Well i found out yesterday how cool it is to show how enthusiastic you are and passionate about OT in an area when you can talk about your research in a job interview!
Don't supose it will help much but if it doesnt do anything else at least it shows that im up to date on what currently is happening for new graduates in an acute physical setting.
So finished all my study and looking for a job - my interviw yesterday was in a rotation position at a large DHB. At the end i asked them if they would like to hear about my reserach findings and then follwing that i added how the research had imporoved my understanding and how it would aid a transtion or fitting into the setting. I added that if i was sucesful in the job that i would be more than happy to do an inservice to present my findings to the team. They commented that the reserach findings were really interesting and that i sounded very passionate about it - becuase it was a phone interview..
I emphasied that as a result of reflecting on the findings i was able to compare my professional practice to my study and realised that i had strenghts in some areas and could try out other strategies that had come been discovered.
Anyway fingers x-d
Friday, January 30, 2009
Thursday, December 11, 2008
The final week
Well in my final stride and boy am i looking forward to a holiday..
So everything is coming along and i'm dong the final bits and pieces...
Literature review - check
Methodology chapter - check
Findings chapter - check
Discussion chapter - check
COnclusion - check
Things to do:
Final bits of intro...
Abstract!
Editing and reviewing all 117 pages
Checking starts and ends of chapter to ensure links well
Put in peer checking comments/examples
Check key words are congruent throughout
Check formatting
Printing check
Then...
Whala - ready for binding and handing my life in
So everything is coming along and i'm dong the final bits and pieces...
Literature review - check
Methodology chapter - check
Findings chapter - check
Discussion chapter - check
COnclusion - check
Things to do:
Final bits of intro...
Abstract!
Editing and reviewing all 117 pages
Checking starts and ends of chapter to ensure links well
Put in peer checking comments/examples
Check key words are congruent throughout
Check formatting
Printing check
Then...
Whala - ready for binding and handing my life in
Thursday, November 27, 2008
figuring out how the core category and phenomenon fits with the conditional paradigm...
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
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
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
Thursday, October 16, 2008
WOW - another interesting interview
Im about buggard - but i felt that i had to get all this excitement out of my head so i can sleep!
Made a link between support and confidence
Intereting points about the new grads responsibility when they are feeling anxious, and chekcing things out before they do it
And developing the individual factors starts at having the attitude to want to work on them
Very interesting point around how new grads dont have the same caseload as a more experienced therapist in terms of level of difficulty and amount - and developing over time
Over confidence came up again - and a nice link between over confidence and patient safety
Being competent to practice you have to be confident
That confidence is not only related to new grads - but experienced therapists also - and the cycle confidence can go on
And that confidence is part of the communication style
Ohhhh - very very intereting data about clinical reasoning!!! And that you do alot of assess and discharge - but missing out on a lot of certain clinical reasoning skills to do with treatment becuase of that - and building on interactive reasoning - knowing how the disability impacts on the person - so yes clincial reasnoing skills develop to be really quick in some areas but missing out in others - not indpeth clinical reasoning
Being safe is the responsibility of the new grad
Prioritisation - doing it together in the morning - but "things change"!! Getting advice from charge nurse.
Possibly a link between priorisation and working at pace
And not giving to much to the new grad - but i think this is purely the type of program that this DHB offers...becuase this is certainly not my experience!
The role of pre experiences - a few examples
Team support in options/resources
The context vs the OT role and professional background
I like this quote "we are not promoting occupation, we’re promoting safety"
Disucssions around people occupations - and the OT role on the ward - and essentially what the OT is employed to be there for
And finally - using the OT models - basically none of the OT tranditional models that we learn about are applicable to the acute physical setting.
But anyways - i need to get some shut eye
Jess
Made a link between support and confidence
Intereting points about the new grads responsibility when they are feeling anxious, and chekcing things out before they do it
And developing the individual factors starts at having the attitude to want to work on them
Very interesting point around how new grads dont have the same caseload as a more experienced therapist in terms of level of difficulty and amount - and developing over time
Over confidence came up again - and a nice link between over confidence and patient safety
Being competent to practice you have to be confident
That confidence is not only related to new grads - but experienced therapists also - and the cycle confidence can go on
And that confidence is part of the communication style
Ohhhh - very very intereting data about clinical reasoning!!! And that you do alot of assess and discharge - but missing out on a lot of certain clinical reasoning skills to do with treatment becuase of that - and building on interactive reasoning - knowing how the disability impacts on the person - so yes clincial reasnoing skills develop to be really quick in some areas but missing out in others - not indpeth clinical reasoning
Being safe is the responsibility of the new grad
Prioritisation - doing it together in the morning - but "things change"!! Getting advice from charge nurse.
Possibly a link between priorisation and working at pace
And not giving to much to the new grad - but i think this is purely the type of program that this DHB offers...becuase this is certainly not my experience!
The role of pre experiences - a few examples
Team support in options/resources
The context vs the OT role and professional background
I like this quote "we are not promoting occupation, we’re promoting safety"
Disucssions around people occupations - and the OT role on the ward - and essentially what the OT is employed to be there for
And finally - using the OT models - basically none of the OT tranditional models that we learn about are applicable to the acute physical setting.
But anyways - i need to get some shut eye
Jess
Monday, October 13, 2008
Great data discovered i think!
Interview one is done and transcriped! Total of 4 hours out of my day :) Getting speedy at transcription now!
Well so carnt wait to discuss this interview with my superviser... Interesting comments around "pace" and how compentence goes alongside confidence. Also another interesting comment around the role of OT within the MDT!!!
Quite excitement im feeling right now!
New ideas came up e.g. "live supervision" and different types of confidence within that.
Abit more depth about "safe" - providing two different views
Sme good examples around knowing that the new grads are making sound clinical judgments
Alot of talk about prioritisation and possibly its fit with working at "pace" - being clinically affective!
Pace - an interesting perspective on this!
And i think more and more is coming out about managing the caseload - and how you can do this to be clinically effective.
Overall - wonderful data i think haha
So exciting :)
Well so carnt wait to discuss this interview with my superviser... Interesting comments around "pace" and how compentence goes alongside confidence. Also another interesting comment around the role of OT within the MDT!!!
Quite excitement im feeling right now!
New ideas came up e.g. "live supervision" and different types of confidence within that.
Abit more depth about "safe" - providing two different views
Sme good examples around knowing that the new grads are making sound clinical judgments
Alot of talk about prioritisation and possibly its fit with working at "pace" - being clinically affective!
Pace - an interesting perspective on this!
And i think more and more is coming out about managing the caseload - and how you can do this to be clinically effective.
Overall - wonderful data i think haha
So exciting :)
Sunday, October 12, 2008
Interiews next
Next up is the semi structured interviews this week - ive got some nice questions as a result of constant comparison analysis and im hoping to get some really nice information to build on what i already have. I will transcribe those interviews and then see where im at - i then should be able to work with all the catergories and concepts and work on a theory as to the "fit" between new grads working in acute physical settings.
I have been working on my literature review and just seeing what information is out there already and what information i can use to confirm the quality of my findings. Ive found that there is some literature on supporting the transition of new grads that will fit in quite nicely. There is also some information on the challenges new grads face as well as strategies to overcome these.
Its all quite exciting at the moment - because im actually getting somewhere!!! Im developing theory grounded in the data that i have collected! Weird but its a good feeling!
Off to sleep now - had a huge weekend of coding, reading literature and getting organised for this busy week that is coming up
I have been working on my literature review and just seeing what information is out there already and what information i can use to confirm the quality of my findings. Ive found that there is some literature on supporting the transition of new grads that will fit in quite nicely. There is also some information on the challenges new grads face as well as strategies to overcome these.
Its all quite exciting at the moment - because im actually getting somewhere!!! Im developing theory grounded in the data that i have collected! Weird but its a good feeling!
Off to sleep now - had a huge weekend of coding, reading literature and getting organised for this busy week that is coming up
Friday, October 10, 2008
Literature chapter
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.
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.
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
Sunday, August 31, 2008
Reviewing questions for next focus group
Ive been doing some thinking about what questions were really useful - and ive come to the agreement that they were all useful - the ones that i used.
I didnt really need to go into what skills and knowledge were essential - as the participants generally talked about them - however i still want to leave it in there just incase they dont discuss them.
Talking about challenging situations was great - we got some lovely examples and it really stimulated ideasas to why they were challenging.
Talking about support was a major theme that came through - the preferable/what was there. But the interesting thing was that the participant thought new grads were suitable for acute as long as the right support was available. So i think getting a clear picture of support is really important in the data collection phase - furthermore - discussing the reality of the work enviro and "why" this impacts the suitablity is also important to talk about.
I want to add in a question around the suitablity in specific settings following the discussion about whether or not they suit acute settings and whether they would employ in this area. I want to put this in because one participant perspection was that orthopaedics was not suitable - but no other participants agreed or disagreed; nor did they mension their own perspeptions of their settings e.g. neuro/med etc. So id like to add in a question if someone mensions in the next f.group about specific areas/suitability.
Jess
I didnt really need to go into what skills and knowledge were essential - as the participants generally talked about them - however i still want to leave it in there just incase they dont discuss them.
Talking about challenging situations was great - we got some lovely examples and it really stimulated ideasas to why they were challenging.
Talking about support was a major theme that came through - the preferable/what was there. But the interesting thing was that the participant thought new grads were suitable for acute as long as the right support was available. So i think getting a clear picture of support is really important in the data collection phase - furthermore - discussing the reality of the work enviro and "why" this impacts the suitablity is also important to talk about.
I want to add in a question around the suitablity in specific settings following the discussion about whether or not they suit acute settings and whether they would employ in this area. I want to put this in because one participant perspection was that orthopaedics was not suitable - but no other participants agreed or disagreed; nor did they mension their own perspeptions of their settings e.g. neuro/med etc. So id like to add in a question if someone mensions in the next f.group about specific areas/suitability.
Jess
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