In March 2009, OPP Ltd was commissioned by an NHS Foundation Trust to design a junior nurse development programme targeted at minority groups within the nursing population.

The Head of Nursing at the Trust and her team had identified a differential between the ethnic mix in Bands 5 and 6 of the nursing staff versus that of Bands 7, 8 and 9. She was keen to investigate the causes of this, with the goal of nurturing a greater ethnic mix in the more senior bands.

Partnering with OPP

OPP was chosen as the Trust’s partner through a formal tender process. OPP stood out from the competition because the company was flexible, providing a tailor-made solution. The Trust were impressed by the professionalism and depth of knowledge and experience of OPP’s Consultancy team, and found the proposition to be great value for the work being suggested.

A stimulating mix of approaches

OPP worked closely with the Trust’s staff to design a solution. Information was gathered and opinions sought from senior stakeholders and staff already in the more senior roles.

A programme was developed to give participants an insight into the responsibilities, opportunities and challenges that form an essential part of a Band 7 Ward Sister/Charge Nurse role, as well as a clearer understanding of the framework of competencies required.

The programme was intended to help foster the ambitions of junior nurses to move into more senior positions, to identify whether ethnic disparities were due to professional hurdles or personal resistance, and to address the gaps between the different levels in terms of self-confidence, management expertise, breadth of strategic thinking and self-awareness.

Events and seminars were set up to address participants’ development, and a variety of interventions were incorporated into a six-stage programme spanning two days. This quickly became fully subscribed, and subsequently four development programmes took place over a six-month period.

Some of the outcomes differed from the original proposal, but the consultants were able to work with these changes to develop something that really fitted the needs of the Trust.

Pre-work and preparation

Roadshows and briefing sessions encouraged applications from nurses from a full range of ethnic backgrounds. Participants completed background reading, filled in the TKI questionnaire and evaluated their perceived skills within the context of the competency framework required for higher bands.

Workplace simulations and observation

Development days revolved around participants completing typical daily tasks of a Ward Sister/Charge Nurse. Activities included prioritising emails, role plays, evaluating a new product and making recommendations to the Trust, talks from speakers from a similar working background to theirs, clinical examples to improve understanding of unfamiliar leadership terminology, workshops exploring aspects of self-awareness and self-confidence, and personal development planning sessions.

Observations of the simulations were compiled by observers from the Trust, and OPP’s occupational psychologists wrote up reports for each participant, which were fed back via coaching sessions with staff.

Following up in context

The final stage of the development programme was a follow-up meeting for each participant with their line manager. This offered a chance to review participant experiences during the programme, discuss areas of strength and weakness, and agree an action plan for their ongoing development.

Findings

Pre- and post-event evaluations

For the majority of competencies, participants’ actual score from the simulations was around two-thirds lower than their self-evaluated score before the development. For the organisers, this was seen as positive: analysis revealed that these inflated opinions resulted from a limited appreciation of the Ward Sister role, and in most cases participants reassessed themselves at a more realistic level based on their experiences during the development.

The programme of events was seen as an authentic 'job preview' of the senior role, and as a result participants gained a clearer understanding of their development needs. Participants also registered increased levels of motivation to change their habits, behaviours and perspectives, as well as to explore any self-imposed obstacles.

TKI analysis

The Thomas-Kilmann Conflict Mode Instrument (TKI) helps individuals to assess their behaviour in situations in which the concerns of two people appear to be incompatible. OPP’s initial research into the role indicated that managing such disagreements formed a recurring challenge, and the TKI was introduced to help participants have a clearer insight into their approaches when dealing with these situations, as well as an opportunity to explore other tactics they could use.

OPP’s psychologists consolidated the data obtained from the TKI to produce a profile of a ‘typical’ Band 5/6, showing which influencing and conflict-handling approaches they used the most. This allowed a profile to be built up of the general operating culture of junior nursing staff.

This analysis showed a preference for using the Avoiding, Accommodating and Competing styles in most situations. OPP’s psychologists hypothesised that in practical terms, these styles may respectively resemble a lack of self-belief, a lack of perceived authority within burgeoning leadership roles, and a response to time pressure, stress and inexperience. Behaviour noted during the simulation exercises supported this, and indicated that some participants show an overdependence on a single tactic during their interactions.

Based on this analysis, OPP was able to make a series of recommendations for the future training of nurses in these and other bands.

Feedback

Feedback from both the commissioning staff from the Trust and the programme participants has been overwhelmingly positive. Participants found the workplace simulations naturally challenging, since they were benchmarking performance against professional standards up to three levels higher than their current roles.

They agreed, however, that this degree of challenge was appropriate in meeting the objectives of the development:

"It has made me think about myself and learn about things that were hidden in me. It has helped me to want to aspire for greater heights in my career."

"It brought out the 'real me': what I need to develop, and what I will need to help me to be a competent leader."

Future plans: the gold standard has been set

Even though tighter budget restrictions mean that the Trust may not be able to offer such a comprehensive development programme in the near future, OPP's intervention has set the "gold standard" to inspire them to create more 'homemade' development strategies.

"We gained enormously from working with OPP, because they helped us approach things very differently than if we had been left to our own devices.

"The experience opened our minds to new tools and approaches, and OPP’s professionalism was really aspirational. We were impressed by their delivery and the detailed work they put into each suggestion."

Running the programme in collaboration with OPP has allowed the Trust to articulate its vision for future development, and has given the organisation practical skills and knowledge of its own, which will inform its future work in this area.

In addition, the experience with OPP has made the Trust aware of how off-the-shelf personality tools such as the TKI can be used in a tailored, cost-effective way to add significant value to development sessions.

For information about how we could work with your organisation for individual, team or leadership development, please contact our Sales Team on +44 (0)845 603 9958 or by email at enquiry@opp.eu.com.