scholarly journals Barriers and facilitators of clinician and researcher collaborations: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Julie Williams ◽  
Tom J. Craig ◽  
Debbie Robson
Keyword(s):  
Clinical Practice ◽  
Barriers And Facilitators ◽  
Local Context ◽  
Working Relationships ◽  
Collaborative Partnerships ◽  
Working Together ◽  
Research Findings ◽  
Personal Qualities ◽  
Facilitators And Barriers ◽  
Conducting Research

Abstract Background The poor translation of research findings into routine clinical practice is common in all areas of healthcare. Having a better understanding of how researchers and clinicians experience engagement in and with research, their working relationships and expectations of each other, may be one way to help to facilitate collaborative partnerships and therefore increase successful translation of research into clinical practice. Aims To explore the views of clinical and research staff about their experiences of working together during research projects and identify the facilitators and barriers. Methods We conducted four focus groups with 18 participants - clinicians, researchers and those with a dual clinical-research role, recruited from one mental health Trust and one university. Data was analysed using thematic analysis. Results Eight themes were identified under the headings of two research questions 1) Barriers and facilitators of either engaging in or with research from the perspective of clinical staff, with themes of understanding the benefits of the research; perceived knowledge and personal qualities of researchers; lack of time and organisational support to be involved in and implement research; and lack of feedback about progress and outcome of research. 2) Barriers and facilitators for engaging with clinicians when conducting research, from the perspective of researchers, with themes of understanding what clinicians need to know and how they need to feel to engage with research; demonstrating an understanding of the clinician’s world; navigating through the clinical world; and demands of the researcher role. Conclusion There was agreement between clinicians and researchers about the barriers and facilitators for engaging clinicians in research. Both groups identified that it was the researcher’s responsibility to form and maintain good working relationships. Better support for researchers in their role calls for training in communication skills and bespoke training to understand the local context in which research is taking place.

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Clinical Practice ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Speech Language Pathologists ◽  
School Based ◽  
Research Findings ◽  
Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

Working Together

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Randi Veiteberg KVELLESTAD ◽  
Ingeborg STANA ◽  
VATN Gunhild
Keyword(s):  
Design Education ◽  
Critical Evaluation ◽  
Business Environment ◽  
Arts And Crafts ◽  
Action Research Project ◽  
Student Groups ◽  
Different Types ◽  
Working Together ◽  
Personal Qualities ◽  
Manual Skills

Teamwork involves different types of interactions—specifically cooperation andcollaboration—that are necessary in education and many other professions. The differencesbetween cooperation and collaboration underline the teacher’s role in influencing groupdynamics, which represent both a foundation for professional design education and aprequalification for students’ competences as teachers and for critical evaluation. As a testcase, we focused on the Working Together action-research project in design education forspecialised teacher training in design, arts, and crafts at the Oslo Metropolitan University,which included three student groups in the material areas of drawing, ceramics, and textiles.The project developed the participants’ patience, manual skills, creativity, and abilities,which are important personal qualities for design education and innovation and representcornerstones in almost every design literacy and business environment. The hope is thatstudents will transform these competences to teaching pupils of all ages in their futurecareers.

scholarly journals Exploring the Relationship between Locational and Household Characteristics and E-Commerce Home Delivery Demand

Logistics ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 29
Author(s):  
Cheng Cheng ◽  
Takanori Sakai ◽  
André Alho ◽  
Lynette Cheah ◽  
Moshe Ben-Akiva
Keyword(s):  
Online Shopping ◽  
Household Survey ◽  
Past Research ◽  
Home Delivery ◽  
Local Context ◽  
Household Characteristics ◽  
Use Of Data ◽  
Research Findings ◽  
Individual Household ◽  
Parcel Deliveries

The rapid growth in online shopping and associated parcel deliveries prompts investigation of the factors that contribute to parcel delivery demand. In this study, we evaluated the influence of locational and household characteristics on e-commerce home delivery demand. While past research has largely focused on the impacts of the adoption of online shopping using individual/household survey data, we made use of data from an e-commerce carrier. A linear regression model was estimated considering factors such as degree of urbanization, transit and shopping accessibility, and household attributes. The results both confirm and contradict prior research findings, highlighting the potential for a non-negligible influence of the local context on demand for parcel deliveries.

scholarly journals Coincidence analysis: a new method for causal inference in implementation science

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Rebecca Garr Whitaker ◽  
Nina Sperber ◽  
Michael Baumgartner ◽  
Alrik Thiem ◽  
Deborah Cragun ◽  
...  
Keyword(s):  
Causal Inference ◽  
Media Coverage ◽  
Hpv Vaccination ◽  
Implementation Strategies ◽  
Local Context ◽  
Comparative Approach ◽  
Vaccination Rates ◽  
Vaccination Uptake ◽  
Level Data ◽  
Working Together

Abstract Background Implementation of multifaceted interventions typically involves many diverse elements working together in interrelated ways, including intervention components, implementation strategies, and features of local context. Given this real-world complexity, implementation researchers may be interested in a new mathematical, cross-case method called Coincidence Analysis (CNA) that has been designed explicitly to support causal inference, answer research questions about combinations of conditions that are minimally necessary or sufficient for an outcome, and identify the possible presence of multiple causal paths to an outcome. CNA can be applied as a standalone method or in conjunction with other approaches and can reveal new empirical findings related to implementation that might otherwise have gone undetected. Methods We applied CNA to a publicly available dataset from Sweden with county-level data on human papillomavirus (HPV) vaccination campaigns and vaccination uptake in 2012 and 2014 and then compared CNA results to the published regression findings. Results The original regression analysis found vaccination uptake was positively associated only with the availability of vaccines in schools. CNA produced different findings and uncovered an additional solution path: high vaccination rates were achieved by either (1) offering the vaccine in all schools or (2) a combination of offering the vaccine in some schools and media coverage. Conclusions CNA offers a new comparative approach for researchers seeking to understand how implementation conditions work together and link to outcomes.

Exploration of Barriers and Facilitators to Implementing Best Practice in Exercise Medicine in Primary Pediatric Care—Pediatrician Perspectives

2021 ◽  
pp. 1-8
Author(s):  
Kim D. Lu ◽  
Dan Cooper ◽  
Raluca Dubrowski ◽  
Melanie Barwick ◽  
Shlomit Radom-Aizik
Keyword(s):  
Primary Care ◽  
Best Practice ◽  
Barriers And Facilitators ◽  
Pediatric Care ◽  
Team Approach ◽  
Implementation Barriers ◽  
Primary Care Clinics ◽  
Exercise Medicine ◽  
Practice Variability ◽  
Facilitators And Barriers

Purpose: Despite the known health benefits of physical activity (PA), few primary care pediatricians discuss, evaluate, or prescribe PA for children. The goal of this study was to examine pediatricians’ thoughts and practices related to child PA and the perceived facilitators and barriers to implementing PA evaluation and prescription in pediatric primary care clinics. Methods: The Consolidated Framework for Implementation Research was used to explore implementation barriers and facilitators. A mixed-method design combined questionnaires and focus groups with 27 pediatricians. Results: Despite the pediatricians’ beliefs that PA is important for patients, there was wide practice variability in their approaches to discussing PA. Several perceived barriers to implementing PA evaluation and prescription were identified, including lack of knowledge and training, managing time for PA with multiple demands, the need for a team approach and simple PA tools and resources, support for patient tailoring of PA messaging, and a need for PA best practice champions. Conclusion: The identified barriers to implementing evidence in PA suggest several directions for improvement, including a care-team approach; quick, inexpensive, and simple PA tools; community PA partnerships; PA training in medical education; evidence-based strategies; and PA directories for families. These efforts could facilitate the implementation of PA best practices in pediatrics.

A hermeneutical rapprochement framework for clinical ethics practice

2017 ◽  
Vol 26 (3) ◽  
pp. 674-687 ◽  
Author(s):  
Franco A Carnevale
Keyword(s):  
Clinical Practice ◽  
Moral Philosophy ◽  
Clinical Ethics ◽  
Charles Taylor ◽  
Local Context ◽  
Ethical Practice ◽  
Educational Preparation ◽  
Normative Development

Background: A growing number of frameworks for the practice of clinical ethics are described in the literature. Among these, hermeneutical frameworks have helped highlight the interpretive and contextual nature of clinical ethics practice. Objectives: The aim of this article is to further advance this body of work by drawing on the ideas of Charles Taylor, a leading hermeneutical philosopher. Design/Findings: A Hermeneutical Rapprochement Framework is presented for clinical ethics practice, based on Taylor’s hermeneutical “retrieval” and “rapprochement.” This builds on existing hermeneutical approaches for the practice of clinical ethics by articulating a framework with interpretive and reconciliatory scope that extends beyond the presenting “local” context. A Hermeneutical Rapprochement Framework considers broader socio-historical horizons and imaginaries grounded on Taylor’s expansive work in epistemological, ontological, political, and moral philosophy. Discussion: The framework is discussed in terms of how it can be operationalized for clinical practice as well as normative development. Implications for the educational preparation of clinical ethicists are also discussed. Although this work is directly relevant for clinical ethicists, it can also help inform the ethical practice of all clinicians.

Strategic objectives for improving understanding of informant discrepancies in developmental psychopathology research

2013 ◽  
Vol 25 (3) ◽  
pp. 669-682 ◽  
Author(s):  
Andres De Los Reyes
Keyword(s):  
Best Practices ◽  
Developmental Psychopathology ◽  
Research Priorities ◽  
Informant Discrepancies ◽  
Multiple Informants ◽  
Strategic Objectives ◽  
Behavioral Assessments ◽  
Research Findings ◽  
Conducting Research ◽  
Developmental Assessments

AbstractDevelopmental psychopathology researchers and practitioners commonly conduct behavioral assessments using multiple informants' reports (e.g., parents, teachers, practitioners, children, and laboratory observers). These assessments often yield inconsistent conclusions about important questions in developmental psychopathology research, depending on the informant (e.g., psychiatric diagnoses and risk factors of disorder). Researchers have theorized why informant discrepancies exist and advanced methodological models of informant discrepancies. However, over 50 years of empirical data has uncovered little knowledge about these discrepancies beyond that they exist, complicate interpretations of research findings and assessment outcomes in practice, and correlate with some characteristics of the informants providing reports (e.g., demographics and mood levels). Further, recent studies often yield take-home messages about the importance of taking a multi-informant approach to clinical and developmental assessments. Researchers draw these conclusions from their work, despite multi-informant approaches to assessment long being a part of best practices in clinical and developmental assessments. Consequently, developmental psychopathology researchers and practitioners are in dire need of a focused set of research priorities with the key goal of rapidly advancing knowledge about informant discrepancies. In this paper, I discuss these research priorities, review work indicating the feasibility of conducting research addressing these priorities, and specify what researchers and practitioners would gain from studies advancing knowledge about informant discrepancies in developmental psychopathology research.

scholarly journals Planning Implementation Success of Syncope Clinical Practice Guidelines in the Emergency Department Using CFIR Framework

2021 ◽  
Author(s):  
Jing Li ◽  
Susan S. Smyth ◽  
Jessica Miller Clouser ◽  
Colleen A. McMullen ◽  
Vedant Gupta ◽  
...  
Keyword(s):  
Emergency Department ◽  
Clinical Practice ◽  
Family Caregivers ◽  
Implementation Strategy ◽  
Care Pathway ◽  
Implementation Strategies ◽  
Mobile App ◽  
Care Plan ◽  
Local Context ◽  
Successful Implementation

Background and Objectives: Overuse and inappropriate use of testing and hospital admission are common in syncope evaluation and management. Though guidelines are available to optimize syncope care, study suggested that the current clinical guidelines have not significantly impacted resource utilization surrounding emergency department (ED) evaluation of syncope. Matching implementation strategies to barriers and facilitators and tailoring strategies to local context hold significant promise for a successful implementation of clinical practice guideline (CPG). Our team applied implementation science principles to develop a stakeholder-based implementation strategy. Methods and Materials: We partnered with patients, family caregivers, frontline clinicians and staff, and health system administrators at four health systems to conduct quantitative surveys and qualitative interviews for context assessment. The identification of implementation strategies was done by applying the CFIR-ERIC Implementation Strategy Matching Tool and soliciting stakeholders’ inputs. We then co-designed with patients and frontline teams, developed and tested specific strategies. Results: 114 clinicians completed surveys and 32 clinicians and stake-holders participated in interviews. Results from the surveys and interview indicated low awareness of syncope guidelines, and communication challenges with patients, lack of CPG protocol integration into ED workflows, and organizational process to change were recognized as major barriers. Thirty-one patients and their family caregivers participated in interviews and ex-pressed their expectations: clarity regarding their diagnosis, context surrounding care plan and diagnostic testing, and a desire to feel cared about. After identifying change methods to address those barriers, the multilevel, multicomponent implementation strategy, MISSION, included pa-tient educational materials, mentored implementation, academic detailing, Syncope Optimal Care Pathway and corresponding Mobile App, and Lean quality improvement methods. The pilot of MISSION demonstrated feasibility, acceptability and initial success on appropriate testing. Con-clusions: Effect multifaceted implementation strategies that target individuals, teams, and healthcare systems can be employed to plan successful implementation and promote adherence to syncope CPGs.

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