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.

Brian Goldman: Doctors make mistakes. Can we talk about that?

Recently a video was uploaded to TED of a TED Talk given by Dr Brian Goldman (click here for the talk). Dr Goldman is an Emergency Room doctor in Toronto. His talk was about the consequences of doctors not being open about the errors they make. This video really complements the BBC radio 4 programme by Prof James Reason that I wrote about yesterday. The ideas covered are very similar, but Dr Goldman talks about his own errors and the experiences after it and what he wished he had done differently and how much he wished he could have spoken to someone about it.  He gave a very moving talk about the errors he had made and demonstrated just how much emotion healthcare professionals feel when they make an error and how gut wrenchingly sorry they are when it happens. Which is probably why the University of Michigan reported a reduction in compensation costs for medical errors when a hospital switched to an open reporting culture. On Prof Reason’s radio programme patients talked about the importance of being able to talk afterwards to the doctors who had made an error with their care. The University of Michigan team also commented that when doctors were open and spoke to their patients about the errors made, this meant that litigation processes were stopped, or were never even started in the first place because patients didn’t feel like something unjust had been done to them once they spoke to the doctors. My thought after watching and listening to these two programmes was, is the reduction in compensation costs for medical errors in Michigan because patients get to see doctors and therefore can see how sorry the doctors are, can see that those emotions are authentic and that they weren’t taking the error lightly? You can judge for yourselves, I now have to go off and read all these University of Michigan reports as I have to find out more!

One other thought I had after watching/listening to these programmes was that there is a lot of noise in healthcare at the moment about openness towards errors. What I am not sure about is whether this is something new, or I am only tuning in to it all at the moment because of the research I am doing, and because of talks within the pharmacy profession about creating a just culture (one aspect of a just culture is openness about errors). I clearly have to do some more reading of the literature to find out.

James Reason on BBC Radio 4 20.02.2012

Prof James Reason's swiss cheese model (from BMJ 2000; 320: 768-70)

Jane and I got very excited yesterday when we heard that Prof James Reason was talking on Radio 4 on Monday night about medical errors. Prof Reason is most famous for his swiss cheese model (above), and when anyone talks about human factors research, or safety in organisations, his swiss cheese model is the first thing that springs to mind. He is that good and that famous!

The radio programme called Dr – Tell Me the Truth is a two-part programme hosted by James Reason about medical errors. What I really enjoyed about yesterdays episode (the next one is on Monday 27th February 2012) was hearing from a range of stakeholders in medical errors. During the programme we heard from patients, researchers, clinicians and lawyers all relating their experiences of when errors had been brushed under the carpet and when clinicians had been open and up front that they had made an error. There was even an excerpt from a qualitative interview of a patient who had experienced a medical error in her cancer treatment and subsequently enrolled in a research project with the University of Michigan. In this excerpt you heard the patient say that she had the opportunity to talk to the clinicians that made the mistake and tell them how she was so cross at herself for not speaking out more in her consultations and not pushing until she got the response she needed. One of the clinicians there turned to her and said it wasn’t her fault (which obviously it wasn’t). The patient said when recalling this meeting that this simple experience made her feel listened to and not ignored and not like this error which was to have a huge impact on her life and health was not being swept under the carpet and ignored. This same theme was echoed again and again, where patients reported just being told that an error had been made, and being able to talk to the Doctor about it helped so much. The University Of Michigan had also been involved in lots of initiatives to create hospitals where doctors were completely open about errors. At first everyone was worried this would lead to more litigation, especially in cases where patients did not experience any ill effects of the error and did not know it had happened. However, what they found was the opposite that it actually dramatically reduced how much they were paying out in compensation for medical errors see here.

Next week they will be hearing from Sir Liam Donaldson about whether the same principles could work for the NHS. Also from other healthcare professionals. I am hoping we hear from a pharmacist too in the next programme. There are so many professional groups in the NHS that it would be a shame (and biased) if they just talked about errors made by doctors.

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.

BPS Psychology in the pub

The highbury vaults in Bristol. This is not where this psychology in the pub talk was held, but many psychologists can often be found here due to its proximity to the Uni of Bristol Exp Psych dept!

On Wednesday evening I attended a social event held by the south-west hub of the British Psychological Society. This was great because after the “outside the box inside pharmacy” conference both Jane and I commented that there were no similar local events for psychologists that were being run by our professional body (which is the British Psychological Society). Not long after we said this, as if someone was listening in to our conversation, or reading my mind (or simply down to coincidence) I received an invite to the psychology in the pub session. The great thing is that this is going to run once a month and there is an informal talk from a local psychologist about what they do / a piece of their work. How great is that! Ok, so I sound a little geeky now, but psychology is such a diverse subject that you can’t be an expert in every aspect of psychology so it is great to talk to other psychologists and learn from them a little more about psychology.

The psychology in the pub sessions were kicked off by a talk from Jo Maddocks who is a chartered occupational psychologist and co-founded an occupational psychology group in Bristol – called JCA. His area of expertise was emotional intelligence and he and his colleagues devised a questionnaire to assess emotional intelligence (which he delivers with a lot of interactive group work for companies). What was interesting was that the key to understanding emotional intelligence is reflecting on your own behaviours and your own emotions and figuring out how others are going to respond – and if they don’t respond in the way you expect, then you reflect on that too, and so on. It did spark a few thoughts in my mind and finally I know something about EI, a topic which I remember hearing about when I did my a-level psychology class.

I am looking forward to lots more of these events, despite the rumours psychologists are great fun, and I really enjoyed meeting those that went on Wednesday.

Recruitment update for Pharmacy Student Study

Recruitment figures for Pharmacy Student study up to 17.01.2012

Currently we have 21 participants recruited into the pharmacy student study. We need a minimum of 110 participants. To fulfill this ambitious target we are currently recruiting  from the 2011/12 4th year MPharmacy Students. After the summer exams we will be recruiting the 2011/12 3rd year MPharmacy Students who will then become the 2012/13 4th year MPharm students (and will be targeted for recruitment a second time from October 2012 onwards).

As you can see from this Syringe we still have a long way to go!

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