Is Experience Enough? Though it is possible to learn from experience formal reflection and guidance is needed for its effective implementation.

Background: Much of the learning in healthcare occurs during the performance of routine work. It is accepted that pedagogical systems should surround the learner to ensure that they learn the appropriate lessons from their practice. An important aspect of workplace learning is reflection, and learners should share their insights with experienced guides.
We have recently had the opportunity to study the unguided experiential learning of “Soft signs” by caregivers in learning disabilities. “Soft signs” are minor changes in a person’s condition and behaviour that may precede the onset of acute illness.

Caregivers in learning disabilities often need to refer those for whom they care for advice about possible episodes of acute illness. A recent study demonstrated that they find it difficult to express their concerns to health professionals. Severity scoring systems are often used to standardise communication but systems such as NEWS2 that use vital signs data are often unsuitable for care home and domestic use.

RESTORE2™ Mini is a scoring system based on the recognition of soft signs. Training sessions for RESTORE2™ Mini, provided an opportunity to understand the caregivers’ prior workplace-based learning.

Ethical approval and consent: Northumbria University gave ethical approval for the study. 19 caregivers gave informed consent to participate. Participants had at least three years experience of caring in learning difficulties and had recently attended a teaching session for RESTORE2™ Mini.

Design: Thematic analysis of semi-structured interviews with caregivers for persons with learning disabilities.

Results: The caregivers understood from experience that behavioural changes foreshadowed the emergence of acute illness, but they lacked the confidence to share their insights with health professionals. The teaching associated with the introduction of RESTORE2™ Mini validated their perceptions and given them the confidence to present their observations.