Centre for Critical Research in Nursing and Midwifery

Learn and Earn Career Pathway

The Learn and Earn career pathway (LECP) was established in 2017 following a pilot by Islington, Haringey and Camden community education provider networks (CEPNs) and is managed via Community Matters.

It attempted to address some of the perceived barriers to employers’ engagement with apprenticeships by means of administrative assistance, financial incentives and the development of a bespoke ‘apprenticeship-plus’ model where additional training, particularly clinical skills, are included within the offer.

Specifically, it was set up to promote the career pathway towards nursing and to explore the viability of using apprenticeships as a sustained funding source for training required to progress along the pathway.

Learn more about this project.

Principal investigator: Mike O'Driscoll

Co-investigators: Professor Michael Traynor, Professor Helen Allan

Funding amount: £10,000 funded by NCL

Principal investigator: Liang Q Liu, Sarah Knight, Helen Allan & Jacinta Kelly

Funding amount: £39,766.12 funded by British Skin Foundation

September 2013 to February 2014

Principal investigator: Dr Liang Q Liu

Co-investigators: Moody, Julie, Dyson, Sue E., Traynor, Michael and Gall, Angela (Royal National Orthopaedic Hospital)

Final publications: Liu, Liang Q. , Moody, Julie and Gall, Angela (2016) A quantitative, pooled analysis and systematic review of controlled trials on the impact of electrical stimulation settings and placement on pressure ulcer healing rates in persons with spinal cord injuries. Ostomy Wound Management , 62 (7). pp. 16-34. ISSN 0889-5899

Liu, Liang Q. Moody, Julie, Dyson, Sue E., Traynor, Michael and Gall, Angela (2014) A systematic review of electrical stimulation for pressure ulcer prevention and treatment in people with spinal cord injuries. Journal of Spinal Cord Medicine, 37 (6). pp. 703-718. ISSN 1079-0268 (doi: 10.1179/2045772314Y.0000000226)

October 2013 - July 2014

Investigators

Principal investigator: Kathy Wilson
Other investigators: Professor Michael Traynor, Dr Sinead Mehigan, Oznur Korukcu 
Funded by: HENCEL
Funding amount: £70,000

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2014

Purpose of the study

The project aimed to provide HENCEL with a detailed review of progress of nursing research and development being delivered through the nurse consultant role across north central and east London. We were able to conclude from the project that nurse consultants were created as an occupational position without an initial precise definition of their role. Their numbers and precise remits have therefore developed organically, with no necessary agreed set of activities that define the role.

Investigators

Principal investigators: Professor Michael Traynor, Professor Sue Dyson
Other investigators: Dr Liang Liu
Funded by: HENCEL

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January 2015 - April 2015

Purpose of the study

A report commissioned by Health Education North Central and East London (HENCEL) and produced on behalf of the School of Health and Education, Middlesex University.

Investigators

Principal investigator: Sinead Mehigan
Other investigators: Kathy Wilson, Anki Odelius, Kevin Corbett, Jacqueline Grove
Funded by: HENCEL

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2014 - 2015

Principal investigator: Dr Liang Q Liu

Co-investigators: Dr Sinead Mehigan

Final report/publication: Liu, Liang Q. and Mehigan, Sinead (2016) the effects of surgical hand scrubbing protocols on skin integrity and surgical site infection rates: a systematic review. AORN journal , 103 (5). pp. 468-482. ISSN 0001-2092 (doi: 10.1016/j.aorn.2016.03.003)

December 2014 - May 2015

Purpose of the study

A report commissioned by HENCEL and produced on behalf of Middlesex University, School of Health and Education.

Investigators

Principal investigator: Professor Michael Traynor
Other investigators: Dr Kevin Corbett, Dr Sinead Mehigan
Funded by: Whittington Health and Health Education North Central and East London (HENCEL) 
Funding amount: £34,945

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December 2014 - March 2015

Investigators

Principal investigator: Dr Sinead Mehigan 
Other investigators: Professor Michael Traynor, Kathy Wilson
Funded by: HENCEL

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February 2015 - February 2016

Principal investigator: Dr Liang Q Liu

Co-investigators: Dr Sarah Chapman (University of Bath), Dr Angela Gall (Royal National Orthopaedic Hospital), Ms Rachel Deegan (Royal National Orthopaedic Hospital), Dr Sarah Knight (Royal National Orthopaedic Hospital), Professor Michael Traynor, Professor Helen Allan

Funding: £2,000 funded by Hospital Saturday Funds Charity and £11,005 funded by Department of Adult, Child and Midwifery
R&D funding to carry on a study in collaboration with London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital.

Final report/publication: Liu, Liang Q. , Chapman, Sarah, Deegan, Rachel, Knight, Sarah L. , Traynor, Michael , Allan, Helen T. and Gall, Angela (2020) Development and preliminary validation of a tool measuring concordance and belief about performing pressure-relieving activities for pressure ulcer prevention in spinal cord injury. Journal of Tissue Viability . ISSN 0965-206X (Published online first) (doi: 10.1016/j.jtv.2020.05.002)

November 2014 - November 2016

Purpose of the study
This research was a first step in developing and evaluating new evidence-based NHS services to support parents whose babies cry for prolonged amounts of time. It aimed to find out whether a large-scale study is justified.

Investigators
Principal investigator: Professor Ian St James-Roberts

Other investigators

Professor Stephen Morris (University College London)
Dr Rosemary Garratt (De Montfort University)
Professor Sue Dyson (Middlesex University)
Ms Nicy Turney (Leicestershire Partnership NHS Trust)
Ms Christine Buzzard (Leicestershire Partnership NHS Trust)
Dr Elaine Boyle (University of Leicester)
Ms Rachel Plachcinski (National Childbirth Trust)
Ms Sally Rudge (Consultant Clinical Psychologist)
Mr Charles Owen (Institute of Education)
Mrs Jan Bullen (Chairperson of Cry-sis)

Funded by: NIHR

Collaborating partners: Middlesex University, De Montfort University, Institute of Education at  University of London, Leicestershire Partnership Trust, Cry-sis

Principal investigator: Liang Q Liu

Co-investigators: Angela Gall, Sarah Knight, Professor Helen Allan

November 2015 - April 2016

Purpose of the study

A feasibility study to test the design of an intervention study to evaluate the nurse delegation and supervision tool (NDST) in general medical care of frail elderly patients.

Investigators

Principal investigator: Professor Helen T Allan (PI) 
Other investigators: Dr Carin Magnusson (University of Surrey) and Dr Kit Tapson and Dr Liang Liu (Middlesex University, CCRNM)
Collaborators: Dr Maggie Davies (West Sussex Hospitals Foundation Trust - Worthing)
Funded by: Burdett Trust for Nursing

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September 2015 - September 2016

Purpose of the study
A project exploring volunteering in the UK and Ghana, its current scope and impact and how positive attitudes toward volunteering can be incorporated into pedagogic practice.

The aim of the project is to create a development package to support undergraduate nursing students on their programmes, include volunteering in everyday life, and assist academic staff in incorporating volunteerism into their nursing programmes.

Investigators
Collaborators: Professor Sue Dyson, Professor Olga van den Akker, Dr Sheila Cunningham, Dr Liang Liu (Middlesex University) and the  University of Ghana
Funded by: Middlesex University Department of Adult, Child and Midwifery Research and Knowledge, and Transfer Incentives Monies

2016 - 2017

Principal investigator: Dr Liang Q Liu

Co-investigators: Dr Sinead Mehigan, Mr Branford, Olivier A

Final report/publication: Liu, Liang Q. , Branford, Olivier A. and Mehigan, Sinead (2018) BREAST-Q measurement of the patient perspective in oncoplastic breast surgery: a systematic review. Plastic and Reconstructive Surgery-Global Open, 6 (8). e1904. ISSN 2169-7574 (doi: 10.1097/GOX.0000000000001904)

February 2017 - December 2018

Principal investigator: Dr Q Cheng (Queen Mary University London), Professor Y Hao (Queen Mary University, London)
Co-investigator: Dr Liang Qin Liu, Dr A Gall (Royal National Orthopaedic Hospital), Dr S Knight (Royal National Orthopaedic Hospital)

Funded by: MDVSN plus (Medical Device and Vulnerable Skin Network plus, EPSRC-NIHR partnership) in collaboration with Queen Mary University London
Funding amount: £48,000

Evaluation of Online Simulated Scenarios for Nursing

April 2020 -  July 2021.

Download report: Evaluation of an Online Screen based Simulation Initiative

Introduction

In April 2020 the adult child midwifery (ACM) department at Middlesex University started using online screen-based simulation (OSBS) software sourced from Oxford Medical Simulation[1] (OMS). OMS was originally designed to be used with virtual reality hardware and delivered in the classroom setting. However, due to COVID-19 restrictions the delivery of the programme was remote and online only i.e. students participated in these simulations on their own computers, and mostly at home

This simulation platform places students into a virtual ward or single bedded area, students are then able to control their environment and interact with the surrounding equipment as in clinical practice. There is a usually a support worker present in the room who the student can interact and communicate with. Each of the simulations features a patient presenting with a specific medical condition with certain scenarios also involving patients presenting with a variety of social or psychological issues. The student is then required to undertake a clinical assessment of that patient, using their clinical knowledge to draw conclusions and make decisions regarding patient care within a safe environment

Principal investigator:  Mike O’Driscoll

Co-investigators: Professor Michael Traynor

Learning Objectives

Learning objectives for 3rd Year (adult and children and young people) nursing students who were to go into practice earlier than anticipated (through an opt in 'extended placement') because of the increased need for staff as a result of the COVID-19 pandemic: included

• To develop knowledge and understanding of the physical assessment of an acutely unwell patient and reflect on their practice.
• To develop the technical and non-technical skills required when assessing and intervening with the acutely unwell patient and reflect on their practice.
• To upskill current third year adult and children and young people nursing students to prepare them for being deployed as a result of the COVID-19 pandemic.

The OSBS initiative was also aimed at adult and children and young people third year nursing students who did not opt for the 'extended placement' and with adult and children and young people second year students; mental health nursing students (2nd and 3rd year); nursing associates (2nd year); third
year midwifery students and PG Dip 2nd year students. For these groups there were slightly different learning objectives:

• Enable healthcare students to develop knowledge and understanding of the physical assessment of the acutely unwell patient.
• Enable healthcare students to develop technical and non-technical skills required when assessing and intervening with the acutely unwell patient.

Evaluation Findings

The response rate to the online survey was 25% (617 students invited, 154 wholly or partially completed questionnaires obtained). 13 students took part across two online focus groups. Seven members of staff took part in an online focus group and one took part in a one to one interview (as they had been
unable to attend the focus group).

There is strong evidence of the OSBS learning objectives having been met, particularly from survey evidence regarding which skills students perceived they had gained which could be transferred into practice and learning outcomes or objectives they felt they had achieved, and this is supported by focus
group evidence. A very large majority of respondents felt that they had gained skills in making clinical decisions based on their observations and prior knowledge; escalating issues to senior members of staff and using time effectively across different activities.

Respondents were very positive (mean ratings above four on a scale of 1 to 5 about the last scenario participated in, on a range of measures including realism, usefulness and overall satisfaction. Most respondents did not consider  there were serious barriers to their participation in OSBS
and there were no statistically significant differences in perceived barriers to participation by scenario, age, learning style, programme or year of programme and few differences on gender. However, a considerable limitation of the evaluation is that those who took part in the evaluation had participated
in the OSBS (i.e. those who experienced barriers  (or did not like OSBS for whatever  reason) were under-represented in the evaluation)/

Download full report: Evaluation of an Online Screen based Simulation Initiative

Principal investigator:  Dr Liang Q Liu

Co-investigators:  Ms Jacinta Kelly, Professor Mariachiara, Di Cesare,  Professor Michael Traynor, Professor Helen Allan

Funded by:  Burdett Trust for Nursing and Middlesex university research fund

Funding amount:  £8,600 (£6,540 + £2,060)

Completed: October 2021

The project report, funded by The Burdett Trust for Nursing and Middlesex university internal research fund, explores the knowledge, attitudes, and experiences of healthcare support workers in pressure ulcer (PrU) prevention, a prevalent issue in healthcare settings with substantial personal and financial impacts. The study used a mixed-method approach, comprising both quantitative surveys and qualitative focus groups, to examine the attitudes and practical knowledge of healthcare support workers like Health Care Assistants (HCAs), Nursing Associates (NAs), and Trainee Nursing Associates (TNAs).

The findings highlight a significant knowledge gap in PrU prevention among healthcare support workers. Although the participants demonstrated positive attitudes toward prevention, their practical knowledge scores were relatively low, with particular weaknesses in understanding ulcer aetiology, risk assessment, and effective interventions. Key themes emerged, including the need for enhanced communication, structured guidelines, and multidisciplinary teamwork to improve PrU care delivery. Challenges cited were inadequate formal training, heavy workloads, and resource constraints, which limited effective PrU care.

The report calls for formalized, continuous training, integrating support workers into a multidisciplinary approach, and possibly enhancing the autonomy of skilled support workers. The study suggests further research on a national scale to assess these issues broadly and underscores the need for structured educational programs tailored to support workers’ roles, aiming to optimize their contributions to PrU prevention and patient care quality.

Publications related to this project are: 
 
Liu, Liang Q.,  Kelly, Jacinta, Di Cesare, Mariachiara , Allan, Helen T. and Traynor, Michael (2023)  Healthcare Support Workers Reflect on their Experiences of Pressure Ulcer Prevention. --- submitted in September 2023. A Qualitative Exploratory Study. Currently is under review by Journal of Wound Care. Manuscript ID jowc.2023.0252 
 
Liu, Liang Q., Kelly, Jacinta, Di Cesare, Mariachiara , Allan, Helen T. and Traynor, Michael (2023) The knowledge and attitudes regarding pressure ulcer prevention among healthcare support workers in the UK: a cross-sectional study. Journal of Tissue Viability . 2023;32(1):130-135. doi:10.1016/j.jtv.2022.11.004 ISSN 0965-206X 
 
Liu, Liang Q., Kelly, Jacinta., Di Cesare, Mariachiara., Allan, Helen T. and Traynor, Michael. Healthcare Support Workers Reflect on their Experiences of Pressure Ulcer Prevention. --- A Qualitative Exploratory Study.  Society of Tissue Viability (SoTV) 2023 Annual Conference in Peterborough, 26 – 27 April 2023. 
 
Liu, Liang Q., Kelly, Jacinta, Di Cesare, Mariachiara. , Allan, Helen T. and Traynor, Michael (2022) The knowledge and attitudes regarding pressure ulcer prevention among healthcare support workers in the UK: a cross-sectional study. In: Society of Tissue Viability 2022 Conference: Solving skin and wound challenges together, 18-19 May 2022, Glasgow, UK. . [Conference or Workshop Item] 

This study is in collaboration with London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital. Awarded in May 2017.The project was registered as a NIHR Portfolio study NHS Trust, and National Spinal Injury Centre, Stoke Mandeville Hospital NHS Trust.

Aim and objectives: To assess the effectiveness of early intervention using text messaging as a reminder regarding concordance to ‘pressure relief’ regimen. To examine the effectiveness of early intervention using text messaging for pressure ulcer prevention.

Principal investigator: Dr Liang Q Liu

Co-investigators: Dr Angela Gall (Royal National Orthopaedic Hospital), Ms Rachel Deegan (Royal National Orthopaedic Hospital), Dr Sarah Knight (Royal National Orthopaedic Hospital), Ms Hester Dunne (Stoke Mandeville Hospital) Professor Helen Allan

Funded by: Rosetrees Trust.

Funding amount: £18,491

Completed: December 2022

Publications related to this project are:Liu, Liang Q. , Deegan, Rachel, Dunne, Hester Knight, Sarah L., Allan, Helen T. and Gall, Angela "A pilot study for testing feasibility and preliminary influence of early intervention using text messaging for pressure ulcer prevention in individuals with spinal cord injury." Journal of Tissue Viability (2024). In press

Liu, Liang Q. , Deegan, Rachel, Knight, Sarah L., Chapman, Sarah, Traynor, Michael , Allan, Helen T. and Gall, Angela (2019) Early intervention for pressure ulcer prevention in people living with spinal cord injury who are newly discharged from hospital: A preliminary report. In: Tissue Viability Society annual conference 2019, Southampton, 1-2 May 2019. [Conference or Workshop Item]

Ongoing project:

Project title: Manage risk of pressure ulcer in people living with a Spinal Cord Injury

This study is in collaboration with London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital. Awarded in May 2023 .The project was registered as a NIHR Portfolio study

Principal investigator: Dr Liang Q Liu

Co-investigators:  Dr Sarah Knight (Royal National Orthopaedic Hospital), Ms Jacinta Kelly, Ms Evangeline MARTINEZ (ROYAL NATIONAL ORTHOPAEDIC HOSPITAL NHS TRUST), Professor Helen Allan

Funded by: British Skin Foundation

Amount of funding: £39,766

Principal investigator: Professor Helen Allan

Co-investigators: S Drakapoulou, MT

Partners: NCL

Forthcoming paper: Interprofessional and inter-organisational collaboration in the COVID 19 vaccination programme in NCL.

Behind the Screens: Stories from the Covid Vaccination Programme in North Central London

Principal investigator: Dr Liang Q Liu

Co-investigator: Dr Sinead Mehigan

Final report is pending to submit to AORN

Principal investigator: Liang Q Liu

Co-investigators: Sinead Mehigan

Principal investigator: Liang Q Liu

Co-investigators: Sinead Mehigan