Induction

was long. And surprisingly tiring, considering all I did was sit on my behind all day.

Credit to the organisers, the day was relevant and well structured. I even think everyone got their IT access sorted! Lots of useful information about line managers and educational supervisors and other HR related queries.

I do indeed have a load of e-learning to do on hand washing, moving and handling, violence and agression, fire, etc, but hopefully it won’t take too long as I did it all last year.

The social media policy was fun to read, a bit intimidating but generally reasonable and proportionate.

My ID badge even says “Dr” on it, which was a nice surprise for all of us as there had been some discussion about that at the end of fifth year. The new medical grade titles (FY1, FY2, CT1, etc) are so poorly understood that having your title on your badge is important for recognition of your role by patients and nurses. (For the record I’d far rather be address by my first name, I’m not precious about the title.)

I’m doing my first day of shadowing tomorrow, shift starts at 8am so I better get some sleep. Can’t remember the last time I had to get up that early.

New Job

Screen Shot 2014-07-28 at 22.25.46 Sooooo….

It’s been a while since I last wrote anything here. Not sure if making a comeback is the right thing to do; the biggest celebrity comeback I have been aware of recently is the Monty Python reunion, and that doesn’t seem to have been particularly well received. I, however, am not in it for the money. Hopefully that will count in my favour. I figure that trying out the blogging thing again at the point of a major life transition (what? I’m a doctor now you say!?!) is worth a shot. So no promises from me, if it all falls apart I’m blaming it on the working hours (which actually seem remarkably civilised on paper, perhaps more on that a little later).

Opposite is the timetable for my first induction day tomorrow (29th July). No sign of the ever mocked hand-washing, moving and handling or fire safety, although my understanding is that will all be covered in the compulsory eLearning (joy). A session on social media in the morning, I might live tweet that one like I did with the medical school social media session😉

Hopefully I can skip out on the tour of the site (6 years…) and get home early.

Initially I wasn’t sure about dress code, it’s clearly a totally non-clinical day, so casual? Then I realised this was very much “medical student” thinking and (dammit Jim) I’m a doctor, I should probably try and dress the part at all times. Except night shift. I’m hoping I can ditch the shiny shoes and wear something a little more comfortable through the wee small hours. A pair of black trainers? I will ask during my first shadowing shift which is Wednesday!!!

By ross71521 Posted in Work

The Cloud Part 4 – Evernote

www.evernote.com

Cost: 45USD/year (free account available)
Storage: 1GB upload/month (60MB/month for free account)
Native clients: Mac, Windows, Chrome OS, iOS, Android, Blackberry, Palm, Windows Phone, Web
Twitter: @evernote

Evernote is the hub of my research project, and has been from the beginning. It is, at it’s core, a note taking app. But beyond simple rich text, it can also store all kinds of files within notes. Pictures and PDFs can be text searched, with words and characters identified by excellent server side optical character recognition. Voice notes can be created at the touch of a button. Word files and PowerPoints can even be stored if, for some reason, Dropbox isn’t also a major part of your life.

The first note I created related to my research project was a record of my first discussed with my supervisor about the project, way back in October. Since then, every research meeting I’ve had had been recoded in Evernote. My supervisor is a very visual learner, so he likes to draw diagrams on flip chats and whiteboards. A quick photo with my iPhone and I can keep a record of those in the note as well.

Next, when it came to actually consenting and interviewing patients, I kept all my records in Evernote. As ever, no confidential patient info went into the cloud, just their study number. All the details about what an individual consented to, whether they were interviewed and when, what doctor they saw, all just a couple of clicks away. Of course, this information was being generated continuously, which I why I had my iPad with me when I was speaking to patients. I updated details as I went along, keeping all kinds of useful information in the same place.

I was also using Evernote to keep my research diary. Everyday I would tap out a few lines, keeping a record of any problems or concerns, and how I was going to address them. The best thing about keeping everything digitally is it was almost impossible to loose information. If I had thought it, chances are I made a note of it, in which case my tagging system or a simple search would lead me instantly to it. No flicking though paper diaries or endless loose sheets of paper looking for the result jotted down on the corner of a random page. (This coming from the king of “I know I wrote it down somewhere.”)

Finally, now I’m writing my actually honest-to-God thesis, Evernote is once again proving itself invaluable. Each section (Introduction, Methods, Results, etc) is a separate note. There is no complicated formatting for me to fiddle about with. No margins thank goodness. Margins are the bane of my life. Well – margins, tabs, indents – the whole alignment business really gets to me. So thankfully there’s none of that. I just use bold for headings and that’s it. I plan to write and edit the whole thing in Evernote before moving to a Word document at the very last minute. I would be using Apple’s Pages software (much more user friendly handing of margins) but, as academics the world over have been complaining for years, it doesn’t have referencing support internally (without super expensive plugins), and Mendeley haven’t made a referencing tool for it either. So I’m stuck with Word, but thankfully only for a short period.

Evernote’s real strength is its ubiquity. As you can see from the list of native clints at the top of the page, it really is everywhere, and you can do almost everything on an iOS device that you can on a desktop (there is some stuff with tables that isn’t on mobile, but that’s the only thing that I was affected by). I don’t carry my laptop around with me, if I can’t do it on my iPad then I’m not interested. Evernote gives me that flexibility and that’s why it’s become such an indispensable tool.

The Cloud Part 3 – Dropbox

www.dropbox.com (This is my referral link, using it to sign up will net you 250MB additional free space, and me an extra 500MB!)

Cost: Free
Storage: 2GB
Native clients: Mac, Windows, Linux, iOS, Android, Blackberry, Web
Twitter: @Dropbox/@DropboxOps

Dropbox is possibly the best invention ever. It was founded in 2007 by two MIT students who were fed up with emailing themselves files to work on more than one computer. In truth, Dropbox isn’t actually anything revolutionary, it just makes it incredibly easy to do what’s been technically possible since the dawn of the internet.

Once you install Dropbox on a traditional computer (i.e. not a mobile device), it will create a folder in your home drive (for example ‘My Documents’ on an old skool Windows XP machine; I think Windows 7 has a different folder structure…?). You can install Dropbox on all the computers you’re using, and the contents of that folder will always be kept up to date. You can work on a file on one computer and save it to the Dropbox folder as usual. If you then go home and open the Dropbox folder on another computer, the file will be there, waiting for you. Simples.

I use Dropbox to store all the files relevant relevant to my BSc. Anything at all, it goes in my Dropbox (except anything patient identifiable. Putting patient data into the cloud is about as good an idea as jam made with broken glass; you’re going to get cut at both ends, as well as in the middle.) Then, when I have a brilliant idea at 3am, I have access to the file, no matter where I am. Dropbox is like a USB stick that you can’t loose. But it’s even better than a USB stick because additionally, the mobile apps mean you can access and edit your files on the go. And for the security minded amongst you, as we all should be, the mobile app (at least on iOS) has an optional pass code lock. There is also a web interface, meaning even if you’re on a computer where you can’t install Dropbox, like in an internet café, you can get to your files through a browser, although you have to download and upload them individually. Dropbox also has lots of sharing options for collaboration and a ‘Public’ folder where you can put files and get a public link to them, so you can share with anyone. Dropbox also has loads of little ways of gaining free space, like linking your Facebook and twitter accounts. Plus if you’re a student you get bonus space because Dropbox loves students.

So what are you waiting for, go sign up now (using the link at the top of the page if you wouldn’t mind. I don’t get to see who you are if you use it, it just gets both of us free space.)

The Cloud Part 2 – Mendeley

www.mendeley.com

Cost: Free
Storage: 500MB
Native clients: Mac, Windows, Linux, iOS, Web (third party Android apps available via the Mendeley API)
Twitter: @MendeleyTips/@MendeleySupport

Mendeley is a cloud/social reference management system. It has numerous features that I don’t utilise, such as collaborative working and discovering research papers. At present, I still use traditional sources to find my papers, such a PubMed or Ovid Medline. Once I’ve found one I’m interested in, I use a javascript bookmarklet in the bookmarks bar of my browser to copy the paper to my Mendeley account. This bookmarklet will scrape the paper information off the page and bring up a popup where I can modify basic information, like which folder it goes to, and allows me to add richtext notes if I want to. At the same time, I’ll download the PDF of the paper to my computer. The final step is to go to the Mendeley Desktop application, which I leave running in the background, and attach the PDF to the reference entry that’s just been created in my library.

There are other methods of getting paper and reference entry linked up, but I find this to be the most reliable one. Very occasionally, the bookmarklet will collect completely the wrong information about a paper. When this happens, it’s a simple case of copying the PMID from PubMed and pasting it into the application; Mendeley can find everything else from there. Once the PDF is linked to your library, it will be uploaded to the Mendeley server the next time you sync. It’s important to make a distinction between what is public and what is private at this point. Once you add a reference to Mendeley, it is part of the freely available database of citations. Mostly the paper will already be known to Mendeley, but occasionally with old papers you’re adding it for the first time. However, any PDFs you upload remain in your private library. You can access them from anywhere, but nobody else can.

The best thing about using Mendeley for papers is it’s consistency. I don’t know about you, but I’m forever downloading the PDFs of papers, and just saving them as is. Soon enough I’ve got 10 PDFs in my “Papers” folder, all of which have file names that are no more than a random string of characters. With Mendeley, the title, authors, journal, year and abstract are all stored in an intelligent, accessible fashion. Can’t remember what a paper was called, but remember the journal it was in? No problem, just sort your library by journal name.

Even better is the PDF handling aspect. All properly created PDFs, i.e. ones where the text layer is actually machine readable text and not just a picture of words, are indexed and searchable within the application. Very useful for when I forget to reference a passage when I put it into my thesis, and then need to find where it came from I also add highlights and ‘sticky notes’ to PDFs to help deal with information overload.

A very important aspect of all things cloud based for me is how well they integrate with mobile devices, and Mendeley have done an excellent job. You can view and edit the details of everything in your library from the app. Most importantly, you can also download all your papers so they stay on the device for offline use. The Mendeley app also appears in the “Open in…” menu when you view a PDF in Safari. This means you can add not just paper details but actually files to your library when on the go. The only limitation of the app is that you can’t view PDF highlights or annotations.

Of course, collecting my references is only half the battle, next I need to integrate them into my thesis. I can’t really comment on this process because I’ve never used Mendeley for this process before. However, they have a plugin for MS Word that allows you to add citations into the text as you go along and automatically generate a bibliography in whatever style you require. Or at least, that’s what I’ve heard, I really hope it works.

The Cloud Part 1 – The Problem

I hate using computers that aren’t mine. Mostly because the computers I have access to (that aren’t mine) invariably belong to some big organisation, like the university. And this, invariably, means they are running Windows. So basically, I hate using Windows. I’ve been bitten by the Apple bug and am now well and truly ‘locked in’ to their ‘ecosystem’. This doesn’t bother me; it is, on the whole, a very accommodating, pleasant ecosystem to inhabit. Indeed, my real problem comes when I have to leave that rainforest and venture into the contaminated, overcrowded city this is Microsoft Windows.

This is not the only reason I dislike using other computers. Things aren’t setup the way I like them. I don’t have access to all my stuff. I can’t compulsively check Twitter every 2 minutes. Etc.

Before I started my research project, it was clear that using my own computer was not going to be an option. First and foremost because of the data I was handling. Until I had collected all my data and got it formatted and anonymized correctly, I was dealing with a lot of patient identifiable stuff. This had to stay on the GP practice server, and to access it I would need a networked PC. Networking my MacBook was never on the cards.

On to a Windows PC it was then. And not even a new Windows PC. An old, mass-produced, NHS standard issue Dell PC running, what else, Windows XP. Back in the day, I liked XP. It was modern, user-friendly. I’m familiar with it, I’ve been using it since near enough the day it was released. Unfortunately that day was over 10 years ago. As much as I know how to use it, I know how painfully out of date it is. I trusted this computer to look after my precious thesis work about as much as I would trust the school bully to look after my homework. This was not computer and user in perfect harmony, it was a battle, one I had no intention of loosing.

So, how to solve these multitude of problems? The answer was the cloud. I have been using cloud services, like iCloud, Evernote and Dropbox, for a while now. I use all the iCloud services: address book, calendar, documents and photos. For awhile back in third year I was using Evernote for all my lecture notes, although that took a bit of a back seat because the app kept crashing (it’s fixed now).

Over the next couple of days I’m going to outline which services I use and explain how they help make my research life a little bit easier.

Food diary

Here’s pictures of everything I ate today. Why? Because I can.

Breakfast

Lunch Part 1

Lunch Part 2 - I forgot to photograph the chocolate before I ate it.

Dinner

Pudding - That's Nutella on the spoon.

Remote and Rural

I forgot to say, I’ve applied for the Remote and Rural option for 4th year. If I get it, it means I’ll be spending the whole of next year in Inverness.

I got an email on Friday telling me that I would find out if I had an interview for it this morning. Interveiws will be held tomorrow, which is a fine bit of notice since I need to travel back to Aberdeen for it. I need to travel back to Aberdeen from Inverness to be interviewed by people who have travelled down to Aberdeen from Inverness specifically to do these interveiws. It’s madness.

I’m getting very twitchy. I wish they would hurry up and let us know.

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.

By ross71521 Posted in BSc