A nexus analysis of domestic video chat: Actions, practices, affordances, and mediational means

This thesis explores the use of domestic video chat (VC) applications such as Skype or FaceTime. The present research contributes to a growing body of work on the medium of VC by building on the concept of affordances (Hutchby, 2001b) in order to explore how the capabilities of the technology are used in practice outside of the professional sphere. This study is unique in the field of VC because it combines findings from micro analyses of recorded VC sessions and interview data under the framework of nexus analysis (Norris & Jones, 2005b). The video recordings were analysed using an approach informed by conversation analysis (Hutchby & Wooffitt, 1998) and the interviews were analysed using inductive qualitative coding (Gibbs, 2007; Mason, 2002). The findings indicate that in VC interactions the roles of caller and called have little significance in the openings and closings. Noticings, which were especially common in the openings, play a vital role in relationship maintenance through VC. In some cases these noticings led to virtual tours, which were resources for expressing alignment and constructing a joint attentional frame. Practices of paying attention appeared to be a central concern for participants; therefore a second maxim of VC was formulated: focus your attention on the VC interaction (for the first maxim see Licoppe & Morel, 2012). The maxim of attention is suspended in lapsed VC encounters, which were framed as exceptional use and were only practised by a minority of participants. Finally, it is argued that the affordances of a technology cannot simply be classed as a ‘limitation’ or ‘possibility’, because they are context dependent. Therefore, a thorough analysis must take into account the mediational means (bodies, objects, and the environment), the mediated actions, and the relational histories of the participants

Longer in primary care: a mixed-methods study of the Welsh GP training model

Background A new model of general practitioner (GP) training was introduced in Wales, whereby trainees spend one year in hospital and two years in general practice (the 1+2 model), a change from the previous model of 18 months in each setting. Aim To evaluate the 1+2 model of GP training in Wales. Design & setting Longitudinal mixed-methods evaluation via repeated surveys and focus groups with GP trainers and trainees across the Welsh training schemes. Method Yearly surveys and focus groups between June 2020 and December 2022. Quantitative survey data was analysed in SPSS. Qualitative survey data and focus group transcripts were analysed thematically. Results Spending more time in general practice was seen as a major benefit. The consensus was that general practice is the best place to learn essential consultation skills. Furthermore, general practice was viewed as a flexible educational setting where knowledge gaps can be addressed. The main concern about the 1+2 model was that trainees would miss experience of key specialties. However, as trainees progressed through the training programme, this concern diminished. All trainees and most trainers thought that the benefits of the 1+2 model outweighed drawbacks. Conclusion Spending more time in general practice during GP training appears to improve how prepared trainees felt for practice. Future changes should explore options to enhance hospital experience without reducing time spent in general practice

Sustained benefits of a generalist training programme for UK doctors: A survey-based follow-up study

Objectives: To conduct a follow-up of all broad-based training (BBT) trainees who participated in the original evaluation completed in 2017. The follow-up study explored the impact of BBT on career decisions, sustained benefits and unintended disadvantages of the programme, and views on the future of training. Design: Scoping interviews informed the design of an online survey. The interview transcripts were analysed thematically. The survey was piloted with six volunteers and sent out to all former BBT trainees. Data from the survey were transferred to Excel and SPSS for analysis. The open text comments on the survey were subject to a thematic content analysis. Setting: Participants were working in general practice, paediatrics, psychiatry, or medicine. Participants: Eight former BBT trainees participated in the scoping interviews. Interview participants were selected to ensure a diversity of current specialties and to represent all three BBT cohorts. All former BBT trainees were invited to complete the survey (n=118) and 70 replied. Results: The benefits of BBT were sustained over time: participants were confident in their career decisions, took a holistic approach to care, and capitalised on their experiences in other specialties in their current roles. A minority of trainees also experienced temporary challenges when they joined a specialty training programme after completing the BBT. Whatever their speciality, experience in core medicine, paediatrics, psychiatry and general practice was valued. Disadvantages were short lived (catching up upon transition specialty training) or affected a minority (impact on sense of belonging). Conclusions: The BBT programme supported the development of generalist doctors. Greater attention needs to be given to training secondary care doctors who take a holistic view of the patient and navigate their specialist care

Recent research into healthcare professions regulation: a rapid evidence assessment

Background and aims Over the last decade, regulators have taken significant steps towards tackling perceptions that regulatory systems are burdensome. There has been much international research activity in the regulation of health and care professionals. This article reports a review of studies on health professions regulation between January 2011 and March 2020. Its chief object was to provide robust and up-to-date evidence to assist regulators in policy development and implementation. The main objectives of this study were to: 1. Identify and retrieve research in the field of health and care professions regulation in English since 2011; 2. Evaluate the published research, exploring its utility to regulators and practitioners, and drawing out any key messages; 3. Draw conclusions concerning the scope and limitations of the research literature and identify areas for further research. Methods We undertook a rapid evidence assessment (REA) of the international literature on health and care professions regulation, including reviewing ten UK regulators’ websites to identify issues of concern and strategic priorities. We retrieved 3833 references, using a four-stage screening process to select the 81 most relevant. Results Results are reported within six key themes: harm prevention and patient safety; fitness to practise; quality assurance of education and training; registration including maintenance of registers; guidelines and standards and relations with regulatory bodies. Conclusions Regulation of professionals in health and care is comparatively undeveloped as a field of academic study. Consequently, the published evidence is diffuse and small-scale. Most work presents relatively weak data of low relevance to regulators, mainly reporting or describing the current position. Few studies are able to show the impact of regulation or demonstrate a causal link between regulation and its effects. To inform their research and policy agendas health and social care regulators need to commission, interpret and apply the scholarly literature more effectively; academics need to engage with regulators to ensure that their research provides high-quality evidence with practical relevance to the regulators’ agendas. Further study is needed to explore how effective academic collaborations between regulators and researchers may be created and sustained