Struggling to write? Start your own writers’ retreat!

 

by Dr Jessica Watson
NIHR Doctoral Senior Clinical Research Fellow
Centre for Academic Primary Care

 

Have you ever planned to do some writing, only to find yourself distracted by emails and ‘urgent’ tasks? Do you find you have a growing list of unpublished papers and grant proposals to write? Does it feel as if there is never enough time to get going with your writing?

As academics, writing is arguably our most important task. The mantra ‘publish or perish’ is not just a matter of prestige and a means to academic career progression. Nor is it simply about keeping our University rankings within the Research Excellence Framework. It is an ethical imperative.

Most medical research is funded either through taxpayers’ money or through charitable donations and relies on the trust and goodwill of voluntary research participants. This is both a privilege and responsibility. We must ensure that money … Read more

Why doctors need to improve the way we discuss assisted dying

Paul Teed
PhD candidate
Centre for Academic Primary Care 
University of Bristol

Assisted dying can be a divisive and polarising subject. But there is one aspect on which most people probably agree – the need to improve the conversations people have about death.

At the moment, there is uncertainty in the UK regarding what people – especially health professionals – can and cannot say when the topic of assisted dying comes up. Conversation can become especially stilted when it turns to patients obtaining the medical documentation required for an assisted death abroad.

The situation requires clarification. Currently, if a doctor in the UK writes a specific report to help with an assisted death abroad (three organisations in Switzerland accept UK citizens), the General Medical Council (GMC) may view this as a “fitness to practice” issue.

However, if a doctor provides copies of medical records, even with the knowledge that … Read more

How we learned to love doing workshops

 

by Jessica Roy
Research Associate
Centre for Academic Primary Care
@DV_Bristol


The prospect of running a three-hour conference workshop can provoke anxiety even for the most seasoned conference-goer. Last month, I was a member of the IRIS+ research team, led by Dr Eszter Szilassy, that attended and presented a workshop at the Second European Conference of Domestic Violence in Porto, Portugal.

The conference brings together researchers, practitioners and policy makers from all corners of the globe to discuss, debate and exchange knowledge regarding domestic violence and abuse (DVA).

For context, the IRIS+ project is a training and intervention programme to support clinicians (GPs and nurses) to identify, document and refer female and male victims and perpetrators of DVA, as well as their children, to our dedicated specialist support service.

Before presenting, we had concerns that our workshop might not attract an audience, partly because we thought our … Read more

How do we teach clinicians to talk about the end of life?

By Dr Lucy Selman
Research Fellow (Qualitative Research in Randomised Trials)
Centre for Academic Primary Care
@Lucy_Selman

 

Image credit: Doctor and patient – Government of Alberta. Creative Commons License 2.0 (Non-commercial No Derivatives). Source: Flickr: https://www.flickr.com/photos/governmentofalberta/21221196734

In a systematic review published this month, we identified 153 communication skills training interventions for generalists in end of life care. In randomised controlled trials, training improved showing empathy and discussing emotions in simulated interactions (i.e. with actor patients) but evidence of effect on clinician behaviours during real patient interactions, and on patient-reported outcomes, was inconclusive.

The global increase in the proportion of older people and length of life means providing end of life care is now increasingly the responsibility of generalist as well as specialist palliative care providers. But many clinicians find communicating about end of life issues challenging: how do you best discuss imminent mortality, limited treatment options, what to … Read more

Worried about asking people to take part in research? Don’t be!

by Dr Alison Gregory
Research Fellow (Traumatised and Vulnerable Populations), Senior Research Associate
Centre for Academic Primary Care
@AlisonGregory73

 

When I first became a health researcher, I felt that people would see taking part in research as a bother, a pain, or a waste of their time and that, by association, they would see me as akin to a nuisance caller, intent on coercing them into some unwanted activity. Thankfully, after 10 years doing research, it’s become apparent to me that this is far from the truth.

For a start, the tentativeness with which most of the researchers I know proceed as they recruit participants is anything but a hard-sell. In fact, due to necessarily stringent ethics and governance processes and practices, strict eligibility criteria, and a healthy dose of ‘only wanting to do what’s best for people’, we are possibly more in danger of being talked out of … Read more

Multimorbidity could cause a healthcare crisis – here’s what we can do about it

File 20170801 21062 7c1f04
Older patients often suffer from multiple conditions.
Shutterstock

Chris Salisbury, University of Bristol

Multimorbidity is one of the biggest challenges facing healthcare. In recent years, a succession of research studies have shown that people with multiple health problems are more likely to have a worse quality of life, worse mental health and reduced life expectancy. The more health problems someone has, the more drugs they are likely to be prescribed and the more frequently they are likely to consult a GP or be admitted to hospital.

You might think this is all rather self-evident – it’s hardly a surprise that sick people get ill, take medicines and go to doctors more often than healthy people.

So why has multimorbidity become so prominent in discussions about healthcare over the last decade?

There has been an explosion in the number of research papers published on the the topic, numerous … Read more

Insights from the Oxford International Primary Care Research Leadership Programme

by Dr Alyson Huntley
Research Fellow
Centre for Academic Primary Care, University of Bristol
and
Dr Sarah Tonkin-Crine
Health Psychologist
Nuffield Department of Primary Care Health Sciences, University of Oxford

Two individuals are supported by the NIHR School for Primary Care Research (NIHR SPCR) to attend the Oxford Leadership Programme every year. This year researchers Drs Alyson Huntley from the Centre for Academic Primary Care, University of Bristol and Sarah Tonkin-Crine, from the Nuffield Department of Primary Care Health Sciences, University of Oxford attended the first week of events at St Hughs’ College, Oxford.

As cohort#12 of the International Primary Care Research Leadership Programme we were lucky to stay at St Hugh’s College, Oxford during a very hot and sunny week in July. After arriving at the college on Sunday afternoon we were given our timetable and a list of our cohort members spanning the UK, Catalonia and … Read more

Confessions of a NIHR Knowledge Mobilisation Research Fellow

by Dr Lesley Wye
Senior Research Fellow
Centre for Academic Primary Care

For 25 years, I have been a frustrated researcher. Like many, I came into the field of research to make a difference. But as the years passed, I realised that research had little influence on healthcare policy making or practice. I wanted to do something, so in 2009 I applied for a NIHR post-doctoral fellowship to skill up research teams to make a bigger impact. The feedback on my (unsuccessful) application was that researchers just had to publish in the BMJ and things would change (if only!).

Imagine my delight when a few short years later, the NIHR Knowledge Mobilisation Research Fellowship scheme was launched. Its aim was to create a “cadre of knowledge mobilisers”, proficient both in the practice and research of knowledge mobilisation (or ways of sharing knowledge). In 2014, I became one of them.

Although … Read more

We need to think about treatment journeys when evaluating complex interventions

By Dr Katrina Turner
Senior Lecturer
Centre for Academic Primary Care

Most clinical trials are pragmatic in nature and aim to assess the effectiveness of a new treatment against ‘treatment as usual’. When interpreting trial results, researchers tend to focus primarily on what treatment participants in different trial arms received. This may be difficult in the usual care arm, as this arm is often poorly defined, whereas the intervention arm is often clearly defined prior to the trial starting. In addition, this focus is very narrow. Treatment is a process and patients’ experiences of accessing and receiving care could also influence their treatment outcomes, and thus the trial’s results.

A paper recently published in Trials  highlights that differences do exist between the experiences of participants randomised to usual care and intervention arms. These differences relate not only to what treatment participants receive, but also how they access and engage with … Read more