Winner of blank brain competition number 2

I am very late in posting this, so huge apologies to all our entrants, but the good news is we have a winner!

On Monday (11th March 2013) we held a random prize draw which consisted of me writing all the entry numbers down on slips of paper putting them in a box and shaking them up and then running up to Jane’s (my PhD supervisor’s office) to ask if she would do the prize draw. As Jane was just about to start a tutorial with some of her lovely 3rd year MPharm students, we asked one of them to do the prize draw instead.

As you can see from the photo below William, one of our MPharm students is holding the winning entry number which he chose at random.

IMG_0852

Here is William Pike – one of our MPharm students who very kindly did the prize draw and then let me take a photo of the winning entry number

The winning entry is blank brain number 5 which was definitely one of my favourites. Congratulations to entrant number 5, a £50 Amazon voucher is on its way to you in the post now! I hope you find something lovely to spend it on.

Blank brain entry number 5

So that is the last blank brain competition for now / this project / my PhD, as we didn’t have any entries from our MPharm students. The good news is, I will definitely be staying on in academia (I will let you all know more details when that is all official) so I am hoping that I can run similar activities with my future research projects.

Thank you so much again to everyone who entered a blank brain. I am very proud of this aspect of my PhD, it was intended as just a bit of fun, but these images have been so useful in articulating the importance of mental workload to the safety of pharmacists’ work. It looks like human factors research is going to be used more and more to improve the safety of healthcare in the coming years, which is a great thing, and I am so excited that we were some of the first to adopt this approach in pharmacy.

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Pills, Thrills and Pharmacy Spills

I am very late in writing this post and I have to apologise to Mr Dispenser for being so tardy, but I just wanted to let you know about a fantastic book about pharmacy that has just come out. This book was written by Mr Dispenser, who is, if you read his book clearly not your average pharmacist as in his spare time (!!!) he has been collecting funny anecdotes from pharmacists around the UK (and I suspect further afield) as well as documenting his own experiences of pharmacy life. The book is called Pills, Thrills and Methadone Spills and you can download it as an e-book from Amazon or a paper back versioncover_v13

This book had me chuckling constantly (I have to admit mostly at the silly things patients say as I am often one of those patients). Also, for me this has been the most fun way to learn about pharmacy life and the things that might be on pharmacist’s minds – I love academic papers, but how nice to learn in such an engaging way. I have no doubt I will be referencing it in my thesis (especially the chapter titled “The missing prescription” – which is a lovely narrative of the mistakes that are made by several people at the same time and the devil that is confirmation bias).

This isn’t a book aimed at academia (although for all those working in pharmacy practice research and teaching it is a fabulous resource) what Mr Dispenser has achieved through his blog, and now this fantastic book is a dialogue between pharmacists all around the world – and that is amazing. You can follow Mr Dispenser’s blog or on twitter:@mrdispenser for many more funny stories from the pharmacy world. Great job Mr D!

One year and 2 months later….

… and the last participant of study 1 has

taken part!!!!!!!!!!!!

source: a photo taken by my better half at a fireworks display in Bristol a few years back

As I write this post the final participant is just running through the study, and it seemed like a good time to reflect on what has been involved in this study, as quite often I find, you don’t quite realise how much work you’ve done until you add up how many questionnaires you’ve administered, or hours you’ve spent with participants. So here we go – a few stats:

  • It has taken a year and 2 months
  • It has involved 104participants.
    • 52 4th year MPharm students from the University of Bath took part.
    • 52  community pharmacists from the south-west (and also a lot farther afield thanks to some very dedicated pharmacists) took part
  • 416 questionnaires have been completed for this study (I am slightly regretting asking so many questions now that I have seen the finished size of the study database)
  • In testing time alone it has taken 208 hours

I am, as you can tell, relatively calm about this landmark moment in my PhD! 

Actually when you look at the stats above, that doesn’t look like that much for a years work but it feels like a lot more has been involved – and there has really – all the difficult to measure time spent on recruitment, posting out info, e-mailing and telephoning pharmacists and pharmacies.

But I didn’t do this alone – a few people in particular have been a huge support – and have contributed a lot to this research so here are my acknowledgements:

  1. Jane – my very dedicated supervisor – I need several posts just to tell you how flipping wonderful she is. We have the best time ever working together, it is not work, it’s lots of giggles. We can be serious too though.
  2. Chris – who looks after our student dispensary – and for the last 2 years my research projects!
  3. My Office – I work in an office with about 9 other people (it varies from time to time) PhD students and Research Officers. Between them they have fielded phone calls for me and met participants when I have been with other participants in our student dispensary, which helpfully has no mobile phone reception, or easy-to-get to land-line. Without them, many participants may never have found me! Universities are such rabbit warrens – I still get lost and I’ve been here 4 years!

So there you go, study 1 down! Study 2 and the follow-up study will be down before Christmas. Hooray!

And now to leave my desk and head off for a celebratory dinner with Mr F!

Winner of the Community Pharmacist Blank Brain Competition

I am very late in posting this, but a couple of weeks ago – on Friday 28th September to be precise, we held the random prize draw for the winner for the community pharmacist blank brain competition. My fabulous colleague Dr Rachel Charlton (Pharmacoepidemiology Research Officer Extraordinaire) kindly selected one number at random from a hat (well actually a bag – as I didn’t have a hat to hand). Below is a photo of the winning number – entry number 3  (Rachel is a wee bit camera-shy so I promised I would only take a photo of her hand to put on the blog).

 

And here is the winning entry!!

It was a brilliant entry – but I thought they all were – I was so thrilled to even get 1 entry never mind 11! So thank you to all the pharmacists who submitted a blank brain. You have made my PhD that bit more special and exciting and I am so proud of this competition – it just goes to show, research can easily be fun and engaging and relevant to the population it is designed for,  it doesn’t have to be all about statistics and experiments!

Please keep your eyes out for more blank brain competition updates – I hope to have some more exciting news very soon.

25.9.12 – an even more overdue study update

I cannot believe it has been 3 months since I posted an update on our progress – I am a very bad PhD student!

In my defence, I have been super busy meeting lots of amazing community pharmacists who have been coming to the University of Bath to take part in our study. I have also been trying to write some reports and bits of pieces (hopefully some of which I can upload sometime soon – I will as soon as they are published).

Anyway, lets talk figures, after all this year was about reaching recruitment and study targets – so how am I doing?

Community Pharmacist study

We are almost – but not quite at our target sample – we need about 20-30 more recruits. We have 78 people signed up to date – most of them booked in to take part if they haven’t already done so. I had planned to have everyone recruited by now, so I am a little behind my “in a perfect world” schedule – however, luckily for me, I went on a project planning course once and they told me to always budget for 25% extra time for each part of your study in your project timetable as things always take longer than we anticipate. The teacher on this course was correct and I knew she was having worked as an assistant to other research projects before I started my PhD. So I had made sure I had wiggle room in my timetable when I planned it all out. We still haven’t used up all our mail-shot attempts (we try never to do more than 3 otherwise it seems a bit like we are pestering people to take part in our research) and I will also follow-up with some telephone calls to make sure that pharmacists receive the packs as often they don’t or they get lost in the mounds of paperwork that community pharmacies receive.

The great news is that of those 78 pharmacists I have met and tested 51 of them. Forty-0ne of these pharmacists have taken part in the first study and 10 in the second. I need a minimum of 52 pharmacists to take part in study 1 and study 2 – and I almost have enough people signed up in the next couple of weeks for study 1 so I am so very close to completing that data set. I have also met one person and interviewed them as part of the follow-up study. I will be recruiting participants for this follow-up study in the coming weeks (I need another 9 pharmacists for this part) – so if you have taken part in study 1 or 2 – you may receive an e-mail / letter asking if you would like to take part in the follow-up study. I cannot wait for this part – I love interviewing people, not just because I enjoy talking to people, but because I learn so much during these interviews about the topic I am studying. Fingers crossed my participants will enjoy it too!

We are almost there! If you are reading this and you are a community pharmacist and you haven’t yet taken part in our study – please read our study page to find out more about taking part. We can offer funds for locum cover for your pharmacy for a day – so that you can come and take part without your pharmacy having to bear the cost of being one pharmacist down! If you are interested in taking part you can get in touch with me here and I will reply ASAP.

Pharmacy Student Study

The students return next week (w/c 1st October 2012) and so phase 2 of our pharmacy student research will begin. We need 52 pharmacy students to take part, and so there is lots of work to be done between now and Christmas. I am hoping that I can recruit and test all the pharmacy students we need for our second and final study so that the data is all ready to analyse in January. Fingers crossed we have lots of willing recruits! You can find out more about this study here.

So there you have it, as you can see I have been busy, but there is a LOT of work still to do! I’ll be back with another update soon (I promise I will not wait 3 months this time).

Error Diary

On Friday I found a great website called error diary which I wanted to share on here because I really love the idea behind it. The aim of this website is to get people talking about the everyday errors that we all make so that we can start to think about errors in a new way,  instead of just beating ourselves up about them and not learning from them.  I also thought it might be of interest to those lucky people who are taking part in our research, other pharmacists and anyone interested in this area of research.

You can read all about the origins of error diary on the website, but from what I can gather it was created by some researchers at University College London – in particular, Dr Dominic Furniss. The website is supported by a grant from the EPSRC (the Engineering and Physical Sciences Research Council) – this same grant also supports a huge study called CHI+MED which is looking at human error in the context of healthcare professionals’ interactions with medical devices (e.g. medicine pumps).

I should point out here that the pharmacy world is clearly aware of the work that the CHI+MED research team are carrying out because Prof Harold Thimbleby one of the members of the CHI+MED management team was presenting at the Royal Pharmaceutical Society Medicines Safety Symposium today in London. I am hoping this means that he will have inspired lots more research into human error and pharmacy systems.

Errordiary.org also has a page dedicated to resilience strategies. Those things we do to help us avoid making the same error time and time again. I have developed quite a few resilience strategies whilst running our experiments, to stop me forgetting to do or say  something. I have a script that I read from when I am briefing our participants (in fairness this is just best practice for anyone running experimental studies with human participants). I also have a post-it note with all the things I need to remember to do when running the study that sits on my computer desktop (on one of those electronic post-its that you can get on windows 7). It is very useful especially because I often run two participants at the same time which can open up lots of opportunities for errors to occur. One thing the errordiary website has inspired me to do is start noting down (with their permission) all the resilience strategies that my participants tell me about in their debrief. All those things they do on a day-to-day basis in their dispensary to avoid making an error – I am also going to write my own down as and when I notice them occurring.

Now that I have found these great sites and the CHI+MED project, I am sure I will be writing more about their work in future posts.

Image source: errordiary.org

17.06.2012 – A long overdue study update!

I cannot believe it, the end of this week marked the end of my second year of my PhD. I am now officially a third (and hopefully final) year PhD student. The great news is, we are running to plan. As you should be able to see from the Gantt chart above I have until December this year to finish my data collection. Thankfully, everything seems to be running pretty smoothly, as you can see in my updates below.

Pharmacy Student Study Update

Well the great news is that we have completed the first of the two planned studies with our pharmacy students at the University of Bath. I finally hit my target recruitment for study 1. It has taken me a good 9 months to get all the participants we needed, thankfully I completed the qualitative aspect months ago and all the data is ready and waiting to be analysed. So this week I am going to be looking at that as I have a week off from the Community Pharmacist study (more about that in the update below). In October when the students return, we will start the second study and hope that our recruitment is quicker this time round – with all that we have learnt from this first study about how to engage students in our research.

The students who have taken part in our first study have been fantastic and they have given me lots of ideas, and plans for future research. So a huge thank you to all of them for all their help. Finishing this first study was a real boost for my motivation – the end is now in sight and it is just the icing on the top of the cake that I met so many students on my way to this first target.

Community Pharmacist Study Update

Things are starting to move pretty quickly now which is exciting. We have around 20 pharmacists from a range of community pharmacy settings (supermarket, national chain, independent, as well as some lovely locum pharmacists) signed up and booked in to take part so we are already roughly 1/5 of our way to our minimum recruitment figures (min 104 participants – max 130 participants). The rest are slowly but surely coming in and we are starting to experience a snow-ball effect where the participants we have already met are recommending our project to their colleagues. I will take this opportunity to say thank you so much to those pharmacists who are recommending our study – we really appreciate your support. Unlike the pharmacy student participants, our community pharmacist participants need a little more notice to either organise locum cover, or find a day when they can come in, and so I have just begun to meet my first few participants in the last few weeks. So far so good, the testing is going well and our first few participants have reported that they enjoyed the study and see the applications of the theory underlying these studies and our plans for the future as important for their profession which is more than encouraging.

It has now been about six weeks since I sent out the first round of invitations to pharmacists to invite them to take part (before that we spent a few weeks contacting pharmacy organisations asking for their permission to carry out the research with their pharmacists). The standard protocol is to do three mail shots, so after this we have one more mail-shot to do (in about another 6 weeks time). I will also be following this mail-shot up with phone-calls to pharmacies over the coming weeks, to aid recruitment. Anyway, Jane and I spent almost 2 whole days preparing information packs for our second round of invitations to pharmacists to take part in the study. I am so grateful to Jane, like all lecturers she is stupidly busy, but she still finds time to help me out stuffing envelopes.

Key dates:

One of the big upcoming events in this project’s diary is our Project Management Group meeting which is next Monday 25th June, which I am both nervous and excited for. It’s like having a mini viva (viva: the oral exam which all PhD students have to pass to receive their PhD) every time we meet with our PMG. All the members are incredibly knowledgeable and very important in the Pharmacy world and so it is important to me that I can show them what a great job that Jane, Marjorie and I have been doing since we last met. In July we will submit our interim report to our funders so the meeting is in preparation for this.

One other little project…

As if I didn’t have enough to do this week, this is the week that our bathroom is being renovated. This is the first major thing we have done to our home and I am very nervous that there is something we haven’t considered or planned for. Purposefully, I have not planned to meet any participants this week, as I know that tomorrow when our bathroom is ripped out I am going to be a bag of nerves and won’t settle until it is all re-fitted and finished! A nervous researcher is not ideal especially when running experiments because the experimenter can consciously or unconsciously have a large effect on participants behaviour. I always aim to be calm, collected and approachable. If any of my family or friends are reading this last line I know they are now laughing because I am not well-known for being calm and collected, I am generally quite an excited, over-enthusiastic person!

I promise to be back with another update soon!

Pharmacy student & Community Pharmacist studies progress update

SUCCESS image credits to the_chosen_pessimist
(http://the-chosen-pessimist.deviantart.com/art/SUCCESS-100186742)

Well it has been a while since I wrote an update on our progress. So I suspect I have a lot to write about in this update post. February and March were very exciting months for us and I am pleased to say that the projects are progressing pretty much as well as we could possibly hope for. I love the photo above, I saw a presentation once where someone used this, and it is just such a great photo – perfectly demonstrates that feeling of yes – I’ve done it. Well we haven’t quite done it yet, but we are feeling pretty good about where we have got to so far so I thought this was a fitting image for this post!

Pharmacy Student Study Update

I have now reached the end of recruitment with our current 4th year Pharmacy students. Our total number of participants hit 43 – so we have no quite reached our target for the first (of 2) experiments with the pharmacy students. However, all 43 participants provided complete sets of data (for which I am very thankful) so they can all be part of the analysis. I am going to set about analysing this data now and see if we have found anything, but as we are 9 short of our minimum sample size of 52 for experiment 1 (we based this on Cohen’s power primer paper) I expect we will need to recruit and test some more participants. If the analyses don’t show anything significant yet (my sneak peaks definitely suggest there may be some trends) I will recruit the remaining 9 (or a few more if we can) from the 3rd year students once they have sat their dispensing exams next month.

I had completed the qualitative arm of experiment 1 at the end of 2011 so I am slowly transcribing this data and need to start analysing that too.

Community Pharmacist Study Update

To date we have 5 of the large multiple pharmacies signed up (this includes community pharmacies based in supermarkets). They all wrote back within a few days of receiving our letter and one company even rang to say how interested they were! We also have been contacted by a few community pharmacists (even before we sent out recruitment letters) who have seen our media coverage and said they would like to take part! We are thrilled by this response. We have yet to contact individual pharmacists, but we have our first project management group meeting on Thursday and we wanted to hold off before we spoke to our key advisors to make sure whether they had any hints and tips on how best to approach individual pharmacists (that we haven’t already thought of).

This brings me onto our second item – our project management group (PMG). I can’t quite believe we have managed to do this, but, we have a rather prestigious set of individuals (who I won’t name just yet as I haven’t asked them if I can) all involved in UK pharmacy practice either at a strategic, academic or practice level who have agreed to be members of our PMG. The first meeting is this Thursday (5th April 2012) which I am preparing for at the moment. This meeting will just be an introduction to the project, but we will meet 3 more times before the end of the project to discuss our findings and prepare our reports to PTECO and plan journal and conference papers.  The members of our PMG have been specifically selected to give a local and national strategic view on the impact our data may have on practice. They may also have alternative interpretations of our results to offer, given their insights into community pharmacy practice across organisations, experiences of running a community pharmacy and/or as a community pharmacist. This will ensure our research stays firmly grounded in UK pharmacy practice. Personally, I cannot wait for this first meeting, it is a huge opportunity for me to meet these individuals, nevermind have them involved in my doctoral research.

I think this study will move a lot quicker than the pharmacy student study so I hope to be providing very regular updates on our progress with it.

All in all, things are looking very good! What a lucky PhD student I am!

James Reason on BBC Radio 4 Part 2

Back in February I got very excited and wrote a post about a 2-programme BBC Radio 4 series presented by Prof James Reason. I have finally had chance to catch up with the second part of this programme – even though it aired on 5th March! Yes I have been that busy. I like being busy though so I am most definitely not complaining.  Before you read this, you may want to read my earlier post which introduces the programme.

The second installment, I am sad to report did not include pharmacists amongst the healthcare professionals invited to talk on the programme. I had hoped it might, but it is only a 30 minute programme and they really were going for the heads of the big NHS /NHS related services so, it is not surprising. Despite the lack of pharmacy input into the programme, it was still very interesting and there were lots of points that could easily apply to pharmacy practice.

Firstly Sir Liam Donaldson, Chairman of the National Patient Safety Agency commented on his own visit to the University of Michigan Health Centre who have been looking at the effects of an open policy to medical errors over the last decade (which was the focus of the previous episode of this programme). He said one thing he noticed that was very different was the training that was given to staff on how to talk to patients about the errors that had been made with their care. He also noted that the support that was provided to the patient and the family was much more than just an apology that they stayed without them throughout the whole process. In terms of our work into mental workload, the emphasis would definitely have to consider both how to train pharmacists to avoid errors, but also how to deal with them if they did happen (especially if they happened because of mental overload).

Next, a representative from the National Reporting and Learning Service talked about how the approach to errors has changed in UK healthcare over the last few years. How she felt that the daily reports (e.g. before staff started their shift on a ward) had changed to include a focus on situations or patient issues that had the potential to lead to errors being made. Again this could easily be applied to pharmacy practice (this may be especially useful for locum pharmacists).

By contrast Peter Walsh CEO of Action Against Medical accidents painted a much bleaker picture of our healthcare system today. He spoke about a case his organisation has been dealing with where the errors that had been made in a young man’s care was covered up. This young man died because of these errors, and at the time the family were made aware that some errors had been made but they were not given the full story and shockingly neither was the coroner. Peter Walsh said that cover-ups were still tolerated in our health system and that this needed to change. I agree with this, but for this to happen I think we need to implement Sir Donaldson’s observation that healthcare professionals need to be trained and supported in how to be open with patients when errors occur.

For me, it is so exciting that these programmes have been aired in the last couple of months. Pharmacy is making a huge step at the moment to changing the safety culture and for that to happen the NHS needs to be making that step too, because ultimately the pharmacy profession works within the culture of the other healthcare services and systems in the UK. The fact that this is being talked about now, gives me hope that healthcare as a whole is moving towards this change in culture…but we shall see what happens.

Student Study & Community Pharmacist Study Updates 14.03.2012

Image by Roger Hargreaves

Sorry for the lack of study updates recently, it has been a busy few weeks. It started with a weeks worth of media coverage of our community pharmacist study that we have just launched in various pharmacy publications – who would have known a project not even completed could create so much interest? For this Jane, Marjorie and I are so very grateful and very excited – we hope there is just as much interest next year when we have data to publish.

In between that I have been testing participants for the student study. We are now up to 40 students through the first experiment so we have almost hit our total for the first study (52). I am hoping we get our last few recruits soon because I cannot wait to look at our data. The database is looking so lovely and full – it’s odd, but to me it really is a thing of beauty. This is probably because I know how many hours of hard work has gone into filling the database and it’s amazing to see the slow but sure outcome of all our efforts.

With regards to the community pharmacist study, the big news is that we got ethics a couple of weeks ago and I have now sent out information about the study (as of today) to pharmacy chain CEOs and superintendent pharmacists, to ask their permission for me to do research with their organisation before I contact their local and regional pharmacy managers about it. The independent pharmacy and small pharmacy chain letters are in process too and I hope I will get them out tomorrow. So we are definitely on a roll.

In between that I have been doing a lot of demonstrating work – which is basically a teaching assistant role for university workshops. I love these sessions – even when I do the same session several times over with different groups of students. However, it does take me out of the lab for hours at a time, and/or away from my desk and so I have noticed that my research time has more than halved in the last few weeks. There are only a few more weeks left of teaching for me now until next October, so I am making the most of it because I really do enjoy working with the students.

In the odd moments of calm I have also been busy working with Jane and Marjorie and some of our other colleagues on papers and grant proposals.

How I have found time to do all this I just don’t know, in fact now I read this it is no wonder I have felt like a headless chicken the last few weeks. Ironically, my mental workload has been very high at times (mostly due to time pressure) and I have noticed myself missing things, doing things wrong or forgetting to do things. So it’s not only pharmacists that may be affected by mental workload, it may be researchers too!

So as you can see it has been an amazing few weeks, busy, but in the best of ways. I have yet to have time to listen to the second installment of the Prof James Reason medical errors BBC radio 4 programme that I wrote about here. I hope I get to listen to it by the end of the week and I will write about it then!

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