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!

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!

Mention in the Pharmacy Business Magazine

Today our project (with a smiley picture of me) was mentioned in the Pharmacy Business Magazine. I am so excited that already there is a bit of a buzz around this project. Not only have we been mentioned in the pharmacy business magazine, but we’ve had lots of visitors to our website and even researchers from other disciplines at our University talking about the research and asking me questions. Hopefully when we have the results at the end of the year – it will be just as exciting. Meanwhile all this attention has spurred me into getting lots of content uploaded to this site – which is great as sometimes I do need a bit of time pressure to get me kick started into action. Especially when it is term time and there is lots of teaching assistant work to be done.

Keep coming back for more updates – I am sure there are going to be lots as I start contacting community pharmacies to see if their pharmacists would like to take part in our study!

P.s. I am writing this whilst a student participant is taking part in the study in one of our sound proofed booths – the study has been running so smoothly after we ironed out most of the glitches in the pilots study that I can multi-task and get things like this done in between each stage of the study. Needless to say I am starting to feel quite relaxed on the days I am testing participants (which is a relief, because during the pilot study I was a bag of nerves).

The blank brain competition….

27.02.2012

On Friday we received the ethics to run a competition whilst recruiting and testing participants. The competition is just for fun and to make this project a bit more interactive and help us to advertise the project. Hopefully it will take off!
Anyway, now that the ethics has  been received I can finally start advertising the competition – which will be called our blank brain competition. More details can be found out about it here (including what made us come up with this slightly bonkers idea). To get this competition kick started, as promised here is my very own completed blank brain as an example of the kinds of entries we are expecting. This is just everything that I am doing/thinking about today. Some of it uni related, some of it not. I have no idea whether this is a normal amount of thinking and doing! We shall see when we get some more entries. I am hoping I can persuade Jane and Marjorie to do their versions of their brains too!

Whilst my brain looks busy and it is, often things aren’t too bad as our office is very orderly and not too noisy. For me, a busy day is when I don’t have time to think about food because I am too busy to notice that it is almost lunchtime!!

Also as promised below are some fMRI images of my brain. By contrast to my completed blank brain, it doesn’t look like much is happening in my brain whilst it was being scanned!

fMRI images of my brain

For those of you who aren’t familiar with fMRI, here is a quick description of what you can see. fMRI stands for Functional Magnetic Resonance Imaging. Often people will have MRIs – Magnetic Resonance Imaging of their brains, following a stroke because it is measuring certain properties of the blood flow in your brain (the idea being that the blood flow changes when regions of the brain are activated / in use). One has a functional MRI when they are put in an MRI scanner for a more prolonged period of time, and the activity in their brain is measured as they are doing different tasks. Where you can see different red and yellow splotches this represents activation in these areas of the brain – the gradient of colour (red through to yellow) tells you how much activation is occurring in that area. I would like to say this is what my brain looks like when I am doing a specific task, but really from my experience of this particular study I think this just relates to confusion, as I had to remember lots of very complex (and random) patterns and consciously I felt like I couldn’t distinguish between those I had seen before and those I hadn’t. So really what you are seeing is confusion – and probably a little bit of anxiety and irritation because the task was so hard!

PTECO funding

Last year around July time Jane, Marjorie and I submitted an application for funding to the Pharmaceutical Trust for Educational and Charitable Objects . We did this because we wanted to be able to recruit community pharmacists to take part in our study because of the impact that expertise, knowledge of and practice of a task has a huge impact on the amount of mental workload experienced when that task is being carried out. Our study takes about 1 hour 30 minutes for participants to complete and so we knew that without this funding we would be asking an awful lot of pharmacies and community pharmacists.

We are very pleased to announce that we were successful in our application for funding from PTECO. This means that we will be able to reimburse pharmacies for the cost of providing locum cover whilst their community pharmacists take part in our study. It is still up to the individual pharmacist whether they would or wouldn’t like to take part, but thanks to PTECO, the pharmacists who would like to take part, can take part during their normal working day and not use one of their precious annual leave days to take part.  

As a young researcher I am very grateful for this opportunity that PTECO have given us and we are hopeful that by working with PTECO that the results will make an impact on pharmacy practice through the promotion of the results through PTECO’s networks.

So as you can see very exciting times are ahead for this project!

You can also read more about this funding on the University of Bath news page and in the January edition of Professional Matters from the Pharmaceutical Journal.

Recruitment Update for Pharmacy Student study 23.02.2012

Good news! Things are looking up. Since my slightly downbeat, and overall nervous post a few days ago, about my concerns over the slow recruitment, I have had some more people sign up over the last few days and I am now much more hopeful that we will reach our first recruitment target in the next few weeks.

By tomorrow I will have tested 33 participants and I have another 5 lined up. So only 14 more pharmacy students needed now! Phew!

One thing I also didn’t mention in my last post, is that there are about 90 students in the 4th year of the Master of Pharmacy programme. My aim is to recruit 52 4th year students this year so I am trying to recruit over half of this group, which is a rather ambitious target for any research project. So when you think about it like that I actually have been very lucky to have so many enthusiastic pharmacy students take part already. So really my recruitment rate is quite healthy. Hooray! I will still keep willing the recruitment to go faster though as I cannot wait till I can run some analyses.

Recruitment update for pharmacy student study

This week I re-started the recruitment and testing for our pharmacy student study. I had to pause recruitment and testing for this study for the whole of December and January whilst the students were away for their Christmas holidays and then the exam period in the new year. So I was well and truly ready to get stuck back in to the data collection. I can’t wait till I’ve completed the first study so that we can run our analyses and see what is happening.

The good news is I made a very good start in this first week as I managed to test six students. I have got another 4 booked in this week and then a couple for the following week. However, frustratingly I need about another 20 people to sign up and I am struggling to get there. My posters, visits to lectures and 2 recruitment e-mails have only pulled in those 12 or so participants, I have one e-mail reminder left and then I am not sure what I am going to do next to get students participating in my study other than relying on the snowball effect from now on.

I now know I have chosen a difficult group to study and I am starting to understand why the researchers whose work I am trying to replicate and extend used psychology undergraduates, not pharmacy undergraduates. The advantage to using Psychology students for research is they have to take part in experiments to gain course credits – so you have a captive audience. When I did my psychology degree we all had to do 10hrs research participation every term for 3 years mostly taking part in post-grads research. So in total those postgrads got 90hrs of my time! For free! Pharmacy students dont have to take part in research and are not used to being invited to take part in research either. Plus pharmacy students have a huge work load (especially compared to psychology students) so it does not surprise me that I am struggling to get loads of volunteers.

However this study is important and just because a population is hard to reach/engage it doesn’t mean you should not involve them in research – in fact not to do so leads to biased research in any given area. So I will keep going! I have one last hope that this term I help teach on the health psychology module to my target participants and so maybe seeing me once a week for the next few months will help me keep my project in their minds and maybe they will eventually sign up.

Having had a mini rant I must also add that I have been so pleased to meet everyone who has taken part so far. They have all been lovely and enthusiastic and have had lots of helpful insights into the real world application of my research. More than that, having met them all I am super impressed with all these soon to be pharmacists that the University of Bath are producing. I am not saying this because it is the corporate line, I honestly can’t sing their praises enough when I compare myself to them at their age I had no clue how to act professionally and yet they are becoming true professionals already. Plus their knowledge on medicines is immense. It is very impressive.

I hope to bring you lots of positive recruitment updates over the next few weeks and fingers crossed I may even reach my targets soon.

P.s. I’ve updated my recruitment syringe on the homepage as I’ve now tested 30 participants in total!

RPS Responsible Pharmacist Symposium 26/01/2012

20120207-214403.jpg

Jane and I were invited to the Royal Pharmaceutical Society (RPS) in London to attend a symposium about the responsible pharmacist regulations. It was organised by Martin Astbury (President of the RPS) and his colleagues and chaired by Catherine Duggan, Director of Professional Development and Support at the RPS. Both Jane and I were very excited to be invited and the day was even more interesting than the programme had promised. Originally billed as a discussion of the responsible pharmacist regulations it quickly led into discussions about the idea of developing a just culture in pharmacy.

In proposing this idea Martin Astbury and Catherine Duggan are breaking new ground in pharmacy practice as discussions in the literature have focused on a more general definition of safety culture. They also invited representatives from other industries e.g. Sean Parker from the Civil Aviation Authority to talk about how the just culture works in the aviation industry. Sean spoke about how the aerospace industry has been working towards a “just culture” and about their successes and failures in terms of safety management. This was very exciting for Jane and I as our mental workload research is based on research from the aerospace industry and we feel that there is a lot of ideas and measures that can be applied in pharmacy practice. What a relief to know that we have been working along the correct lines the last couple of years and that the professional body as a whole is now also considering what can be learnt from this industry.

For me, as a young researcher to be able to meet so many big names in the pharmacy practice world was very exciting. I have yet to perfect my networking skills so I was also very nervous the whole day, but the other conference delegates kindly listened to my ideas and thoughts when we broke up into small groups to discuss how a just culture could work for pharmacy. There were many great view points and it was clear that each sector of pharmacy perceived different barriers to the development of this culture. The overall biggest one was how pharmacy sits within the wider health care services, and is it possible for pharmacy to develop a new culture when they are also embedded in the culture of the NHS and their respective trusts, or communities?

Overall for me, I was just thrilled to be invited to the very first discussion and meeting about this potential shift in pharmacy culture, especially as it fits so nicely with our research. There will be a lot more work and discussion within the profession before anything is decided or done, so I will keep updating this page with news and information as I get it.

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