I am amending an earlier IRB from a previous project. As part of that project, I interviewed 2 hospitalists, 1 hospitalist practitioner, 1 primary care physician, an administrator, and an ER Nurse Manager at one hospital. Questions covered either their role as a hospitalist or how they interact with the hospitalist program. The focus of the study was on communication practices for this new field which has only been in existence since 1996.
This is the beginning of my memo which will be an attachment to my original IRB. Mrs. Donna Peters, in the Tech IRB office, suggested this as the best step to take. I'm still working on the questions but have the overall plan in mind. Dr. Amy Koerber was my PI and will continue as my PI with the amended IRB.
The focus of this study will be on documentation practices of hospitalists. Hopefully this will include looking over documents they produce as a mini-ethnography, observe them creating the documents and then conduct a "think out loud" protocol as they explain the words they selected in their documents. I'd record (probably video this time instead of just audio), transcribe and analyze.
Let me know your thoughts - below is the first draft of my memo. As stated before, I'm still working on the questions, so they are not included!
DATE: January 18, 2009
TO: Texas Tech’s IRB Committee
FROM: Debra Burleson, Ph.D. student; Dr. Amy Koerber, PI
SUBJECT: Amendment to IRB # 501064
My original IRB request in the fall of 2007 was titled “Study of Communication Practices and Expectations of Hospitalists.” Dr. Amy Koerber is my PI. I am continuing this study by adding interviews with hospitalists who were not interviewed in my prior study. I will focus on their documentation practices as they record patient information to be used by hospital personnel during the patient’s hospital stay but also used by the patient’s primary care physician and other specialists.
If time permits, I would like to interview the two hospitalists and a hospitalist practitioner interviewed in my prior study and focus on the same research as mentioned above.
All interviews will be videotaped so that the researcher can transcribe and analyze their procedures but also to use a “think out loud” protocol to capture their thought processes as they write.
I have attached the questions I will ask the hospitalists.
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5 comments:
I think this is a very interesting project with a lot of potential. I agree that a video recording is better than an audio recording for your project as I think mannerisms and facial expressions can be very telling and may provoke questions that audio alone would not.
I worry about your ability to complete a project of this scope within a semester time frame. Clearly this a project that interests you enough to pursue after the semester but I wonder if for the purposes of this class you might want to focus on one particular aspect of the study.
This won't impact your IRB as you would want to do that for the entire study but as one who has often bit off more than I can chew in the project department...
I just wondered what "think out loud" protocol is, and if that is something you should describe in more detail in your proposal?
Also, what is a hospitalist?
I'm new to writing comments back! So, this is for Deanna.
I think you are right about focus. Frankly, I sometimes forget that I can gather enough data for more than one study and yet focus on one aspect at a time. I'm struggling with the questions but our MOO session and readings helped.
Thanks for the comments. D.
Jeannie B.
I should have attached my original IRB. Just in case you don't want to read through it, I'll answer your questions (noting that I need to add some info about "think out loud" protocol).
Hospitalists are internists who only care for patients once they are admitted to a hospital. They do not see these patients after discharge - care reverts to the patients' primary care physician. The hospitalist profession has only existed since 1996, and so one of the interesting aspects of the profession is that no one who is currently a hospitalist trained to be in that role. It is a specialty profession and yet they have not received training. All hospitalists completed medical school/residency with primary care in mind.
I first heard about "think out loud" protocol in November from a Ph.D. student from Belgium. Instead of the researcher making assumptions or guessing, the participant talks through the process of (example) why they made a certain decision. The researcher videos the participant thinking through whatever process they are undertaking.
Trying to get ahead on our readings for the semester, I've read Spinuzzi's book and he mentions this protocol.
Thanks for your comments.
Debra
from Svetlana Rybalko
I find it really interesting topic. I myself had an experience with this kind of care provision, or maybe not exactly the same, but very close....
I was not in the hospital but I was visiting a clinik over a period of one year. I had a permanant doctor, but I was usually seen by internists.
So what I noticed was that, ofcourse all of them were nice and friendly,
but you just don't spend enough time with one person to build any kind of relationships. So, different people were seeing and took notes and reports and measures. But eventually all of this recorded information taken by different people every time was not enough to catch premature delivery.
My guess is that if the same person would see me every time, this would not happen. So going back to taking notes and records - I am sure that you cannot catch and write down everything.But if the same person sees you as a doctor, he would for sure see some changes, that could not be easily tracked by reading medical documentation!
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