Browsing by Author "Kelly, Martina A"
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- ItemOpen AccessA scoping review of the potential for chart stimulated recall as a clinical research method(2017-08-22) Sinnott, Carol; Kelly, Martina A; Bradley, Colin PAbstract Background Chart-stimulated recall (CSR) is a case-based interviewing technique, which is used in the assessment of clinical decision-making in medical education and professional certification. Increasingly, clinical decision-making is a concern for clinical research in primary care. In this study, we review the prior application and utility of CSR as a technique for research interviews in primary care. Methods Following Arksey & O’Malley’s method for scoping reviews, we searched seven databases, grey literature, reference lists, and contacted experts in the field. We excluded studies on medical education or competence assessment. Retrieved citations were screened by one reviewer and full texts were ordered for all potentially relevant abstracts. Two researchers independently reviewed full texts and performed data extraction and quality appraisal if inclusion criteria were met. Data were collated and summarised using a published framework on the reporting of qualitative interview techniques, which was chosen a priori. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines informed the review report. Results From an initial list of 789 citations, eight studies using CSR in research interviews were included in the review: six from North America, one from the Netherlands, and one from Ireland. The most common purpose of included studies was to examine the influence of guidelines on physicians’ decisions. The number of interviewees ranged from seven to twenty nine, while the number of charts discussed per interview ranged from one to twelve. CSR gave insights into physicians’ reasoning for actions taken or not taken; the unrecorded social and clinical influences on decisions; and discrepancies between physicians’ real and perceived practice. Ethical concerns and the training and influence of the researcher were poorly discussed in most of the studies. Potential pitfalls included the risk of recall, selection and observation biases. Conclusions Despite the proven validity, reliability and acceptability of CSR in assessment interviews in medical education, its use in clinical research is limited. Application of CSR in qualitative research brings interview data closer to the reality of practice. Although further development of the approach is required, we recommend a role for CSR in research interviews on decision-making in clinical practice.
- ItemOpen AccessChildren’s and adolescents’ experiences of healthcare professionals: scoping review protocol(2020-03-07) Davison, Gail; Kelly, Martina A; Thompson, Andrew; Dornan, TimAbstract Background Children and adolescents form a distinct patient group, whose experiences are relatively under-represented in research. Surveys have shown that healthcare professionals (HCPs) do not always communicate with them well, leaving children and adolescents under-involved and unsure who to ask when concerned. Recent qualitative studies have recognised that HCPs have a major influence on children’s and adolescents’ experiences, where poorer interactions can lead to fear, missed appointments and potentially a worse clinical outcome. Little is known about how children and adolescents experience the HCPs who play such an integral role in their healthcare. This review aims to explore children’s and adolescents’ lived experience of HCPs, so that a deeper understanding of the interactions between them can equip HCPs to provide care that better aligns with patients’ needs. Method This study will use scoping review methodology to map the existing published literature comprehensively and systematically, following a six-step framework. It will extract children’s and adolescents’ experiences, in the form of direct quotations, and thematically analyse them. The consultation exercise with children and adolescents will gather additional insights. Findings will consist of descriptions of each theme along with exemplar quotations and consultation comments. Discussion This scoping review is unique, as it will present children’s and adolescents’ lived experiences of HCPs, from synthesis of their direct quotations. Findings will assist HCPs to tailor their interpersonal skills to meet patients’ needs so that better healthcare can be provided. This study will have implications for clinical educators, policy makers and guideline developers and provide suggestions for further research. Systematic review registration Not registered
- ItemOpen AccessDevelopment of the Inner City attitudinal assessment tool (ICAAT) for learners across Health care professions(2020-03-06) McKinney, Mark; Smith, Katherine E; Dong, Kathryn A; Babenko, Oksana; Ross, Shelley; Kelly, Martina A; Salvalaggio, GinettaAbstract Background Many health professions learners report feeling uncomfortable and underprepared for professional interactions with inner city populations. These learners may hold preconceptions which affect therapeutic relationships and provision of care. Few tools exist to measure learner attitudes towards these populations. This article describes the development and validity evidence behind a new tool measuring health professions learner attitudes toward inner city populations. Methods Tool development consisted of four phases: 1) Item identification and generation informed by a scoping review of the literature; 2) Item refinement involving a two stage modified Delphi process with a national multidisciplinary team (n = 8), followed by evaluation of readability and response process validity with a focus group of medical and nursing students (n = 13); 3) Pilot testing with a cohort of medical and nursing students; and 4) Analysis of psychometric properties through factor analysis and reliability. Results A 36-item online version of the Inner City Attitudinal Assessment Tool (ICAAT) was completed by 214 of 1452 undergraduate students (67.7% from medicine; 32.3% from nursing; response rate 15%). The resulting tool consists of 24 items within a three-factor model – affective, behavioural, and cognitive. Reliability (internal consistency) values using Cronbach alpha were 0.87, 0.82, and 0.82 respectively. The reliability of the whole 24-item ICAAT was 0.90. Conclusions The Inner City Attitudinal Assessment Tool (ICAAT) is a novel tool with evidence to support its use in assessing health care learners’ attitudes towards caring for inner city populations. This tool has potential to help guide curricula in inner city health.