Publications by authors named "Aileen Barrett"

16 Publications

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What is your story?

Clin Teach 2021 Jun;18(3):205

Editor-in-Chief, The Clinical Teacher, Waterford, Ireland.

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http://dx.doi.org/10.1111/tct.13363DOI Listing
June 2021

Tell me a story.

Authors:
Aileen Barrett

Clin Teach 2021 04;18(2):103

Waterford, Ireland.

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http://dx.doi.org/10.1111/tct.13343DOI Listing
April 2021

Becoming.

Authors:
Aileen Barrett

Clin Teach 2021 02;18(1)

Irish College of General Practitioners, Assessment Fellow, Dublin, Ireland.

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http://dx.doi.org/10.1111/tct.13324DOI Listing
February 2021

How to … synthesise qualitative data.

Clin Teach 2020 08 10;17(4):378-381. Epub 2020 Jun 10.

Karolinska Institutet, Stockholm, Sweden.

Methods of qualitative synthesis are an important component of the research toolbox. In this article, we introduce several ways to approach qualitative data synthesis and discuss how to choose between them. We use published examples throughout to illustrate how these methods are used to address research questions.
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http://dx.doi.org/10.1111/tct.13169DOI Listing
August 2020

Myths and legends in workplace-based assessment; it's all about perspective?

Educ Prim Care 2020 03 3;31(2):74-80. Epub 2020 Feb 3.

GP Training, Irish College of General Practitioners, Dublin, Ireland.

Based on internationally published literature and the experience of the project team, we understood that already established beliefs and perceptions could influence the implementation of new workplace-based assessment (WBA) tools and processes. At the start of a project to design new WBA tools, we, therefore, attempted to understand the perspectives and perceptions of our GP training community and inform the communication strategy for the project. Online and paper surveys were disseminated to GP trainers, trainees and programme directors. Data were extracted from SurveyMonkey, added to paper-based data in an Excel spreadsheet and analysed using descriptive statistics. While it was generally acknowledged that trainers provide regular feedback to trainees, perceptions of the quality of feedback varied between the groups. The majority of participants agreed that WBA would be of value in learning but expressed concerns over increased workload. There were also some misconceptions about the purpose of WBA, with trainees stating they understood WBAs to be valid and reliable as a single-event sign-off tool. Differences in trainer, trainee and programme director perceptions of the use and usefulness of WBA may be attributed to many factors, not least of all (lack of) experience, perspective and position.
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http://dx.doi.org/10.1080/14739879.2020.1712664DOI Listing
March 2020

How to … be reflexive when conducting qualitative research.

Clin Teach 2020 02;17(1):9-12

Centre for Medical Education, Queen's University, Belfast, UK.

Reflexivity can be a complex concept to grasp when entering the world of qualitative research. In this article, we aim to encourage new qualitative researchers to become reflexive as they develop their critical research skills, differentiating between the familiar concept of reflection and reflective practice and that of reflexivity. Although reflection is, to all intents and purposes, a goal-oriented action with the aim of improving practice, reflexivity is a continual process of engaging with and articulating the place of the researcher and the context of the research. It also involves challenging and articulating social and cultural influences and dynamics that affect this context. As a hallmark of high-quality qualitative research, reflexivity is not only an individual process but one that needs to be considered a collective process within a research team, and communicated throughout the research process. In keeping with our previous articles in this series, we have illustrated the theoretical concept of reflexivity using practical examples of published research.
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http://dx.doi.org/10.1111/tct.13133DOI Listing
February 2020

How to…analyse qualitative data in different ways.

Clin Teach 2019 02 25;16(1):7-12. Epub 2018 Nov 25.

University of Groningen Medical Centre, Groningen, the Netherlands.

In this paper, the fifth in a series on qualitative research in medical education, we discuss approaches to analysing qualitative data. We focus primarily on analysing transcribed interview and focus group data. We also touch on the analysis of visual data, a potentially fruitful alternative approach.
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http://dx.doi.org/10.1111/tct.12973DOI Listing
February 2019

How to…do research interviews in different ways.

Clin Teach 2018 12 21;15(6):451-456. Epub 2018 Oct 21.

Karolinska Institutet, Stockholm, Sweden.

This article is the next instalment in our 'How to…' series about qualitative research, and focuses on interviews. In many ways, conducting research interviews can be compared with talking to a patient or a student, yet there are specific elements to consider if you want the interview data to be useful for a research study. In this article, we will reflect on what a 'good' research interview is. We will provide an overview of different types of interviews, both much used and more adventurous. Finally, we present a list of dilemmas and frequently asked questions, with tips, tricks and suggestions. This practical and concise article will be helpful when starting a qualitative research project using interviews. Getting access to participants' inner worlds is the real trick to acquiring rich data.
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http://dx.doi.org/10.1111/tct.12953DOI Listing
December 2018

How to…choose between different types of data.

Clin Teach 2018 10 23;15(5):366-369. Epub 2018 Jul 23.

Irish College of General Practitioners, Dublin, Ireland.

This article, on how to choose the types of data that are most appropriate to your study, is the third in a series that aims to support researchers within clinical education who are new to qualitative research. Although individual or focus group interviews may seem to be the most obvious source of data in qualitative research, we describe some alternative data sources and how they can be of value in answering certain research questions. We provide examples of how research participants may tell you about their experiences through audio diaries, how they may show you what is going on by drawing a picture, and how you can study what actually happens in practice by observing how people interact, move, dress and use space. By doing so, we hope to catch your interest and inspire you to think of all the different possibilities when setting up a qualitative study. In qualitative research, almost everything in the real world can serve as data.
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http://dx.doi.org/10.1111/tct.12925DOI Listing
October 2018

Development and Initial Psychometric Properties of a Questionnaire to Assess Competence in Palliative Care: Palliative Care Competence Framework Questionnaire.

Am J Hosp Palliat Care 2018 Oct 6;35(10):1304-1308. Epub 2018 May 6.

2 St Francis Hospice, Raheny, Dublin, Ireland.

Background: Although the provision of palliative care (PC) is fundamental to the role of the physician, little research has assessed the competence of trainee and experienced physicians in PC.

Aim: To describe the development of a competence questionnaire and assess the level of competence of medical doctors in Ireland to provide PC to individuals with life-limiting conditions and their families.

Design: A survey-based cohort study was employed using a questionnaire based on the Palliative Care Competence Framework, developed specifically for this study.

Setting: The sample was accessed via the Royal College of Physicians of Ireland. All specialties in adult medical care and direct patient contact were included.

Results: A pilot study demonstrated comprehensiveness and ensured face validity. In the main study, all subscales showed internal reliability and evidence of a normal distribution. Strong correlation was noted between knowledge and behavior while moderate correlations were noted between attitudes and behavior and attitudes and knowledge, respectively. As expected, palliative-trained participants scored significantly higher in attitudes, behavior, and knowledge.

Conclusions: The study provides baseline data on the level of competence of PC of doctors working in Ireland. The study also offers a novel assessment tool that has the potential to be used for future research.
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http://dx.doi.org/10.1177/1049909118772565DOI Listing
October 2018

A BEME (Best Evidence in Medical Education) review of the use of workplace-based assessment in identifying and remediating underperformance among postgraduate medical trainees: BEME Guide No. 43.

Med Teach 2016 Dec 14;38(12):1188-1198. Epub 2016 Sep 14.

f Research Unit, Royal College of Physicians and Surgeons of Canada , Ottawa , Canada.

Introduction: The extent to which workplace-based assessment (WBA) can be used as a facilitator of change among trainee doctors has not been established; this is particularly important in the case of underperforming trainees. The aim of this review is to examine the use of WBA in identifying and remediating performance among this cohort.

Methods: Following publication of a review protocol a comprehensive search of eight databases took place to identify relevant articles published prior to November 2015. All screening, data extraction and analysis procedures were performed in duplicate or with quality checks and necessary consensus methods throughout. Given the study-level heterogeneity, a descriptive synthesis approach informed the study analysis.

Results: Twenty studies met the inclusion criteria. The use of WBA within the context of remediation is not supported within the existing literature. The identification of underperformance is not supported by the use of stand-alone, single-assessor WBA events although specific areas of underperformance may be identified. Multisource feedback (MSF) tools may facilitate identification of underperformance.

Conclusion: The extent to which WBA can be used to detect and manage underperformance in postgraduate trainees is unclear although evidence to date suggests that multirater assessments (i.e. MSF) may be of more use than single-rater judgments (e.g. mini-clinical evaluation exercise).
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http://dx.doi.org/10.1080/0142159X.2016.1215413DOI Listing
December 2016

Is the learning value of workplace-based assessment being realised? A qualitative study of trainer and trainee perceptions and experiences.

Postgrad Med J 2017 Mar 2;93(1097):138-142. Epub 2016 Aug 2.

School of Medicine, Brookfield Health Sciences Centre, University College Cork, Cork, Ireland.

Purpose: Workplace-based assessments (WBAs) were originally intended to inform learning and development by structuring effective observation-based feedback. The success of this innovation has not yet been established due in part to the widely varied tools, implementation strategies and research approaches. Using a conceptual framework of in workplace learning, we aimed to explore trainer and trainee experiences and perceptions of the learning value of WBAs.

Study Design: Trainers and trainees who had used at least one WBA in the previous year were invited to participate in semistructured interviews for this phenomenological study. We used a template analysis method to explore and compare the experiences of the two groups, using the emergent themes to develop an understanding of the impact of these experiences on perceptions of learning value.

Results: Nine trainers and eight trainees participated in the study. Common themes emerged among the two groups around issues of responsibility and engagement along with (mis)understandings of the purpose of the individual tools. Trainer-specific themes emerged related to the concurrent implementation of a new e-portfolio and perceptions of increased workload. Trainees associated WBA with a training structure support value but could not translate experiences into values.

Conclusions: WBAs provide trainees with a justified reason to approach trainers for feedback. WBAs, however, are not being reified as the formative assessments originally intended. A culture change may be required to change the focus of WBA research and reconceptualise this set of tools and methods as a workplace learning .
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http://dx.doi.org/10.1136/postgradmedj-2015-133917DOI Listing
March 2017

Profiling postgraduate workplace-based assessment implementation in Ireland: a retrospective cohort study.

Springerplus 2016 20;5:133. Epub 2016 Feb 20.

School of Medicine, College of Medicine and Health Sciences, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland.

In 2010, workplace-based assessment (WBA) was formally integrated as a method of formative trainee assessment into 29 basic and higher specialist medical training (BST/HST) programmes in six postgraduate training bodies in Ireland. The aim of this study is to explore how WBA is being implemented and to examine if WBA is being used formatively as originally intended. A retrospective cohort study was conducted and approved by the institution's Research Ethics Committee. A profile of WBA requirements was obtained from 29 training programme curricula. A data extraction tool was developed to extract anonymous data, including written feedback and timing of assessments, from Year 1 and 2 trainee ePortfolios in 2012-2013. Data were independently quality assessed and compared to the reference standard number of assessments mandated annually where relevant. All 29 training programmes mandated the inclusion of at least one case-based discussion (max = 5; range 1-5). All except two non-clinical programmes (93 %) required at least two mini-Clinical Evaluation Exercise assessments per year and Direct Observation of Procedural Skills assessments were mandated in 27 training programmes over the course of the programme. WBA data were extracted from 50 % of randomly selected BST ePortfolios in four programmes (n = 142) and 70 % of HST ePortfolios (n = 115) in 21 programmes registered for 2012-2013. Four programmes did not have an eligible trainee for that academic year. In total, 1142 WBAs were analysed. A total of 164 trainees (63.8 %) had completed at least one WBA. The average number of WBAs completed by HST trainees was 7.75 (SD 5.8; 95 % CI 6.5-8.9; range 1-34). BST trainees completed an average of 6.1 assessments (SD 9.3; 95 % CI 4.01-8.19; range 1-76). Feedback-of varied length and quality-was provided on 44.9 % of assessments. The majority of WBAs were completed in the second half of the year. There is significant heterogeneity with respect to the frequency and quality of feedback provided during WBAs. The completion of WBAs later in the year may limit available time for feedback, performance improvement and re-evaluation. This study sets the scene for further work to explore the value of formative assessment in postgraduate medical education.
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http://dx.doi.org/10.1186/s40064-016-1748-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761346PMC
March 2016

A BEME (Best Evidence in Medical Education) systematic review of the use of workplace-based assessment in identifying and remediating poor performance among postgraduate medical trainees.

Syst Rev 2015 May 8;4:65. Epub 2015 May 8.

Research Unit, Royal College of Physicians and Surgeons of Canada, 774 Echo Drive, Ottawa, ON, K1S 5N8, Canada.

Background: Workplace-based assessments were designed to facilitate observation and structure feedback on the performance of trainees in real-time clinical settings and scenarios. Research in workplace-based assessments has primarily centred on understanding psychometric qualities and performance improvement impacts of trainees generally. An area that is far less understood is the use of workplace-based assessments for trainees who may not be performing at expected or desired standards, referred to within the literature as trainees 'in difficulty' or 'underperforming'. In healthcare systems that increasingly depend on service provided by junior doctors, early detection (and remediation) of poor performance is essential. However, barriers to successful implementation of workplace-based assessments (WBAs) in this context include a misunderstanding of the use and purpose of these formative assessment tools. This review aims to explore the impact - or effectiveness - of workplace-based assessment on the identification of poor performance and to determine those conditions that support and enable detection, i.e. whether by routine or targeted use where poor performance is suspected. The review also aims to explore what effect (if any) the use of WBA may have on remediation or on changing clinical practice. The personal impact of the detection of poor performance on trainees and/or trainers may also be explored.

Methods/design: Using BEME (Best Evidence in Medical Education) Collaboration review guidelines, nine databases will be searched for English-language records. Studies examining interventions for workplace-based assessment either routinely or in relation to poor performance will be included. Independent agreement (kappa .80) will be achieved using a randomly selected set of records prior to commencement of screening and data extraction using a BEME coding sheet modified as applicable (Buckley et al., Med Teach 31:282-98, 2009) as this has been used in previous WBA systematic reviews (Miller and Archer, BMJ doi:10.1136/bmj.c5064, 2010) allowing for more rigorous comparisons with the published literature. Educational outcomes will be evaluated using Kirkpatrick's framework of educational outcomes using Barr's adaptations (Barr et al., Evaluations of interprofessional education; a United Kingdom review of health and social care, 2000) for medical education research.

Discussion: Our study will contribute to an ongoing international debate regarding the applicability of workplace-based assessments as a meaningful formative assessment approach within the context of postgraduate medical education.

Systematic Review Registration: The review has been registered by the BEME Collaboration www.bemecollaboration.org .
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http://dx.doi.org/10.1186/s13643-015-0056-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428225PMC
May 2015

Interprofessional ethics and professionalism debates: findings from a study involving physiotherapy and pharmacy students.

J Interprof Care 2014 Jan 3;28(1):64-5. Epub 2013 Sep 3.

School of Pharmacy and.

Ethics is a core component of healthcare curricula and may provide ideal content for interprofessional education (IPE). An IPE debate in ethics and professionalism was developed for first year undergraduate pharmacy and physiotherapy students. A controlled "before-and-after" study was conducted. The opinion of students on IPE, the debate topics and debating was determined before and after the debate. While there was no impact on attitudes to IPE or healthcare professionals, students agreed that debating ethics through IPE was a valid teaching modality. Students found the debates challenging. They stimulated critical thinking and interest in complex and controversial issues. Students also found it of benefit to work as a team. We conclude that in-class debate is a useful way of learning together.
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http://dx.doi.org/10.3109/13561820.2013.829423DOI Listing
January 2014

The Modified Rivermead Mobility Index: reliability and convergent validity in a mixed neurological population.

Disabil Rehabil 2010 ;32(14):1133-9

Department of Physiotherapy, Royal College of Surgeons in Ireland, and Beaumont Hospital, Dublin, Ireland.

Purpose: To assess the inter-rater reliability, internal consistency and convergent validity of the Modified Rivermead Mobility Index (MRMI) in a mixed neurological population.

Method: The MRMI was scored for 30 consecutive patients (mean age 54.5+/-15.6 years) by two individual testers. Reliability was examined using intraclass correlation coefficients (ICC3,1) and Bland and Altman plots; internal consistency reliability using Cronbach's alpha (alpha) and convergent validity using Spearman's correlation coefficient (rho) test to compare the MRMI to the 10-m walk test as a gold standard of mobility. As the majority of patients had bilateral deficits, the MRMI was measured and added independently for both sides.

Results: The inter-rater reliability was excellent: ICC (95% CI)=0.93(0.86, 0.96). The Bland and Altman plots contained most data points and there was perfect agreement between raters bilaterally in 27% of cases, with a difference of one point in 60% of cases on the left and 63% of cases on the right. Internal consistency was good at alpha=0.72 (Rater 1) and 0.80 (Rater 2). The Spearman rho between MRMI and the 10-m walk test was high at 0.86.

Conclusions: The MRMI was shown to have high levels of reliability in a mixed neurological population but we recommend that its psychometric properties are further investigated to establish the true clinical utility of this measure.
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http://dx.doi.org/10.3109/09638280903171576DOI Listing
September 2010