Donna Mead

Exploring doctor and patient views about risk communication and shared decision-making in the consultation.

Background  There have been significant conceptual developments regarding shared decision‐making (SDM) and assessments of peoples hypothetical preferences for involvement in treatment or care decisions. There are few data on the perceptions of patients and professionals about SDM in actual practice.

Can feedback be individualised, useful, and economical?

An important, but often neglected, part of any research or audit exercise is the reporting back to participants of the results of that exercise. When feedback is made, it is often of a general, aggregated nature. Considerations of cost and psychological factors usually preclude feedback to individuals. As part of a larger study we have developed a prototype mechanism for providing such individual feedback. This was done by writing a computer program which automatically generated the report, using rules on how to interpret different patterns of responses to a questionnaire. Previous qualitative evaluation had shown a positive response from participating nurses. The current small-scale study reports a more formal evaluation. Participants who received reports on the degree to which their ward was practising primary nursing overwhelmingly found the reports readable, informative, encouraging, accurate and useful.

Research-based measurement tools in the audit process: issues of use, validity and reliability: Taking as an example a tool the authors developed, they examine in detail some of the specific issues related to its use in audit

The National Health Service is in a period of extensive reform. Value for money is now a key objective. As a consequence, audit has become a widely used concept and activity. There has been some discussion in the literature of the use of tools for measurement in audit. These tools have mainly been used to measure outcomes. When they are used in isolation from other measures, an incomplete picture can result. Closs and Tierney ( 1 ) have noted that the current vogue for outcomes in NHS research has resulted in a less than complete evaluation of the phenomena under study, largely because the structures and processes are not being measured in parallel with the outcomes. Thomas and Bond ( 2 ) also noted that research has tended to concentrate on the outcomes of care, and that structures and processes are left assumed and undefined, thus making it impossible to link outcomes (favourable or unfavourable) to specific features of nursing input in particular. This has meant that the actual processes have tended to remain somewhat obscure.

RCN debate: RCN Research Society International Conference, Gateshead, May 2010

Debate holds a special place in the history of the RCN Research Society annual conference. It enables important issues to be explored thoroughly in a manner which is unashamedly competitive but which gives an equal amount of time to both sides of the argument. Debating is considered to be a game of logic and eloquence and it takes place in the style of the British Parliament, hence the audience is referred to as the house. The players (proposers and opposers) make their speeches in turn, alternating between ‘‘government’’ making the case for the motion and ‘‘opposition’’ opposing it. The motion is selected around a topic which is important but around which there may be polarised positions. The proposers are asked to take a position (for or against the motion) and to make a short speech aimed at convincing the house of the cogency of their position. The speeches should be characterised by rigorous logic, be elegant and contain humour. Unlike debate in the houses of parliament, the speakers may be asked to take a position which they do not in fact subscribe to. The skill in such a situation is to prepare arguments which may be contrary to your beliefs and to present them to the house convincingly. In the debate which follows there is at least one player who took a position contrary to the one they believed in!