scholarly journals Learning Experiences Among GP Registrars After a Focused Cardiac Ultrasound Training Program: A Qualitative Interview Study

2020 ◽  
Author(s):  
Rita Sjöström ◽  
Carolina Klockmo ◽  
Lars Söderström ◽  
Gunnar Nilsson
Keyword(s):  
Primary Care ◽  
Cardiac Function ◽  
Training Program ◽  
Skill Acquisition ◽  
Qualitative Content Analysis ◽  
Interview Study ◽  
Cardiac Ultrasound ◽  
Primary Care Clinics ◽  
Focused Cardiac Ultrasound ◽  
Qualitative Interview Study

Abstract Background: Until recently, clinical ultrasound technology was limited to the hospital-based disciplines, and few studies assessed training in focused cardiac ultrasound (FCU) in primary care. We designed an interview study among general practitioner (GP) registrars taking part in an FCU training program and discussed their experiences compared to their documented skills.Methods: This qualitative content analysis used an inductive approach. Five GP registrars and their tutor participated in semi-structured individual interviews during April–July 2017. Participants were interviewed after they each had conducted 20 supervised and 7–10 independent examinations and were encouraged to complete self-directed study using video tutorials on web-based platforms. FCU examinations of study patients recruited from primary care clinics were conducted with a hand-held device (Vscan 1.2) at the Centre of Clinical Research, Östersund Hospital, Sweden. Results: We identified two categories of information: the prerequisites of learning FCU and the acquisition of skills for professional development. Combining theoretical education with hands-on tutorials was an essential part of FCU learning. However, participants suggested that the training program should include group tutorials to give a deeper understanding of scanning positions and a reference standard for evaluating the FCU recordings. In skill acquisition, participants experienced more confidence in performing the technical aspects of FCU than in interpreting the images to evaluate cardiac function. The participants saw several possibilities for applying FCU in primary care, including as a screening tool in rural clinics or to support referrals to specialized care.Conclusions: After completing 20 supervised FCU training sessions, previously inexperienced examiners felt that assessment of cardiac function was more difficult than acquiring adequate ultrasound images. To gain confidence in assessment of cardiac function, respondents suggested personal feedback and group tutorials with discussion of clinical examples in smaller groups for improvement of learning. Demographic differences between patients seen in hospital wards and primary care clinics should also be considered in the design of FCU training programs. Trial registration: NTC02939157, ClinicalTrials.gov.

scholarly journals Primary Care Nurses' Perceptions and Experiences of Patients Being Overweight, as well as Visions and Attitudes About Working with Lifestyle Issues: A Qualitative Interview Study

2020 ◽  
Author(s):  
Marie Bräutigam Ewe ◽  
Cathrine Hildingh ◽  
Jörgen Månsson ◽  
Marie Lydell
Keyword(s):  
Primary Care ◽  
Qualitative Content Analysis ◽  
Qualitative Interview ◽  
Interview Study ◽  
Diabetic Patients ◽  
Motivation To Change ◽  
Individualized Care ◽  
Qualitative Interview Study ◽  
Primary Care Nurses ◽  
Nurses Perceptions

Abstract Background: A primary health care centre (PHCC) is often the first point of contact for overweight patients, and nurses play key roles in overweight and lifestyle management. Since overweight is an increasing problem and a challenge for PHCCs to handle, it is important to describe primary care nurses' perceptions and experience with overweight problems, as well as their visions and attitudes regarding working with lifestyle issues. Methods: This was a qualitative interview study. Thirteen nurses in PHCCs in the southwest of Sweden were interviewed with a semi-structured, face-to-face guide. The interviews were analysed using qualitative content analysis. Results: The nurses had a wish and a willingness to work more with overweight and lifestyle issues than they currently did due to a lack of priority, resources, time and education. They experienced overweight as an increasing problem and felt that society should do more to stop its development. They considered that meeting with the patient was the most important task at PHCCs. How the conversations were structured without pointers and in an individualized manner was crucial for weight management to strengthen the patients’ motivation to change. The nurses experienced that how to use and implement guidelines was unclear. They also asked for a national forum in Sweden for nurses working with overweight and lifestyle issues with lectures about the latest research in the area. Conclusions: The nurses considered overweight to be a complex condition that requires a holistic approach with individualized care. To make this approach possible, a wider range of efforts should be offered to patients through more group meetings, lectures, and digital solutions. The development of a multidisciplinary team with different professions working with this patient group was the nurses’ dream scenario. They wished for a preventive reception for pre-diabetic patients to save costs and suffering. Informing parents earlier about a healthy lifestyle at childcare centres in PHCCs and offering health examinations to promote preventive work were seen as good ideas. Implementing these suggestions in working with overweight and lifestyle issues could be a discussion among the management in PHCCs and for the decision makers in the region.

scholarly journals Factors of importance for reducing fatigue in persons with rheumatoid arthritis: a qualitative interview study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028719 ◽  
Author(s):  
Caroline Feldthusen ◽  
Kaisa Mannerkorpi
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Qualitative Content Analysis ◽  
Controlled Trial ◽  
Hospital Setting ◽  
Qualitative Interview ◽  
Interview Study ◽  
Pharmacological Intervention ◽  
Physically Active ◽  
Qualitative Interview Study

ObjectivePhysical activity plays an important role in the treatment of persons with rheumatoid arthritis (RA) and is the non-pharmacological intervention with the strongest evidence to reduce fatigue. However, physical activity can be challenging for persons who are fatigued. The aim of this study was to investigate factors of importance for reducing fatigue in persons with RA.DesignThis is a qualitative interview study based on semistructured, indepth individual interviews. Interviews were analysed using qualitative content analysis.ParticipantsParticipants were 12 people with RA recruited from a previous randomised controlled trial of a person-centred treatment model focusing on health-enhancing physical activity and daily balance to lessen fatigue in persons with RA.SettingInterviews were conducted in a hospital setting.ResultsThe analysis resulted in one theme:an intellectual and embodied understanding that sustainable physical activity is important to handle fatigue. This included five categories describing barriers and facilitating factors for sustainable physical activity:mentally overcoming the fatigue in order to be active,making exercise easy,reaching for balance,receiving support to be physically activeanddealing with RA disease to be physically active.ConclusionThe participants in this study expressed that physical activity was important in handling fatigue, but also that this insight could only come from personal experience. The use of a person-centred ethic in physiotherapy coaching for patients with fatigue appears to promote sustainable physical activity behaviours by facilitating patients’ resources to overcome barriers to physical activity.

scholarly journals P107: Understanding the sensory experience of performing a rare, high-stakes clinical procedure: a qualitative study of clinicians with lived experience

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S102-S103
Author(s):  
J. Riggs ◽  
M. McGowan ◽  
C. Hicks
Keyword(s):  
Clinical Practice ◽  
Data Collection ◽  
Lived Experience ◽  
Skill Acquisition ◽  
Qualitative Content Analysis ◽  
Tertiary Care ◽  
Mental Practice ◽  
Tertiary Care Centre ◽  
High Stakes ◽  
Qualitative Interview Study

Introduction: Emergency physicians (EP) are expected to be competent in a variety of uncommon but life-saving procedures, including the bougie assisted cricothyrotomy (BAC). Given the rarity and high-stakes nature of the BAC, simulation is often used as the primary learning and training modality. However, mental practice (MP), defined as the “cognitive rehearsal of a skill in the absence of overt physical movement”, has been shown to be as effective as physical practice in several areas, including athletics, music, team-based resuscitation and surgical skill acquisition. MP scripts incorporate cues from different sensory modalities to supplement instructions of how to complete the skill. We sought to explore EPs perspectives on the kinesthetic, visual and cognitive aspects of performing a BAC to inform the development of a MP BAC script. Methods: We undertook a qualitative interview study of EPs at a single tertiary care centre who had done a BAC in clinical practice. Participants were recruited using purposive sampling. The primary method for data collection was in-depth semi-structured qualitative interviews, which were recorded and transcribed verbatim. Data collection and analysis were concurrent; transcripts were coded independently by two researchers using qualitative content analysis on a coding framework based on the previously developed BAC checklist. At each procedural step, the kinesthetic, visual and cognitive cues that enhance MP were identified. Results: Eight EPs (5 staff; 3 Royal College residents) participated in the interviews. All participants had completed at least one BAC in their clinical practice. Data analysis revealed recurrent themes signifying successful completion of each procedural step. These include visual (ie. seeing a spray of blood upon entry into the airway) and kinesthetic (ie. feel of the tracheal rings on a finger) cues that describe aspects of the procedure not found in traditional teaching modalities, such as textbooks. Conclusion: Knowledge gleaned from the interviews of EPs with lived experience gives us a deeper insight into the sensory aspects of performing a BAC in clinical practice. We expect that using these experientially derived cues to inform the development of a MP script will increase its validity and applicability to learners and for skill maintenance. Future work includes evaluating the utility of the developed script in acquiring and maintaining competence performing the BAC.

Effects of payment for performance in primary care: Qualitative interview study

2008 ◽  
Vol 13 (3) ◽  
pp. 133-139 ◽  
Author(s):  
Susan Maisey ◽  
Nick Steel ◽  
Roy Marsh ◽  
Stephen Gillam ◽  
Robert Fleetcroft ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Interview ◽  
Interview Study ◽  
Qualitative Interview Study

scholarly journals Training Needs of Practice Facilitators When Implementing An Opioid Improvement Initiative in Primary Care

2021 ◽  
Author(s):  
Michael L. Parchman ◽  
Brooke Ike ◽  
Katie Osterhage ◽  
Ashley Johnson ◽  
Laura-Mae Baldwin
Keyword(s):  
Primary Care ◽  
Training Program ◽  
Peer Relationships ◽  
Qualitative Content Analysis ◽  
Medication Management ◽  
Building Blocks ◽  
Training Needs ◽  
Evidence Based ◽  
Structured Interviews ◽  
Evidence Based Programs

Abstract Background: Practice facilitation is a commonly employed strategy to implement evidence-based programs into primary care settings. Preparing facilitators for this role requires an understanding of their training needs and support. Here we report on the experiences of facilitators who participated in a training program to support efforts to improve opioid medication management in primary care.Methods: Trainees with prior QI experience were recruited for the six-month training program. Each trainee recruited a clinic for which they would serve as an external facilitator to implement the Six Building Blocks program. At the end of the six-months, we conducted two semi-structured interviews with each trainee. The interviews focused on facilitators and barriers that the trainees experienced during the training and support provided. Qualitative content analysis was used to analyze the transcribed interviews.Results: Three of the five trainees completed the program. In addition to the in-depth understanding of the Six BB program, trainees valued the opportunity to build peer relationships which provided a supportive peer support group. They valued the availability of more experienced facilitators who supported and mentored them. They also mentioned the importance of providing helpful tools and resources and the availability of a clinical expert. Barriers focused on factors internal to the trainees’ clinical setting, the trainees limited clinical knowledge about chronic pain, and difficulty maintaining momentum for change due to the flexible timeline of the program itself.Conclusions: In addition to training on the content of an evidence-based programs, facilitators valued work with supportive peers and the mentoring of more experienced facilitators. Primary care improvement initiatives employing practice facilitators should consider these training needs and the resources required for this supportive infrastructure.

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