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Bitesized teaching
Background
Bitesized Teaching is a simple concept; a 10-minute physical healthcare message delivered to ward-based mental health staff, in the place they work, at a time that's convenient for them. We understand the importance of promoting physical healthcare within mental health settings making the physical care of service users as important as their emotional wellbeing.
This parity of esteem is promoted when physical health experts are available to support specialist mental health staff. Often having just finished placements in medicine, surgery, or primary care, Bitesized teaching offers doctors in training and appropriate others, an evidence-based framework to pass on their knowledge, skills and abilities during mental health placements and allows them to practice their own teaching skills too.
Delivered in only 10 minutes, without any other resources than a single sheet of further information, Bitesized teaching is available in a wide variety of physical healthcare topics that are of particular interest to nursing staff, support personnel and other clinicians offering front line mental healthcare.
Please note these resources are intended to promote general physical health awareness, and are therefore not COVID-19 (Coronavirus) specific.
How it works
There are currently a set of resources for 24 physical health topics that are commonly encountered in mental health settings, and these are all very briefly described on single page. The person delivering the session then uses this sheet as a prompt to develop their 10 minute session on this (or any other topic that the environment have said is important) covering a general overview, key red flags, and initial management issues.
Bitesized Teaching is purposefully flexible, and educators are expected to be responsive to the requests of each ward. To simplify organisation and delivery, Bitesized Teaching does not utilise teaching presentation software or require any further equipment, and it is intended the main delivery style is discussion based around prompts and cues from the single A4 handout.
Delivery structure
There is a simple delivery structure to Bitesized Teaching which is:
- Signs
- Symptoms
- Causes
- Basic ward level management.
Doctors in training are encouraged to be creative in the delivery of each session – they can use pictures, diagrams and equipment to aid what is primarily a discursive based tutorial.
The additional benefits of Bitesized Teaching are that it enhances ward-based working relationships and allows doctors in training to gain important teaching experience.
Contact us
Bitsesized teaching is being expanded and developed all the time, and you are welcome to contact Health Education England's mental health programme at mentalhealth@hee.nhs.uk with suggestions for other sessions topics or further information.
Steps:
1. Make some initial enquiries with the people who provide education for the organization or environment. This can be the Medical Director for teaching in a Trust, or the Learning and Development Department, or a Clinical Practice Educator for a ward or team.
2. Liaise with Ward Managers, to facilitate an appropriate time to conduct a session of Bitesized Teaching.
3. Discuss with doctors in training / other appropriate teaching staff to explain the benefits of Bitesized Teaching.
4. Appoint a co-ordinator to take change of arranging session dates and times, along with which topics are to be covered.
5. Consider sending weekly emails to remind all the environment staff that there’ll be a session, and what topic will be discussed.
6. Consider writing in ward diaries / handover books or other appropriate places that there'll be a session of Bitesized Teaching.
7. Consider constructing a ‘Bitesized Teaching rota’ with session leads and topics. Display prominently around the environment so that Bitesized Teaching remains visible.
8. Continue to reinforce the expectation that appropriately qualified and skilled staff are delivering regular teaching sessions, and an equal expectation that ward staff are receiving regular physical care teaching as part of their development.
A 10 point implementation plan for the Coordinator
• Allocate a date/time for the tutorial
The role of co-ordinator for Bitesized Teaching is to ensure that there is a timetabled day and time each week for the teaching session. Ideally, ensure that the day selected is not when there is a high level of clinical activity
• Timetable the session
The co-ordinator, ward manager and lead nurse must agree on a dedicated 10 minute slot of the handover period where the Bitesized Teaching session can take place
• Ensure that the teaching can be delivered
Bitesized teaching is led by a professional appropriately skilled in physical healthcare and teaching others, with the support of the ward team. It's important that a co-ordinating person ensures that the doctor in training or other physical healthcare educator is prepared to deliver an allocated topic. If the person identified has any concerns then they should inform the co-ordinator.
• Communication to the ward
The co-ordinator should distribute the teaching timetable to the designated ward, ensuring that all staff are aware of where and when Bitesized Teaching will take place. Use the staff noticeboard to advertise the timetable
• Resources
The doctor in training should develop teaching resources for each session in advance of the tutorial. NHS approved resources are the most reliable for information and often have sufficient depth
• The more the merrier
Ensure that all ward staff can attend the tutorial, if it is safe to do so, being mindful of activity on the ward. Not all staff will be able to make every session but Bitesized Teaching aims to run on continuous cycles to ensure that the staff members can attend the tutorials most of the time
• Questionnaires
Before the teaching session begins, ward staff will be given a short questionnaire to complete. After the teaching session has been completed, staff will again be asked to complete a similar questionnaire. Pre and post questionnaires are completed to assess any potential increase in knowledge on the topics being facilitated
• Relevant topics
Staff are encouraged to suggest topics which they would like to be delivered. An example of this may be hyper/hypoglycaemia if you are caring for a patient who has difficulty managing their own blood sugar levels due to a deterioration in their mental health
• Keep it running
The co-ordinator must ensure each teaching session runs smoothly, consistently liaising with the doctors in training and nursing manager.
How was Bitesized Teaching started?
In a 2017 publication in the British Journal of Mental Health Nursing, an article was presented containing some data collected that showed that the use of ‘Bitesized Teaching’ had potentially generated significant increase in practitioners’ perceived knowledge of physical health issues on the ward.
From this, Health Education England agreed to fund a more formal presentation of the Bitesized Teaching Resource, and host information and individual session topics on their website.
How do we ensure that what we teach is relevant and accurate?
The doctors in training should be encouraged to use NHS resources when developing tutorial topics. These are both up to date and accurate. We have provided sample resources elsewhere on this site. The resources can be found here.
What happens if we don’t have time for Bitesized Teaching?
Make the tutorial a regular part of the working week for the ward. Staff can anticipate that they will receive teaching on a given day. The benefit of this initiative is that it is brief and has high impact – there is no need to use more than 10 minutes a week.
What happens if the facilitators are reluctant to deliver the tutorials?
Facilitators should be supported and given time in the preparation and delivery of Bitesized Teaching. Generally, they should spend no more than an hour preparing a tutorial, as it is based on discussions around their existing skills, knowledge and expertise.
If a facilitator is a member of the medical team in training, they can use Bitesized Teaching to gain a Work Based Assessment for their portfolio.
Delivering Bitesized tutorials has been instrumental in enhancing good working relationships in the past, with ward staff greatly appreciative of the time and effort that facilitators commit to helping them consolidate and reinforce their physical healthcare knowledge.
What happens if we teach the same topics more than once?
Remember that attendance at a tutorial will be variable with staff taking annual leave or working night shifts etc, so that it is an expectation that very few staff will attend all of the timetabled sessions in any one cycle of delivery. If you are attending the same tutorial for the second or third time, then remember that the consolidation of knowledge is the best way to retain information. Besides, there can often be 12 weeks or more before the same topic reappears on the timetable and by then, there will be a different doctor delivering the tutorial using a different teaching style. Finally, you can always introduce new topics to extend your knowledge of physical health complaints.
What happens if we don’t have afternoon handover sessions?
Bitesized teaching is flexible to the working practices of the ward. Go by a simple principle –
Where can you find 10 minutes of dedicated tutorial time with maximum staff attendance that causes minimal disruption to the working week?
Some sites have implemented Bitesized teaching during ward rounds, therefore Junior doctors can get a Work Place Based Assessment. It’s an opportunity to have all staff present.
How will I retain all this information?
The doctors in training will provide a handout which you can refer to at a later date. The co-ordinator can collect handouts from successive tutorials to create a central ward-based resource. Remember, the tutorial is 10 minutes long so that it allows maximum retention of relevant information.
Is this going to replace mandatory training?
No. Bitesized Teaching is simply a programme of tutorials designed for you to gain confidence in your understanding of physical health problems.
How much will it cost to set up?
Nothing. It is cost free.
What happens if we don’t have teaching facilities on our ward?
Bitesized Teaching is meant to provide basic, discursive tutorials. There’s no need for electronic teaching aids.
In a 2017 publication in the British Journal of Mental Health Nursing, an article was presented containing some data collected that showed that the use of ‘Bitesized Teaching’ had potentially generated significant increase in practitioners’ perceived knowledge of physical health issues on the ward.
From this, Health Education England agreed to fund a more formal presentation of the Bitesized Teaching Resource, and host information and individual session topics on their website.
• How do we ensure that what we teach is relevant and accurate?
The doctors in training should be encouraged to use NHS resources when developing tutorial topics. These are both up to date and accurate. We have provided sample resources elsewhere on this site. The resources can be found here.
• What happens if we don’t have time for Bitesized Teaching?
Make the tutorial a regular part of the working week for the ward. Staff can anticipate that they will receive teaching on a given day. The benefit of this initiative is that it is brief and has high impact – there is no need to use more than 10 minutes a week.
• What happens if the facilitators are reluctant to deliver the tutorials?
Facilitators should be supported and given time in the preparation and delivery of Bitesized Teaching. Generally, they should spend no more than an hour preparing a tutorial, as it is based on discussions around their existing skills, knowledge and expertise.
If a facilitator is a member of the medical team in training, they can use Bitesized Teaching to gain a Work Based Assessment for their portfolio.
Delivering Bitesized tutorials has been instrumental in enhancing good working relationships in the past, with ward staff greatly appreciative of the time and effort that facilitators commit to helping them consolidate and reinforce their physical healthcare knowledge.
• What happens if we teach the same topics more than once?
Remember that attendance at a tutorial will be variable with staff taking annual leave or working night shifts etc, so that it is an expectation that very few staff will attend all of the timetabled sessions in any one cycle of delivery. If you are attending the same tutorial for the second or third time, then remember that the consolidation of knowledge is the best way to retain information. Besides, there can often be 12 weeks or more before the same topic reappears on the timetable and by then, there will be a different doctor delivering the tutorial using a different teaching style. Finally, you can always introduce new topics to extend your knowledge of physical health complaints.
• What happens if we don’t have afternoon handover sessions?
Bitesized teaching is flexible to the working practices of the ward. Go by a simple principle –
Where can you find 10 minutes of dedicated tutorial time with maximum staff attendance that causes minimal disruption to the working week?
Some sites have implemented Bitesized teaching during ward rounds, therefore Junior doctors can get a Work Place Based Assessment. It’s an opportunity to have all staff present.
• How will I retain all this information?
The junior doctors will provide a handout which you can refer to at a later date. The co-ordinator can collect handouts from successive tutorials to create a central ward-based resource. Remember, the tutorial is 10 minutes long so that it allows maximum retention of relevant information.
• Is this going to replace mandatory training?
No. Bitesized Teaching is simply a programme of tutorials designed for you to gain confidence in your understanding of physical health problems.
• How much will it cost to set up?
Nothing. It is cost free.
• What happens if we don’t have teaching facilities on our ward?
Bitesized Teaching is meant to provide basic, discursive tutorials. There’s no need for electronic teaching aids.
National Bitesized Teaching Coordinators
Dr Ryan Dias - Specialty Trainee in Child and Adolescent Psychiatry
Dr Robert Bartram - SAS Specialty Doctor
Mr Sam Thompson - CAMHS Clinical Nurse
Acknowledgements
The following people have contributed in different ways to Bitesized Teaching
Dr Arthitha Das
Dr Simon Taylor
Dr Paul Rowlands
Sharon Starkey
Nazma Saddique
Helen Butler
Rebecca Burgess-Dawson (HEE)
The Physical Health Committee Derbyshire Healthcare NHS Foundation Trust