Qualitative Interviewing: The Art of Hearing Data

Background
Educational meetings are widely used for continuing medical education. Previous reviews found that interactive workshops resulted in moderately large improvements in professional practice, whereas didactic sessions did not.

Objectives
To assess the effects of educational meetings on professional practice and healthcare outcomes.

Search methods
We updated previous searches by searching the Cochrane Effective Practice and Organisation of Care Group Trials Register and pending file, from 1999 to March 2006.

Selection criteria
Randomised controlled trials of educational meetings that reported an objective measure of professional practice or healthcare outcomes.

Data collection and analysis
Two authors independently extracted data and assessed study quality. Studies with a low or moderate risk of bias and that reported baseline data were included in the primary analysis. They were weighted according to the number of health professionals participating. For each comparison, we calculated the risk difference (RD) for dichotomous outcomes, adjusted for baseline compliance; and for continuous outcomes the percentage change relative to the control group average after the intervention, adjusted for baseline performance. Professional and patient outcomes were analysed separately. We considered 10 factors to explain heterogeneity of effect estimates using weighted meta-regression supplemented by visual analysis of bubble and box plots.

Main results
In updating the review, 49 new studies were identified for inclusion. A total of 81 trials involving more than 11,000 health professionals are now included in the review. Based on 30 trials (36 comparisons), the median adjusted RD in compliance with desired practice was 6% (interquartile range 1.8 to 15.9) when any intervention in which educational meetings were a component was compared to no intervention. Educational meetings alone had similar effects (median adjusted RD 6%, interquartile range 2.9 to 15.3; based on 21 comparisons in 19 trials). For continuous outcomes the median adjusted percentage change relative to control was 10% (interquartile range 8 to 32%; 5 trials). For patient outcomes the median adjusted RD in achievement of treatment goals was 3.0 (interquartile range 0.1 to 4.0; 5 trials). Based on univariate meta-regression analyses of the 36 comparisons with dichotomous outcomes for professional practice, higher attendance at the educational meetings was associated with larger adjusted RDs (P < 0.01); mixed interactive and didactic education meetings (median adjusted RD 13.6) were more effective than either didactic meetings (RD 6.9) or interactive meetings (RD 3.0). Educational meetings did not appear to be effective for complex behaviours (adjusted RD -0.3) compared to less complex behaviours; they appeared to be less effective for less serious outcomes (RD 2.9) than for more serious outcomes.

Authors' conclusions
Educational meetings alone or combined with other interventions, can improve professional practice and healthcare outcomes for the patients. The effect is most likely to be small and similar to other types of continuing medical education, such as audit and feedback, and educational outreach visits. Strategies to increase attendance at educational meetings, using mixed interactive and didactic formats, and focusing on outcomes that are likely to be perceived as serious may increase the effectiveness of educational meetings. Educational meetings alone are not likely to be effective for changing complex behaviours.

Continuing education meetings and workshops: effects on professional practice and health care outcomes

Preface (1999) Preface (1990) 1. Subjects of Sex/Gender/Desire I. 'Women' as the Subject of Feminism II. The Compulsory Order of Sex/Gender/Desire III. Gender: The Circular Ruins of Contemporary Debate IV. Theorizing the Binary, the Unitary and Beyond V. Identity, Sex and the Metaphysics of Substance VI. Language, Power and the Strategies of Displacement 2. Prohibition, Psychoanalysis, and the Production of the Heterosexual Matrix I. Structuralism's Critical Exchange II. Lacan, Riviere, and the Strategies of Masquerade III. Freud and the Melancholia of Gender IV. Gender Complexity and the Limits of Identification V. Reformulating Prohibition as Power 3. Subversive Bodily Acts I. The Body Politics of Julia Kristeva II. Foucault, Herculine, and the Politics of Sexual Discontinuity III. Monique Wittig - Bodily Disintegration and Fictive Sex IV. Bodily Inscriptions, Performative Subversions Conclusion - From Parody to Politics

Postmodern Subjects, Postmodern BodiesThinking Fragments: Psychoanalysis, Feminism, and Postmodernism in the Contemporary WestYearning: Race, Gender, and Cultural PoliticsGender Trouble: Feminism and the Subversion of Identity

Social research, issues, methods and process

Gender, health and theory: conceptualizing the issue, in local and world perspective.

Complementary medicine is increasingly popular for treating many different problems. Doctors and patients need evidence about complementary treatments, but randomised controlled trials need to be carefully designed to take holism into account and avoid invalid results 

You think that by understanding one, you can understand two, for one and one is two. But to understand two, you must first understand “and.” Sufi saying1

Complementary medicine should be evaluated as rigorously as conventional medicine to protect the public from charlatans and unsafe practices,2–5 but many practitioners of complementary medicine are reticent about evaluation of their practice. Sceptics maintain that this is because of fear that investigations will find treatments ineffective and threaten livelihoods. In defence, many practitioners argue that research methods dissect their practice in a reductionist manner and fail to take into account complementary medicine's holistic nature leading to invalid evaluation.

#### Summary points

Complementary medicine comprises many different disciplines, a wide spectrum of practices and philosophies which differ from conventional medicine. Conventional medicine traditionally aims to diagnose illness and treat, cure, or alleviate symptoms. Many complementary disciplines aim not only to relieve symptoms and restore wellness but also to help individuals in a process of self healing within a holistic view of health. In this view, individuals are more than just mind, body, and spirit in a social—family …

https://www.bmj.com/content/bmj/325/7368/832.1.full.pdf

Evaluating complementary medicine: methodological challenges of randomised controlled trials.

Reflexivity is a key aspect of qualitative research. Considerable attention has been given to the ways in which gender mediates the production and analysis of qualitative data; however, much of this has been focused on qualitative interviews with women and the influence of the interviewer’s gender in this specific context. Very little work has been done on comparing different interviewer–interviewee contexts such as male‐to‐female, male‐to‐male or female‐to‐male interviewing. Moreover, the interplay of gender with environmental, psycho‐social and other biographical factors within the interview has received little attention. Drawing on four different studies on cancer care, work and family, and parenting, this article examines how each of these factors potentially mediate the collection of qualitative data in a range of interviewer–interviewee contexts. Moreover, it explores gender as both resource and delimiting factor, examining the use of impression management as a researcher tool to mediate potentially...

The role of gender, environment and Individual biography in shaping qualitative interview data

The role of gender, environment and individual biography in shaping qualitative interview data | NOVA. The University of Newcastle's Digital Repository

Objective To evaluate a training programme intended to improve the management of obesity, delivered to general practice teams.

Design Cluster randomised trial.

Setting Northern and Yorkshire region of England

Participants 44 general practices invited consecutively attending obese adults to participate; 843 patients attended for collection of baseline data and were subsequently randomised.

Intervention 4.5 hour training programme promoting an obesity management model.

Main outcome measures Difference in weight between patients in intervention and control groups at 12 months (main outcome measure) and at 3 months and 18 months; change in practitioners' knowledge and behaviour in obesity management consultations.

Results Twelve months after training the patients in the intervention group were 1 (95% confidence interval - 1.9 to 3.9) kg heavier than controls (P = 0.5). Some evidence indicated that practitioners' knowledge had improved. Some aspects of the management model, including recording weight, target weight, and dietary targets, occurred more frequently in intervention practices after the training, but in absolute terms levels of implementation were low.

Conclusion A training package promoting a brief, prescriptive approach to the treatment of obesity through lifestyle modification, intended to be incorporated into routine clinical practice, did not ultimately affect the weight of this motivated and at risk cohort of patients.

/pdf/improving-management-of-obesity-in-primary-care-cluster-1tnq7zcbqh.pdf

Improving management of obesity in primary care : cluster randomised trial.

Stepping back from the immediate demands of policy-making, Mainstreaming Complementary and Alternative Medicine allows a complex and informative picture to emerge of the different social forces at play in the integration of CAM with orthodox medicine. Complementing books that focus solely on practice, it will be relevant reading for all students following health studies or healthcare courses, for medical students and medical and healthcare professionals.

https://ndl.ethernet.edu.et/bitstream/123456789/63402/1/18.pdf

Philip Tovey

Papers

Evaluating complementary medicine: methodological challenges of randomised controlled trials.

The role of gender, environment and Individual biography in shaping qualitative interview data

The role of gender, environment and individual biography in shaping qualitative interview data | NOVA. The University of Newcastle's Digital Repository

Improving management of obesity in primary care : cluster randomised trial.

The Mainstreaming of Complementary and Alternative Medicine Studies in Social Context