Apply to Learning Sets Support of your line Manager Negotiate time off work to attend the learning sets
What is a learning set? Learning sets give the individuals time to explore issues that they need to resolve in an environment which is empowering and which helps the individual to find a solution www.library.nhs.uk
The 1 st Meeting 6 sessions 4 Facilitators 4 participants Introductions Developed and agreed ways of working Set agenda for each session
The learning sets Objectives for each session Completed sections of application form Presented to the group each week Constructive feedback Identify training needs Financial and Ethical considerations Focus/ Deadlines
The end…but a new beginning Applied for Fellowship Award Attended interview Successful Started Doctoral Fellowship in October 2008
Defining a pulmonary exacerbation in adults with cystic fibrosis (CF) Supervisors: Dr Judy Bradley and Dr Brenda ONeill Prof Stuart Elborn (External) Funding: R&D Doctoral Fellowship
Defining a pulmonary exacerbation in adults with CF No Agreed Definition Research Develop a Standardised Criteria for Defining a Pulmonary Exacerbation in Adults with CF Clinical
Step 1: Literature Review Clinical Markers Signs & Symptoms Current Definitions PROM
Step 2: Delphi Technique Increased cough is indicative of a pulmonary exacerbation Example: Strongly Agree Agree Disagree Strongly Disagree
Data Collection: Web Survey Why? Appeal to a modern society Increased response rates Track participants Ensures surveys are completed Practical and efficient Low cost Facilitate data collection across UK and Ireland
Step 3: Clinical Judgement Analysis Example: Mary Jones has arrived at her CF clinic for a routine appointment. For the past week she has found her sputum to be thicker and difficult to clear. She also has had an increased cough. She is feeling sad at the minute because her sputum is so difficult to clear. She reports no weight loss, no change in exercise capacity and no other symptoms.
Step 3: Clinical Judgement Analysis Is an exacerbation occurring? Is it mild, moderate or severe?
Step 4: Development and testing of Questionnaires Adult CF Patient Exacerbation Questionnaire CF Health Professional Exacerbation Questionnaire
PART A Reproducibility study (n=30) CF Health Professional A -VS- CF Health Professional B PART B Method Comparison Study (n=60-80) CF Health Professional -VS- CF Patients Step 4: Development and testing of Questionnaires
Development & Testing of Questionnaires CF Exacerbation Definition & Questionnaires Clinical Judgement Analysis The Delphi Technique Literature Review
TaskYear 1Year 2Year 3 Ethics and Governance Oct 2008 Feb 2009 Systematic Review Oct 2008 Feb 2009 Delphi StudyFeb 2009 Jan 2010 Clinical Judgement Analysis Feb 2010 Jul 2010 Development and Testing of Questionnaires Aug 2010 Mar 2011 Write upApr 2011 Aug 2011 Dissemination of findings Aug 2011 Sep 2011 Time scale
Important points If you havent started developing your idea – start now! Have an idea that you are passionate about Identify supervisors Apply for learning sets Take a look at the application form (look at last years) Timetable – to keep on schedule
References 1.www.library.nhs.uk/nldocs/NLH_STG_Introducing_Learning_sets.doc [Accessed: 16/02/2009] 2.Britto MT, Kotagal UR, Hornung RW, Atherton HD, Tsevat J, Wilmott RW. Impact of recent pulmonary exacerbations on quality of life in patients with cystic fibrosis. CHEST. 2002;121:64-72 3.Elaffi M, Vinsonneau C, Coste J, Hubert D, Burgel PR, Dhainaut JF, et al. One year outcome after severe pulmonary exacerbation in adults with cystic fibrosis. Am J Resp Crit Care Med. 2004;158-64 4.Goss CH, Burns JL. Exacerbations in cystic fibrosis. 1: Epidemiology and pathogenesis. Thorax. 2007;62:360-7 5.Dakin C, Henry RL, Field P, Morton J. Defining an exacerbation of pulmonary disease in cystic fibrosis. Pediatr Pulmonol. 2001;31:436-442 6.Goss C and Quittner AL. Patient –reported outcomes in cystic fibrosis. Proc Am Thorac Soc. 2007; 4:378-386 7.Mayer-Hamblett N, Ramsey BW, Kronmal RA. Advancing outcome measures for the new era of drug development in cystic fibrosis. Proc Am Thorac Soc. 2007; 4:370-377 8.FDA. Guidance for industry: Patient reported outcome measures: Use in medical product development to support labelling claims. U.S. FDA 2006 Available from: http://www.fda.gov/cder/guidance/5460dft.pdf (Accessed 13th September 2007) 9.Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32(4):1008-15
References 10.Keeney S, Hasson F, McKenna H. Conculting the oracle: ten lessons from using the Delphi technique in nursing research. J Adv Nurs. 2006;53(2):205-12 11.McKenzie B. Using the internet for surveys and health research. J Med Internet Res. 2002; 4(2):e13 12.Huq SZ and Karras BT. A proposed ontology for online healthcare surveys. AMIA 2003 Symposium Proceedings. 2003; p. 304 13.McCabe SE, Couper MP, Cranford JA, Boyd CJ. Comparison of web and mail surveys for studying secondary consequences associated with substance use: Evidence for minimal mode effects. Addictive Behavious. 2006; 31:162-168 14.Cooksey RW. Judgement analysis. Theory methods and applications. London: Academic Press; 1996 15.Kee F, Jenkins J, McIlwaine S, Patterson C, Harper S, Shields M. Fast and frugal models of clinical judgement in novice and expert clinicians. Med Dec Making. 2003; 23:293-300. 16.Jenkins J, Shields M, Patterson C, Kee F. Decision making in asthma exacerbation: a clinical judgement analysis. Arch Dis Child. 2007; 92:672-677
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