A qualitative systematic review and thematic synthesis exploring the impacts of clinical academic activity by healthcare professionals outside medicine

Abstract Background There are increasing opportunities for healthcare professionals outside medicine to be involved in and lead clinical research. However, there are few roles within these professions that include time for research. In order to develop such roles, and evaluate effective use of this time, the range of impacts of this clinical academic activity need to be valued and understood by healthcare leaders and managers. To date, these impacts have not been comprehensively explored, but are suggested to extend beyond traditional quantitative impact metrics, such as publications, citations and funding awards. Methods Ten databases, four grey literature repositories and a naïve web search engine were systematically searched for articles reporting impacts of clinical academic activity by healthcare professionals outside medicine. Specifically, this did not include the direct impacts of the research findings, rather the impacts of the research activity. All stages of the review were performed by a minimum of two reviewers and reported impacts were categorised qualitatively according to a modified VICTOR (making Visible the ImpaCT Of Research) framework. Results Of the initial 2704 identified articles, 20 were eligible for inclusion. Identified impacts were mapped to seven themes: impacts for patients; impacts for the service provision and workforce; impacts to research profile, culture and capacity; economic impacts; impacts on staff recruitment and retention; impacts to knowledge exchange; and impacts to the clinical academic. Conclusions Several overlapping sub-themes were identified across the main themes. These included the challenges and benefits of balancing clinical and academic roles, the creation and implementation of new evidence, and the development of collaborations and networks. These may be key areas for organisations to explore when looking to support and increase academic activity among healthcare professionals outside medicine. The modified VICTOR tool is a useful starting point for individuals and organisations to record the impact of their research activity. Further work is needed to explore standardised methods of capturing research impact that address the full range of impacts identified in this systematic review and are specific to the context of clinical academics outside medicine.

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Misuse of medication in adult substance misuse services: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2020-047283 ◽

2021 ◽

Vol 11 (6) ◽

pp. e047283

Author(s):

Rosalind Gittins ◽

Louise Missen ◽

Ian Maidment

Keyword(s):

Systematic Review ◽

Substance Misuse ◽

Data Extraction ◽

Meta Analysis ◽

Grey Literature ◽

Opioid Analgesics ◽

Physical And Mental Health ◽

Qualitative Synthesis ◽

Treatment Services ◽

The Impact

IntroductionThere is a growing concern about the misuse of over the counter (OTC) and prescription only medication (POM) because of the impact on physical and mental health, drug interactions, overdoses and drug-related deaths. These medicines include opioid analgesics, anxiolytics such as pregabalin and diazepam and antidepressants. This protocol outlines how a systematic review will be undertaken (during June 2021), which aims to examine the literature on the pattern of OTC and POM misuse among adults who are accessing substance misuse treatment services. It will include the types of medication being taken, prevalence and demographic characteristics of people who access treatment services.Methods and analysisAn electronic search will be conducted on the Cochrane, OVID Medline, Pubmed, Scopus and Web of Science databases as well as grey literature. Two independent reviewers will conduct the initial title and abstract screenings, using predetermined criteria for inclusion and exclusion. If selected for inclusion, full-text data extraction will be conducted using a pilot-tested data extraction form. A third reviewer will resolve disagreements if consensus cannot be reached. Quality and risk of bias assessment will be conducted for all included studies. A qualitative synthesis and summary of the data will be provided. If possible, a meta-analysis with heterogeneity calculation will be conducted; otherwise, Synthesis Without Meta-analysis will be undertaken for quantitative data. The reporting of this protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationEthical approval is not required. Findings will be peer reviewed, published and shared verbally, electronically and in print, with interested clinicians and policymakers.PROSPERO registration numberCRD42020135216.

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P070: Mixed effectiveness of emergency department diversion strategies: a systematic review

CJEM ◽

10.1017/cem.2017.272 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S102

Author(s):

S.W. Kirkland ◽

A. Soleimani ◽

B.H. Rowe ◽

A.S. Newton

Keyword(s):

Systematic Review ◽

Health Care ◽

Emergency Department ◽

Health Care Services ◽

Grey Literature ◽

Study Data ◽

Care Utilization ◽

Alternative Source ◽

Increased Risk ◽

The Impact

Introduction: Diverting patients away from the emergency department (ED) has been proposed as a solution for reducing ED overcrowding. The objective of this systematic review is to examine the effectiveness of diversion strategies designed to either direct patients seeking care at an ED to an alternative source of care. Methods: Seven electronic databases and grey literature were searched. Randomized/controlled clinical trials and cohort studies assessing the effectiveness of pre-hospital and ED-based diversion interventions with a comparator were eligible for inclusion. Two reviewers independently screened the studies for relevance, inclusion, and risk of bias. Intervention effects are reported as proportions (%) or relative risks (RR) with 95% confidence intervals (CI). Methodological and clinical heterogeneity prohibited pooling of study data. Results: From 7,306 citations, ten studies were included. Seven studies evaluated a pre-hospital diversion strategy and three studies evaluated an ED-based diversion strategy. The impact of diversion on subsequent health services was mixed. One study of paramedic practitioners reported increased ED attendance within 7 days (11.9% vs. 9.5%; p=0.049) but no differences in return visits for similar conditions (75.2% vs. 72.1%; p=0.64). The use of paramedic practitioners was associated with an increased risk of subsequent contact with health care services (RR=1.21, 95% CI 1.06, 1.38), while the use of deferred care was associated with no increase in risk of subsequently seeking physician care (RR=1.09, 95% CI 0.23, 5.26). While two studies reported that diverted patients were at significantly reduced risk for hospitalization, two other studies reported no significant differences between diverted or standard care patients. Conclusion: The evidence regarding the impact of pre-hospital and ED-based diversion on ED utilization and subsequent health care utilization is mixed. Additional high-quality comparative effectiveness studies of diversion strategies are required prior to widespread implementation.

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Measuring and assessing the impact of using volunteers in UK libraries: issues and methods

Performance Measurement and Metrics ◽

10.1108/pmm-08-2014-0029 ◽

2014 ◽

Vol 15 (3) ◽

pp. 112-121 ◽

Cited By ~ 2

Author(s):

Judith Broady-Preston

Keyword(s):

Systematic Review ◽

Large Scale ◽

Third Sector ◽

Professional Staff ◽

Research Centre ◽

Content Type ◽

Qualitative Approaches ◽

Starting Point ◽

Third Sector Organisations ◽

The Impact

Purpose – The purpose of this paper is to examine a range of issues and methods in relation to measuring the impact of volunteer labour on the design and delivery of all types of library services. With the increasing use of volunteers to deliver library and information services in all sectors, managers need to assess their effectiveness and evaluate the impact of their use in relation to operational service design and delivery, and on the development of the profession and professional practice as a whole. Presented here is an initial scoping study, outlining a range of issues, methods and challenges for more detailed future investigation. Design/methodology/approach – A number of methodological challenges and perspectives are identifiable. Contemporary libraries exhibit increasing similarities with Third Sector organisations, namely a complex stakeholder community, and increasing use of volunteers to supplement or replace services delivered by professional staff. Therefore, a starting point for the research is a systematic review and analysis of the methodologies developed by the Third Sector Research Centre, and those studies in the ESRC contemporary Developing Impact Evaluation strand. As a rich picture is required, both quantitative and qualitative approaches are necessary, with the overall study adopting a mixed methods approach. Findings – This paper reports the findings of the preliminary documentary analysis, literature review and scoping aspects of a large-scale study. Originality/value – Research undertaken to date (June 2014) has failed to identify any published systematic review and examination of these issues.

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Housing with support for older people: a mixed-methods systematic review protocol

HRB Open Research ◽

10.12688/hrbopenres.13124.2 ◽

2020 ◽

Vol 3 ◽

pp. 64

Author(s):

Camille Coyle ◽

Sarah Buggy ◽

Olivia Cagney ◽

Louise Farragher ◽

Caitriona Lee ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Mixed Methods ◽

Older People ◽

Grey Literature ◽

Qualitative And Quantitative ◽

Ovid Medline ◽

The Impact ◽

People’S Perceptions

Background: The implementation of housing with support is rapidly expanding, particularly as life expectancy is increasing throughout the world. This expansion is likely to intensify in the context of coronavirus disease 2019 (COVID-19), which has revealed the risks of relying primarily on nursing homes. This mixed-methods systematic review aims to: 1) explore older people’s perceptions and experiences of housing with support and 2) examine the impact of providing housing with support for older people on their quality of life. Methods: The databases Ovid Medline, Ovid Social Policy & Practice, EBSCO CINAHL, and EBSCO SOCIndex will be searched, and grey literature will also be identified. Quality assessment will be carried out using Joanna Briggs Institute’s Critical Appraisal Checklist for Qualitative Research as well as a tool from the National Institutes of Health for observational cohort studies. This review will employ convergent parallel design; as such, qualitative and quantitative findings will be synthesised separately in the initial stage of analysis. The results from the qualitative and quantitative syntheses will then be integrated in the final stage of the analysis. Conclusion: This systematic review will synthesise the evidence regarding older people’s perceptions and experiences of housing with support and the impact of providing housing with support for older people on their quality of life.

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The Seroprevalence of SARS-CoV-2 in Europe: A Systematic Review

10.1101/2021.04.12.439425 ◽

2021 ◽

Author(s):

Natasha Marcella Vaselli ◽

Daniel Hungerford ◽

Ben Shenton ◽

Arwa Khashkhusha ◽

Nigel A. Cunliffe ◽

...

Keyword(s):

Public Health ◽

Systematic Review ◽

Meta Analysis ◽

Grey Literature ◽

Age Groups ◽

Significant Heterogeneity ◽

Community Studies ◽

Past Infection ◽

Significant Difference ◽

The Impact

AbstractBackgroundA year following the onset of the COVID-19 pandemic, new infections and deaths continue to increase in Europe. Serological studies, through providing evidence of past infection, can aid understanding of the population dynamics of SARS-CoV-2 infection.ObjectivesThis systematic review of SARS-CoV-2 seroprevalence studies in Europe was undertaken to inform public health strategies including vaccination, that aim to accelerate population immunity.MethodsWe searched the databases Web of Science, MEDLINE, EMBASE, SCOPUS, Cochrane Database of Systematic Reviews and grey literature sources for studies reporting seroprevalence of SARS-CoV-2 antibodies in Europe published between 01/12/2019 - 30/09/20. We provide a narrative synthesis of included studies. Studies were categorized into subgroups including healthcare workers (HCWs), community, outbreaks, pregnancy and children/school. Due to heterogeneity in other subgroups, we only performed a random effects meta-analysis of the seroprevalence amongst HCWs stratified by their country.Results109 studies were included spanning 17 European countries, that estimated the seroprevalence of SAR-CoV2 from samples obtained between November 2019 – August 2020. A total of 53/109 studies included HCWs with a reported seroprevalence among HCWs ranging from 0.7% to 45.3%, which did not differ significantly by country. In community studies significant heterogeneity was reported in the seroprevalence among different age groups and the majority of studies reported there was no significant difference by gender.ConclusionThis review demonstrates a wide heterogeneity in reported seroprevalence of SARS-CoV-2 antibodies between populations. Continued evaluation of seroprevalence is required to understand the impact of public health measures and inform interventions including vaccination programmes.

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Clostridium DifficileInfection in Acute Care Hospitals: Systematic Review and Best Practices for Prevention

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2016.324 ◽

2017 ◽

Vol 38 (4) ◽

pp. 476-482 ◽

Cited By ~ 24

Author(s):

Irene K. Louh ◽

William G. Greendyke ◽

Emilia A. Hermann ◽

Karina W. Davidson ◽

Louise Falzon ◽

...

Keyword(s):

Systematic Review ◽

Hand Hygiene ◽

Acute Care ◽

Antimicrobial Stewardship ◽

Grey Literature ◽

Quality Criteria ◽

Acute Care Hospitals ◽

Cochrane Library ◽

Chlorhexidine Bathing ◽

The Impact

OBJECTIVEPrevention ofClostridium difficileinfection (CDI) in acute-care hospitals is a priority for hospitals and clinicians. We performed a qualitative systematic review to update the evidence on interventions to prevent CDI published since 2009.DESIGNWe searched Ovid, MEDLINE, EMBASE, The Cochrane Library, CINAHL, the ISI Web of Knowledge, and grey literature databases from January 1, 2009 to August 1, 2015.SETTINGWe included studies performed in acute-care hospitals.PATIENTS OR PARTICIPANTSWe included studies conducted on hospitalized patients that investigated the impact of specific interventions on CDI rates.INTERVENTIONSWe used the QI-Minimum Quality Criteria Set (QI-MQCS) to assess the quality of included studies. Interventions were grouped thematically: environmental disinfection, antimicrobial stewardship, hand hygiene, chlorhexidine bathing, probiotics, bundled approaches, and others. A meta-analysis was performed when possible.RESULTSOf 3,236 articles screened, 261 met the criteria for full-text review and 46 studies were ultimately included. The average quality rating was 82% according to the QI-MQCS. The most effective interventions, resulting in a 45% to 85% reduction in CDI, included daily to twice daily disinfection of high-touch surfaces (including bed rails) and terminal cleaning of patient rooms with chlorine-based products. Bundled interventions and antimicrobial stewardship showed promise for reducing CDI rates. Chlorhexidine bathing and intensified hand-hygiene practices were not effective for reducing CDI rates.CONCLUSIONSDaily and terminal cleaning of patient rooms using chlorine-based products were most effective in reducing CDI rates in hospitals. Further studies are needed to identify the components of bundled interventions that reduce CDI rates.Infect Control Hosp Epidemiol2017;38:476–482

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Determinants and outcomes of motivation in health professions education: a systematic review based on self-determination theory

Journal of Educational Evaluation for Health Professions ◽

10.3352/jeehp.2016.13.19 ◽

2016 ◽

Vol 13 ◽

pp. 19 ◽

Cited By ~ 39

Author(s):

Cesar Orsini ◽

Vivian I. Binnie ◽

Sarah L. Wilson

Keyword(s):

Systematic Review ◽

Grey Literature ◽

Quality Criteria ◽

Health Professions ◽

Health Professions Education ◽

The Self ◽

Self Determination ◽

Mediation Effects ◽

Academic Activities ◽

Research Profile

Purpose: This study aimed at conducting a systematic review in health professions education of determinants, mediators and outcomes of students’ motivation to engage in academic activities based on the self-determination theory’s perspective. Methods: A search was conducted across databases (MEDLINE, CINHAL, EMBASE, PsycINFO, and ERIC databases), hand-search of relevant journals, grey literature, and published research profile of key authors. Quantitative and qualitative studies were included if they reported research in health professions education focused on determinants, mediators, and/or outcomes of motivation from the self-determination and if meeting the quality criteria. Results: A total of 17 studies met the inclusion and quality criteria. Articles retrieved came from diverse locations and mainly from medical education and to a lesser extent from psychology and dental education. Intrapersonal (gender and personality traits) and interpersonal determinants (academic conditions and lifestyle, qualitative method of selection, feedback, and an autonomy supportive learning climate) have been reported to have a positive influence on students’ motivation to engage in academic activities. No studies were found that tested mediation effects between determinants and students’ motivation. In turn, students’ self-determined motivation has been found to be positively associated with different cognitive, affective, and behavioural outcomes. Conclusion: This study has found that generally, motivation could be enhanced by changes in the educational environment and by an early detection of students’ characteristics. Doing so may support future health practitioners’ self-determined motivation and positively influence how they process information and their emotions and how they approach their learning activities.

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Views of commissioners, managers and healthcare professionals on the NHS Health Check programme: a systematic review

BMJ Open ◽

10.1136/bmjopen-2017-018606 ◽

2017 ◽

Vol 7 (11) ◽

pp. e018606 ◽

Cited By ~ 5

Author(s):

Katie Mills ◽

Emma Harte ◽

Adam Martin ◽

Calum MacLure ◽

Simon J Griffin ◽

...

Keyword(s):

Systematic Review ◽

Healthcare Professionals ◽

Health Management ◽

Controlled Trial ◽

Health Check ◽

Public Access ◽

Cochrane Library ◽

Inclusion Criteria ◽

The Impact ◽

Nhs Health Check

ObjectiveTo synthesise data concerning the views of commissioners, managers and healthcare professionals towards the National Health Service (NHS) Health Check programme in general and the challenges faced when implementing it in practice.DesignA systematic review of surveys and interview studies with a descriptive analysis of quantitative data and thematic synthesis of qualitative data.Data sourcesAn electronic literature search of MEDLINE, Embase, Health Management Information Consortium, Cumulative Index of Nursing and Allied Health Literature, Global Health, PsycInfo, Web of Science, OpenGrey, the Cochrane Library, NHS Evidence, Google Scholar, Google, ClinicalTrials.gov and the International Standard Randomised Controlled Trial Number registry from 1 January 1996 to 9 November 2016 with no language restriction and manual screening of reference lists of all included papers.Inclusion criteriaPrimary research reporting views of commissioners, managers or healthcare professionals on the NHS Health Check programme and its implementation in practice.ResultsOf 18 524 citations, 15 articles met the inclusion criteria. There was evidence from both quantitative and qualitative studies that some commissioners and general practice (GP) healthcare professionals were enthusiastic about the programme, whereas others raised concerns around inequality of uptake, the evidence base and cost-effectiveness. In contrast, those working in pharmacies were all positive about programme benefits, citing opportunities for their business and staff. The main challenges to implementation were: difficulties with information technology and computer software, resistance to the programme from some GPs, the impact on workload and staffing, funding and training needs. Inadequate privacy was also a challenge in pharmacy and community settings, along with difficulty recruiting people eligible for Health Checks and poor public access to some venues.ConclusionsThe success of the NHS Health Check Programme relies on engagement by those responsible for its commissioning, management and delivery. Recognising and addressing the challenges identified in this review, in particular the concerns of GPs, are important for the future of the programme.

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Does mental fatigue affect skilled performance in athletes? A systematic review

PLoS ONE ◽

10.1371/journal.pone.0258307 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258307

Author(s):

He Sun ◽

Kim Geok Soh ◽

Samsilah Roslan ◽

Mohd Rozilee Wazir Norjali Wazir ◽

Kim Lam Soh

Keyword(s):

Systematic Review ◽

Executive Functions ◽

Grey Literature ◽

Relevant Literature ◽

Mental Fatigue ◽

Cognitive Tasks ◽

Table Tennis ◽

Negative Effects ◽

Skilled Performance ◽

The Impact

Background Mental fatigue is a psychobiological state induced by a prolonged duration of demanding cognitive tasks. The effects of mental fatigue on physical performance have been well investigated in the literature. However, the effect of mental fatigue on skilled performance in sports remains unclear. Objective This study aimed to report a comprehensive systematic review investigating the carryover effects of mental fatigue on skilled performance among athletes. Methods A thorough search was conducted on PubMed, Web of Science, EBSCOhost (CENTRAL, SPORTDicus), and Scopus to select relevant literature, as well as on Google Scholar and sources of reference for grey literature. The selected literatures are centred on a mental fatigue protocol in which cognitive tasks are performed prior to athletic tasks. Only studies that used an experimental design to test two conditions, namely mental fatigue and non-mental fatigue, were selected. Results Eleven articles were chosen based on the selection criteria. Mental fatigue affects skilled performance in three sports: soccer, basketball, and table tennis. A decline in skilled performance (decreased accuracy, increased performing time etc) is relevant to impaired executive functions. Seven studies focus on offensive skills, whereas only two studies are associated with defensive skills. Conclusion Mental fatigue has a negative effect on various sports skills of high-level athletes, including their technical and decision-making skills; however, the impact is greater on offensive skills than that of defensive skills in terms of the role of athletes. Impaired executive functions may be responsible for the negative effects of mental fatigue on skilled performance.

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Effectiveness and experiences of the Extension for Community Healthcare Outcomes (ECHO) Model in developing competencies among healthcare professionals: a mixed methods systematic review protocol

Systematic Reviews ◽

10.1186/s13643-021-01832-0 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Gabrielle Chicoine ◽

José Côté ◽

Jacinthe Pepin ◽

Guillaume Fontaine ◽

Marc-André Maheu-Cadotte ◽

...

Keyword(s):

Systematic Review ◽

Mixed Methods ◽

Healthcare Professionals ◽

Data Extraction ◽

Publication Date ◽

Healthcare Outcomes ◽

Community Healthcare ◽

Guided Practice ◽

Development Of Competencies ◽

The Impact

Abstract Background The Extension for Community Healthcare Outcomes (ECHO) Model of continuing tele-education is an innovative guided-practice model aiming at amplifying healthcare professionals’ competencies in the management of chronic and complex health conditions. While data on the impact of the ECHO model is increasingly available in the literature, what influences the model effectiveness remains unclear. Therefore, the overarching aim of this systematic review is to identify, appraise, and synthesize the available quantitative (QUAN) and qualitative (QUAL) evidence regarding the ECHO Model effectiveness and the experiences/views of ECHO’s participants about what influences the development of competencies in healthcare professionals. Methods The proposed systematic review was inspired by the Joanna Briggs Institute (JBI) methodology for Mixed Methods Systematic Reviews (MMSR) and will follow a convergent segregated approach. A systematic search will be undertaken using QUAN, QUAL and mixed methods (MM) studies of ECHO-affiliated programs identified in six databases. A publication date filter will be applied to find the articles published from 2003 onwards. Sources of unpublished studies and gray literature will be searched as well. Retrieved citations will independently be screened by two reviewers. Disagreements will be resolved through discussion until a consensus is reached or by including a third reviewer. Studies meeting the predefined inclusion criteria will be assessed on methodological quality and the data will be extracted using standardized data extraction forms. Separate QUAN and QUAL synthesis will be performed, and findings will be integrated using a matrix approach for the purpose of comparison and complementarity. Discussion This MMSR will fulfill important gaps in the current literature on the ECHO Model as the first to provide estimates on its effectiveness and consider simultaneously the experiences/views of ECHO’s participants. As each replication of the ECHO Model greatly varies depending on the context, topic, and targeted professionals, a better understanding of what influences the model effectiveness in developing healthcare professionals’ competencies is crucial to inform future implementation. Systematic review registration PROSPERO CRD42020197579

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