Abstract
Low levels of behavioural care plan implementation and criticisms of the format of an earlier 'classroom' course led to a patient-centred approach to training psychiatric nurses. The critical change involved a series of practical learning tasks with patients on the ward, leading to a single-subject care plan. The 24 psychiatric nurses attending the new course achieved superior results on two of the skill measures by post-testing. They also conducted more care plans and credited the course with more social validity than their predecessors (n = 41). These findings are important in showing how training formats can overcome institutional constraints on service innovation.

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