Actors with a learning disability training health professionals in clinical simulation

November 22, 2017

The beginning


I first thought about developing a simulation course for health staff during a project that I led that was to map existing clinical education and training about learning disabilities. I wanted to find out about undergraduate, post graduate and work based training for all disciplines and fields of practice. Some of this was easy to find, some of it not but what became quickly apparent was that there wasn’t enough available and that which was delivered was often ad hoc or through the goodwill of learning disability professionals rather than formalised curricula.


I was fortunate enough to be able to carry out a survey across three NHS Trusts to gain the views of health staff about their experiences of and need for learning disability training. I also held roadshows in the main hospitals to speak with staff about their experiences. The results were interesting showing that many staff felt that they did not have the right skills or knowledge to provide effective care and treatment to this population but also that they had never received training. During the roadshows, I met some wonderful health staff who shared positive and negative experiences and at times heart felt sadness that they thought that they might not have provided the right care because of a lack of knowledge and skills. The personal stories of those health staff who responded so honestly and openly to the project galvanised my determination to do something about the situation. After all, if you have never been taught about learning disability and learning disability is not included in your core curricula then it sends out a powerful message about its value. I realised that if we are ever to succeed in reducing health inequalities, poor experiences of care and avoidable premature death then this situation needed to change. And here came the second component to the project – develop and deliver training to health professionals about meeting the health needs of people with a learning disability.


A colleague had recently completed simulation training at the Maudsley Simulation Centre and spoke highly of it. We both recognised the value of experience based learning and thought that it would be particularly suited to learning disabilities as many health staff may not have met someone with a learning disability before or had the opportunity to see a person with a learning disability in a professional role i.e. as an employed actor supporting their learning and CPD.  We approached the Maudsley Simulation Centre with our ideas and they agreed that it would make a great course and were on board with supporting us to develop and deliver the training. I had worked with a local theatre company of actors with a learning disability – the Baked Bean Theatre Company and approached them to see if they wanted to be part of the project – thank fully they agreed and the simulation training was born!


We worked with the actors and their artistic director to develop scenarios based on the literature about health inequalities and their experiences of NHS care. We visited the rehearsal site and met with the actors who made us do some interesting warm up games and ice breakers! The actors also visited the Simulation Centre to familiarise themselves with the environment, the staff team and the audio-visual / live streaming set up that is used to produce the simulation training. The course ‘Meeting the Health Needs of People with a Learning Disability’ contained six scenarios covering mental and physical health whilst also depicting areas of communication, diagnostic overshadowing, behaviour support, working with families and carers, consent and mental capacity and safeguarding.


What we have managed to achieve from our initial ideas of wanting to support our colleagues in mainstream health services and improve health care for people with a learning disability, to developing, delivering and evaluating this course over the past two years have been incredible. It has been amazing to work with such wonderful people and to learn from the actors at the Baked Bean Theatre Company. We hope, funding permitting, that we will be able to continue to run the course, which is fully coproduced and demonstrates improvements in participants’ knowledge, skills and confidence to care for and treat people with a learning disability using NHS services.



Actors with intellectual disabilities in mental health simulation training, The Journal of Mental Health Training, Education and Practice


Simulation training to support healthcare professionals to meet the health needs of people with intellectual disabilities, Advance in Mental Health and Intellectual Disability




Karina Marshall-Tate

Training & Development Manager

Estia Centre

South London & Maudsley NHS Foundation Trust


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