GP perspectives on hospital discharge letters : an interview and focus group study

Background: Written discharge communication following inpatient or outpatient clinic discharge is essential for communicating information to the GP, but GPs’ opinions on discharge communication are seldom sought. Patients are sometimes copied into this communication, but the reasons for this variation, and the resultant effects, remain unclear. Aim: To explore GP perspectives on how discharge letters can be improved in order to enhance patient outcomes. Design & setting: The study used narrative interviews with 26 GPs from 13 GP practices within the West Midlands, England. Method: Interviews were transcribed and data were analysed using corpus linguistics (CL) techniques. Results Elements pivotal to a successful letter were: diagnosis, appropriate follow-up plan, medication changes and reasons, clinical summary, investigations and/or procedures and outcomes, and what information has been given to the patient. GPs supported patients receiving discharge letters and expounded a number of benefits of this practice; for example, increased patient autonomy. Nevertheless, GPs felt that if patients are to receive direct discharge letter copies, modifications such as use of lay language and avoidance of acronyms may be required to increase patient understanding. Conclusion: GPs reported that discharge letters frequently lacked content items they assessed to be important; GPs highlighted that this can have subsequent ramifications on resources and patient experiences. Templates should be devised that put discharge letter elements assessed to be important by GPs to the forefront. Future research needs to consider other perspectives on letter content, particularly those of patients

QUALITATIVE RESEARCH METHODS: A COMPARISON BETWEEN FOCUS-GROUP AND IN-DEPTH INTERVIEW

Qualitative research methods tend to be used more and more in academic research. The cost for these methods is quite low and the results may be very interesting and useful for many fields of study. However, the utility and the characteristic of qualitative research methods differ from subject to subject and from discipline to discipline. This paper comes close to a comparison of two qualitative research methods (focus-group and in-depth interview) used in investigating the opinion of academics, analyzing by comparison the results founded in a research conducted in the Bucharest University of Economics using focus group and in-depth interviews. The conclusions of the study reveal that apart of the limits states in the literature, there are other elements that can contribute to obtaining unrealistic results.Qualitative research methods, focus group, in-depth interview, academic research

Doe one need to go a long way to dig deep? An empirical comparison of online and traditional focus groups.

We evaluate the potential of online focus groups to trigger deep level customer information, which is the major aim of focus groups. We do so by comparing its yield to that of its traditional counterpart. The traditional focus group substantially outperforms online focus groups in level of disclosure, in number of words generated, and in number of ideas generated. However, participants do not reveal these differences in their self-reports. Further, in line with the view that disclosure requires gradual warming up, we find increases in disclosure during the interview in traditional focus groups but not in online focus groups. We conclude that in its present form, the online focus group is not particularly suitable to yield deep level customer information. Starting from our finding that the difference in communication speed explains the differences in disclosure, we suggest some methodological improvements to online focus groups that might increase their yield.Characteristics; Communication; Disclosure; Focus groups; Group dynamics; Implications;

Global Music Perspectives: Music Outside the Western Canon in Local Schools

As a class, we are designing a research project for investigating how music teachers from counties in South-Central Pennsylvania use music from outside the Western canon (i.e. world music ). We are performing a qualitative study by interviewing k-12 music teachers from school districts in South-Central Pennsylvania. Teachers may choose to participate in a focus group interview with other teachers or in one-on-one interviews. The focus group interview will not exceed two hours and the one-on-one interviews will not exceed an hour. The interviews will be guided using a questionnaire (see attached), but the conversation may deviate from these questions at the discretion of the interviewer(s). We will transcribe these interviews to extract common thematic materials and relevant information. We will also compile a literature review of relevant peer-reviewed articles and use the data from said articles to expand upon our gathered information

Ladder of Life: Qualitative data collection tool to understand local perceptions of poverty dynamics

This resource examines GENNOVATE’s Ladder of Life exercise, a focus group tool conducted with poor women and men that explores their understandings and interpretations of the different wellbeing groups and poverty trends in their community, as well as the key factors and processes seen to shape these dynamics. The resource reviews the purpose of the tool, highlights key fieldwork procedures, and reproduces the interview guide

Development of a Dysphagia Management Protocol for Older Residents in a Care Home Setting. (abstract only)

Purpose: The aim of this study is to develop a co-designed dysphagia management protocol for older residents living in a care home setting. Method: A qualitative study is being conducted within four care homes in a region in the North of England; these were purposively selected to ensure representation of a range of care models across the care home sector. A literature search was conducted to establish good practice in the management of dysphagia in care homes. The findings from the literature review informed the development of semi-structured interview/focus group guides. Eight focus groups have been conducted with 40 members of the nursing and care assistant team and semi-structured interviews conducted with four nursing home managers. These have explored the assessment and management of dysphagia and the barriers and opportunities for improvement in dysphagia management. Interviews will also be conducted with residents (n=16) and nominated relatives, and quality managers (n=4). The interview and focus group data are being analyzed using the Framework Approach. Results: The literature review and preliminary data analysis suggest the following emerging themes: Lack of integrated approaches to education and training; Enablers and barriers to effective dysphagia management; Impact of relationship with other health care professionals on dysphagia management. Conclusion: These findings will lead to the co-design of a protocol for optimizing nutrition and hydration which is based on evidence and best practice principles and which can be adopted in the care home setting. This protocol will be produced by January 2018. The study has been funded by the Abbeyfield Foundation

Perceptions from Athletic Training Students Involved in an Intentional Peer-Assisted Learning Pedagogy

Context: Peer-assisted learning (PAL) has been shown to benefit students across educational levels. Current research has investigated perceptions of PAL, postgraduate impact, as well as prevalence. This study investigated athletic training students’ perceptions of an intentional PAL pedagogy on both the peer-student and peer-tutor. In this study, the peer-tutors had training prior to implementation. Objective: To explore athletic training students’ perceptions of an intentional PAL pedagogy. Design: Qualitative study using a phenomenological approach. Setting: Focus group interviews with professional undergraduate athletic training students. Patients or Other Participants: Eleven athletic training students from 1 accredited athletic training program volunteered for this study. Five students (4 females, 1 male) serving as peer-tutors and 6 (5 females, 1 male) peer-students participated in focus group interviews in spring term 2015. The peer-tutors completed training prior to tutoring the peer-students. Main Outcome Measure(s): Focus group interviews were conducted with a structured interview protocol. The peer-student and peer-tutor groups were asked separate questions. Interview data were analyzed inductively to uncover dominant themes, first by organizing the data, then summarizing into codes, and finally interpreting. Credibility was secured through member checking, triangulation, and investigator triangulation. Results: Themes indicated that both peer-students and peer-tutors perceived that, through PAL, they collaborated, built relationships, gained confidence, were exposed to varied techniques, and the PAL pedagogy served as a way to review and practice, which changed their clinical educational experiences. Peer-tutors developed skills in leadership and teaching through their PAL experience. Conclusions: Evidence demonstrated that PAL created a learning environment in the student’s clinical educational experiences that involved collaboration, relationships, confidence building, and more time for review and practice

'The designer', 'the teacher' and 'the assessor': changing academic identities

This paper explores the assessment practices of a group of academics working in the subject area of Design in a post-1992 university in the UK. We are interested in how academics assess and why they assess in the ways that they do. We focus on interview data collected from a design lecturer during the Assessment Environments and Cultures project in order to undertake the analysis. We examine the interview texts in terms of the positions that are taken up by this lecturer and the positions this makes available to ‘the student’. This analysis draws attention to the material effects of discourse. We suggest that there are multiple discourses in circulation in this school, which position academics and students in different ways, and that these different positionings (at times) create tension. The implications in terms of changing academic identities and assessment practices are discussed

Exploring access to end of life care for ethnic minorities with end stage kidney disease through recruitment in action research

BACKGROUND: Variation in provision of palliative care in kidney services and practitioner concerns to provide equitable access led to the development of this study which focussed on the perspectives of South Asian patients and their care providers. As people with a South Asian background experience a higher risk of Type 2 Diabetes (T2DM) and end stage kidney failure (ESKF) compared to the majority population but wait longer for a transplant, there is a need for end of life care to be accessible for this group of patients. Furthermore because non English speakers and people at end of life are often excluded from research there is a dearth of research evidence with which to inform service improvement. This paper aims to explore issues relating to the process of recruitment of patients for a research project which contribute to our understanding of access to end of life care for ethnic minority patients in the kidney setting. METHODS: The study employed an action research methodology with interviews and focus groups to capture and reflect on the process of engaging with South Asian patients about end of life care. Researchers and kidney care clinicians on four NHS sites in the UK recruited South Asian patients with ESKF who were requiring end of life care to take part in individual interviews; and other clinicians who provided care to South Asian kidney patients at end of life to take part in focus groups exploring end of life care issues. In action research planning, action and evaluation are interlinked and data were analysed with emergent themes fed back to care providers through the research cycle. Reflections on the process of patient recruitment generated focus group discussions about access which were analysed thematically and reported here. RESULTS: Sixteen patients were recruited to interview and 45 different care providers took part in 14 focus groups across the sites. The process of recruiting patients to interview and subsequent focus group data highlighted some of the key issues concerning access to end of life care. These were: the identification of patients approaching end of life; and their awareness of end of life care; language barriers and informal carers' roles in mediating communication; and contrasting cultures in end of life kidney care. CONCLUSIONS: Reflection on the process of recruitment in this action research study provided insight into the complex scenario of end of life in kidney care. Some of the emerging issues such as the difficulty identifying patients are likely to be common across all patient groups, whilst others concerning language barriers and third party communication are more specific to ethnic minorities. A focus on South Asian ethnicity contributes to better understanding of patient perspectives and generic concepts as well as access to end of life kidney care for this group of patients in the UK. Action research was a useful methodology for achieving this and for informing future research to include informal carers and other ethnic groups.Peer reviewedFinal Published versio

Comparative Approaches in Developing Inventory of Roles and Communication Skills for Training Needs Assessment of Frontline Extension Workers

The specific objectives of the study were to: (l) determine the appropriate approach in developing roles and communication skills required by field extension workers; (2) develop an inventory of roles of frontline extension workers using selected approaches; and (3) develop an inventory of specific communication skills needed by frontline extension workers using selected approaches. In addition, the study also attempted to develop a prototype instrument to assess the communication skills training needs of field extension workers. The study was descriptive in nature involving the use of three methods of data gathering namely open-ended questionnaire, individual interviews and focus group interview. A total of 39 respondents were selected to gather the data. The findings of the study were as follows; 23 roles of frontline extension workers were derived from the experts and practitioners through the use of open-ended questionnaire. From these 23 roles, 33 communication skills were derived. The initial 23 roles were later compressed into five major roles through the follow up interviews. Nineteen communication skills were derived from the five major roles. Through the use of focus group interview. l4 roles of extension workers were derived. The experts and practitioners listed 21 communication skills needed to perform the 14 roles of extension workers. For each of the 21 communication skills, specific skills were again derived. The study found that the focus group interview provided the most comprehensive data among the three methods of data gathering used in the study. The 21 communication skills derived through the focus group interview could be used in deter mining a prototype instrument for developing training needs assessment instrument required by frontline extension workers. Based on the findings of the study, the experience and observations of the researcher, it is recommended that focus group interview should be given priority in providing comprehensive data for developing an inventory of communication skills and roles of frontline extension workers