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Biomedical subjects

Lyndal Trevena

Publications and source records attributed to Lyndal Trevena.

9 recordsLinked to original sources
PubMed2005

Impediments to higher degree training for Australian clinical researchers in general practice.

CONTEXT & OBJECTIVE: Evidence-based general practice requires skilled researchers in the field. This study explores the issues faced by professionals from the Australian general practice sector who were considering higher degree training in research. METHOD: Sixteen participants were interviewed by telephone during October 2002. All were purposively selected across general practice-related professions and had expressed an interest in research. Interviews were audio-taped, transcribed and analysed independently by two researchers. RESULTS: Three main themes emerged: (1) "The Specialist Gap"--a perceived lack of training options providing research skills that were relevant to general practice, particularly mixing quantitative and qualitative methods. (2) "Career Changes"--the ability to expand career opportunities through research was highly desirable, particularly the potential to combine clinical skills with population health roles. (3) "Career impediments"--perceptions of current degree options implied that their currency was limited by lack of career advancement. Course selection was often by affiliation and personal recommendation rather than career pathways yet students face large financial costs for little career gain. CONCLUSION: Training for clinical researchers in the Australian general practice sector may be limited by lack of career opportunities for graduates. If a stronger culture of research is to develop, career development strategies need to be further explored.

Australia↗
PubMed2004

Protocol for a randomised controlled trial of a decision aid for the management of pain in labour and childbirth [ISRCTN52287533].

BACKGROUND: Women report fear of pain in childbirth and often lack complete information on analgesic options prior to labour. Preferences for pain relief should be discussed before labour begins. A woman's antepartum decision to use pain relief is likely influenced by her cultural background, friends, family, the media, literature and her antenatal caregivers. Pregnant women report that information about analgesia was most commonly derived from hearsay and least commonly from health professionals. Decision aids are emerging as a promising tool to assist practitioners and their patients in evidence-based decision making.Decision aids are designed to assist patients and their doctors in making informed decisions using information that is unbiased and based on high quality research evidence. Decision aids are non-directive in the sense that they do not aim to steer the user towards any one option, but rather to support decision making which is informed and consistent with personal values. METHODS/DESIGN: We aim to evaluate the effectiveness of a Pain Relief for Labour decision aid, with and without an audio-component, compared to a pamphlet in a three-arm randomised controlled trial. Approximately 600 women expecting their first baby and planning a vaginal birth will be recruited for the trial.The primary outcomes of the study are decisional conflict (uncertainty about a course of action), knowledge, anxiety and satisfaction with decision-making and will be assessed using self-administered questionnaires. The decision aid is not intended to influence the type of analgesia used during labour, however we will monitor health service utilisation rates and maternal and perinatal outcomes. This study is funded by a competitive peer-reviewed grant from the Australian National Health and Medical Research Council (No. 253635). DISCUSSION: The Pain Relief for Labour decision aid was developed using the Ottawa Decision Support Framework and systematic reviews of the evidence about the benefits and risks of the non-pharmacological and pharmacological methods of pain relief for labour. It comprises a workbook and worksheet and has been developed in two forms - with and without an audio-component (compact disc). The format allows women to take the decision aid home and discuss it with their partner.

Journal Article↗
PubMed2003

Integrated decision making: definitions for a new discipline.

The birth and early growth of a new discipline from the union of evidence-based medicine (EBM) and the theoretical foundations of human psychology and behaviour has led to a plethora of new terms to define and redefine a paradigm shift in clinical decision making. This paper provides a short glossary of (1) terms to describe the practitioner-patient relationship in decision making and (2) terms describing some of the tools for facilitating evidence-based decision making. In addition, it is proposed that a more acceptable name for this discipline may be 'integrated decision making' (IDM). A case is argued for the fact that this term better addresses many of the concerns raised by practitioners and consumers about barriers to the integration of evidence and patient preferences in clinical practice and the changing nature of the practitioner-patient relationship in healthcare today.

Cooperative Behavior↗
PubMed2003

What medical students value in a population health tutor: characteristics for consideration in staff recruitment and development.

BACKGROUND: Recent moves to integrate aspects of population health into medical curricula have created new staff development challenges for many institutions. Small group teaching in population health is a relatively new initiative, often requiring recruitment of additional staff and considerable training. This analysis identifies the tutor characteristics rated most positively by medical students in a small-group course in population health and discusses their implication for staff recruitment and development. METHOD: Retrospective evaluation of tutors by students using a self-administered questionnaire. Overall tutor rating was analysed against various tutor characteristics, using univariate logistic regression methods. Optional qualitative comments were summarized by thematic methods and triangulated with findings from the quantitative analysis. RESULTS: Creating a supportive group climate was the tutor attribute most positively evaluated by students (OR=9.62, 95%CI 4.46-20.83). Perceived interest in teaching (OR=8.93, 95%CI 3.83-20.83) and the ability to give useful feedback (OR=8.40, 95%CI 4.07-17.54) were also highly rated by students as valuable qualities in their tutors. Qualitative analysis highlighted the importance of informed comment, good knowledge and expert input from tutors. CONCLUSION: Whilst a degree of content expertise in population health was desirable in a tutor, its value was secondary to good facilitation skills and an enthusiasm for teaching when student evaluation was considered. Faculties implementing small-group methods of teaching population health should consider facilitation skills and interest in teaching as priorities when recruiting and training staff. As is the case for self-directed student-led learning in basic and clinical sciences, these appear to be more influential than content expertise, from the students' perspective.

Australia↗