Assessment of Communication and Interaction Skills - MAFIADOC.COM

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Persons with mental illness may often perform poorly in communication and interaction. ❖ Assessment of skills will contribute to more effective intervention.

Usefulness of the Assessment of Communication and Interaction Skills as experienced by occupational therapy practitioners and their students Tore Bonsaksen, Ingunn Myraunet, Cecilia Celo, Kjell Emil Granå, & Brian Ellingham 3rd MoHO Institute, October 2012

A dual background  Persons with mental illness may often perform poorly in communication and interaction  Assessment of skills will contribute to more effective intervention  Lack of standardized assessments used in OT mental health practice in Norway  Need to explore their usefulness in practice before conducting a formal translation Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

Assessment of Communication and Interaction Skills (ACIS)  Structured observation in a specific occupational setting where interaction takes place  20 discrete skills concerning physicality, information exchange, and relations  Identifies strengths and problem areas  Identifies the impact of context on skills  A basis for planning and evaluating intervention Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

Integrating the ACIS in student fieldwork  During mental health fieldwork, can students and their fieldwork educators explore the usefulness of the ACIS together?  Interested fieldwork educators (n=3) and their students (n=6) were recruited in 2009  Procedure  Week 1: Didactic seminar  Week 2-7: Clinical experience  Week 8: Focus group interviews

Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

Aim of the study …to explore the usefulness of the Assessment of Communication and Interaction Skills in mental health settings as experienced by occupational therapy practitioners and occupational therapy students

Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

Methodology  Student sample: Five women and one man, age 20-24 years. No mental health work experience in the group  Fieldwork educator sample: Two women and one man, age 25-37 years. Mental health work experience varied between one and 12 years  Two focus groups, one with the students and one with the fieldwork educators  Interviews transcribed verbatim  Thematic analysis

Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

Experiences from using the ACIS Observation

Scoring

Clinical utility

Selecting activities

Scoring procedure

Client-directed work

 Suitable activities  Diverse activities

 Numerical scores

 Client feedback

Therapist role

Feelings about scoring

Multidisciplinary work

 Participationdependent information

 Being ‘good’ or ‘bad’  Improving teamwork  Doing the client  Improving justice accountability

Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

Observation Selecting activities • Suitable activities • Diverse activities

«The last time I did it was on a camping trip in the forest. Then I could add to the things I knew [from a previous observation]»

Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

Observation Therapist role • Participation-dependent information

«The student and I tried to alternate the roles of observer and therapist in the situation. [The different roles] can be a source of perceiving the client’s skills in different ways. What you observe depends on how active your role is.»

Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

Scoring Scoring procedure • Numerical scores

«[We] scored the ACIS separately, and then we went through it and looked at differences between our scores. We spoke about possible reasons for this […] We tried to bring up more ideas about what to consider the next time. I learned a lot from such discussions.» Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

Scoring Feelings about scoring • Being ‘good’ or ‘bad’ • Doing the client justice

«If you assign a score of 3 or 2, there must be a reason for it. In the beginning, […] you considered everything you had done with the client and not just the situation [in which] you were actually observing»

Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

Clinical utility Client-directed work • Client feedback

«We can observe and validate the client, for instance [by telling the client] that he or she is good at initiating conversation, or making eye contact, or backing others up. We can bring these observations back to the client.»

Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

Clinical utility Multidisciplinary work • Improving teamwork • Improving accountability

«[It should be used] in multidisciplinary settings and when writing clinical reports, to make the information specific. Just saying that ‘the patient communicates well’ – what is it that he does that serves his communication well?»

Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

Study limitations  Small convenience sample  Lacks information about participants actual knowledge about and skill in using the ACIS  Preliminary, not yet validated translation used  Translation of interview statements into English

Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

Conclusion  The ACIS provides a useful structure to the observation of communication and interaction skills  The selection of activity and context affects the clients’ skills  The therapist’s level of engagement during the activity may impact on what he observes from it  The assessment procedure may be emotionally challenging for novice assessors  The ACIS is perceived as useful when giving feedback to clients, and using it in practice may improve therapist accountability and the functioning of multidisciplinary teamwork

Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012

References 





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Bonsaksen, T., Myraunet, I., Celo, C., Granå, K.E., & Ellingham, B. (2011). Experiences of occupational therapists and occupational therapy students in using the Assessment of Communication and Interaction Skills in in mental health settings in Norway. British Journal of Occupational Therapy, 74(7), 332-338. Bonsaksen, T., Myraunet, I., Celo, C., Granå, K.E., & Ellingham, B. (2010). Bedre samarbeid mellom utdanning og praksis – erfaringer fra ACIS-prosjektet [Improved collaboration between education and practice – experiences from the ACIS project; in Norwegian]. Ergoterapeuten, 53(6), 52-55. Forsyth, K., Lai, J-S., & Kielhofner, G. (1999). The Assessment of Communication and Interaction Skills (ACIS): Measurement properties. British Journal of Occupational Therapy, 62(2), 69-74. Forsyth, K., Salamy, M., Simon, S., & Kielhofner, G. (1998). A user’s guide to the Assessment of Communication and Interaction Skills (ACIS). Version 4. Chicago, ILL: University of Illinois. Haglund, L. & Thorell, L.H. (2004). Clinical perspective on the Swedish version of the Assessment of Communication and Interaction Skills: stability of assessments. Scandinavian Journal of Caring Sciences, 18(4), 417-23. Hsu, W-L., Pan, A-W., & Chen, T-J. (2008). A psychometric study of the Chinese version of the Assessment of Communication Skills. Occupational Therapy in Health Care, 22(2-3), 177-185. Kjellberg, A., Haglund, L., Forsyth, K., & Kielhofner, G. (2003). The measurement properties of the Swedish version of the Assessment of Communication and Interaction Skills. Scandinavian Journal of Caring Sciences, 17(3), 271-277.

Bonsaksen, Myraunet, Celo, Granå, & Ellingham, 2012