VAlidation of the Mcast CommunicAtion Screening Tool (VAMCAST) v1.0
Research type
Research Study
Full title
VAlidation of the Mcast CommunicAtion Screening Tool (VAMCAST): improving patient access to communication support during mental capacity assessments.
IRAS ID
322534
Contact name
Mark Jayes
Contact email
Sponsor organisation
Northern Care Alliance NHS Foundation Trust
Duration of Study in the UK
1 years, 11 months, 28 days
Research summary
Research Summary:
The Mental Capacity Act (2005) says that healthcare staff need to help patients to make decisions. Patients who have communication problems due to conditions such as a stroke need specific help. The law says staff need to make information about decisions easier to understand. Staff also need to help patients to talk about decisions more easily. Research shows that many staff do not know how to help these patients to make decisions. This project aims to help staff to support patients with communication problems to make decisions.
We have developed a new communication test. The aim of the test is to show staff when a patient has communication problems and how to help the patient to make a decision. The test also tells staff when to ask a speech and language therapist for help. We need to do this research to find out if the test gives correct results and if staff can use it accurately.
We will ask 100 people living at home to take the communication test. These people will be stroke survivors. Some will have communication problems. We will make videos of people taking the test.
We will check the test gives the correct result for each person by:
•comparing the results with other communication tests;
•comparing the results with a speech and language therapist's expert opinion;
•using the test twice, to check it gives the same results at different times;
•checking the test gives the same results when different people use it.We will check staff can use the test accurately with patients by:
•watching how 15 healthcare staff use the test with 75 stroke survivors in hospital;
•interviewing staff about how they used the test;
•making changes to the test instructions;
•checking that staff can follow the new instructions more accurately.When the research is over, we will make the test freely available to healthcare staff.
Summary of results:
We found that the new communication screening tool provides accurate information about stroke survivors’ communication abilities that is consistent with information obtained from existing validated assessment tools. However, the tool may not differentiate stroke survivors’ specific communication abilities from other cognitive abilities that impact on communication (like memory). We do not this this finding will limit the screening tool’s future use.
Our results suggest that healthcare professionals can have confidence in using the tool to identify if a stroke survivor is likely to need communication support, in the absence of expert judgement by an SLT.
We found that when the tool is used at two different time points with the same person, it is likely to provide the same or very similar results. We also found that when two different people use the tool with the same person, they are likely to obtain the same or very similar results.
Healthcare professional participants were able to use the screening tool accurately most of the time, but some participants made a small number of errors following its instructions. We identified three main types of user error. First, some healthcare professional participants did not always read out task instructions accurately. Second, healthcare professionals did not always repeat task commands in the way they were supposed to. Third, some healthcare professionals made errors when scoring the screening tool. These findings have been used to identify a small number of potential changes that we will make to the screening tool e-learning and administration instructions to help people to use the tool more accurately.
All healthcare professional participants reported finding the screening tool, the e-learning and administration instructions easy to use. They all thought the screening tool would be useful in healthcare settings. Participants were able to suggest other uses for the tool beyond mental capacity assessment. They suggested that it could be used to identify patients with communication needs and ways to support them in more general healthcare situations, when access to expert support from a speech and language therapist may not be available.
REC name
London - Brighton & Sussex Research Ethics Committee
REC reference
23/LO/0099
Date of REC Opinion
24 Feb 2023
REC opinion
Further Information Favourable Opinion