The impact of the changes to United Kingdom psychiatry training recruitment in 2021

Purpose The purpose of this paper is to review and critically evaluate UK psychiatry national recruitment process for 2021, which was re-structured following the COVID-19 pandemic. Additionally, this paper aims to review the empirical evidence of the selection methodologies in psychiatry recruitment. Design/methodology/approach The UK national psychiatry recruitment process is discussed, with a focus on the changes made to recruitment in 2021. The advantages and disadvantages of different selection methodologies are explored, with an emphasis on evaluating the validity, acceptability and reliability of different recruitment selection methodologies. The potential impact of the changes to psychiatry recruitment are explored. Findings The decision of the National Recruitment Office to remove certain selection methods for recruitment in 2021 may have limited their ability to choose the best candidate for the training place and be fair to the applicant. Overall, there is a lack of research into the validity of the selection methods used in psychiatry recruitment. A framework for outcome criteria relevant to psychiatry recruitment should be developed, which would allow research into selection methods and guide the NRO to examine the evidence base effectively. Originality/value This paper examined the recruitment methods used to choose doctors for psychiatry training in the UK, demonstrating that the empirical evidence base for psychiatry recruitment is limited. This paper can contribute to our understanding of selection methodologies used in psychiatry recruitment and highlights the value of different recruitment approaches for choosing the best psychiatrists of the future.

Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a qualitative study with veteran stakeholders from a pilot trial of multimodal chiropractic care

Background Low back pain (LBP) is common among military veterans seeking treatment in Department of Veterans Affairs (VA) healthcare facilities. As chiropractic services within VA expand, well-designed pragmatic trials and implementation studies are needed to assess clinical effectiveness and program uptake. This study evaluated veteran stakeholder perceptions of the feasibility and acceptability of care delivery and research processes in a pilot trial of multimodal chiropractic care for chronic LBP. Methods The qualitative study was completed within a mixed-method, single-arm, pragmatic, pilot clinical trial of chiropractic care for LBP conducted in VA chiropractic clinics. Study coordinators completed semi-structured, in person or telephone interviews with veterans near the end of the 10-week trial. Interviews were audiorecorded and transcribed verbatim. Qualitative content analysis using a directed approach explored salient themes related to trial implementation and delivery of chiropractic services. Results Of 40 participants, 24 completed interviews (60% response; 67% male gender; mean age 51.7 years). Overall, participants considered the trial protocol and procedures feasible and reported that the chiropractic care and recruitment methods were acceptable. Findings were organized into 4 domains, 10 themes, and 21 subthemes. Chiropractic service delivery domain encompassed 3 themes/8 subthemes: scheduling process (limited clinic hours, scheduling future appointments, attendance barriers); treatment frequency (treatment sufficient for LBP complaint, more/less frequent treatments); and chiropractic clinic considerations (hire more chiropractors, including female chiropractors; chiropractic clinic environment; patient-centered treatment visits). Outcome measures domain comprised 3 themes/4 subthemes: questionnaire burden (low burden vs. time-consuming or repetitive); relevance (items relevant for LBP study); and timing and individualization of measures (questionnaire timing relative to symptoms, personalized approach to outcomes measures). The online data collection domain included 2 themes/4 subthemes: user concerns (little difficulty vs. form challenges, required computer skills); and technology issues (computer/internet access, junk mail). Clinical trial planning domain included 2 themes/5 subthemes: participant recruitment (altruistic service by veterans, awareness of chiropractic availability, financial compensation); and communication methods (preferences, potential barriers). Conclusions This qualitative study highlighted veteran stakeholders’ perceptions of VA-based chiropractic services and offered important suggestions for conducting a full-scale, veteran-focused, randomized trial of multimodal chiropractic care for chronic LBP in this clinical setting. Trial registration ClinicalTrials.govNCT03254719

The Feasibility and Challenges of Conducting Online Research to Examine Movement Behavior in Parents and Children During the COVID-19 Pandemic

The global pandemic of COVID-19 shifted the methodology of this research project. The purpose of this perspective article is to discuss the feasibility and challenges of converting an in-person mixed methods study that examined associations among and beliefs about physical activity, motor competence, and perceived competence to an online format with parents and children during the COVID-19 pandemic. Recruitment was conducted through a University research registry, social media, and public listservs. All correspondence with participants was through email and secure platforms. Physical activity was assessed with accelerometers mailed to participants. Motor competence was assessed through participant-filmed trials of motor skills. Perceived competence was assessed with the Self-Perception Profile for Adults and Children delivered on Qualtrics. Semi- structured interviews to examine beliefs were conducted over Zoom. Approximately 200 families expressed interest in the study, 76 parent-child dyads consented and assented, and 61 parent-child dyads completed at least one component of the study. It is feasible to conduct online research that contributes to scientific knowledge and has potential advantages. However, various challenges need to be considered regarding the application of online research. These challenges included recruitment, the data collection process, and data quality. Future research needs to address these challenges by utilizing wide-reaching and diverse recruitment methods, easing participants' burden with technology, and developing motor competence and perceived competence assessments that can be administered online. The way research was conducted changed due to COVID-19 and adapting to and/or integrating online methods is both necessary and feasible, but modifications must be taken into consideration.

Motivations and Barriers for Adult Learner Achievement: Recommendations for Institutions of Higher Education

Recent trends in higher education indicate a steady increase in the number of adult and non-traditional learners returning to complete college degrees. Though higher education can provide numerous economic and career enhancement opportunities, adult learners experience several challenges when they return to college. The purpose of this qualitative research study was to gather and analyze data from employees from companies in the Midwest to determine the challenges and motivations of adult learners who plan to return to higher education. The results highlight that it is important for institutions of higher education to collaborate with employers to identify ways to modify their student recruitment methods to attract more adult student learners and identify supportive resources to help them complete their degrees successfully.

ELaPro, a LOINC-Mapped Core Dataset for Top Laboratory Procedures of Eligibility Screening for Clinical Trials

Background Screening for eligible patients continues to pose a great challenge for many clinical trials. This has led to a rapidly growing interest in standardizing computable representations of eligibility criteria (EC) in order to develop tools that leverage data from electronic health record (EHR) systems. Although laboratory procedures (LP) represent a common entity of EC that is readily available and retrievable from EHR systems, there is a lack of interoperable data models for this entity of EC. A public, specialized data model that utilizes international, widely-adopted terminology for LP, e.g. LOINC, is much needed to support automated screening tools. Objective The aim of this study is to establish a core dataset for LP most frequently requested to recruit patients for clinical trials using LOINC terminology. Employing such a core dataset could enhance the interface between study feasibility platforms and EHR systems and significantly improve automatic patient recruitment. Methods We used a semi-automated approach to analyze 10516 UMLS-annotated screening forms from the Medical Data Models (MDM) portal’s data repository. An automated semantic analysis based on concept frequency is followed by a manual expert review performed by physicians to analyze complex recruitment-relevant concepts not amenable to automatic approach. Results Based on analysis of 138225 EC from 10516 screening forms, 55 laboratory procedures represented 77.87% of all UMLS laboratory concept occurrences identified in the selected EC forms. We identified 26413 unique UMLS concepts from 118 UMLS semantic types and covered the vast majority of MeSH disease domains. Conclusions Only a small set of LP cover the majority of laboratory concepts in screening EC. The results prove the feasibility of establishing a core dataset for a group of LP common to most EC forms. We present ELaPro (Eligibility Laboratory Procedures), a novel, LOINC-mapped, core dataset for the most frequent 55 LP requested in screening for clinical trials in multiple machine-readable data formats.

DoorWOmen & Gendering the Door: An Explorative Study of Women's Experiences of the Bouncer Occupation within New Zealand's Night-Time Economy.

<p>Patriarchal norms and misogynistic attitudes often result in women’s exclusion from positions of power in institutional structures through the use of sexual harassment, discriminatory recruitment methods and exclusion from social circles. Traditionally, previous research on bouncers has focused on the occupation’s close affinities with violence and the domination of men, ignoring the benefits and experiences of women in door-work. This research addresses an important literature gap within the context of New Zealand, by exploring how women working as bouncers in New Zealand’s Night Time Economy (NTE) experience and navigate their occupations, based on stereotypical assumptions that women are unsuitable to bouncing. Applying a feminist lens, this qualitative study employed semi-structured interviews with twelve women who had experience working as bouncers in New Zealand’s NTE. This study found that gendered violence, discrimination and misogyny were a routine and ‘expected’ part of being a female bouncer, and uncovered how the women in this study constructed malleable performances of gender to do their work. These experiences profoundly impacted their feelings of safety in the workplace, which may point to reasons why women still remain the minority within the bouncer occupation. Based on these findings, this research concludes that women in door-work are faced with a paradox where femininity is simultaneously resisted in a masculine occupation, but where they are expected to adhere to men’s expectations of appropriate gender norms within the workplace. This study therefore exposes the difficult and highly gendered terrain women in door-work are expected to navigate, and emphasises the need to address misogynistic attitudes and gendered violence within the workplace, the wider NTE and beyond.</p>

DoorWOmen & Gendering the Door: An Explorative Study of Women's Experiences of the Bouncer Occupation within New Zealand's Night-Time Economy.

<p>Patriarchal norms and misogynistic attitudes often result in women’s exclusion from positions of power in institutional structures through the use of sexual harassment, discriminatory recruitment methods and exclusion from social circles. Traditionally, previous research on bouncers has focused on the occupation’s close affinities with violence and the domination of men, ignoring the benefits and experiences of women in door-work. This research addresses an important literature gap within the context of New Zealand, by exploring how women working as bouncers in New Zealand’s Night Time Economy (NTE) experience and navigate their occupations, based on stereotypical assumptions that women are unsuitable to bouncing. Applying a feminist lens, this qualitative study employed semi-structured interviews with twelve women who had experience working as bouncers in New Zealand’s NTE. This study found that gendered violence, discrimination and misogyny were a routine and ‘expected’ part of being a female bouncer, and uncovered how the women in this study constructed malleable performances of gender to do their work. These experiences profoundly impacted their feelings of safety in the workplace, which may point to reasons why women still remain the minority within the bouncer occupation. Based on these findings, this research concludes that women in door-work are faced with a paradox where femininity is simultaneously resisted in a masculine occupation, but where they are expected to adhere to men’s expectations of appropriate gender norms within the workplace. This study therefore exposes the difficult and highly gendered terrain women in door-work are expected to navigate, and emphasises the need to address misogynistic attitudes and gendered violence within the workplace, the wider NTE and beyond.</p>

Comparison of Recruitment Strategies for Engaging Older Minority Adults: Results From Take Heart

Few studies report best practices for recruiting older adults from minority, low SES communities for behavioral interventions. In this presentation, we describe recruitment processes and numbers for Take Heart, a randomized controlled trial testing the effectiveness of an adapted heart disease self-management program for primarily African American, low SES adults 50 years or older in Detroit. Community-based (CB), electronic medical record (EMR), and in-person hospital clinic (HC) recruitment methods were implemented. Within 22 months, 453 participants were enrolled, with an overall recruitment yield of 37%. The CB method had the highest yield (49%), followed by HC (36%) and EMR (16%). The average cost of recruiting and enrolling one participant was $142. Face-to-face interactions and employing a community health worker were particularly useful in engaging this population. Further research is needed to confirm these findings in other minority and low SES populations and share lessons learned about recruitment challenges and successes.

Trials and Tribulations: Palliative Care Trial Recruitment Approaches and Challenges

In 2017, we received funding form the Patient-Centered Outcomes Research Institute to conduct a large, state-wide, randomized controlled trial to test the effectiveness of a home-based palliative care (HBPC) program within accountable care organizations. Participants were randomized to either HBPC or enhanced usual care, where physicians were provided added training and support in core palliative care practices. Originally, we planned to obtain patient referrals to the trial from primary care physicians, however we were unable to engage primary care physicians in patient identification processes. In this session we will describe the numerous trial modifications made to our trial recruitment methods and the success of each approach. Ultimately, after 20 months of trial recruitment, we had recruited just 28 patients and 10 of their caregivers. Findings from this terminated trial may inform other researchers in development of participant recruitment methods.

The Utility of Social Media Recruitment to Achieve a More Diverse Participant Sample

The COVID-19 pandemic created an immediate, lasting impact on recruitment methods in academic research, most notably in the field of gerontology. To protect older adult participants’ health during the COVID-19 crisis, the Daily Balance Project, a 30-day micro-longitudinal study of older adults' awareness of balance in daily life, shifted to complete remote administration. Our new remote protocol included developing new methodologies to recruit participants with varying degrees of fall risk and educational attainment. In this study, we present our approach to remote online recruitment and compare educational attainment, objective and subjective fall risk, and alignment of objective/subjective fall risk across three samples recruited via a) Fall Clinic registry (16 participants); b) University e-newsletter to faculty and staff (5 participants); c) social media recruitment (7 participants). Eligibility included being 65+ and wireless internet at home. For samples a and b, screening assessments were conducted via phone while baseline assessments were conducted in-person. For sample c, screener and baseline assessment were virtual. Analysis of recruitment methods aims to determine whether recruitment via social media platforms may provide a sample of participants with more variation in fall risk or alignment of subjective versus objective balance. Results demonstrate no significant differences in educational attainment (p=0.7949) or balance confidence (p=0.213), despite significant differences in the alignment of objective and subjective fall risk (p=0.031). Participants from samples a and b proved more able to accurately assess fall risk, while sample c had the most misalignment between subjective and objective fall risk assessments.