Thematic Analysis Of Free-text Responses Research Articles

Exploring experiences of cancer care in Wales: a thematic analysis of free-text responses to the 2013 Wales Cancer Patient Experience Survey (WCPES)

ObjectivesTo provide the first systematic analysis of a national (Wales) sample of free-text comments from patients with cancer, to determine emerging themes and insights regarding experiences of cancer care in...

The outcomes and acceptability of near-peer teaching among medical students in clinical skills.

ObjectivesTo determine the outcomes and acceptability of final-year students tutoring in Clinical Skills to Years 1-2 students in a 4-week Medical Education elective. MethodsA paper-based survey with 14 questions requiring responses on a Likert-like scale and 2 questions with free-text responses was used to investigate Year 6 student-tutor (n=45) and Years 1-2 tutee (n=348) perceptions of near-peer teaching in Clinical Skills. The independent t-test compared mean responses from student-tutors and tutees, and thematic analysis of free-text responses was conducted. ResultsTutee perceptions were significantly higher than student-tutor self-perceptions in small-group teaching and facilitation skills (p=0.000), teaching history-taking skills (p=0.046) and teaching physical examination skills (p=0.000). Perceptions in aspects of ‘Confidence in tutoring’ were not significantly different for student-tutors and tutees, with both having lowest perceptions for identifying and providing remediation for underperforming tutees. Student-tutors rated all areas of personal and professional development highly. Main themes emerging from analysis of student comments were the benefits to student-tutors, benefits to tutees and areas needing improvement, with outcomes of this near-peer teaching relating well to cognitive and social theories in the literature. ConclusionsBoth student tutors and their tutees perceived near-peer teaching in Clinical Skills to be acceptable and beneficial with particular implications for Medical Education.

“Talking and thinking”: Impact of a simulation on pharmacy undergraduates׳ beliefs and attitudes about living in poverty

AimsTo evaluate the effect of participation in a simulation exercise, on Bachelor of Pharmacy (B.Pharm.) undergraduates׳ attitudes and beliefs toward those living in poverty. To explore the acceptability of the simulation to students and their perception of how it related to their future practice. MethodSecond-year B.Pharm. undergraduates participated in the Community Action Poverty Simulation (CAPS), designed to allow participants to experience aspects of what it is like to live in poverty. Students completed the Short Form of the Attitude Toward Poverty Scale (ATP-SF) anonymously one week prior- and post-participation to examine the effect of the simulation. A paired comparison of the ATP-SF score and its subscales was undertaken. Free-text questions examined students׳ opinions of the simulation, what they learned from participating and how it could be improved. ResultsIn total, 76 pairs of complete questionnaires were analyzed. A trend toward improvement in attitudes toward those living in poverty was seen (change in ATP-SF total score, P = 0.07). This appeared to be associated with changes in the structural perspective subscale (implying more attribution of poverty to societal structures) post-simulation (P < 0.01). No statistically significant changes were seen on the other two subscales (“personal deficiencies” and “stigma”). Thematic analysis of free-text responses indicated that participating in the simulation challenged the veracity of some negative attitudes and beliefs about poverty, and increased understanding and empathy. ConclusionParticipation in the simulation had some positive effects on student attitudes, empathy, and beliefs related to those of low socioeconomic status.

Quality improvement in paediatric palliative care: multidisciplinary stage 1 service evaluation at a tertiary children's hospital

Aims A stakeholder survey was performed in order to evaluate practice against the Association for Children9s Palliative Care (ACT) Integrated Palliative Care Pathways Standards and provide a baseline for service development. Methods A multidisciplinary subcommittee of staff adapted the ACT Service Self Assessment Tool for use in an online survey of hospital professionals. Stakeholder inclusion criteria were defined by seniority, speciality and profession (n=104). Sixty questions evaluated how well current care provision meets ACT standards by scaled and free text responses. Anonymised data were analysed using SPSS Statistics v17.0, graphs prepared with Excel v8.0 and a thematic analysis of free-text responses was completed. Results Subgroup analysis by specialty shows both variation in response rate (table 1) and in percentage of caseload/time spent on palliative care (figure 1). Figure 2 summarises overall aspects of good practice and those in need of further development. Blue ovals in figures 3–5 highlight a selection of specific ACT Standards for improvement. Theme-based analysis reveals: (A) Strengths (1) Good experience and communication within/between professional groups. (2) PICU/NICU expertise in end-of-life care. (3) Holistic family-centred care/support and child-friendly environment. (4) Dedicated pain management and bereavement counselling services. (B) Challenges (1) Lack of shared definition/framework/structure for paediatric palliative care. (2) Poor linkage with community services: discharge planning/out of hours care. (3) Emotive communication: end-of-life discussions; debriefing after child9s death. (4) Barriers preventing families accessing timely spiritual/pastoral/psychological care. (5) Practical limitations: privacy/space on ward; accommodation; interpreters. (C) Wish list (1) Dedicated paediatric palliative care team: consultant-led with regional outreach. (2) Holistic palliative care education, training and supervision for staff. (3) Greater access to psychological support: same day/out of hours and for siblings. (4) Specific written guidance/information resources for staff, children and families. (5) Clearer pathways of care linking hospital and community services: hospices/respite. Conclusions This is the largest service evaluation of palliative care in a tertiary children9s hospital, using ACT9s Service Self Assessment Tool to highlight key areas for quality improvement. Senior multidisciplinary stakeholders have identified their strengths, challenges and necessary resources, processes and outcomes for service development. Stage 2 service user evaluation proposed: to explore children and families9 priorities.