Lecture attendance among university paramedic students: A sequential mixed methods study

Background Lecture absenteeism is a widespread issue and has been reported for a large range of university disciplines. The aim of this study was to describe face-to-face lecture attendance within a Bachelor of Paramedicine cohort at a large Australian university and explore associated factors. Methods A sequential mixed method study was undertaken using lecture attendance counts, a cross-sectional questionnaire and semi-structured interviews. Attendance was recorded at four time points throughout one semester. The Lecture Attendance Scale, a standardised 34-item questionnaire with a 7-point Likert rating scale, was used to examine reasons behind students’ choice to attend lectures or not, followed by further exploration via semi-structured interviews. Results Lecture attendance ranged from 30% to 76%, with a mean of 49.2%. On analysis of the questionnaire, eight factors were identified, and these were largely supported by the interview data. Conclusion High levels of lecture attendance were not observed. This study suggests that the decision to attend a lecture can be complex and is influenced by a range of student and organisation-related factors. Understanding and utilising this information to modify and improve healthcare curricula delivery is vital, especially where there may be an association between attendance and the development of clinical skills, and professional attitudes and qualities. This is especially important in healthcare education in the post-COVID-19 pandemic era where the value of in-person education will continue to be examined.

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Primary care patient and practitioner views of weight and weight-related discussion: a mixed-methods study

BMJ Open ◽

10.1136/bmjopen-2019-034023 ◽

2020 ◽

Vol 10 (3) ◽

pp. e034023 ◽

Cited By ~ 2

Author(s):

Calum T McHale ◽

Anita H Laidlaw ◽

Joanne E Cecil

Keyword(s):

Primary Care ◽

Mixed Methods ◽

Weight Management ◽

Primary Care Patient ◽

Overweight And Obesity ◽

Shared Responsibility ◽

Mixed Methods Study ◽

Structured Interviews ◽

Related Factors ◽

Cross Sectional

ObjectiveTo understand the beliefs that primary care practitioners (PCPs) and patients with overweight and obesity have about obesity and primary care weight management in Scotland.SettingSeven National Health Service (NHS) Scotland primary care centres.ParticipantsA total of 305 patients and 14 PCPs (12 general practitioners; two practice nurses) participated.Design and methodologyA cross-sectional mixed-methods study. PCPs and patients completed questionnaires assessing beliefs about obesity and primary care weight communication and management. Semi-structured interviews were conducted with PCPs to elaborate on questionnaire topics. Quantitative and qualitative data were synthesised to address study objectives.Results(1) Many patients with overweight and obesity did not accurately perceive their weight or risk of developing weight-related health issues; (2) PCPs and patients reported behavioural factors as the most important cause of obesity, and medical factors as the most important consequence; (3) PCPs perceive their role in weight management as awareness raising and signposting, not prevention or weight monitoring; (4) PCPs identify structural and patient-related factors as barriers to weight communication and management, but not PCP factors.ConclusionsIncongruent and/or inaccurate beliefs held by PCPs and patient may present barriers to effective weight discussion and management in primary care. There is a need to review, standardise and clarify primary care weight management processes in Scotland. Acknowledging a shared responsibility for obesity as a disease may improve outcomes for patients with overweight and obesity.

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Uncertainty about cellulitis and unmet patient information needs: a mixed methods study

British Journal of General Practice ◽

10.3399/bjgp18x697349 ◽

2018 ◽

Vol 68 (suppl 1) ◽

pp. bjgp18X697349

Author(s):

Anna Lalonde ◽

Emma Teasdale ◽

Ingrid Muller ◽

Joanne Chalmers ◽

Peter Smart ◽

...

Keyword(s):

Mixed Methods ◽

Information Needs ◽

Qualitative Data ◽

Information Provision ◽

Mixed Methods Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Face To Face ◽

Patient Information Needs ◽

History Of

BackgroundCellulitis is a common painful infection of the skin and underlying tissues that recurs in approximately a third of cases. Patients’ ability to recover from cellulitis or prevent recurrence is likely to be influenced by their understanding of the condition.AimTo explore patients’ perceptions of cellulitis and their information needs.MethodMixed methods study comprising semi-structured, face-to-face interviews and cross-sectional survey, recruiting through primary care, secondary care and advertising. Adults aged 18 or over with a history of cellulitis (first or recurrent) were invited to complete a survey, take part in an interview or both. Qualitative data was analysed thematically.ResultsThirty interviews were conducted between August 2016 and July 2017. Qualitative data revealed low prior awareness of cellulitis, uncertainty around diagnosis, concern/surprise at the severity of cellulitis, and perceived insufficient information provision. People were surprised they had never heard of the condition and that they had not received advice or leaflets giving self-care information. Some sought information from the internet and found this bewildering. Two hundred and forty surveys were completed (response rate 17%). These showed that, while most people received information on the treatment of cellulitis (60.0%, n = 144), they reported receiving no information about causes (60.8%, n = 146) or prevention of recurrence (73.3%, n = 176).ConclusionThere is a need for provision of basic information for people with cellulitis, particularly being informed of the name of their condition, how to manage acute episodes, and how to reduce risk of recurrence.

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Experiences of GP trainees in undertaking telephone consultations: a mixed-methods study

BJGP Open ◽

10.3399/bjgpopen20x101008 ◽

2020 ◽

Vol 4 (1) ◽

pp. bjgpopen20X101008 ◽

Cited By ~ 1

Author(s):

Umar Chaudhry ◽

Judith Ibison ◽

Tess Harris ◽

Imran Rafi ◽

Miles Johnston ◽

...

Keyword(s):

Mixed Methods ◽

Clinical Information ◽

Mixed Methods Study ◽

Strong Positive Correlation ◽

Structured Interviews ◽

Cross Sectional ◽

Electronic Survey ◽

Positive Experiences ◽

Positive Correlations ◽

Observation Tools

BackgroundPrimary care telephone consultations are increasingly used for patient triage, reviews, and providing clinical information. They are also a key postgraduate training component yet little is known about GP trainees’ preparation for, or experiences and perceptions of, them.AimTo understand the experiences, perceptions, and training of GP trainees in conducting telephone consultations.Design & settingA mixed-methods study was undertaken of North Central and East London (NCEL) GP trainees.MethodA cross-sectional electronic survey of trainees was performed with subsequent semi-structured interviews. Survey data were analysed using descriptive statistics, and qualitative data using thematic analysis.ResultsThe survey response was 16% (n = 100/618), and 10 participated in semi-structured interviews. Trainees felt least confident with complicated telephone consulting, and there was a strong positive correlation between the percentage reporting having received training and their confidence (R2 = 0.71, P<0.0001). Positive experiences included managing workload and convenience. Negative experiences included complex encounters, communication barriers, and absence of examination. Trainees reported that training for telephone consultations needed strengthening, and that recently introduced audio-clinical observation tools (COTs) were useful. Positive correlations were found between the length of out-of-hours (OOH) but not in-hours training and the level of supervision or feedback received for telephone consultations.ConclusionThis project sheds light on GP trainees’ current experiences of telephone consultations and the need to enhance future training. The findings will inform a wider debate among stakeholders and postgraduate learners regarding training for telephone consultations, and potentially for other remote technologies.

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Exploration of sedentary behaviour among general practitioners: protocol for a mixed methods study

International Journal of Clinical Trials ◽

10.18203/2349-3259.ijct20210145 ◽

2021 ◽

Vol 8 (1) ◽

pp. 51

Author(s):

Richard S. Mayne ◽

Nigel D. Hart ◽

Neil Heron

Keyword(s):

General Practice ◽

Mixed Methods ◽

Sedentary Behaviour ◽

General Practitioners ◽

Mixed Methods Study ◽

Structured Interviews ◽

New Ways Of Working ◽

Adverse Health Outcomes ◽

Sequential Mixed Methods ◽

Working Day

Background: Many general practitioners (GPs) are sedentary for most of their working day. Levels of sedentary behaviour may have been exacerbated by increased use of telemedicine in light of the COVID-19 pandemic, as this is traditionally performed while sitting down. Excessive sedentary behaviour is associated with many adverse health outcomes and increased all-cause mortality. This study will gain quantitative data on levels of sedentary behaviour among GPs and general practice specialty trainees (GPSTs), to identify to what extent general practice is a sedentary occupation, as well as qualitative data regarding the barriers and facilitators to reducing sedentary behaviour in the general practice setting.Methods: The study follows a sequential, mixed-methods model. The first stage will involve the dissemination of a questionnaire survey, where participants self-estimate their sedentary behaviour on a working day and on a non-working day. The second stage will use thigh-worn accelerometers and a sleep/work log to obtain objective data regarding sedentary behaviour among a purposive subset of participants who responded to the questionnaire. The third stage will involve semi-structured interviews with a purposive subset of accelerometer study participants, analysed with the application of a theoretical framework regarding the acceptability of healthcare interventions.Conclusions: This paper outlines a protocol for a sequential, mixed-methods study exploring sedentary behaviour among GPs and GPSTs. Findings of this study will shed light on the new ways of working as a result of the COVID-19 pandemic, which will be relevant to clinicians working in similar primary care settings throughout the world.Trial Registration: ClinicalTrials.gov Identifier: NCT04556695. Date of registration: 21st September 2020.

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A mixed methods study exploring the views and experiences of internationally qualified midwives in Australia: Research Protocol (Preprint)

10.2196/preprints.13406 ◽

2019 ◽

Author(s):

Mitra Javanmard ◽

Mary Steen ◽

Rachael Vernon ◽

Megan Cooper

Keyword(s):

Mixed Methods ◽

South Australia ◽

Mixed Methods Study ◽

Second Phase ◽

Snowball Sampling ◽

Structured Interviews ◽

Human Research Ethics ◽

Sequential Mixed Methods ◽

Transitional Experiences ◽

Two Phases

BACKGROUND Approximately, 13% of the total Australian midwifery workforce is internationally qualified. Although they play a significant role in the Australian midwifery system, there is limited understanding of their transitional experiences. OBJECTIVE This mixed methods study aims to explore the transitional experiences and perspectives of internationally qualified midwives practising in Australia. METHODS This study uses an explanatory sequential mixed methods design incorporating two phases. The first phase of the study includes an e-survey that will be distributed to internationally qualified midwives in Australia, via the website e-bulletins of the Australian Nursing and Midwifery Federation and Australian College of Midwives. Additionally, potential respondents will be recruited via social media (Twitter, Facebook) and associated snowball sampling. At the end of the e-survey, respondents will be asked whether they are willing to take part in an interview. Data from the e-survey will be statistically analysed. The results of the e-survey and literature review will help to develop a guide for interview questions, with these interviews taking place during the second phase. A nested sample of participants will be created using the same selection criteria as for the e-survey. Semi-structured interviews will provide a deeper insight into the transitional experiences of internationally qualified midwives. Data will then be thematically analysed. RESULTS An integration of the e-survey results and interview findings will be synthesised to explore and better understand the transitional experiences of this group of midwives. The resulting data may potentially be used to formulate recommendations for future recruitment and retention practices, and to aid the Australian midwifery workforce in valuing diversity and fostering a supportive work environment. CONCLUSIONS At the time of writing this protocol, data collection had not yet commenced, however collection was subsequently completed in late 2018 and analysis is currently underway. CLINICALTRIAL This study was approved by the University of South Australia Human Research Ethics Committee (Protocol Number: 0000036397).

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Factors influencing non-adherence to opioids in cancer patients: a mixed-methods cross-sectional study

F1000Research ◽

10.12688/f1000research.27725.1 ◽

2020 ◽

Vol 9 ◽

pp. 1471

Author(s):

Rattaphol Seangrung ◽

Mallika Ahuja ◽

Koravee Pasutharnchat ◽

Rungwipha Mahawan

Keyword(s):

Mixed Methods ◽

Cancer Patients ◽

Cross Sectional Study ◽

Pain Clinic ◽

Related Factors ◽

Cross Sectional ◽

Face To Face ◽

Factors Influencing ◽

Strong Opioids ◽

Problem Awareness

Background: Strong opioids are mainly utilized to attenuate pain in cancer patients. Adherence to analgesic drugs significantly promotes adequate pain management and improves quality of life. We aimed to identify the factors influencing non-adherence to strong opioids in cancer patients. Methods: A descriptive, cross-sectional, two-phased, mixed methods design was conducted prospectively to evaluate a cohort of 101 cancer patients who are currently prescribed strong opioids from a pain clinic in Thailand between January and March 2018. Participants were asked to complete a questionnaire that included the following sections: general characteristics; the Medication Taking Behavior in Thai (MTB-Thai) for assessing adherence to medications; and factors influencing nonadherence, which were analyzed using multivariate logistic regression. In addition, face-to-face in depth interviews were conducted with patients showing non-adherence to strong opioids (MTB-Thai score ≤21) and analyzed using thematic content analysis. Results: Of 101 cancer pain patients that completed the questionnaire, 39.6% showed non-adherence to strong opioids. Illness understanding (P=0.047) and the use of more than three types of pain medication (P=0.032) were significant factors influencing non-adherence. Qualitative analysis indicated that fear of long-term outcomes, opioid side effects, ineffective pain control, attempts to make the regimen more acceptable, poor understanding, and non-acceptance of disease related to non-adherence. Conclusion: Non-adherence to opioids for cancer patients is a common problem. Awareness of patient factors, medication-related factors, and illness-related factors will provide the knowledge and adequate advice that may enhance adherence to medications.

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Model for Utilizing Distance Learning post COVID-19 using (PACT)™ A Cross Sectional Qualitative Study

10.21203/rs.3.rs-31027/v2 ◽

2020 ◽

Author(s):

Samar A Ahmed ◽

Nagwa Nashat Hegazy ◽

Hany W. Abdel Malak ◽

Cliff W. Kayser ◽

Noha M Elrafie ◽

...

Keyword(s):

Distance Learning ◽

Qualitative Study ◽

Assessment Tool ◽

Social Issues ◽

Clinical Skills ◽

Warning Signs ◽

Team Work ◽

Cross Sectional ◽

Face To Face ◽

Face To Face Learning

Abstract BackgroundCOVID -19 pandemic pressured medical schools globally to shift to Distance learning (DL) as an alternative way to ensure that the content delivered is satisfactory for student progression.Aim of the workThis work aims at mapping priorities for post-COVID planning for better balance between distance learning and face to face learning.MethodsThis qualitative study aimed to develop a model for utilizing DL using The Polarity Approach for Continuity and Transformation (PACT)™. A virtual mapping session was held with 79 faculty from 19 countries. They worked in small groups to determine upsides and downsides of face-to-face and DL subsequently. An initial polarity map was generated identifying five tension areas; Faculty, Students, Curriculum, Social aspects and Logistics. A 63-item assessment tool was generated based on this map, piloted and then distributed as a self-administered assessment. The outcomes of this assessment were utilized for another mapping session to discuss warning signs and action steps to maintain upsides and avoid downsides of each pole.ResultsParticipants agreed that face-to-face teaching allows them to inspire students and have meaningful connections with them. They also agreed that DL provides a good environment for most students. However, students with financial challenges and special needs may not have equal opportunities to access technology. As regards social issues, participants agreed that face-to-face learning provides a better chance for professionalism through enhanced team-work. Cognitive, communication and clinical skills are best achieved in face-to-face. Participants agreed that logistics for conducting DL are much more complicated when compared to face-to-face learning. Participants identified around 10 warning signs for each method that need to be continuously monitored in order to minimize the drawbacks of over focusing on one pole at the expense of the other. Action steps were determined to ensure optimized use of in either method.ConclusionIn order to plan for the future, we need to understand the dynamics of education within the context of polarities. Educators need to understand that the choice of DL, although was imposed as a no-alternative solution during the COVID era, yet it has always existed as a possible alternative and will continue to exist after this era. The value of polarity mapping and leveraging allows us to maximize the benefit of each method and guide educators' decisions to minimize the downsides for the good of the learning process.

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Model for utilizing distance learning post COVID-19 using (PACT)™ a cross sectional qualitative study

BMC Medical Education ◽

10.1186/s12909-020-02311-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Samar A. Ahmed ◽

Nagwa N. Hegazy ◽

Hany W. Abdel Malak ◽

W. Cliff Kayser ◽

Noha M. Elrafie ◽

...

Keyword(s):

Distance Learning ◽

Qualitative Study ◽

Assessment Tool ◽

Social Issues ◽

Clinical Skills ◽

Warning Signs ◽

Team Work ◽

Cross Sectional ◽

Face To Face ◽

Face To Face Learning

Abstract Background COVID − 19 pandemic pressured medical schools globally to shift to Distance learning (DL) as an alternative way to ensure that the content delivered is satisfactory for student progression. Aim of the work This work aims at mapping priorities for post-COVID planning for better balance between distance learning and face to face learning. Methods This qualitative study aimed to develop a model for utilizing DL using The Polarity Approach for Continuity and Transformation (PACT)™. A virtual mapping session was held with 79 faculty from 19 countries. They worked in small groups to determine upsides and downsides of face-to-face and DL subsequently. An initial polarity map was generated identifying five tension areas; Faculty, Students, Curriculum, Social aspects and Logistics. A 63-item assessment tool was generated based on this map, piloted and then distributed as a self-administered assessment. The outcomes of this assessment were utilized for another mapping session to discuss warning signs and action steps to maintain upsides and avoid downsides of each pole. Results Participants agreed that face-to-face teaching allows them to inspire students and have meaningful connections with them. They also agreed that DL provides a good environment for most students. However, students with financial challenges and special needs may not have equal opportunities to access technology. As regards social issues, participants agreed that face-to-face learning provides a better chance for professionalism through enhanced team-work. Cognitive, communication and clinical skills are best achieved in face-to-face. Participants agreed that logistics for conducting DL are much more complicated when compared to face-to-face learning. Participants identified around 10 warning signs for each method that need to be continuously monitored in order to minimize the drawbacks of over focusing on one pole at the expense of the other. Action steps were determined to ensure optimized use of in either method. Conclusion In order to plan for the future, we need to understand the dynamics of education within the context of polarities. Educators need to understand that the choice of DL, although was imposed as a no-alternative solution during the COVID era, yet it has always existed as a possible alternative and will continue to exist after this era. The value of polarity mapping and leveraging allows us to maximize the benefit of each method and guide educators’ decisions to minimize the downsides for the good of the learning process.

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Patients’ understanding of cellulitis and their information needs: a mixed-methods study in primary and secondary care

British Journal of General Practice ◽

10.3399/bjgp19x701873 ◽

2019 ◽

Vol 69 (681) ◽

pp. e279-e286 ◽

Cited By ~ 1

Author(s):

Emma Teasdale ◽

Anna Lalonde ◽

Ingrid Muller ◽

Joanne Chalmers ◽

Peter Smart ◽

...

Keyword(s):

Mixed Methods ◽

Secondary Care ◽

Information Needs ◽

Information Provision ◽

Mixed Methods Study ◽

First Episode ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Face To Face ◽

History Of

BackgroundCellulitis is a painful infection of the skin and underlying tissues, commonly affecting the lower leg. Approximately one-third of people experience recurrence. Patients’ ability to recover from cellulitis or prevent recurrence is likely to be influenced by their understanding of the condition.AimTo explore patients’ perceptions of cellulitis, and their information needs.Design and settingMixed-methods study comprising semi-structured, face-to-face interviews and a cross-sectional survey, recruiting through primary and secondary care, and advertising.MethodAdults aged ≥18 years with a history of cellulitis were invited to take part in a survey, qualitative interview, or both.ResultsIn all, 30 interviews were conducted between August 2016 and July 2017. Qualitative data highlighted a low awareness of cellulitis before the first episode, uncertainty about when it had been diagnosed, concern/surprise at the severity of cellulitis, and a perceived insufficient information provision. People were surprised that they had never heard of cellulitis and that they had not received advice or leaflets giving self-care information. Some sought information from the internet and found this confusing.A total of 240 surveys were completed (response rate 17%). These showed that, although many participants had received information on the treatment of cellulitis (60.0%, n = 144), they often reported receiving no information about causes (60.8%, n = 146) or prevention of recurrence (73.3%, n = 176).ConclusionThere is a need to provide information for people with cellulitis, particularly in regard to naming their condition, the management of acute episodes, and how to reduce the risk of recurrences.

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Usability and perceived usefulness of patient-centered medication reconciliation using a personalized health record (Preprint)

10.2196/preprints.28189 ◽

2021 ◽

Author(s):

Denise Jacoline van der Nat ◽

Victor J B Huiskes ◽

Margot Taks ◽

Bart Pouls ◽

Bart J F van den Bemt ◽

...

Keyword(s):

Medication Reconciliation ◽

Rating Scale ◽

Cross Sectional Study ◽

Perceived Usefulness ◽

Health Record ◽

Patient Centered ◽

Related Factors ◽

Cross Sectional ◽

System Usability Scale ◽

Personalized Health

BACKGROUND The acceptance and usage of a personalized health record (PHR) depends on usability and perceived usefulness of the PHR. OBJECTIVE Therefore, the aim of this study was to assess usability and perceived usefulness of an online PHR for medication reconciliation and to describe associations between usability and perceived usefulness and patient-, setting-, and medication-related factors. METHODS A multicenter cross-sectional study was conducted with patients with either an outpatient visit (rheumatology ward) or planned admission in the hospital (cardiology, neurology, internal medicine or pulmonary wards). All patients received an invitation to update their medication list in an online PHR two weeks prior to their appointment/admission. One month after the hospital visit, PHR-users were asked to rate usability (using the System Usability Scale (SUS)) and perceived usefulness on a 5-point Likert scale. The SUS-scores were classified according to the adjective rating scale and furthermore dichotomized in the categories: low (SUS between 0-51) or good (SUS 51-100) usability. Association between patient-, setting-, and medication-related factors and the usability and perceived usefulness were analysed. RESULTS 255 (34%) of the 743 invited PHR-users completed the questionnaire. The majority of inpatients (78%) and outpatients (83%) indicated that usability of the PHR was good. At the outpatient clinic, experience with digital devices (adjusted odds ratio 1.36; 95%CI:1.01–1.83) was significantly associated with a good usability. Regarding perceived usefulness, the majority of the in- and outpatients (76% and 78%, respectively) reported that the PHR yielded at least one benefit (out of seven) with regard to their visit to the physician. CONCLUSIONS Usability and perceived usefulness of a PHR for medication reconciliation were rated by patients as good. Further research should explore the barriers and facilitators of patients with a low rated usability and perceived usefulness.

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