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| Strategies for Improving Accuracy and Retention of Physical Crisis Intervention Techniques |
| Tuesday, May 31, 2005 |
| 9:00 AM–10:20 AM |
| Williford C (3rd floor) |
| Area: EDC; Domain: Applied Research |
| Chair: Robert L. Shapiro (HMEA) |
| Discussant: Robert L. Shapiro (HMEA) |
| Abstract: Adequate training in physical crisis management is a crucial component in ensuring the safety of people supported by human services agencies and the staff working with this population. Once crisis management techniques are acquired and can be implemented effectively, it becomes critical to ensure that techniques are implemented accurately at times temporally distant from the initial training. Providing adequate training and ensuring retention reduces the risk of injury to staff and those supported. This symposium focuses on different strategies for enhancing technique acquisition, and explores the degree of technique degradation over time. The topics considered include using information gained on rate of degradation to determine the optimal interval at which to provide retraining or recertification; using video self-modeling to provide remedial training and periodic review; and using extrastimulus prompts to improve the topography of techniques during initial training. The implications of using these strategies in an applied setting, where resources are limited and the population to be trained is increasingly diverse, are discussed. |
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| Training Staff in Restraint: A Closer Look at the Accuracy and Latency of Response |
| LORI J. PINIARSKI (HMEA) |
| Abstract: The current emphasis on educating children in the least restrictive environment brings the management of behaviors and the use of restraint techniques to the public school system. Professional training programs, such as Non-Violent Crisis Intervention, are used nationwide to train de-escalation and proper restraint procedures. In most settings, direct care staff are trained annually to ensure the safety of staff and student. During practical application, the use of these techniques is restricted to emergency situations. Thus, the opportunity for practice and feedback to guide the safety of these strategies may be lacking. Little is known about staff retention of technique, especially in settings where the frequency of use is low. In this study, a follow-up measure looking at the accuracy and latency of staff response was taken at one-month, six-month and one-year intervals post training. Performance feedback and simulation training were used to increase the accuracy and latency of staff responses. The performance of staff who received systematic feedback and practice in a simulated setting was compared to the original training group in an attempt to explore what parameters of training are needed. |
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| Improving Retention Rates of Physical Crisis Intervention Strategies through the use of Video Self-Modeling |
| SUSAN O'SHEA (Simmons College), Robert L. Shapiro (HMEA) |
| Abstract: Although some human service environments require physical crisis intervention on a regular basis, interventions of this nature are typically implemented infrequently. This limited use often results in technique degradation over time. This is often demonstrated during the annual recertification process, where human services staff regularly requires reinstruction before successfully completing required techniques. This degradation increases the risk of injury to staff and the people we support. Video Self-Modeling has been implemented successfully to both teach new skills through the use of Video Feed Forward and to improve the efficiency or efficacy of already existing skills through the use of Positive Self-Review. The use of Positive Self-Review allows for viewing an image of yourself completing the activity/technique appropriately multiple times. Using a multiple-baseline across subjects design this research compares retention rates of subjects first without access to video positive self-review and then with access. A comparison is made of retention rates as well as improvement of skills upon onset of implementation of the intervention. Successful results offer an option for efficient and cost-effective training, which could be implemented without requiring additional trainer presence. |
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| Using Visual Prompts to Enhance Accuracy in Implementation of Physical Crisis Management Techniques |
| ROBERT L. SHAPIRO (HMEA) |
| Abstract: The use of physical crisis management techniques is a critical component in effectively supporting people who engage in potentially dangerous behavior. It affords staff with non-injurious, pain-free methods to be used within a hierarchy of least-restrictive interventions for diffusing hazardous situations and ensuring the safety of all involved. Accurate implementation of these techniques is critical to ensure safety and reduce the risk of injury and/or pain for all involved. This study investigated the use of visual extrastimulus prompts in the form of highlighting trainer body parts to cue proper location for learner foot and hand placement within the context of a five-day physical crisis intervention training program and a one-day physical crisis intervention recertification program. A multiple baseline design was utilized to demonstrate a functional relationship, with interobserver reliability of 95%. The implications of utilizing visual prompts in this teaching format are discussed, including efficiency of training and likely outcomes in actual crisis situations. |
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