A tour of my desk

Data Analysis

I was at a meeting last night. Actually, come to that, I was at a meeting today as well. I go to a lot more meetings now than I used to. Not sure I enjoy that. Anyway, I’m getting off topic, and I haven’t even got past the first paragraph yet.

So I was at a meeting last night. Basically it was three very intelligent people (and me) sitting in a room with a whole stack of audio diary transcripts. Three weeks worth of data collection. We all have copies, and we’re all armed with highlighters. I love highlighters. I was given a blue one last night, which is probably my least favorite highlighter colour, but I guess you can’t complain.

We each read through the transcript and identify themes. The highlighters are there to make sure we don’t forget the theme once we’ve identified it. Then we go around the room and everyone explains what themes they’ve found and where. Mostly this process involves lots of nodding and affirmative noises being made by the rest of the room while one person talks, but just occasionally someone will have read something differently or see it a different way. This is interesting, but that’s when things get interesting for me. Oh wait, I haven’t told you what I’m doing yet.

I have a laptop in front of me, and it’s hooked up to a data projector. I’m running this software called NVivo. I think of it as the SPSS of the qualitative research world. This is pretty apt because I don’t tap even 10% of the potential power of SPSS, and the same is true of NVivo. Once the clever people (and me) have identified a passage in the transcript that they think exemplifies a particular theme, I highlight it (digitally this time) in NVivo and hit “Code New Node”. A node is the NVivo equivalent of a theme. I can name the node something like “Dr Stress”, that’s quite a common one, doctors are stressed people. Then, every time we find another example of doctor stress, it’s just highlight and click: coded. Obviously the issue is when the clever people disagree with what theme a sentence falls under. This results in Ross Stress, which I personally think should be a theme.

What amazes me most about this process, which incidentally is called Thematic Analysis, good name, is how quickly patterns emerge. Here we have diaries from 10 different doctors recorded over 3 weeks, each done immediately after they’ve seen patients and before they’ve had a chance to discuss their surgery with the other doctors. And yet very quickly we establish a group of 7 or 8 themes that come up again and again. It’s almost enough to make me believe this research is more than carefully packaged speculation.

I jest of course, but you know what I mean, it all feels remarkably scientific for a process that supposedly takes the scientific method we’re all so familiar with from quantitative research and turns it on its head.

After a bit more technical wizardry from me I can present all the initial themes and their supporting evidence to one of the clever people. Together, he and I distill our 7 or 8 rough themes into something a little more cohesive. This is not a very interesting process and mostly involves long silences where we both stare at the list and think. Once we have our cohesive list of themes, that’s it. Before you know it data analysis is done and it’s just down to me to write it all up.

Monday

You know that feeling when you can see something bad rushing towards you, but can’t do anything to stop it?

I haven’t had a bad day in quite a while. In fact, I don’t think I’ve had a bad day since my last exam, mid November. That was until this week. This week was not a good week. I got through it, but mostly by denial on Monday and Tuesday; and from Wednesday on because I knew I had a fantastic weekend coming up. And it’s been a fantastic weekend. Walking through the wind and the rain, across a bog in fact, on Saturday. With 3 wonderful companions, who complained not a peep that I led them into a dead end valley in that awful weather. And then going swimming today with those same marvelous people. I love swimming. I couldn’t tell you the last time I went, but I made up for it today. I love rock climbing too, couldn’t tell you the last time I did that. Or archery, I find that very relaxing, but I don’t know when I last did that either.

So; there we are. A superb, energetic, de-stressing weekend. It’s over now.

All I have to look forward to is Monday. And a 9am until 8pm day. Staring at a computer screen, desperately trying to work out what to write. It is not an appealing prospect.

But what’s even less appealing is the fact that I will be doing the same the day after. Admittedly, not quite as late into the evening. And then again the next day. And again after that. The same thing, over and over, for weeks on end.

I can see it coming.

The hopelessness.

The circular reasoning.

Dreading sleep each night, because all it does is hasten the arrival of the coming day.

I hate it. I hate feeling this way. I hate… I hate feeling that all I’m dreading is the dread itself. It feels, false. Like the feeling is real, but the reason is not. Effect without cause.

Real enough to exist, but not real enough to stop.

Helimed 2 landing at Raigmore Hospital

I never grow tired of seeing this.

Callsign: Helimed 2 (G-SASB)
A Eurocopter EC-135 (T2+) operated by Bond Air Services on behalf of the Scottish Ambulance Service lands at Raigmore Hospital in Inverness.

Cigarettes

Someone, in either flat C or D, has been smoking.

I object to this on multiple levels: willful destruction of self; harm to those around you; financial support of large unethical multi-nation corporations. However, on this occasion, I object for far more selfish reasons. There are smoke detectors frickin’ everywhere around here, and if I’m turfed out of my nice warm flat into the rain by the fire alarm… well, I will not be pleased. And I will be ratting them out, make no mistake.

Possibly, whomever the smoker is, they have already thought of this. I have myself encountered this problem. Not with cigarettes you understand, with toast. I bought a toaster from Tesco a few years ago, one of the Tesco Value ones, and it was kinda broken. It wouldn’t stay down, the clicky thing didn’t click, so I had to tie it down with a rubber band. It made the toaster work, but it worked indefinitely, just kept on toasting until I remembered it. I’ll admit, burnt toast was not an uncommon occurrence. That’s fine in itself, but when your burnt toast has the potential to turf several hundred students out of bed at 7:30am, it becomes more of an issue. So, I devised a cunning plan.

You must promise not to tell anyone about this, cause I’m sure it contravenes several health and safety regulations: I sellotaped a sandwich bag over the smoke detector. I know, I know. Dangerous. But it wasn’t a permanent addition to the smoke detector, more of an occasional accessory.

So, smokers of the world, quit (or at the very least tape up your smoke detector).

Every Journey

I have completed the first draft of my methods section! It is the smallest possible step I could take, methods being the shortest chapter in my thesis. However, despite the number of revisions ahead of me, it is a start and I’m glad of it.

Besides, if I can crank it out in 2 days, how long can the rest take, really?

Famous. Last. Words.

The Fear – Extended Director’s Edition

I’ve been pretty calm about my BSc thesis. I finished data collection weeks ago, analysis is half finished and we’re week on track to achieve our target of analysis complete by mid-March. All of this, I’m led to believe, puts me well ahead of other BSc’ers, particularly those doing lab based projects who are still battling with cell cultures and Western Blots.

You will recall I was back in Aberdeen at the weekend. On Friday I went by the administration office to see Morag, our course secretary. Together we went through the cupboard where they store all the theses from past students, and picked out a couple that used a similar qualitative methodology to mine. One used focus group and the other interviews, since I’m using both in my project I took both documents home with me. Obviously I was quite busy at the weekend seeing Amy, so I didn’t have a chance to look at them. And thank goodness I didn’t.

It only took me an hour or so to read through all the important bits of both theses this morning. It was then that I was struck by the enormity of the task facing me over the next 9 or 10 weeks. They are huge, and in one case unruly, documents. Several layers of carefully constructed denial fell away with an almighty mental crash and left me rather shell shocked. We are all familiar with The Fear. That ominous feeling that hits before exams, when you can no longer pretend they don’t exist, and one goes scurrying to the library. Well, I got a full on dose of The Fear this morning. I suspect the rest of this week will be spent in its icy clutches. Just how much of the next 9 weeks I will be spending there remains to be seen.

Dopamine

Well, I just changed my Facebook status, so I guess that makes it official: I’ve got a girlfriend.

I know, I’m just as surprised as you are. Her name’s Amy, and we went to school together, so we’ve know each other for more than 6 years. It happened at Hogmanay (that’s New Year to you English lot), totally unexpected. There was no alcohol involved (just wanted to mention that), it may have been spontaneous, but it was also sober! I decided that I had nothing to loose by telling her how I felt and, to my great relief, it wasn’t a one way street. Yay!

She’s a psychology student at Aberdeen, I’m obviously up in Inverness at the moment, so it’s a bit of a weekend relationship at present. Still, thanks to Apple and iMessage we have unlimited texts, just as well since we’re both fans of the long, essay-like message. Case in point, I just sent one that was 1118 characters long. You’d have thought twitter would have taught me to keep it brief.

I haven’t been in a relationship, or on so much as a date for that matter, since summer 2010. And to be honest, I was in a relationship in name only by the end, so I’m a bit out of practice at the whole thing. Thankfully I don’t seem to have done anything stupid yet; I wait with bated breath.

I don’t really know what else to tell you. I’m absolutely shattered after my four day weekend, so I think it’s time to call it a night. I’ve got two 15,000+ word theses waiting for me to read tomorrow, I’ll need to be well rested and well caffeinated for that.

Methods and Madness

I’ve been tapping away on twitter a lot recently about my research project, but I haven’t really explained what it is I’m doing.

Title: “To investigate what impact giving patients in general practice control of their booked appointment length has on the patient’s and the doctor’s experience of the consultation.”

It’s mostly qualitative research, although there is some numbers work involved too, which keeps me happy.

(I was in the coffee room the other day and someone asked me how I was getting on. “Fine; I’ve collected all my data and now I’m doing the fun bit, moving numbers around and calculating things!” They looked at me like I’d grown a second head, apparently you don’t have to be a stats enthusiast to be a GP trainee)

So anyway, data collection was quite simple. For 3 weeks; one before Christmas, two after; all the patients coming to see a particular GP that day would be directed to me first. I had a desk and things set up beside reception, but no seat unfortunately, so I was on my feet. All the patients had initially been asked if they were willing to take part by the admin team when they booked their appointment, but this didn’t constitute informed consent. However, it did at least mean they knew something different was going to be happening to them. So I explained what we were doing, and got them to sign my consent form. Which, incidentally, was a horribly worded document. I am led to believe the really convoluted bits – about people having access to your medical records, which wasn’t even required for the study – come straight off a standard research consent form given to us by the ethics committee. It that’s true, it’s shameful, because it was misleading, overly complicated and poorly worded. But I digress.

If they agreed to sign my consent form, which most did, I would give them a questionnaire to fill in after they’d seen the doctor. I cannot stress this enough. How many times did I say, “please fill this in after you’ve seen the doctor,” only to then have them start trying to fill it in in front of me, or go sit in the waiting room, where I can still see them, and start! Assuming they don’t forget/change their mind/have to rush off because their appointment was half an hour late, they would fill in the form and put it in the box next to my desk.

I would be consenting patients and collecting forms until lunch, then the fun really began. One of the questions on the consent form is “Would you be willing for a member of the research team to contact you to arrange a follow up interview?” We, the research team, were actually very surprised by the response to that. My supervisor in particular was worried that no one would want to have an interview, but actually the vast majority agreed. So every afternoon I would stick up the Do Not Disturb sign on my door and start calling patients. Before Christmas this went very well, everyone seemed to be at home, but in January people obviously had better things to do cause it was a nightmare trying to reach people.

Once I got a participant on the phone I would offer them either a face to face or telephone interview. Most took telephone which initially suited me fine, better than having to arrange a mutually convenient time, but as I got going I found that the quality of the interviews done face to face was significantly better than the telephone ones in most cases. Something for the discussion section of my thesis no doubt.

Interviews were, and I only recently learned that this was the correct term, ‘semi-structured’. I had four stem questions, five in the latter half of the research, that I asked everyone. Between these stem questions I was free to ask whatever I liked in response to what the participant was telling me. The range of comments was extraordinary. I think I had one gentleman who said about 6 words the whole time and wouldn’t budge no matter how much I pressed him. Compared with the woman who just about spoke for 15 minutes without any prompting from me.

Interviews were recorded on a dictaphone then transcribed. Initially this was being done by one of the typists in the practice, but I got bored one day and did a chunk of them myself. Once transcribed, the interviews were copied into an analysis program called NVivo which allows you do do fancy things with themes and highlights and annotations and is good fun as long as you don’t have to do it for too long.

The questionnaires are analyzed separately. All the questions are preference scales, the results of which I copied into SPSS, a software program I’m currently engaged in an affair with, and together we hunted for trends and significant results (there are precious few of either).

I might follow up with a post on the results, but I’m not sure how much I can release before publication. We are aiming for the British Journal of General Practice after all!

A failed attempt on Ben Wyvis

Really, I should have know better.

This is what the Mountain Weather Information Service had to say about the northwest highlands for Saturday:

Effect of Wind

Buffeting widely considerable even lower hills, and higher up, general mobility difficult for several hours. Severe wind chill.

Leaving aside the questionable grammar for a moment, the meaning is pretty clear. Still, I decided I’d like to have a go at a Munro, and since Ben Wyvis is closest to Inverness it seemed like a good enough choice.

Ben Wyvis, a snowy white mass in the distance

Things started out looking quite nice, it wasn’t too cold or even raining when I left the car park. I could see the mountain covered in snow and swathed in cloud, but from this distance it looked quite inviting.

The walk in follows the course of a stream for several kilometres, and the cold weather had created some lovely snow shapes and ice pools.

I bet that's cold

Ooh pretty!

At this stage the view back towards the valley was prettier than the mountain ahead.

A slightly icy but otherwise pleasant approach and the mountain starts to reveal quite how much of a monolith it is.

Looks like a hell of a long way to the top from here

This is the last nice view I got, before things really started to turn.

As soon as I started the ascent proper, the wind picked up. A strong breeze at first, it soon developed into a sideways storm threatening to push me off the wet stone steps laid into the ground.

Not so pleasent anymore; taken at about 500m elevation.

I met a couple of groups of people coming back down, all saying the same thing. “We had an attempt at the top, but didn’t get further than the big boulder about half way up.” Everyone was very nice and chatty, even more so than they are in the Cairngorms. I reassured them I had no ambition of hitting the summit today, but would see how I went on the way up.

Sure enough the higher I climbed, the windier it got. The wind also picked up rain, sleet and then hail as I ascended. By the time I reached the boulder that had served as the end point for the various groups I had passed, the weather situation was truly dire. I took shelter behind the stone monolith for a moment to assess the situation. I was still curiously warm and my gear was keeping me reasonably dry, so I had no worries in that regard. The path was very clear, and even if it hadn’t been, I had a map, a compass and the nous to use them. It did register in some small part of my brain that, in my rush to pack this morning, I had not brought the two things that would have been very useful if the proverbial shit hit the fan, namely my GPS and my survival blanket.

My hand was forced by a couple of lads I had passed a few 10s of meters back. They had one massive rucksack between them, ice axes strapped to it, but they didn’t strike me as completely prepared. I couldn’t quite put my finger on it, and possibly they were seasoned experts, but I just felt they looked less than comfortable in their gear. Slightly old looking jackets. You get the picture. They had said they were going to press ahead when we chatted as I overtook them. So, as I huddled behind that boulder, watching them close the gap between us, I felt I had no choice.

“To hell with it, if they can make it I can make it; onwards!”

I managed about 20 paces.

20 paces before the wind made it impossible not only to walk on the slick steps, but to even stand upright. “Ok, I’ve been defeated, no shame in that, time to head for home.” Except, getting down was proving to be altogether more tricky than getting up there. Walking headlong into the wind is all well and good. Turning your back on it and trying to head back done steep steps was almost my undoing.

So down onto all fours I went, creeping backwards away from the top, tail well and truly between my legs. Thankfully I managed to regain my upright posture before the two lads appeared through the clouds, huddled behind that same boulder I had paused at not minutes before. They’re faces said it all really, they weren’t going any higher today either.

Thus, I retreated, running most of the 3km back to the car, just for the fun of it. (I only slid on ice and ended up on my backside once.)

My intended route, and how far I managed to get