Michael Hodgins

Arts-based health research and academic legitimacy: transcending hegemonic conventions

Using the Canadian context as a case study, the research reported here focuses on in-depth qualitative interviews with 36 researchers, artists and trainees engaged in ‘doing’ arts-based health research (ABHR). We begin to address the gap in ABHR knowledge by engaging in a critical inquiry regarding the issues, challenges and benefits of ABHR methodologies. Specifically, this paper focuses on the tensions experienced regarding academic legitimacy and the use of the arts in producing and disseminating research. Four central areas of tension associated with academic legitimacy are described: balancing structure versus openness and flexibility; academic obligations of truth and accuracy; resisting typical notions of what counts in academia; and expectations vis-à-vis measuring the impact of ABHR. We argue for the need to reconsider what counts as knowledge and to reconceptualize notions of evaluation and rigor in order to effectively support the effective production and dissemination of ABHR.

Using Positive Organizational Scholarship in Healthcare and Video Reflexive Ethnography to Examine Positive Deviance to New Public Management in Healthcare

Following increased interest in and use of new public management (NPM), greater regulation has been introduced into many Western health systems. Yet, the effects have revealed the negative aspects of NPM. Positive organizational scholars have argued that adversity can give rise to positive deviance. Yet as a form of noncompliance, positive deviance can be difficult to examine. This methodological article demonstrates how the combined methodologies of positive organizational scholarship in healthcare (POSH) and video reflexive ethnography (VRE) can help examine positive deviance. This study illustrates the methodological utility of POSH VRE to respectfully study the impact of NPM-inspired expectations on public health clinicians, positively reframe how clinicians constructively respond to and manage obstruction, and reveal the unintended effects of NPM-inspired expectations. As a participatory methodology, POSH VRE can promote trust between researchers and clinicians, thereby unveiling instances of positive deviance to NPM in healthcare.

What does it take to deliver brilliant home-based palliative care? Using positive organisational scholarship and video reflexive ethnography to explore the complexities of palliative care at home:

Background: Despite the increasing number of people requiring palliative care at home, there is limited evidence on how home-based palliative care is best practised. Aim: The aim of this participatory qualitative study is to determine the characteristics that contribute to brilliant home-based palliative care. Design: This study was inspired by the brilliance project – an initiative to explore how positive organisational scholarship in healthcare can be used to study brilliant health service management from the viewpoint of patients, families, and clinicians. The methodology of positive organisational scholarship in healthcare was combined with video-reflexive ethnography. Setting/participants: Home-based specialist palliative care services across two Australian states participated in the study. Clinicians were able to take part in the study at different levels. Pending their preference, this could involve video-recording of palliative care, facilitating and/or participating in reflexive sessions to analyse and critique the recordings, identifying the characteristics that contribute to brilliant home-based palliative care, and/or sharing the findings with others. Results: Brilliance in home-based palliative care is contingent on context and is conceptualised as a variety of actions, people, and processes. Care is more likely to be framed as brilliant when it is epitomised: anticipatory aptitude and action; a weave of commitment; flexible adaptability; and/or team capacity-building. Conclusion: This study is important because it verifies the characteristics of brilliant home-based palliative care. Furthermore, these characteristics can be adapted for use within other services.

A qualitative exploration: questioning multisource feedback in residency education

BackgroundMultisource feedback (MSF), involves the collection of feedback from multiple groups of assessors, including those without a traditional hierarchal responsibility to evaluate doctors. Allied healthcare professionals (AHCPs), administrative staff, peers, patients and their families may all contribute to the formative assessment of physicians. Theoretically, this feedback provides a thorough view of physician performance; however, the ability of MSF programs to consistently impact physician behavior remains in question. Therefore, the objective of this study was to explore perceptions and prerequisites to an effective MSF program in postgraduate medical education from the perspectives of both pediatric residents and AHCPs.MethodsThis exploratory study was conducted in a pediatric inpatient unit prior to implementation of a MSF program. Focus groups were conducted with purposefully recruited participants from three distinct groups: junior pediatric residents, senior pediatric residents, and AHCPs. Discussions were audio recorded, transcribed verbatim and analyzed using thematic analysis.ResultsBoth residents and AHCPs expressed a strong interest in the concept of MSF. However, more in depth discussions identified barriers to residents’ acceptance of, and AHCPs’ provision of feedback. Roles and responsibilities, perceptions of expertise, hospital culture/interprofessionalism and power dynamics were identified as barriers to the acceptance and provision of feedback. All groups expressed interest in opportunities to engage in bi-directional feedback.ConclusionsThe identified barriers and prerequisites to providing and accepting MSF suggest limits to the efficacy of the MSF process. Our findings suggest that these factors should be considered in the design and implementation of MSF programs.

Deliberative dialogues between policy makers and researchers in Canada and Australia

Knowledge translation (KT) and implementation science are growing fields in Canada, Australia, and worldwide. Many audiences are targeted as KT knowledge users—policy makers represent one key knowledge user in the health care field. The need for policy makers to understand research and for researchers to understand policy processes is commonly recognized. There is also increasing interest in health policy that focuses on KT as a framework for understanding the use of evidence and, in particular, describing the influence of research on policy along with concepts of coproduction and user involvement. With relationship building central to successful evidence-informed policy, this article explores deliberative dialogue as a potential approach to enhancing KT. It describes two examples of researcher efforts to cultivate relationships and contacts with policy and decision makers via such dialogues and illustrates the inherent opportunities and challenges of doing so.