Im so glad i did an anotated bibliography!!!!!!!!! Im understand how "literature" fits in now!!!!!!!!
First it helped me to see what was out there...then this helped me focus my initial data collection.
Now that i have some data i can see how i can use the literature out there to validate my findings. Pretty good this grounded theory thing i recon!!!!!!!!!!
P.S - i found some literature to back that up in my literature review chapter!
Plan to continue working through the literature chapter this week.
But boy its gonna be a big week - 2 interviews 2 transcriptions! and 4 days of work all before Friday.
Friday, October 10, 2008
The categories and subcategories
Ive learnt something today - ive learnt that using the direct quotes and putting them alongside the subcategories is starting to develop the dimensions and characteristics of my categories! It took 6 hours but i have something to show for it!!!! And this time i have more than one word - in some cases i have several sentences that show the context of the subcategory. There are pages and pages - but i think open coding is well on its way...and axial coding as well.
Monday, October 6, 2008
The core category?
Core Category Criteria [GLASER78, pp. 94-95)
must be central
reoccur frequently
takes more time to saturate
connections with other categories comes quick and richly
clear and grabbing implication for formal theory
considerable carry through, does not lead to dead ends
completely variable
is also a dimension of the problem
tend to prevent two other sources (social interest and logical deductive) of establishing a core which are not grounded
to see if #9 is a false criteria
can be any kind of theoretical code: a process, a condition, dimensions, a consequence.
At this stage i am thinking "the individual" may be the core category...or maybe it is the transition
So the Categories/Subcategories...
Support
-Informal
-formal
-active
-transition (or is this separate??)
Clinical reasoning
-decision making
-safety
Skills and Knowledge
-prioritisation
-managing referrals
-standardised assessments
-communication
Rotation
-purpose???
-grounding
-preparation
-consolidation
Individual
Safety
Occ Focused OT
HMMMMMMMMMMMMM I guess this core will come - just have to keep working
CALLED VALIDATION OF THE DATA - BUT FILLING IN THE CATEGORIES NEEDS TO HAPPEN FIRST :)
must be central
reoccur frequently
takes more time to saturate
connections with other categories comes quick and richly
clear and grabbing implication for formal theory
considerable carry through, does not lead to dead ends
completely variable
is also a dimension of the problem
tend to prevent two other sources (social interest and logical deductive) of establishing a core which are not grounded
to see if #9 is a false criteria
can be any kind of theoretical code: a process, a condition, dimensions, a consequence.
At this stage i am thinking "the individual" may be the core category...or maybe it is the transition
So the Categories/Subcategories...
Support
-Informal
-formal
-active
-transition (or is this separate??)
Clinical reasoning
-decision making
-safety
Skills and Knowledge
-prioritisation
-managing referrals
-standardised assessments
-communication
Rotation
-purpose???
-grounding
-preparation
-consolidation
Individual
Safety
Occ Focused OT
HMMMMMMMMMMMMM I guess this core will come - just have to keep working
CALLED VALIDATION OF THE DATA - BUT FILLING IN THE CATEGORIES NEEDS TO HAPPEN FIRST :)
All of the categories of data
The individual
“Better suited for some types of OT’s than others”
Confidence
Attitude
Previous experience
Personality
Willingness to learn/interested
Teachable
Reflective
Analytical -think out of the square
Anxiety
Maturity
Support
“With appropriate support...”
“We make it suitable”
Formal
-Supervision
-In-services
-Rotation programme
-Orientation programme
-Clinical supervision
-Peer review group
-New Grad learning programme
-Observing & active supervision
-Overlap - one OT leaving/one coming
-Young department - not so good
Informal
- Buddy
- Other disciplines
- Team
- OT department staff
- Interdisciplinary
- Peer support
- Morning/afternoon tea/lunch room/office
- Daily basis
Prioritisation
How to
What’s important?
Learnt rapidly
Deal with things thrown at you that morning
Factors to determine which one to see first
Getting information to
Gaining confidence
Referrals
Appropriate
Take responsibility
Prescribed to do…
Dealing with
Pace/volume
Reasoning/decision-making
Scope to develop strong clinical reasoning
Develop ability to think quickly on feet
Become conditioned
Unsure of
Opportunity to have reasoning backed up by other professions
Struggle bridging gap between theory and practice
Pressure to make speedy decisions
Occupational focused OT
Use OT skills in an acute setting
Not just there to be part of the discharge process
Short time-frame - can still do valuable OT work
Using OT process
Cannot develop long term relationships
Grounding/Preparation
“good way to prepare a new grad for virtually anything they might do”
Sets them up
Range of experience in a wide variety of clinical settings
Builds on core skills
Manage in any other area
Good place to consolidate their learning
Help consolidate
Good grounding
Basic occ ther skills
Opportunity to do a lot
Nuts and bolts
Simple occ ther skills
Medical Team
Call on at last minute
No idea what an OT does
Inappropriate referrals
Prescribe what an OT should do
Politics/personality types
Dealing with
Knowledge
Treatment options,
Resources
Manual handling
Standardised assessments - cognistat
What’s available?
Conditions, what should I be doing
Can teach
Training
Communication
Asking the right questions
Good at listening
If they don’t understand
Ability to talk
Speaking to people
Get the right information
Confidence
Coping & Managing
Appropriate/lots of support in place - manage challenges & cope
Taking on responsibility
Safety
Clinical
-Knowing the boundaries
-How much they can do with their level of expertise/competence
-Working at level of experience/competence
Cultural
“Better suited for some types of OT’s than others”
Confidence
Attitude
Previous experience
Personality
Willingness to learn/interested
Teachable
Reflective
Analytical -think out of the square
Anxiety
Maturity
Support
“With appropriate support...”
“We make it suitable”
Formal
-Supervision
-In-services
-Rotation programme
-Orientation programme
-Clinical supervision
-Peer review group
-New Grad learning programme
-Observing & active supervision
-Overlap - one OT leaving/one coming
-Young department - not so good
Informal
- Buddy
- Other disciplines
- Team
- OT department staff
- Interdisciplinary
- Peer support
- Morning/afternoon tea/lunch room/office
- Daily basis
Prioritisation
How to
What’s important?
Learnt rapidly
Deal with things thrown at you that morning
Factors to determine which one to see first
Getting information to
Gaining confidence
Referrals
Appropriate
Take responsibility
Prescribed to do…
Dealing with
Pace/volume
Reasoning/decision-making
Scope to develop strong clinical reasoning
Develop ability to think quickly on feet
Become conditioned
Unsure of
Opportunity to have reasoning backed up by other professions
Struggle bridging gap between theory and practice
Pressure to make speedy decisions
Occupational focused OT
Use OT skills in an acute setting
Not just there to be part of the discharge process
Short time-frame - can still do valuable OT work
Using OT process
Cannot develop long term relationships
Grounding/Preparation
“good way to prepare a new grad for virtually anything they might do”
Sets them up
Range of experience in a wide variety of clinical settings
Builds on core skills
Manage in any other area
Good place to consolidate their learning
Help consolidate
Good grounding
Basic occ ther skills
Opportunity to do a lot
Nuts and bolts
Simple occ ther skills
Medical Team
Call on at last minute
No idea what an OT does
Inappropriate referrals
Prescribe what an OT should do
Politics/personality types
Dealing with
Knowledge
Treatment options,
Resources
Manual handling
Standardised assessments - cognistat
What’s available?
Conditions, what should I be doing
Can teach
Training
Communication
Asking the right questions
Good at listening
If they don’t understand
Ability to talk
Speaking to people
Get the right information
Confidence
Coping & Managing
Appropriate/lots of support in place - manage challenges & cope
Taking on responsibility
Safety
Clinical
-Knowing the boundaries
-How much they can do with their level of expertise/competence
-Working at level of experience/competence
Cultural
Saturday, October 4, 2008
Working with data and categories
Over the last wee while i have been continuously working with the data. Having completed 2 focus groups i have alot of information to be working with.
Ive been drawing up "models" and trying to sort out how all the categories fit together.
My supervisor and I have realised that the "fit" for new grads in acute care practice is all about being able to clinically reason at pace. The models i have been playing with are no where near right YET, but every time i do another one it changes in some aspect and new bits get added. At the moment i am i guess focusing on the transition period and i have identified more questions that im interested in asking the participants about. Just picking the "right' participant is hard because they all to a degree have talked about some aspects of things i wish to go "futher into".
The transition is all around "bridging the gap" between student and new graduate or theory and practice. A comment that i am really interested in is "becoming conditioned" - and i guess this seems to fit with the idea of clinical reasoning at pace.
Ive been thinking today about how all this data is going to fit with my literature review section. This is something that im going to need to get clear relatively quickly so i can get on to making sure it is all going to fit together.
Another thing that is interesting me at the moment is the theme around support, and if this is different dependant on the individuals prev experience. Also how this relates to the hospital context and the support available. I have tried drawing some diagrams to compare the new grad with and without prev experience in acute and how long it takes them to establish clinical reasoning at pace. Im nto happy with these diagrams either - as i wanted to include the support in there but i not understanding if it is the same at first for all, then grad decreases - or if its different, or even changes over the course of the rotation.
Im also interested in what the particiants think about different types of acute settings. Whether one is "easier", "good to start in", not great for a new grad" or whether its one that they will be ready for after a few other rotations.
Another thing that is popping up in my head is - does clinically reasoning gradually develop or does it just happen one day? Also how can we determine that one person can reason at pace - in all clinical situations how complex or simple they are..
The "individual" is an interesting theme i think. We all know that everyone is different and that some people are more confidient..mature etc. But does the type of setting make any difference to how a new grad's "personality" or "attitude" fits or transitions into the work context?
Anyways these are the questions that popped up in my head during coding - memos etc.. so things i want to find out more about..
Those new grads that have no acute experience, how many struggle or jump straight in and strive?
How many new grads struggle all the way through a particular rotation?
How well do they reflect?
How much support do they need?
Does reflection help them develop and gain clinical reasoning skills at pace?
How many think outside the square?
How important is peer review and in-services, compared to supervision?
How well do they use the OT process?
Why is support from PT, SW and SLT good?
Is having enough support an issue for new grads?
How often do they respond to inappropriate referrals?
How do they take responsibility for referrals?
How well do they prioritise?
What are the implications of poor prioritisation? Examples.
What coping strategies do they use to manage rapid learning of skills such as prioritisation?
How well do they multi task?
How well do they make speedy decisions?
What factors make it hard to make speedy decisions?
Does a new grads support stay the same throughout the rotation/year or does it change. If it changes, how and why?
How would you define being safe in clinical practice?
Why is clinical reasoning different at first?
How long does clinical reasoning take to develop?
What is the purpose of a rotation programme?
What is it about the medical model acute service that makes it hard for new grads?
Is clinical reasoning different across cases?
What’s simple? What’s complex?
How do they balance working within a medical model, and applying the OT process/models?
How do they deal with team members who don’t value/know the OT role?
How do you know if a new grad is making sound clinical reasoning judgments?
Do the new grads realise the role as a new grad I as learning process?
Do you think the attitude of new grads differs across different acute settings e.g. orthopaedics vs. medical/neuro?
How well do they communicate with
a) OT collegues
b) The medical team
c) clients
Is the fit between new grads and acute looking at the context of the hospital or the clinical reasoning?
Is clincial reasoning in acute about knowing the recipe? Clinical reasoning or knowing the recipe??
How important is it having an acute placement in the fit and the speed of fitting?
Anyways meeting my superviser on Wed - then it will be time to organise the semistructured interviews
All 4 now
Ive been drawing up "models" and trying to sort out how all the categories fit together.
My supervisor and I have realised that the "fit" for new grads in acute care practice is all about being able to clinically reason at pace. The models i have been playing with are no where near right YET, but every time i do another one it changes in some aspect and new bits get added. At the moment i am i guess focusing on the transition period and i have identified more questions that im interested in asking the participants about. Just picking the "right' participant is hard because they all to a degree have talked about some aspects of things i wish to go "futher into".
The transition is all around "bridging the gap" between student and new graduate or theory and practice. A comment that i am really interested in is "becoming conditioned" - and i guess this seems to fit with the idea of clinical reasoning at pace.
Ive been thinking today about how all this data is going to fit with my literature review section. This is something that im going to need to get clear relatively quickly so i can get on to making sure it is all going to fit together.
Another thing that is interesting me at the moment is the theme around support, and if this is different dependant on the individuals prev experience. Also how this relates to the hospital context and the support available. I have tried drawing some diagrams to compare the new grad with and without prev experience in acute and how long it takes them to establish clinical reasoning at pace. Im nto happy with these diagrams either - as i wanted to include the support in there but i not understanding if it is the same at first for all, then grad decreases - or if its different, or even changes over the course of the rotation.
Im also interested in what the particiants think about different types of acute settings. Whether one is "easier", "good to start in", not great for a new grad" or whether its one that they will be ready for after a few other rotations.
Another thing that is popping up in my head is - does clinically reasoning gradually develop or does it just happen one day? Also how can we determine that one person can reason at pace - in all clinical situations how complex or simple they are..
The "individual" is an interesting theme i think. We all know that everyone is different and that some people are more confidient..mature etc. But does the type of setting make any difference to how a new grad's "personality" or "attitude" fits or transitions into the work context?
Anyways these are the questions that popped up in my head during coding - memos etc.. so things i want to find out more about..
Those new grads that have no acute experience, how many struggle or jump straight in and strive?
How many new grads struggle all the way through a particular rotation?
How well do they reflect?
How much support do they need?
Does reflection help them develop and gain clinical reasoning skills at pace?
How many think outside the square?
How important is peer review and in-services, compared to supervision?
How well do they use the OT process?
Why is support from PT, SW and SLT good?
Is having enough support an issue for new grads?
How often do they respond to inappropriate referrals?
How do they take responsibility for referrals?
How well do they prioritise?
What are the implications of poor prioritisation? Examples.
What coping strategies do they use to manage rapid learning of skills such as prioritisation?
How well do they multi task?
How well do they make speedy decisions?
What factors make it hard to make speedy decisions?
Does a new grads support stay the same throughout the rotation/year or does it change. If it changes, how and why?
How would you define being safe in clinical practice?
Why is clinical reasoning different at first?
How long does clinical reasoning take to develop?
What is the purpose of a rotation programme?
What is it about the medical model acute service that makes it hard for new grads?
Is clinical reasoning different across cases?
What’s simple? What’s complex?
How do they balance working within a medical model, and applying the OT process/models?
How do they deal with team members who don’t value/know the OT role?
How do you know if a new grad is making sound clinical reasoning judgments?
Do the new grads realise the role as a new grad I as learning process?
Do you think the attitude of new grads differs across different acute settings e.g. orthopaedics vs. medical/neuro?
How well do they communicate with
a) OT collegues
b) The medical team
c) clients
Is the fit between new grads and acute looking at the context of the hospital or the clinical reasoning?
Is clincial reasoning in acute about knowing the recipe? Clinical reasoning or knowing the recipe??
How important is it having an acute placement in the fit and the speed of fitting?
Anyways meeting my superviser on Wed - then it will be time to organise the semistructured interviews
All 4 now
Wednesday, September 17, 2008
2nd focus group completed!
Well the 2nd focus group was held yesterday and it went great. Got some lovely examples - and i think they are more specific than the last one - i think it has worked well - the first focus group gave a broad range of challenges and ideas - and now we are adding a bit of depth.
Im in the middle of transcribing! 20 minutes to go - but i must say this time is easier than last time - the recording was a little dodgy last time and i had to listen over and over again to get the right words and phrases.
Some of the same "ideas" came up - e.g. prioritising, dependant on the individual. But it was good to get a problem solving example, and a little more on clinical reasoning. But at this stage (not having completed the transcribing or starting to code) im not sure completly of what "new" or similar.
Will post when coding...
Im in the middle of transcribing! 20 minutes to go - but i must say this time is easier than last time - the recording was a little dodgy last time and i had to listen over and over again to get the right words and phrases.
Some of the same "ideas" came up - e.g. prioritising, dependant on the individual. But it was good to get a problem solving example, and a little more on clinical reasoning. But at this stage (not having completed the transcribing or starting to code) im not sure completly of what "new" or similar.
Will post when coding...
Sunday, September 7, 2008
Coding the first focus group
Well over the weekend and this morning i have been cutting up the transcript and categorising.
So far im looking at; depends on the individual; support - informal and formal; team dynamics; prioritisation; referrals; spring board/preparation; coping and managing and suitability. I no it seems like alot at the moment - but if i keep working through these ideas then im sure that main categories and subcatergories will develop.
But its been really exciting and ive been writing down my own questions alongside some ideas - and i have one member from the focus group (1) that i would like to re-interview in a semi structured interview style. I will talk about all this with my superviser.
I have identified some ideas that i think i could develop further - so thats promising!
I might write these down and have them handy for focus group 2 - just incase some of the same ideas are mensioned.
So focus group 2 is all booked in and ready to role next week - based on how much information i got in focus group 1 i bet il be in for some intense coding and analysiing post focus group 2! - but at least it will be exciting and interesting. Its awesome to have some "data to work with" that are "real" - and even better its great to know that all this work so far this year has lead to the data actually happening.
Cannot wait to have some "RESULTS" to get writing about !
Jess
So far im looking at; depends on the individual; support - informal and formal; team dynamics; prioritisation; referrals; spring board/preparation; coping and managing and suitability. I no it seems like alot at the moment - but if i keep working through these ideas then im sure that main categories and subcatergories will develop.
But its been really exciting and ive been writing down my own questions alongside some ideas - and i have one member from the focus group (1) that i would like to re-interview in a semi structured interview style. I will talk about all this with my superviser.
I have identified some ideas that i think i could develop further - so thats promising!
I might write these down and have them handy for focus group 2 - just incase some of the same ideas are mensioned.
So focus group 2 is all booked in and ready to role next week - based on how much information i got in focus group 1 i bet il be in for some intense coding and analysiing post focus group 2! - but at least it will be exciting and interesting. Its awesome to have some "data to work with" that are "real" - and even better its great to know that all this work so far this year has lead to the data actually happening.
Cannot wait to have some "RESULTS" to get writing about !
Jess
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