#OTalk Research – Tuesday 5th September – Engaging occupational therapists in and with research

September’s #OTalk will feed into the Research and Development Review being undertaken by the Royal College of Occupational Therapists with the particular aim of considering how we encourage qualified occupational therapists to engage in and with research to boost the professions’ capacity for research.

The chat will be co-hosted by @TheRCOT and @JoWatson22. It will be supported by @preston_jenny from the #OTalk Research team.

The Royal College of Occupational Therapists has launched a substantial review of its research and development activity. This is no small task and will involve undertaking a bit of a ‘journey’ over the next 12-18 months, the outcome of which will be a revised RCOT Vision, Strategy and Action Plan for Research and Development. As you can imagine, there is a great deal to consider, and this is where we need your help.

We know that there is a lot of great research going on that is both undertaken by occupational therapists and informs occupational therapy practice, so there is a lot to celebrate as the image below suggests.
5.9.17
However, we also know that we still have a long way to go to develop a really strong evidence base to underpin the broad spread of our practice and robustly demonstrate the effectiveness of our interventions and the value that occupational therapy brings to the lives of individuals, groups and communities. One way to try to speed up the rate of progress is to increase the professions’ capacity for research, or the number of occupational therapists who are engaged in or with research. That’s what we’d like to chat with you about during tonight’s #OTalk.

The questions forming the basis of our discussion are:

  1. What does engaging in or with research mean to you?
  2. To what extent do you think engaging with research is, could or should be core to the practice of all occupational therapists?
  3. Research engagement takes many forms. What tangible things can you do to demonstrate involvement on a spectrum or range of levels?
  4. How receptive is the culture of your workplace to engagement with research?
  5. What would make the biggest difference to supporting and enabling more occupational therapists to engage with research at some level?

We are really looking to hearing all of your thoughts and ideas, which will be a very welcome contribution to the RCOT Research and Development Review. If you get a chance ahead of the #OTalk session, it would be really helpful if you could give some particular thought to the types of practical activities that you could do to engage in or with research. We’d really love to hear all of the creative ideas that you can come up with so that we can use as examples them to inspire others.

Thank you.

Post chat

Online Transcript

The Numbers
3.717M Impressions
961 Tweets
72 Participants
769 Avg Tweets/Hour
13 Avg Tweets/Participant

 

#OTalk Participants

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#OTalk Research 4th July 2017

This month OTalk Research chat comes to you from Michelle Perryman, @symbolic_life and the North West Doctoral Network. Supported by Emma Hooper, @hooper_ek from the #OTalk Research Team.

yellow brick

At no point would we of the North West Doctoral Network, say that we are novelist in the making. But! What we do have are stories to tell, and these stories are how we are following the yellow brick road on the doctoral research path, climbing the mountain and collecting the tools along the way. I might suggest a PhD is not a novel, but, it does make you wonder, why do people do a PhD. What is it about contributing to the knowledge base of the profession in which people work, and how has this been rewarding and challenging?

In respect to our academic minds, creative thinking and new expression, I could provide many references to theoretical perspectives upon, what we should and shouldn’t do and how we should or shouldn’t do it. However, these are just a few person’s view.

So, the aim of this OTalk Research is to open up this conversation to Occupational Therapy professionals and wider, to understand the process of engaging in doctoral studies. The OTalk Research will allow for people who are considering doing, are doing and have done a doctoral research, to come together and share their experiences. How did you get by?  How did you, or do you stop yourself from throwing your computer out of the window, or accidentally dropping it in the bath? If you are thinking of embarking upon doctoral studies what would you like to know?

So, here are a few reflective questions to ponder;

  • What drives/drove you to consider or do a Doctoral Research?
  • What support mechanisms have you used throughout the journey? How and why are these important?
  • What is the highlight of your doctoral research so far?
  • How did you or do you maintain your motivation throughout your time studying?
  • Do you have any tips to get started in finding your voice?

Many thanks for your time and wisdom, we are looking forward to creating a relaxed academic environment to have a cup of tea and a chat! Hey, you could even turn up in your pyjamas I know I intend to…

Have a wonderful start to the summer,

Michelle Perryman and the North West Occupational Therapy Doctoral Network


The following has been added by @Helen_OTUK (#OTalk Team member & Chair of the Royal College of Occupational Therapists North West Regional committee) following the launch of The Constance Owens Trust, 70th Anniversary Awards at the Royal College of Occupational Therapists North West Regional Shout about Practice event on 24th May 2017 by Helena Culshaw, Chair of the trustees.

2017-05-25 (3)

Royal College of Occupational Therapists members can find a more detailed background to the Constance Owens Trust awards in OTNews June 2017 p54.

Post chat

online transcript

The Numbers

1.304M Impressions
806 Tweets
63 Participants
645 Avg Tweets/Hour
13 Avg Tweets/Participant

#OTalk Participants

#OTalk Research – Tuesday 6th June 2017

June’s #OTalk Research chat will be hosted by @ROTTERSPlym on the topic of ‘Feel the fear and start doing research tomorrow.’

 

Intro Blog:

 

When thinking about hosting #OTalk Research the ROTTERS curry club (Hocking et al, 2017) members looked at the previous #OTalks on research. The #OTalk research of 10th May 2016—what does it mean to engage with research within practice?—highlighted that we all know what the barriers to research in a clinical setting are. It’s important to recognise these, but the negative consequences of not doing research are too great for the profession. Occupational therapists need to ‘lean in’ (Sandberg, 2015) and start to do research in clinical practice. We also discussed how other professionals appear to us to be more focussed, i.e. better at explaining their role to others and doing (clinical) tasks in a systematic way. The group recognised the need to move forward and address this by being more focussed that is, explaining occupational therapy clearly in the workplace and measuring outcomes of practice. In keeping with the ‘lean in’ ethos we, as occupational therapists, need to change the conversation from what we can’t do in terms of research to what we can do. For some members this reminded them of a talk that Jen McAnuff (NIHR/HEE Clinical Doctoral Research Fellow, Newcastle University) and Sam Armitage (Senior Occupational Therapist, Sheffield Children’s NHS Foundation Trust) gave at the College of Occupational Therapists Specialist Section – Children, Young People and Families Annual Conference 2016 called ‘Five ways to implement evidence based-practice, starting Monday’.

Building on Jen and Sam’s challenge this #OTalk Research—Feel the fear and start doing research tomorrow—is a rallying cry for us to work together to act. As a starting point here are some questions to think about:

  • What are the facilitators of your participation in research?
  • What resources can we all draw upon within our organisation and within research community?
  • Who do we need to collaborate within and outside your usual clinical and research networks to make research happen?
  • What is the first step you will take tomorrow to progress research in your area of work?

 

Screen Shot 2017-05-08 at 21.44.35

 

References

Hocking M, Warren A, Bannigan K (2017) CPD with a twist: The ROTTERS curry club. OT News (2) 46-47

McAnuff J, Armitage S (2016) ‘Five ways to implement evidence based-practice, starting Monday’. College of Occupational Therapists Specialist Section – Children, Young People and Families Annual Conference 2016 (personal communication)

Sandberg S (2015) Lean In: Women, Work, and the Will to Lead. London: WH Allen

Post Chat

Online Transcript

The Numbers

1.209M Impressions
495 Tweets
38 Participants
396 Avg Tweets/Hour
13 Avg Tweets/Participant

#OTalk Participants

 

#OTalk 2nd May 2017 – Developing Outcome Measures.

This week’s #OTalk is on the topic of developing outcome measures and will be hosted by Alison Laver-Fawcett (@alisonlaverfaw) from York St John University in the UK.

Here’s what Alison had to say:

In the early 1990s I embarked on developing and standardising an occupational therapy assessment. It was a daunting prospect as I had little idea of where to start! The process involved my undertaking several interrelated psychometric research studies and became the focus of my doctoral studies. Luckily I had a lot of excellent support, advise and mentorship on my test development journey and finally, around 5 years later, the test was published (the Structured Observational Test of Function, SOTOF, Laver and Powell, 1995). Since then I have been committed to supporting occupational therapists to use and develop standardised occupational therapy assessments and outcome measurement and so I am delighted to have been asked to host this #OTalk on ‘Developing Outcome measures’.

So why is this topic so important? Outcome measures are required to evaluate the effectiveness of occupational therapy services. Commissioners of services expect service evaluation evidence that draws upon the routine application of robust outcome measures. Outcome measurement is driven by both policy and professional standards. The College of Occupational Therapists began its 2013 Position Statement on ‘Occupational therapists’ use of standardised outcome measures’ with the following assertion:

‘The College of Occupational Therapists promotes the use of evidence-based outcome measures to demonstrate the delivery of high quality and effective occupational therapy services and to provide credible and reliable justification for the intervention that is delivered. Without accruing data from such sources the evidence-base to support the value of occupational therapy will fail to grow and the profession will be challenged to produce the robust information that will be essential to support future commissioning of occupational therapy services’ (p1).

There are quite few psychometric terms related to test development so here are a few definitions for students or as a reminder:

Reliability is ‘the extent to which the same measurements of individuals obtained under different conditions yield similar results,’ (Everitt, 2006, p.200).

Inter-rater reliability is the level of agreement between different raters administering the test (Bowers, 2014)

Test-retest reliability is the ‘correlation of scores obtained by the same person on two administrations of the same test and the consistency of this score over time,’ (Laver Fawcett, 2007, p.198).

Validity relates to whether the outcome measure assesses what it proposes to measure.

Content validity is ‘the degree to which the content of an … instrument is an adequate reflection of the construct to be measured’ (Mokkink et al, 2012: 9).

Face validity is the ‘degree to which (the items of) an … instrument indeed looks as though they are an adequate reflection of the construct to be measured’ (Mokkink et al, 2012: 9).

Whether you are an experienced researcher, a clinician or a student please join us on 2nd May for this #OTalk twitter chat and share your ideas and experience. It is never too early in your occupational therapy career to start engaging in the development of outcome measures. On the Occupational Therapy Programme at York St John University students have been collaborating with me to undertake psychometric studies for their final year dissertation (e.g. see Laver-Fawcett et al, 2016). You may have an idea for a new outcome measure, so where do you start with test development? You may be using an unstandardized outcome measure developed in your service and want to know how you would go about standardising it and checking it is a valid and reliable measure. Although you may not be embarking on developing a new outcome measure from scratch, you may still want or need to engage in related research and undertake psychometric studies. For example, you may identify an outcome measure developed in a different country and want to translate it or develop a culturally sensitive version or need to develop norms for your client population. Previous psychometric research may have had limitations that warrant replication of studies, for example existing studies of reliability or validity may have been conducted using small sample sizes and more robust evidence is required. You may want to evaluate the clinical utility of an outcome measure for your area of practice or understand your clients’ experience of undertaking the test.

Suggested talking points and discussion questions to focus our chat:

  1. If you were looking to develop an outcome measure what would it be and why?
  2. What factors should occupational therapists consider before deciding to develop an outcome measure?
  3. If you are using an unstandardized outcome measure, how would you go about standardising this?
  4. How can we check the reliability of a new or existing measure?
  5. How do we know if our outcome measure is really measuring what it was developed to measure?
  6. If occupational therapists are client centred why are there so few face validity studies of occupational therapy outcome measures?

References

Bowers D. (2014) Medical Statistics from Scratch: An Introduction for Health Professionals. 3rd ed. Chichester: Wiley.

College of Occupational Therapists (COT; 2013) Position statement: Occupational therapists use of standardized outcome measures. London: COT. Available from: https://www.cot.co.uk/sites/default/files/position_statements/public/COT-Position-Statement-measuring-outcomes.pdf (accessed 25 April 2017)

Everitt BS. (2006) Medical Statistics from A to Z: A Guide for Clinicians and Medical Students. Cambridge: Cambridge University Press.

Laver, A. J. & Powell, G. E. (1995). The Structured Observational Test of Function (SOTOF). Windsor: NFER-NELSON.

Laver-Fawcett AJ. (2007) Principles of Assessment and Outcome Measurement for Occupational Therapists and Physiotherapists: Theory, Skills and Application. Chichester: Wiley. Note: BAOT/COT members can access an electronic copy of this book at: http://lib.myilibrary.com.cot.idm.oclc.org/ProductDetail.aspx?id=83859

 Laver-Fawcett A J, Brain L, Brodie C, Cardy L, Manaton L (2016) The Face Validity and Clinical Utility of the Activity Card Sort – United Kingdom (ACS-UK). British Journal of Occupational Therapy, 79(8) 492–504. doi:10.1177/0308022616629167. Available from: http://journals.sagepub.com/doi/abs/10.1177/0308022616629167 (accessed 25th April 2017).

Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM and de Vet HCW (2012) COSMIN checklist manual. Available at: http://www.cosmin.nl/images/upload/files/COSMIN%20checklist%20manual%20v9.pdf (accessed 25 April 2017).

Some related resources:

College of Occupational Therapists (nd). Resources to help you choose assessments and outcome measures. Available from: https://www.cot.co.uk/cot-library/assessments-and-outcome-measures (accessed 25 April 2017)

College of Occupational Therapists (nd). Developing an assessment tool or outcome measure. Available from: http://www.cot.co.uk/cot-library/developing-assessment-tool-or-outcome-measure (accessed 25 April 2017)

Laver-Fawcett, A J (2014) Routine standardised outcome measurement to evaluate the effectiveness of occupational therapy interventions: essential or optional? Ergoterapeuten, 4, 28-37. Available from: http://www.ergoterapeuten.no/Admin/Public/Download.aspx?file=Files%2fFiles%2fFagartikler%2foutcome.pdf (accessed 25th April 2017).

Laver-Fawcett AJ (2010). The importance of measuring outcomes, including patient reported outcome measures (PROMS). BAOT Lifelong learning event Slide Share. Available at: https://www.slideshare.net/baotcot/the-importance-ofmeasuringoutcomes (accessed 25 April 2017)

Link to a bibliography for Outcomes and Evaluation of Occupational Therapy: https://lsbu.rl.talis.com/lists/ABE8C0F1-30D2-60C4-137E-3F7348999C39/bibliography.html (accessed 25 April 2017)

Post chat transcript

Online transcript

The Numbers

687,039 Impressions
356 Tweets
41 Participants
285 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants

#OTalk Research – Tuesday 4th April 2017

This weeks #OTalk is on the topic of how NHS R&D departments can help occupational therapists and will be hosted by Prof Susan Corr, Head of Research and Development at Leicestershire Partnership NHS Trust (@LPTresearch).

 

Here is what Susan had to say…

 

I took up my post at Leicestershire Partnership NHS Trust in 2013 after many years as an occupational therapy academic and researcher. I thought it a great opportunity to enable clinical staff to become research active and support the development of clinical academic roles across all healthcare professions.

Being research active in an NHS organisation comes in many guises mainly conducting, facilitating and/or implementing research.

Many NHS staff conduct research, often for the purposes of obtaining a qualification but also there are now many more staff aware that a clinical academic career pathway is a possibility for allied health professionals and nurses. NHS R&D departments can support these staff with all aspects of undertaking research including study design, grant writing, establishing academic partners and obtaining necessary approvals.

Most NHS Trusts support studies that are on the National Institute for Health Research (NIHR), in that they have staff funded by the NIHR to enable service users and carers to be participants in national and international studies. Clinical staff can play a key role in facilitating this research in many ways including from taking on the role of local Principal Investigator for a study that offers their service users the opportunity to participate to handing out leaflets about studies. All these studies come to services through Trust R&D departments.

Accessing, critically appraising and utilising evidence in the workplace is key to ensuring care is high quality evidence based. NHS R&D departments can signpost staff to library facilities but may also deliver training or facilitate team discussions that help services to set up their own journal clubs for example. They may also host research events where recently conducted research is shared enabling clinical staff to learn about studies and discuss how to implement findings.

 

During this chat I would like to consider the following:

 

  1. What worked well when asking NHS R&D for support when conducting research?
  2. Service users consider research to be the ‘zone of hope’. How would you respond if asked what studies are happening locally?
  3. What helps utilising your/colleagues critical appraisal skills to discuss and implement research in your service?
  4. If you arranged a meeting with your Trusts R&D dept what would be your burning question/need?

 

Post Chat

Online Transcript

The Numbers

1,460,757 Impressions
327 Tweets
24 Participants
262 Avg Tweets/Hour
14 Avg Tweets/Participant

#OTalk Participants

#OTalk Research – Tuesday 7th March 2017

March’s #OTalk Research will be hosted by Dr Karen Morris and supported by Nikki Daniels (#OTalkResearch team).

Intro Blog Post:

I believe that occupational therapists are curious beings. We all have passions and things that excite us within our work, things that we want to pursue, niggles that we want to find out more about. Research can be a hard and lonely slog, made easier through remembering what inspired us to start the journey and the support of others.

The inspiration for this #OTalk is an article by Doris Pierce, one of my heroes. Whilst I do not always fully understand the complexity of her writing on first reading, I find her work inspirational. Within this particular article, Pierce explores the development of occupational science research through the metaphor of construction. She discusses the need for strong foundations hidden below the ground (descriptive research), followed by walls (relational research comparing different variables) before the roof can be built and supported (predictive research). I like this idea as it reinforces the need to strong qualitative research to underpin good quality quantitative research – both are equally important and cannot exist without each other.

The Journal of Occupational Science have kindly given us permission to share Pierce’s article with you should you be interested in reading it prior to the #OTalk (although this is not required for you to take part).

Article removed following chat

Pierce D (2012) ‘Promise: The 2011 Ruth Zemke Lecture in Occupational Science. Journal of Occupational Science 19(4), pp298-311

This #OTalk will consider:

  1. Who inspires you with their research and why?
  2. What do you think are the strengths of our current research ‘building’?
  3. Where (and how) would you like to see our research building strengthened?
  4. What do you think of the idea that qualitative research is the foundation for quantitative research?
  5. If you had a million pounds what area of OT research would you invest it in?
  6. Who do you think are the key architects in OT research and why? What about the builders?

Post chat

Online transcript

The Numbers

1,338,541 Impressions
609 Tweets
68 Participants
487 Avg Tweets/Hour
Avg Tweets/Participant

 

#OTalk Participants

#OTalk Research – 7th February 2017 – Complex Interventions

February’s #OTalk Research is being hosted by Niina Kolehmainen and supported by Lynne Goodacre 

Complex Interventions

As a therapist, do you know what your interventions are? What they consist of? What the different components are (who does what to whom to what end)? What their benefits are, as well as the harms?

Or do you doubt your interventions, question yourself, feel unclear about what it is you are actually providing? Do you wonder what your interventions are really made of, even question whether they are doing much good at all? Quite a while ago I found myself in this second group. Feeling like a non-believer, a doubter (dare I say, a fraud?).

If you too find yourself in this second group, take solace: “The problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts.” (Bertrand Russell).

Today, over a decade after my doubting started, I find myself in a world where the most credible thinking around non-drug interventions starts with a strong appreciation that we need to question our interventions. As a field, we have increasingly come to realise that we have tended to gloss over some key questions about our interventions, and just jump in to using them. We use them before we even really knew what they are. We don’t pay enough attention to questions like “what is this intervention actually made of?” and “how do I believe this intervention will lead to the outcomes I am trying to achieve?”.

In 2000, the UK Medical Research Council published its first guidance on how the international multidisciplinary research community should approach non-drug interventions [1]. This guidance recognises that non-drug interventions are complex: they have many moving parts that can be difficult to pin down and define, the relationships between the parts can be messy, and the pathways from the parts to the outcomes can be difficult to specify. The MRC guidance is also very clear that despite these challenges we must try to be clearer about our interventions.

Since its publication, the MRC guidance has been elaborated [2], and additional parts have been added (e.g. the process evaluation guidance [3] ). From when I first read the guidance in 2005 to today, I consider it and its added parts as the most fundamental and important methodology document for anyone doing any research into therapy interventions. I also think that if we as a clinical community took on board some of its basic tenets the quality of our thinking around our interventions would hugely improve – and would put us in a genuine position to lead health interventions across research and practice.

One key element of the guidance is the development of cumulative theory. In the simplest way this means we need to be very clear about our ideas before we start applying them. This may be ideas about the problem, e.g. being specific and having evidence about who exactly is affected, in what way, and the factors playing a role). This may be ideas about the solution, e.g. specific solutions that might make things better, the use of these solutions in different situations, and barriers to implementing the solutions. So all quite practical questions.

The MRC guidance argues we need to take these questions as seriously as the question of “does this intervention work?”. This is so that we have clarity (a good theory!) about the problem and possible solutions, and a good foundation for thinking about out intervention. So for those who think theory has little benefit for practice, keep in mind that “There is nothing more practical than a good theory.” (Kurt Lewin).

So, here is the stall set up. Below is a running order for the haggling – but feel free to bring your own goods along and offer them up too so we’ll get a lively discussion =).

Running order for questions:

1) How clear do you feel on your interventions: what they are made of, and what ideas and evidence there is about the problems and solutions?

2) Have you come across the MRC guidance? Have you used it? What do you make of it?

3) How much, and in what ways, do you currently think about and seek evidence about the problems you are trying to address (as opposed to evidence about the interventions)?

4) How much do you consider each component within your intervention (how specific are you?), and form hypotheses about how each component targets the outcome?

5) What one thing can you do to become clearer about the interventions you use? How will this help you and the patients?

References:

[1] Medical Research Council. A framework for development and evaluation of RCTs for complex interventions to improve health. London: Medical Research Council; 2000.

[2] Craig P, Dieppe P, Macinture S, Michie S, Nazareth I, Petticrew M, et al. Developing and evaluating complex interventions: new guidance. London: Medical Research Council; 2008.

[3] Moore G, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: Medical Research Council guidance. London: MRC Population Health Science Research Network; 2014.

 

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The Numbers

1,038,026 Impressions
397 Tweets
44 Participants
318 Avg Tweets/Hour
9Avg Tweets/Participant

#OTalk Participants