Struggling with all of this - and linking all my categories together to make an overall picture.. So ive pulled everything to bits and will use this list to guide my linking sentances.
Causal conditions (coming in with)
Influence the process towards fitting in
Phenomenon (the individual)
The phenomenon that arises from the causal condition of coming in with is the individual.
Contextual conditions (wanting to)
Fitting in is shaped by contextual conditions.
The contextual conditions influence what strategies are used.
Intervening conditions (under pressure/taking responsibility)
They prevent or alter the journey towards fitting in.
The intervening conditions influence the development of the strategies for fitting in.
Actions/interactions (letting them decide/working alongside/checking in)
Strategies used by the individual to progress towards fitting in.
Consequences (Having the confidence/belonging/coming to terms with)
The behaviour/responses of the individual as a result of the strategies used.
Hopefully this helps
Thursday, November 27, 2008
Tuesday, November 25, 2008
Memo from back in August
I was reading through my book of memos earlier and discovered a question that i had wrote down on Monday 25th of August. It was funny - i believe that i know understand more about what i was questioning back then..
The question was.. we are trained to do more than what is appropriate or required in acute settings... Is this a reason why new graduates dont "fit"?
The findings i have that relate to this in my research is all around the models that new graduates try and apply in the acute setting and this is a particular struggle for them..Previous research has identified that this is an ongoing concern and challenge for OT's - but i guess its more of a struggle particularly for new graduates as they transition into the acute care and are trying to consolidate and transfer knowledge from one context to another..seems the knowledge they are wanting to transfer just doesnt fit with the acute setting as easy as say a rehab setting where they can utilse a "long term" rehab focused model...
Anyways good to know that my question in some ways back in Aug has been answered hehe
Jess
The question was.. we are trained to do more than what is appropriate or required in acute settings... Is this a reason why new graduates dont "fit"?
The findings i have that relate to this in my research is all around the models that new graduates try and apply in the acute setting and this is a particular struggle for them..Previous research has identified that this is an ongoing concern and challenge for OT's - but i guess its more of a struggle particularly for new graduates as they transition into the acute care and are trying to consolidate and transfer knowledge from one context to another..seems the knowledge they are wanting to transfer just doesnt fit with the acute setting as easy as say a rehab setting where they can utilse a "long term" rehab focused model...
Anyways good to know that my question in some ways back in Aug has been answered hehe
Jess
Finding a definition to prompt me to think
Ive started to discuss my findings - part of which i need to talk about the implications of my research on occupational therapy...
So putting a hole heep of definitions together to prompt me to think more..
Implication
Noun
1. something that is suggested or implied
2. an act or instance of suggesting or implying or being implied
3. a probable consequence (of something)
1. The act of implicating or the condition of being implicated.
2. The act of implying or the condition of being implied.
3. Something that is implied, especially:
a. An indirect indication; a suggestion.
b. An implied meaning; implicit significance.
c. An inference. See Usage Note at infer.
a meaning that is not expressly stated but can be inferred
The act of implicating or the condition of being implicated.
The act of implying or the condition of being implied.
Something that is implied, especially:
An indirect indication; a suggestion.
An implied meaning; implicit significance.
An inference. See Usage Note at infer.
noun
an implicating or being implicated
an implying or being implied
something implied, from which an inference may be drawn
Logic a formal relationship between two propositions such that if the first is true then the second is necessarily or logically
May need to go for an aspect of the word..
Implicate
1. To involve or connect intimately or incriminatingly: evidence that implicates others in the plot.
2. To have as a consequence or necessary circumstance; imply or entail: His evasiveness implicated complicity.
3. Linguistics To convey, imply, or suggest by implicature.
4. Archaic To interweave or entangle; entwine.
Imply
1. to express or indicate by a hint; suggest
2. to suggest or involve as a necessary consequence: a spending commitment implies a corresponding tax imposition
Will do some more brainstorming with these
So putting a hole heep of definitions together to prompt me to think more..
Implication
Noun
1. something that is suggested or implied
2. an act or instance of suggesting or implying or being implied
3. a probable consequence (of something)
1. The act of implicating or the condition of being implicated.
2. The act of implying or the condition of being implied.
3. Something that is implied, especially:
a. An indirect indication; a suggestion.
b. An implied meaning; implicit significance.
c. An inference. See Usage Note at infer.
a meaning that is not expressly stated but can be inferred
The act of implicating or the condition of being implicated.
The act of implying or the condition of being implied.
Something that is implied, especially:
An indirect indication; a suggestion.
An implied meaning; implicit significance.
An inference. See Usage Note at infer.
noun
an implicating or being implicated
an implying or being implied
something implied, from which an inference may be drawn
Logic a formal relationship between two propositions such that if the first is true then the second is necessarily or logically
May need to go for an aspect of the word..
Implicate
1. To involve or connect intimately or incriminatingly: evidence that implicates others in the plot.
2. To have as a consequence or necessary circumstance; imply or entail: His evasiveness implicated complicity.
3. Linguistics To convey, imply, or suggest by implicature.
4. Archaic To interweave or entangle; entwine.
Imply
1. to express or indicate by a hint; suggest
2. to suggest or involve as a necessary consequence: a spending commitment implies a corresponding tax imposition
Will do some more brainstorming with these
Tuesday, November 11, 2008
Getting to grips with "skills"
It has occured to me that perhaps the emphasis i have been placing on the skills that the new graduate comes with isnt there in the data.
I have gone through the transcripts and nothing popped out at me to suggest that the participants talked about the skills that new graduates bring. I see more in the data that suggests that its not what skills the new grad comes with that is important - its more about the attitude to work on and quickly learn the skills they need in the acute setting.
From the data - when ever the participants were prompted to talk about the skills required - they talked about that prioritisation, time management, managing the fast paced ward were important. Furthermore, they talked alot about how the acute setting was suitable for new grads to develop clinical reasoning skills and "core" OT skills.
Im thinking the skills they come with doesnt really infuence the fit into acute setting at all, and its the fact that there are lots of good opportunities to develop and learn the skills needed for acute settings. So therefore - i have removed "skills" from what the new grad comes in with...as i dont think the data supports that the skills influence the fit into acute care. Certainly they do influence how they cope and manage after transitioning into the setting, but not at first.
Participants did talk about looking at how they transfer skills from their placement but thats as far as it went and there was no specific detail in the data.
However - im still thinking that the knowledge they bring may fit in with what they come with - but im not sure if this fits in coming in with or with wanting to practice in an occupatinoal focused way....
Here is the information that i could put in the coming in with section under the subcategory of "having the knowledge"...
The second concept in coming in with was having knowledge. Participants indicated that prior experiences in the acute physical setting would speed up the transition as the new graduates would know the place and would only have to focus on learning and developing skills and knowledge. Participants spoke about the knowledge new graduates brought with them from their training, including the OT processes and models. However participants pointed out that the new graduates didn’t feel they had the skills and knowledge to practice in an acute setting.
They come to us with great knowledge of the OT processes and OT models (FG1: C65).
I think they come feeling that that don’t have skills and knowledge, that they just want to consolidate. (FG2: A2).
hmmmmmmmm - some thinking to be done
I have gone through the transcripts and nothing popped out at me to suggest that the participants talked about the skills that new graduates bring. I see more in the data that suggests that its not what skills the new grad comes with that is important - its more about the attitude to work on and quickly learn the skills they need in the acute setting.
From the data - when ever the participants were prompted to talk about the skills required - they talked about that prioritisation, time management, managing the fast paced ward were important. Furthermore, they talked alot about how the acute setting was suitable for new grads to develop clinical reasoning skills and "core" OT skills.
Im thinking the skills they come with doesnt really infuence the fit into acute setting at all, and its the fact that there are lots of good opportunities to develop and learn the skills needed for acute settings. So therefore - i have removed "skills" from what the new grad comes in with...as i dont think the data supports that the skills influence the fit into acute care. Certainly they do influence how they cope and manage after transitioning into the setting, but not at first.
Participants did talk about looking at how they transfer skills from their placement but thats as far as it went and there was no specific detail in the data.
However - im still thinking that the knowledge they bring may fit in with what they come with - but im not sure if this fits in coming in with or with wanting to practice in an occupatinoal focused way....
Here is the information that i could put in the coming in with section under the subcategory of "having the knowledge"...
The second concept in coming in with was having knowledge. Participants indicated that prior experiences in the acute physical setting would speed up the transition as the new graduates would know the place and would only have to focus on learning and developing skills and knowledge. Participants spoke about the knowledge new graduates brought with them from their training, including the OT processes and models. However participants pointed out that the new graduates didn’t feel they had the skills and knowledge to practice in an acute setting.
They come to us with great knowledge of the OT processes and OT models (FG1: C65).
I think they come feeling that that don’t have skills and knowledge, that they just want to consolidate. (FG2: A2).
hmmmmmmmm - some thinking to be done
DISCOVERING whats in the data
Well today i have read through every word the participants have said and tried to make sense of the categories and subcategories.
My thoughts at the moment:
The categories and subcategories.....
Working alongside (axial)
- "observing"
- "reflecting with" - i did have this separate - but i think it fits nicely in here
- ?? "Learning things with/trying new things out" - going to keep this here - it might fit in with observing but it might be separate
Checking in (axial)
- "needing to ask"
- "get support"
- "checking out before" - maybe need to find a better open code ? recognising they dont know
Being under pressure (axial)
- "doing things quickly"
- "pacing yourself"
- "amount of referrals" - maybe also timing of referrals/inappropriate/pace of referrals etc
Having confidence (axial)
- "competent to practice" "to say you dont know"
- "giving your opinion"
- "feeling supported"
Letting them decide (axial)
- "figuring out how"
- "a change to test it out"
- "taking a risk"
- "knowing your boundaries"
Having the right attitude (axial)
- "an interest in"
- "lets do it"
- wanting to be there
Developing relationships (axial) - thinking this may fit with checking in some how..
- "belonging"
- "having someone there"
- "sharing"
Knowing the place
- "exposure to"
Finally... i am still working on one more category - to see if it fits - or if it stands alone - or if it even should be there..
Its around practicing in an occupational focused way.
Im thinking that one of the open codes could be "wanting to". What im finding is that the participants have said how new graduates are wanting to practice in an occupational focused way...not being seen as someone who purely gives out equipment or just there to be part of the discharge process. They are wanting to use their OT skill, proceses and models in the acute environment but they are "struggling" in the medical focused actue environment. The new graduate comes with great knowledge about the OT models and processes - but they are struggling to put theory into practice. I wonder if this is because of the following things:
- the perception of the team - that they dont value or have any idea of what an OT can do - they see an OT's role as being purely equipment provision - so that "norm" is there - and from my memory ing Craig, Robertson & Milligan's study (2004), the team members valued the OT role for their "quick fix" approaches..
- the next thing is all around the timing and pace or amount of referrals. With limited time, and when the new grad doesnt have the knowledge about "diagnosis" and how it affects function - im wondering whether this links to what one of the participants said... around the referrals come in late..we have little time "and thats why we get in a situation where we are purely prescribing equipment".
- the next thing is all around the types of models the new grads are trying to use to practice in an "occupational focused" way. The models are all focused on long term...building up relationships over time.. and "they dont account for the fact that its a very short part of the patients journey. So i take this as meaning that the new grads come out with great knowledge of the models and want to use it and it doesnt work (very simple language haha).. So.. is this why they struggle to practice in an occ focused way??
So at the moment - i am thinking that this fits somewhere..and i think it may even stand alone as a category. And all this thinking has made me realise that maybe this contributes or impacts of the fit between new grads into acute settings. I think certainly this is definitly going to be included in the "future areas for research" part of my discussion.
But if this doesnt fit in the end - i am going to have to do some thing abot it after my dissertation is done - maybe something additional..
Enough thinking for the day - doubt that will be the case
Jess
My thoughts at the moment:
The categories and subcategories.....
Working alongside (axial)
- "observing"
- "reflecting with" - i did have this separate - but i think it fits nicely in here
- ?? "Learning things with/trying new things out" - going to keep this here - it might fit in with observing but it might be separate
Checking in (axial)
- "needing to ask"
- "get support"
- "checking out before" - maybe need to find a better open code ? recognising they dont know
Being under pressure (axial)
- "doing things quickly"
- "pacing yourself"
- "amount of referrals" - maybe also timing of referrals/inappropriate/pace of referrals etc
Having confidence (axial)
- "competent to practice" "to say you dont know"
- "giving your opinion"
- "feeling supported"
Letting them decide (axial)
- "figuring out how"
- "a change to test it out"
- "taking a risk"
- "knowing your boundaries"
Having the right attitude (axial)
- "an interest in"
- "lets do it"
- wanting to be there
Developing relationships (axial) - thinking this may fit with checking in some how..
- "belonging"
- "having someone there"
- "sharing"
Knowing the place
- "exposure to"
Finally... i am still working on one more category - to see if it fits - or if it stands alone - or if it even should be there..
Its around practicing in an occupational focused way.
Im thinking that one of the open codes could be "wanting to". What im finding is that the participants have said how new graduates are wanting to practice in an occupational focused way...not being seen as someone who purely gives out equipment or just there to be part of the discharge process. They are wanting to use their OT skill, proceses and models in the acute environment but they are "struggling" in the medical focused actue environment. The new graduate comes with great knowledge about the OT models and processes - but they are struggling to put theory into practice. I wonder if this is because of the following things:
- the perception of the team - that they dont value or have any idea of what an OT can do - they see an OT's role as being purely equipment provision - so that "norm" is there - and from my memory ing Craig, Robertson & Milligan's study (2004), the team members valued the OT role for their "quick fix" approaches..
- the next thing is all around the timing and pace or amount of referrals. With limited time, and when the new grad doesnt have the knowledge about "diagnosis" and how it affects function - im wondering whether this links to what one of the participants said... around the referrals come in late..we have little time "and thats why we get in a situation where we are purely prescribing equipment".
- the next thing is all around the types of models the new grads are trying to use to practice in an "occupational focused" way. The models are all focused on long term...building up relationships over time.. and "they dont account for the fact that its a very short part of the patients journey. So i take this as meaning that the new grads come out with great knowledge of the models and want to use it and it doesnt work (very simple language haha).. So.. is this why they struggle to practice in an occ focused way??
So at the moment - i am thinking that this fits somewhere..and i think it may even stand alone as a category. And all this thinking has made me realise that maybe this contributes or impacts of the fit between new grads into acute settings. I think certainly this is definitly going to be included in the "future areas for research" part of my discussion.
But if this doesnt fit in the end - i am going to have to do some thing abot it after my dissertation is done - maybe something additional..
Enough thinking for the day - doubt that will be the case
Jess
Wednesday, November 5, 2008
Focusing on the fit ONLY
Its becoming clear that i need to be constantly reminding myself that i am looking at the fit between new grads working in acute care settings - and not getting side tracked on the "interesting things to me"
Some of the things that are in my mind that i want to try and get out around the fit........as i am in the middle of analysis
Just wanting to pull together =The experiences/knowledge and skills the new grad brings with them that influences the initial fit into acute care.
"Different therapists come in with different needs"
"There exposure to different things as a student is really a key thing"
"So it depends on their past experiences a lot" - as to what role orientation plays
For example
"Some may have done a placement in orthopaedics and not have to worry about learning about different transfers. Some may have done a community placement and are well use to equipment. Some have done a mental health placement and the whole cognition thing is something that they are more aware of".
"There’s not replacement for experience, I think new grads perhaps need to relax and the fact that they are new grads, and a lot of the learning with experience"
"I suppose in an ideal world that transition, like having a placement and having a student opportunity in an acute or physical setting. Any job you choose to go into - if you’ve already had a student placement your going to be better to transition"
"You can know a place, but if you don’t have those clinical reasoning skills its still going to be difficult"
Previous experience in acute - transition is much shorter
For example
"We’ve had someone, because they’ve had placements here as well, they’ve had a couple of student placements within the DHB, they settle in within 2 or 3 weeks".
"If the new grad has been lucky enough to have a placement in a DHB or an acute setting somewhere. Often that transition is much easier as it would if you were looking at…if your just been in mental health and you go into mental health -that transition is made easy. So I think that that makes a big difference. I think they definitely struggle if they have had no hospital experience, and they come into a hospital environment as a new grad it can be very overwhelming, there’s just that business, you have to learn those prioritisation skills quickly. How you move a patient when they may not have physically moved somebody before. It really depends on the person, we’ve had dome new grads who have fitted in with in a couple of days, and we’ve had some that have taken months to settle into the hospital environment, and its just the speed and the pressure that it has".
Some of the things that are in my mind that i want to try and get out around the fit........as i am in the middle of analysis
Just wanting to pull together =The experiences/knowledge and skills the new grad brings with them that influences the initial fit into acute care.
"Different therapists come in with different needs"
"There exposure to different things as a student is really a key thing"
"So it depends on their past experiences a lot" - as to what role orientation plays
For example
"Some may have done a placement in orthopaedics and not have to worry about learning about different transfers. Some may have done a community placement and are well use to equipment. Some have done a mental health placement and the whole cognition thing is something that they are more aware of".
"There’s not replacement for experience, I think new grads perhaps need to relax and the fact that they are new grads, and a lot of the learning with experience"
"I suppose in an ideal world that transition, like having a placement and having a student opportunity in an acute or physical setting. Any job you choose to go into - if you’ve already had a student placement your going to be better to transition"
"You can know a place, but if you don’t have those clinical reasoning skills its still going to be difficult"
Previous experience in acute - transition is much shorter
For example
"We’ve had someone, because they’ve had placements here as well, they’ve had a couple of student placements within the DHB, they settle in within 2 or 3 weeks".
"If the new grad has been lucky enough to have a placement in a DHB or an acute setting somewhere. Often that transition is much easier as it would if you were looking at…if your just been in mental health and you go into mental health -that transition is made easy. So I think that that makes a big difference. I think they definitely struggle if they have had no hospital experience, and they come into a hospital environment as a new grad it can be very overwhelming, there’s just that business, you have to learn those prioritisation skills quickly. How you move a patient when they may not have physically moved somebody before. It really depends on the person, we’ve had dome new grads who have fitted in with in a couple of days, and we’ve had some that have taken months to settle into the hospital environment, and its just the speed and the pressure that it has".
A list of things i need to remember to improve the quality of my writing
Had a session with the learning centre today - things i learnt that i need to be aware of and go over when checking for grammar and flow of writing include....
Checking there is no repetition
Consitancy - verbs (endings) & nouns (single/plural)
Proof reading - reading of writing - reading out loud
Run on sentances....
Apostrophies (before/after or at all)
Incomplete sentances
Missing prepostions e.g. on, in, to.
So will use this list when editing my writing over the next month
Jess
Checking there is no repetition
Consitancy - verbs (endings) & nouns (single/plural)
Proof reading - reading of writing - reading out loud
Run on sentances....
Apostrophies (before/after or at all)
Incomplete sentances
Missing prepostions e.g. on, in, to.
So will use this list when editing my writing over the next month
Jess
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