” advised Maggie.

“Our Cancer Care Navigators’ role is very much about skilful signposting. If they can get these two things right, we know it’s unlikely they’ll get into difficulty. The Communication Practice’s team designed and delivered a three-hour forum theatre-style online workshop that did this. 

“The workshop was also expertly designed to foster feelings of belonging between participants, something too many online workshops failed at during the pandemic. After the session, participants all reported an increase in confidence, as well as expressing how positive they had found it as a bonding experience,” Maggie explained.

Participant-led content

In July 2022, TCP ran a three-hour forum theatre-style workshop for 12 newly recruited CCNs on Zoom. It had been designed collaboratively with the CCG’s clinical team, aiming to support participants in developing the communication skills specified above.

Delivered live to 12 newly recruited CCNs, the first half of the workshop was also recorded for the benefit of others who couldn’t attend. Access to the recording was password-protected and available for one month after the workshop. It saw three of our actors bringing to life a realistic scenario, using forum theatre. Actors took on the roles of a CCN, a patient, and the patient’s carer. They delivered a scripted performance demonstrating what could go wrong in a conversation.  The script was based on actual experiences that CCNs within the CCG had shared.

Participant-led learning

The performance was then re-run. Audience members were invited to shout “Stop!” and suggest what the CCN could say and do differently to improve the conversation outcomes. 

Taking learning from this, the second half of the workshop gave participants opportunities to practise conversations with our actors role-playing patients and patients’ partners. 

Participant-led doing

After a 10-minute break followed by a brief introduction, participants joined one of four breakout rooms. There were three participants per room. The aim was to practise a challenging conversation from their own working life as a CCN. They could choose a conversation from the past or a conversation they were expecting to have in the future. 

An actor-coach hosted each breakout room. They allowed each participant to practise their conversation at least once and gave feedback and coaching after each conversation. This feedback and coaching was framed around evidence-based best practice.

Success

The sessions were a great success. A significant theme was active listening. This is a skill our professional role-play actors are highly accomplished at and a differentiator that sets us apart from day one, according to Maggie.

In spite of all the additional difficulties Covid brought during the period in which this workshop was planned for and delivered, its success is indisputable:

• Participants gave it an average 5 Star rating
• Norfolk and Waveney CCG commissioned us to run further workshops with patient carer advocates