Study Design – Deciding what is possible….

Currently I am practicing good Infection Control and am in quarantine – which has thrown a spanner in the works with regard to my active research at UHCW, but on the positive has given me time to work on planning my next phase of work.

Following the emerging themes produced from Study 1 and 2 (including interviews with Healthcare Professionals) the design for Study 3 has had to change.  It is no longer feasible to carry out the Inherent/Elective categorisation task as originally planned, as there is too much ‘noise’ around the concepts of Hand Hygiene triggers such as “Patient Contact” and “Contaminated Items”.  Therefore, instead of using existing audit data for a retrospective analysis, the new design involves an in-situ observational study collecting fresh Hand Hygiene data relating to specific activities deemed “Inherent” or “Elective” by current Healthcare Professionals.

From a conceptual point of view, this seems simple.  Indeed, when discussing the idea with others the idea – to see whether people perform Hand Hygiene more at certain points than others, and then whether this behaviour is stable – seems both clear and interesting; however when delving slightly deeper, the actual quantitative analysis required to investigate this theory appears much more complex.  Issues such as the use of binary (dichotomous) data, and a within-subjects design, makes the study actually quite abnormal.   However, after much design/re-design and discussions with some great sources of help, I think we may be getting close to a solution.  Today I thus have to just confirm that  the McNemar and Cochran Q are potentially solutions, and then I can firm up the design…

Whilst statistics are difficult in such cases, as has been said to me recently, the good part is once you have found the correct design, the actual carrying out is relatively simple. I cannot say how much I am looking forward to that part…!  The redesign of Study 3 has really shown how hard it can be to decide what is possible in research – having to compromise what you find interesting with what is possible to quantify or work into a design.  Patience, logic and the understanding that future work is always an option.  Lessons learnt…!

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Loneliness of the Long Distance PhD Student

The title of this post comes directly from a ‘misquote’ inspired by ‘The Loneliness of the Long Distance Runner’ – and was something I was thinking about when I was out on a bit of a run with the Trainers of Glory yesterday.

Having been ‘off’ running for a few weeks I had been a bit worried about making it through the event, but with the support of my lovely running buddies the day went well – even with the unscheduled ‘pit stop’ with the lovely chaps of the St John’s Ambulance – so I think the conclusion was that I am back on track with the plan for our ‘big’ challenge later in the year.  

Thus, whilst out in the Warwickshire countryside, my thoughts turned to my PhD journey; which is now into its 4th year, and has seen many twists and turns.  The 4th year is an ‘extension’ period, rather than being an originally planned 4th year, and is reflective of how time-consuming a PhD can be when things do not go to plan.  The concept of ‘loneliness’ is not a new one when discussing PhD students, the advice is plentiful as to making sure you have regular contact with peers, outside activities, contact with your department etc; however the ‘burden’ of responsibility towards your project, and in many cases those who have given their time and help to you, can make you feel isolated – solely responsible, dealing with issues that no-one else will understand or even be interested in… 

So, the PhD is definitely more of a marathon than a sprint – and what I’ve learnt with my running is that the support of others is key; and I realise that over my PhD history the hardest times have been when I have felt isolated.  The past week was very difficult, because I felt I had the weight of the world – or rather the project – on my shoulders, and that I had to try and solve all the problems, all at once, and all alone. Wrong.  Once I started to discuss the issues with some key people related to the work I was amazed at how much better I felt – it didn’t feel like admitting failure, nor did it result in complete panic/astonishment/horror in their eyes; just an understanding ear, a shoulder to lean on, and more offers of help than you could possibly imagine. 

To complete the analogy then, I’ve decided to see this past week as my ‘unscheduled pit-stop’ – and thus I am very hopeful that the outcome will be the same as Sunday, that I can now go on to complete successfully.  Time is growing short, and no-doubt there are more challenges ahead, but exciting times too – including the HPA2012 conference next week, and a number of sessions with staff at my case study site to keep me rooted in the active research….

Smooth Pit Stop – essential for success! (picture from uk.eurosport.yahoo.com)

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A Golden Weekend

  Some weekends are just golden, and it has to be said the one just passed can definitely be classed as such an example.  After a rather difficult few days with work, with research hitches seeming to come from all sides, expected and unexpected, it was wonderful to wrap Friday up on a positive – including a great email conversation with a dedicated Infection Control champion – and then delve into a weekend of indulgence.  And cake.  Amazing cake.

I managed to talk about my work and gradually developing future plans with a dear friend on Friday evening, and this helped me clarify in my own head many of the ‘need to do’ stepping stones that make up my chosen path.  Sometimes it really helps to talk to someone outside the bubble of academia, because they ask the questions you forget to ask yourself.

Saturday and Sunday were all about relaxing and recharging, and I was very fortunate to find the best of the sunshine to enjoy the beautiful grounds at Burghley, indulge in lunch at the Orangery, then join the rest of the country (so it seemed!) in watching the Olympic triumphs in the evening.  It is wonderful to see how the country can embrace hard work, dedication and team work – and how humble all the athletes are when interviewed, continually thanking other people. After a week of seeming like I have constantly needed other people’s support in my own work, it has been good to see that even these high achievers have a support network they continue to turn to.

Oh, and on Sunday I had a birthday.  Did I mention there was cake?

My main objective this week is to complete my transcriptions, and by the end of the week have Phase 2 fully mapped out for the end of August and September.  This will require me calling again on those around me who have continued to support me throughout this process, but I feel that together we can keep the project moving forwards, and the more I listen to the interviews already collected, the more I am motivated to ensure we take this work somewhere….

For your chance to be involved in Phase 2 – click here