The challenges of cross-cultural research and teaching in family medicine: How can professional networks help?

Modern medical training emphasizes the value of understanding the patient’s ideas, concerns and expectations, and the use of their personal perspective to assist communication, diagnosis, and uptake of all appropriate health and treatment options. This requires doctors to be ‘culturally sensitive’, which “… involves an awareness and acceptance of cultural differences, self-awareness, knowledge of a patient’s culture, and adaptation of skills”. Yet most of us work in one country, and often one community, for much of our professional careers. Those who enter into academic pursuits will similarly be constrained by our own backgrounds and experiences, even though universities and medical schools often attract a multicultural membership. We therefore rely on our professional training and networks to extend our scope and understanding of how cultural issues impact upon our research and its relevance to our discipline and curricula. This article uses a reflexive narrative approach to examine the role and value of international networks through the lens of one individual and one organisation. It explores the extent to which such networks assist cross cultural sensitivity, using examples from its networks, and how these can (and have) impacted on greater cross-culturalism in our teaching and research outputs

Principles of patient and public involvement in primary care research, applied to mental health research. A keynote paper from the EGPRN Autumn Conference 2017 in Dublin

Clinical research relies on patients being willing to participate in research projects, and making this possible for patients with mental health problems can be a particular challenge. In the modern era, many countries have seen a movement to give a stronger voice to patients both in choices around their care and in how research is conducted. How to achieve effective patient and public involvement (PPI) and to make the patients real partners in this effort is itself a subject of research evaluation. This opinion piece—based on a keynote lecture given at the European General Practice Research Network 2017 autumn meeting in Dublin—describes both the reasons for expanding PPI, how it can usefully be achieved, and how this may relate to the particular context of mental health. There can be moral, methodological or policy reasons for PPI. The three commonest models of good practice in PPI are the ‘one off,’ the ‘fully embedded’ and the ‘outreach’ models. In research into common mental health problems in family practice, ‘outreach’ approaches that minimize commitment over time may work best. ‘Expert patients’ from mental health charities can sometimes play this role. PPI may be challenging and involve extra effort, but the gains for all may be considerable. Wonca Europe networks including EGPRN can extend this message and findings

New perspectives - approaches to medical education at four new UK Medical Schools

To create more UK doctors, the government has funded an increase in medical student numbers of 57% (from 3749 to 5894)1 between 1998 and 2005. This has been done by increasing student places at existing medical schools; creating shortened programmes open to science graduates; “twinning” arrangements, which host an existing curriculum at a new site; and four entirely new schools (table 1). Through reflection on our experiences and the literature evidence, we examine to what extent these new schools have a common vision and approach to undergraduate medical education, and we discuss the rationale for and likely outcomes of these new ventures

Improving the Boosted Correlogram

Introduced seven years ago, the correlogram is a simple statistical image descriptor that nevertheless performs strongly on image retrieval tasks. As a result it has found wide use as a component inside larger systems for content-based image and video retrieval. Yet few studies have examined potential variants of the correlogram or compared their performance to the original. This paper presents systematic experiments on the correlogram and several variants under different conditions, showing that the results may vary significantly depending on both the variant chosen and its mode of application. As expected, the experimental setup combining correlogram variants with boosting shows the best results of those tested. Under these prime conditions, a novel variant of the correlogram shows a higher average precision for many image categories than the form commonly used

Learning about patient safety: organisational context and culture in the education of health care professionals

Objectives This study investigated the formal and informal ways pre-registration students from medicine, nursing, physiotherapy and pharmacy learn about keeping patients safe. This paper gives an overview of the study and explores findings in relation to organizational context and culture. Methods The study employed a phased design using multiple qualitative methods. The overall approach drew on ‘illuminative evaluation’. Ethical approval was obtained. Phase 1 employed a convenience sample of 13 pre-registration courses across the UK. Curriculum documents were gathered, and course directors interviewed. Phase 2 used eight case studies, two for each professional group, to develop an in-depth investigation of learning across university and practice by students and newly-qualified practitioners in relation to patient safety, and to examine the organizational culture that students and newly-qualified staff are exposed to. Analysis was iterative and ongoing throughout the study, using frameworks agreed by all researchers. Results Patient safety was felt to have become a higher priority for the health care system in recent years. Incident reporting was a key feature of the patient safety agenda within the organizations examined. Staff were often unclear or too busy to report. On the whole, students were not engaged and may not be aware of incident reporting schemes. They may not have access to existing systems in their organization. Most did not access employers' induction programmes. Some training sessions occasionally included students but this did not appear to be routine. Conclusions Action is needed to develop an efficient interface between employers and education providers to develop up-to-date curricula for patient safety

Correlation between prescribing quality and pharmaceutical costs in English primary care: national cross-sectional analysis

Background Both pharmaceutical costs and quality-indicator performance vary substantially between general practices, but little is known about the relationship between prescribing costs and quality Aim To measure the association between prescribing quality and pharmaceutical costs among English general practices Design and setting Cross-sectional observational study using data from the Quality and Outcomes Framework and the Prescribing Analysis and Cost database from all 8409 general practices in England in 2005-2006 Method Correlation between practice achievement of 26 prescribing quality indicators in eight prescribing areas and related pharmaceutical costs was examined. Results There was no significant association between the overall achievement of quality indicators and related pharmaceutical costs (P= 0.399). Mean achievement of quality indicators across all eight prescribing areas was 79.0% (standard deviation 4.4%). There were small positive correlations in five prescribing areas: influenza vaccination, beta blockers, angiotensin converting enzyme inhibitors, lipid lowering, and antiplatelet treatment (all