ORCID Profile
0000-0001-8744-930X
Current Organisations
Monash University
,
University College London
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: BMJ
Date: 06-2022
DOI: 10.1136/BMJOPEN-2021-057655
Abstract: To investigate the impact of the COVID-19 pandemic on the research activity and working experience of clinical academics, with a focus on gender and ethnicity. Qualitative study based on interviews and audio/written diary data. UK study within clinical academia. Purposive s le of 82 clinical academics working in medicine and dentistry across all career stages ranging from academic clinical fellows and doctoral candidates to professors. Qualitative semistructured interviews (n=68) and audio diary data (n=30 including 16 participants who were also interviewed) collected over an 8-month period (January–September 2020), thematically analysed. 20 of 30 (66.6%) audio diary contributors and 40 of 68 (58.8%) interview participants were female. Of the participants who disclosed ethnicity, 5 of 29 (17.2%) audio diary contributors and 19/66 (28.8%) interview participants identified as Black, Asian or another minority (BAME). Four major themes were identified in relation to the initial impact of COVID-19 on clinical academics: opportunities, barriers, personal characteristics and social identity, and fears and uncertainty. COVID-19 presented opportunities for new avenues of research. Barriers included access to resources to conduct research and the increasing teaching demands. One of the most prominent subthemes within ‘personal characteristics’ was that of the perceived negative impact of the pandemic on the work of female clinical academics. This was attributed to inequalities experienced in relation to childcare provision and research capacity. Participants described differential experiences based upon their gender and ethnicity, noting intersectional identities. While there have been some positives afforded to clinical academics, particularly for new avenues of research, COVID-19 has negatively impacted workload, future career intentions and mental health. BAME academics were particularly fearful due to the differential impact on health. Our study elucidates the direct and systemic discrimination that creates barriers to women’s career trajectories in clinical academia. A flexible, strategic response that supports clinical academics in resuming their training and research is required. Interventions are needed to mitigate the potential lasting impact on capacity from the pandemic, and the potential for the loss of women from this valuable workforce.
Publisher: Wiley
Date: 17-01-2022
DOI: 10.1111/MEDU.14724
Abstract: A taskforce established by Medical Education asks readers to engage in discussion about how the journal and field can do better to ensure that health professional education publishing is inclusive of erse knowledge and perspectives.
Publisher: Wiley
Date: 05-2018
DOI: 10.1111/TCT.12793
Publisher: Springer Science and Business Media LLC
Date: 03-09-2020
DOI: 10.1007/S10459-019-09914-4
Abstract: While University students increasingly participate in work-integrated learning (WIL), their dignity is often violated during WIL. The current literature is limited in so far as it typically focuses on student perspectives within healthcare contexts and does not use the concept of 'dignity'. Instead, this study explored student and supervisor perspectives on student dignity during WIL across healthcare and non-healthcare disciplines. Research questions included: What are: (1) types of student dignity experiences and patterns by groups (2) factors contributing to experiences (3) consequences of experiences? Sixty-five semi-structured interviews were conducted using narrative interviewing techniques with 30 supervisors and 46 students from healthcare (medicine, nursing and counselling) and non-healthcare (business, law and education) disciplines. Data were analyzed using framework analysis. Nine common narrative types were identified within 344 stories: verbal abuse, right for learning opportunities, care, inclusion, reasonable expectations, right for appropriate feedback, equality, trust, and right to be informed. Factors contributing to dignity experiences and consequences were often at the in idual level (e.g. student/supervisor characteristics). We found some salient differences in perceptions of experiences between students and supervisors, but few differences between healthcare and non-healthcare disciplines. This study extends WIL research based on student perspectives in healthcare, and provides practice and further research guidance to enhance student dignity during WIL.
Publisher: BMJ
Date: 09-2022
DOI: 10.1136/BMJOPEN-2021-060281
Abstract: Evaluate existing evidence on interventions intended to increase recruitment, retention and career progression within clinical academic (CA) careers, including a focus on addressing inequalities. Systematic review. Medline, Embase, Cochrane Controlled Register of Trials, PsycINFO and Education Resource Information Center searched October 2019. Eligible studies included qualified doctors, dentists and/or those with a supervisory role. Outcomes were defined by studies and related to success rates of joining or continuing within a CA career. Abstract screening was supported by machine learning software. Full-text screening was performed in duplicate, and study quality was assessed. Narrative synthesis of quantitative data was performed. Qualitative data were thematically analysed. 148 studies examined interventions of which 28 were included in the quantitative synthesis, 17 in the qualitative synthesis and 2 in both. Studies lacked methodological rigour and/or were hindered by incomplete reporting. Most were from North America. No study included in the syntheses evaluated interventions aimed at CA dentists. Most quantitative evidence was from multifaceted training programmes. These may increase recruitment, but findings were less clear for retention and other outcomes. Qualitative studies reported benefits of supportive relationships, including peers and senior mentors. Protected time for research helped manage competing demands on CAs. Committed and experienced staff were seen as key facilitators of programme success. Respondents identified several other factors at a programme, organisational or national level which acted as facilitators or barriers to success. Few studies reported on the effects of interventions specific to women or minority groups. Existing research is limited by rigour and reporting. Better evaluation of future interventions, particularly those intended to address inequalities, is required. Within the limits of the evidence, comprehensive multifaceted programmes of training, including protected time, relational and support aspects, appear most successful in promoting CA careers. Open Science Framework: osf.io/mfy7a
Publisher: Springer Science and Business Media LLC
Date: 12-2021
DOI: 10.1007/S40670-021-01476-8
Abstract: The Foundation Interim Year-one (FiY1) Programme was part of a UK strategy to increase the medical workforce in response to the COVID-19 pandemic. However, the strategy was introduced urgently without evidence. We sought to explore the transition experience of medical student to FiY1 to foundation doctor, with a view to inform future undergraduate education. In this hermeneutic phenomenology study, semi-structured in idual interviews were completed with nine foundation doctors who had experience of an FiY1 placement. A template analysis approach was taken, and themes reported. Participants reported that FiY1 tended to offer a positive experience of transition as a stepping stone to becoming a foundation doctor. Having a degree of clinical responsibility including the right to prescribe medication with supervision was highly valued, as was feeling a core member of the healthcare team. Participants perceived that FiY1 made them more prepared for the foundation transition, and more resilient to the challenges they faced during their first foundation job. The FiY1 fostered many opportunities for junior doctors to bridge the transition to foundation doctor. Aspects of the FiY1 programme, such as early licencing and increased team membership, should be considered for final-year students in the future.
Publisher: BMJ
Date: 06-2013
Publisher: Informa UK Limited
Date: 17-06-2021
Publisher: Informa UK Limited
Date: 18-08-2022
Publisher: Wiley
Date: 22-08-2015
DOI: 10.1111/MEDU.12784
Publisher: Informa UK Limited
Date: 27-12-2020
Publisher: Wiley
Date: 25-08-2020
DOI: 10.1111/MEDU.14201
Publisher: Wiley
Date: 15-04-2019
DOI: 10.1111/MEDU.13869
Publisher: Wiley
Date: 09-09-2013
DOI: 10.1111/MEDU.12215
Abstract: The delivery of undergraduate clinical education in underserved areas is increasing in various contexts across the world in response to local workforce needs. A collective understanding of the impact of these placements is lacking. Previous reviews have often taken a positivist approach by only looking at outcome measures. This review addresses the question: What are the strengths and weaknesses for medical students and supervisors of community placements in underserved areas? A systematic literature review was carried out by database searching, citation searching, pearl growing, reference list checking and use of own literature. The databases included MEDLINE, EMBASE, PsycINFO, Web of Science and ERIC. The search terms used were combinations and variations of four key concepts exploring general practitioner (GP) primary care, medical students, placements and location characteristics. The papers were analysed using a textual narrative synthesis. The initial search identified 4923 results. After the removal of duplicates and the screening of titles and abstracts, 185 met the inclusion criteria. These full articles were obtained and assessed for their relevance to the research question 54 were then included in the final review. Four main categories were identified: student performance, student perceptions, career pathways and supervisor experiences. This review reflects the emergent qualitative data as well as the quantitative data used to assess initiatives. Underserved area placements have produced many beneficial implications for students, supervisors and the community. There is a growing amount of evidence regarding rural, underserved areas, but little in relation to inner city, deprived areas, and none in the UK.
Publisher: Wiley
Date: 30-11-2020
DOI: 10.1111/MEDU.14415
Publisher: UCL Press
Date: 19-01-2022
DOI: 10.14324/LRE.20.1.03
Abstract: The delivery of integrated care requires the establishment of effective professional relationships that foster collaborative working across health systems. Evidence for how to prepare practitioners to work in those settings is limited. By exploring an innovative postgraduate Programme for Integrated Child Health (PICH) this article highlights the conditions by which effective collaboration can be encouraged. Our qualitative evaluation of PICH involved one-to-one semi-structured interviews with 23 postgraduate general practice and paediatric trainees and their mentors. We analysed the data using the concept of the ‘third space’, where multiple discourses between in iduals with erse professional backgrounds occur, enabling creative exploration of tensions inherent in new ways of working in order to identify enablers and barriers to collaboration. Our analysis identified three themes that enabled collaboration: effective communication, boundary work and educational spaces and four themes that were barriers: traditional hierarchical professional identities, curriculum design, financial systems and workplace spaces. PICH demonstrated the value of educational spaces and their role in enabling collaborative practice, as participants explored their professional identities and those of other disciplines. Structural factors in the workplace which inhibit collaborative practice were also evident. We conclude by proposing a model for collaborative learning in third spaces based upon the recognition that, while educational programmes alone will not lead to change, they have the potential to inform the development of productive workplace spaces that will be required if collaborative practice in healthcare is to become a reality.
Publisher: Wiley
Date: 26-06-2015
DOI: 10.1111/TCT.12385
Abstract: There is an insufficient number of medical students intending to pursue general practitioner (GP) careers. The undergraduate curriculum has traditionally prioritised teaching in large hospital settings despite most National Health Service patient contact occurring in primary care. Primary care is faced with providing health care for an ageing population with high levels of co-morbidities. Patients who live in deprived areas suffer many disadvantages affecting their health and additionally tend to be underserved. Globally, there has been an initiative to provide medical students with extended clinical placements in rural and remote areas. These placements have identified many beneficial outcomes however, little is known about placements in other underserved, deprived areas. This paper describes an innovative pilot programme to address these issues. The North East of England has a large proportion of the most deprived communities and worst health care outcomes in England. In Teesside, Phase 1 Medicine at Durham University provides the pre-clinical curriculum. Durham students then join Newcastle University for Phase 2 Medicine, the clinical years. The Difficult and Deprived Areas Programme (DDAP) places fourth-year students in general practice and community settings in post-industrial, deprived areas for 14 weeks, thus adopting and applying principles from rural initiatives (continuity and immersion) to other deprived settings. The DDAP allows students to learn about psychosocial determinants of health and to pursue community interests whilst gaining an excellent clinical grounding. There is an insufficient number of medical students intending to pursue general practitioner careers The DDAP provides a model for educators seeking to implement initiatives in similar underserved, deprived settings, which may potentially alleviate GP workforce shortages.
Publisher: Springer Science and Business Media LLC
Date: 07-01-2019
Publisher: Informa UK Limited
Date: 14-08-2019
Publisher: Wiley
Date: 18-08-2023
DOI: 10.1111/MEDU.15181
Abstract: Medical schools require highly skilled and committed clinical faculty to teach, assess, supervise and mentor students' clinical care. Medical education is facing a crisis in recruiting and sustaining these clinical teachers. Faced with multiple demands and responsibilities in fast‐paced clinical environments, teachers may not have the time, resources or stamina to sustain these critical roles. Medical school leaders must commit to and provide structures and processes to attract, sustain and retain clinical teachers. The authors use the lens of self‐determination theory to frame approaches to support teacher sustainability. Self‐determination theory describes sources of human motivation. The theory and its evidence base characterise three human psychological needs: autonomy, competence, and relatedness. This theory can bridge in idual psychological and institutional leadership perspectives to help medical school leaders anticipate and respond to their clinical teachers' needs. The authors propose three practical steps: practices to advance employee‐centredness, processes to align in idual and institutional values, and restructuring education to support clinical teachers' needs alongside student and patient needs. The authors describe limitations to this relational approach that focuses on leadership actions and consider in idual agency as another key factor for sustainability. Medical school leaders can develop and apply theory‐driven approaches to advance sustainability. Sustainability now and in the future requires careful attention to the needs of clinical teachers and to their relationships with and within medical schools.
Publisher: BMJ
Date: 12-2019
DOI: 10.1136/BMJOPEN-2019-033614
Abstract: The aim of the study was to explore what components of the General Medical Council’s (GMC) Quality Assurance Framework work, for whom, in what circumstances and how? UK undergraduate and postgraduate medical education and training. We conducted interviews with a stratified s le of 36 in iduals. This included those who had direct experiences, as well as those with external insights, representing local, national and international organisations within and outside medicine. The GMC quality assure education to protect patient and public safety utilising complex intervention components including meeting standards, institutional visits and monitoring performance. However, the context in which these are implemented matters. We undertook an innovative realist evaluation to test an initial programme theory. Data were analysed using framework analysis. Across components of the intervention, we identified key mechanisms, including transparent reporting to promote quality improvement dialogical feedback partnership working facilitating interactions between regulators and providers, and role clarity in conducting proportionate interventions appropriate to risk. The GMC’s framework was commended for being comprehensive and enabling a broad understanding of an organisation’s performance. Unintended consequences included confusion over roles and boundaries in different contexts which often undermined effectiveness. This realist evaluation substantiates the literature and reveals deeper understandings about quality assuring medical education. While standardised approaches are implemented, interventions need to be contextually proportionate. Routine communication is beneficial to verify data, share concerns and check risk however, ongoing partnership working can foster assurance. The study provides a modified programme theory to explicate how education providers and regulators can work more effectively together to uphold education quality, and ultimately protect public safety. The findings have influenced the GMC’s approach to quality assurance which impacts on all medical students and doctors in training.
Publisher: BMJ
Date: 04-2018
Publisher: Wiley
Date: 24-07-2018
DOI: 10.1111/MEDU.13643
Publisher: Wiley
Date: 15-05-2019
DOI: 10.1111/MEDU.13886
Abstract: Although the literature on professional identity formation in medical education is increasing, it is scant by comparison on student and clinician identities within interprofessional contexts. We therefore adopt a novel discursive approach to identities to explore how soon-to-become graduates and workplace-based clinicians construct their own and others' identities in interprofessional student-clinician (IPSC) interaction narratives. We conducted a qualitative narrative interview study with 38 students and 23 clinicians representing the fields of medicine, midwifery, nursing, occupational therapy, paramedicine and physiotherapy. Through framework analysis, we identified the breadth of student and clinician identity constructions across 208 IPSC interaction narratives, and explored how common constructions differed by narrative and narrator. Through in-depth positioning analysis, we explored how student and clinician identities are discursively positioned within two selected IPSC interaction narratives. We identified 11 common constructions of student identities and eight common constructions of clinician identities across all 208 narratives. We found differences in identity constructions across positively versus negatively evaluated narratives, and student versus clinician narrators, highlighting the rhetorical nature of narratives. Our in-depth positioning analysis of two narratives illustrates how one student and one clinician discursively positioned theirs and others' identities during interprofessional interactions, and how identities vary depending on narrators' evaluations of their stories. Although both positioning analyses illustrate how the narrators' language serves to reproduce the common societal discourse of interprofessional conflict, the clinician narrative also draws on the competing discourse of interprofessional collaboration. Although some of the identities support previous uniprofessional research, our findings illustrate greater breadth and depth in terms of student and clinician identities within interprofessional contexts. We encourage educators to embed identities curricula into existing workplace learning for students and clinicians to help them make sense of their developing professional and interprofessional identities. Workplace educators should facilitate meaningful IPSC interactions to promote interprofessional learning and collaboration.
Publisher: BMJ
Date: 09-2017
DOI: 10.1136/BMJOPEN-2017-017584
Abstract: The proportion of junior doctors required to complete psychiatry placements in the UK has increased, due in part to vacant training posts and psychiatry career workforce shortages, as can be seen across the world. The aim of this study was to understand the lived experience of a Foundation Year 1 junior doctor psychiatry placement and to understand how job components influence attitudes. The study was conducted using a cross-sectional qualitative phenomenological approach. Hospital and community psychiatry department settings in the North East of England, UK. In total, 14 Foundation Year 1 junior doctors were interviewed including seven men and seven women aged between 23 and 34 years. The majority had completed their medical degree in the UK and were White British. The lived experience of a junior doctor psychiatry placement was understood by three core themes: exposure to patient recovery, connectedness with others in the healthcare team and subjective interpretations of psychiatry. The experiences were moderated by instances of role definition, reaction to the specialty and the organisational fit of the junior doctor capacity in the specialty. The study reinforces and adds to the literature by identifying connectedness as being important for both job satisfaction and morale, which is currently damaged within the junior doctor population. The study provides in-depth insights into the lived experience of psychiatry placements and can be taken forward by educationalists to ensure the placements are meaningful experiences for junior doctors by developing role definition, belonging, structure and psychiatric care responsibility.
Publisher: Informa UK Limited
Date: 29-05-2019
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Paul Crampton.