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Biomedical subjects

Peter Campion

Publications and source records attributed to Peter Campion.

11 recordsLinked to original sources
PubMed2006

Involve the patient and pass the MRCGP: investigating shared decision making in a consulting skills examination using a validated instrument.

BACKGROUND: Shared decision making is an important aspect of patient centredness. Lack of this consulting behaviour is a common reason for failure in the Membership of the Royal College of General Practitioners (MRCGP) consulting skills examination. AIM: To investigate candidates' performance in shared decision making and overall performance in the MRCGP consulting skills assessment compared with an independently validated measure, the OPTION ('observing patient involvement') scale. DESIGN: Cross-sectional study. SETTING: MRCGP examination, UK. PARTICIPANTS: Two hundred and fifty-two consultations submitted by 36 GPs submitting seven consultations per videotape. METHOD: A stratified sample of 63 candidates, 21 each from fail, pass and merit selected from candidates in the MRCGP consulting skills examination, were approached for participation. Participants' examination videotapes were independently assessed for shared decision making using the OPTION scale by two non-clinical raters. RESULTS: Thirty-six candidates (of 63; 57%) who participated were no different from non-participants. Candidates who passed the 'sharing management options' in the MRCGP had significantly higher OPTION scores than those who did not (35.4 versus 27.3; mean difference = 8.1, P = 0.044). There was a significant difference between OPTION scores of MRCGP candidates with 'fail' and 'pass' (including pass with merit): 28.6 versus 36.1, 95% confidence interval CI = 1.13 to 13.87. Scores decreased as clinician age increased but were not significantly associated with sex of GP, age or sex of patient or consultation duration. The probability of passing the MRGCP increased as OPTION scores increased. CONCLUSION: This study demonstrated concurrent validity of the MRCGP consulting skills assessment of sharing management options against an independent validated instrument for shared decision making, the OPTION scale. Candidates who performed best in the MRCGP exhibited high scores with OPTION. This study provides the basis for further work to demonstrate evidence for the potential of training for professional assessment to improve consulting competence.

Adult↗
PubMed2005

Smuggled tobacco, deprivation and addiction.

OBJECTIVE: To identify the links between smuggled tobacco, deprivation and addiction across one Health Authority in the North East of England and identify the impact on people living in disadvantaged areas. DESIGN: Anonymous postal survey. Sample size 11 443. Multivariate analysis including an 'Ideal Types analysis' examined the probabilities of purchase of smuggled tobacco and associations with population characteristics. SETTING: Sample taken from across the Hull & East Riding Health Authority area in the UK. PARTICIPANTS: Randomly selected from those aged 16 and over, who were registered with a GP in the Health Authority area on the 1 September 2000. RESULTS: The predicted probability of having ever bought smuggled tobacco for a male, employed, heavy smoker living in a deprived area was 0.67. A female with the same characteristics had a probability of 0.49. For the unemployed the probabilities are 0.55 and 0.37 respectively. For respondents living in non-deprived areas the probability of having ever bought smuggled tobacco was much lower. This probability was further reduced for respondents who were unemployed. Respondents living in deprived areas had a 134% higher probability of being heavily addicted to tobacco. Links between addiction and deprivation are confirmed. CONCLUSIONS: This study confirms and extends the findings of previous qualitative studies. The results of this analysis demonstrate that people who have bought smuggled tobacco are heavy smokers with high levels of addiction, living in socially deprived areas, but are more likely to be in employment. They are likely to use smuggled tobacco to save money and sustain their smoking habit.

Adolescent↗
PubMed2004

Achieving multiple topic shifts in primary care medical consultations: a conversation analysis study in UK general practice.

The 'by the way' phenomenon, while commonly described in medical texts on the consultation, has not been systematically explored from an interactional perspective. Starting from a 'noticing' of an example of this phenomenon we studied a collection of over 200 recorded consultations in British general practice. New topics were introduced by both parties, but more commonly by patients, who used two sorts of device to change topic: an announcement, usually at the start of a consultation, but sometimes later, that they had multiple topics, which we have called a 'pre-announcement', and an apparently unexpected sudden change of topic, which we have called an 'in-situ announcement'. These phenomena occurred in about one third of our unselected collection of recorded consultations, drawn from nine doctors, and 27 surgery (office) sessions. We argue that this management of multiple topics is an important and normal part of the consultation, in contrast to its problematic status implied in some medical literature.

Family Practice↗