Jessica Blake, Senior Occupational Therapist, Research Assistant and CAHPR East Anglia Committee Member, reflects on the February 2021 CAHPR East Anglia research evening.
The first CAHPR Eastern region research evening of 2021 comprised a range of interesting topics, including reflections on delivering virtual semi-structured interviews during COVID-19, the benefit of advanced clinical practitioners (ACPs) in hand therapy, the success of a trial of a mobile stroke unit (MSU), and vitamin D levels in ambulance staff. The presentations on virtual interviewing and the MSU helped me reflect on current practice and I share these reflections below.
VIRTUAL INTERVIEWING DURING COVID-19
Having struggled to implement a research study myself at the start of the pandemic, it was interesting to see how virtual interviewing has developed as a ‘new normal’ in qualitative research. The flexibility and reduction in costs have benefits for both researchers and participants. However, it was interesting that the presenter reflected on the possible impact of virtual interviews on both the researcher’s and interviewee’s privacy. Interviews are not normally conducted in a researcher’s house and equally, a participant may not want the inside of their house on display!
Unlike conducting interviews in an institutional building, it was reported to be difficult to maintain levels of professionalism, and to present a ‘neutral’ or objective setting when interviewing virtually at home. The presenter also made interesting points about how body language and other ways of communicating are lost through virtual interview. I did wonder whether the transcription process of a standard face-to-face interview causes us to lose this kind of data (when following certain methodologies) and if this is the case, what the impact of this on the data analysis may be.
Reflecting on my own practice, I think it is also important to consider the points raised about data security, and to check possible institutional restrictions on certain applications when interviewing and recording virtually. I would also want to consider the ways in which I could set up any virtual meetings so that they are more neutral. My wacky wallpaper has been commented upon in work meetings before, and I wonder whether this impacts on my level of perceived professionalism!
MOBILE STROKE UNIT
The presentation on the mobile stroke unit (MSU) was also really interesting. The MSU is a pilot intervention that aims to assess patients with suspected stroke more quickly by having a CT scanner on board that can be used outside the patient’s home. Clot-busting treatment (thrombolysis) following stroke is time-dependent (‘time is brain’), and the MSU could make identifying the candidates for this treatment more rapid. The most interesting point for me was that the project found that many ‘stroke patients’ identified through the triage system were found not to have had a stroke by the ambulance crew on arrival. These patients were instead fallen patients, stroke mimics, people with heart syncope, or had a variety of other conditions. Further, many patients who were triaged as a ‘fall’ were often later found to have had strokes and were therefore not seen by the MSU.
This apparent problem with triage was really interesting and I thought about my possible role when visiting reactive ‘falls’ patients and whether I should be screening for stroke more actively. I was also really impressed that the MSU caters for the triage discrepancy by ensuring that the unit is able to effectively assess and treat non-stroke patients, and aims to be more effective than a standard ambulance. This seemed like a really nice solution to the issue, rather than attempting to change something that is outside of the project’s power.
Thinking about ways to make improvements that are within your control and adopting a critical mind when visiting patients with suspected diagnoses is something I have taken from this presentation and wish to bring into my practice.
Follow Jessica on twitter @JessBlakeOT