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Making Birth better: How research shapes practice #bbresearch17

Indulging in my passion for research, I am today reflecting on my time at  …an intimate conference made into a delightful day thanks to  & …More specifically …    &   …

I personally enjoyed this as a more intimate conference, where deeper conversations could get the brain working on what was really needed in maternity services and health research…Another reflection of the day can be seen on Steller here…

As you can see, we had a great line up for the day, and a fish and chip lunch no less!

Highlights for me include:

Stop sexualising breastfeeding!!!! The great presentation by

Learning about associated with at with

Learning so much about at with Prof. Soo Downe

Getting a wave from miles away from  across the miles sending & midwifery love to us all …..❤️

Powerful words from at …. how do we cope as midwives, & ensure excellence in maternity care?

And of course.. # learning all about making sure that blood goes to baby with  with ❤️

Learning about the barriers to identifying poor shared by prof at  with 🎓

Yet there were a couple of overarching themes that came from the day…including….

 

Thank you to everyone who came to see these wonderful presentations (including those who came to see my own presentation of course – you gave me lots to think about!)!…and thank you all for such an intimate and heartwarming day discussing my favorite topic…Research in Midwifery 😍…

 

And a last word from the Head of Midwifery at Hinchingbrooke  Hospital….(Heather Gallagher)…..

bbresearch

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 💚💙💜❤

 

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Mindfulness and Self-Care in Midwifery

As my main research interests are firmly rooted within supporting a positive staff experience for healthcare workers, especially midwives in work-related psychological distress, I am always looking for new opportunities to share knowledge with others in this area. …The Global Alliance for Nursing and Midwifery (GANM) is a joint project sponsored by the Pan American Health Organization (PAHO) and the World Health Organization (WHO) Collaborating Center for Nursing Knowledge, Information Management & Sharing at the Johns Hopkins School of Nursing. This blog post provides an overview of a webinar session hosted by GANM entitled “Mindfulness and Self-Care in Midwifery:  Review of Current Evidence and Guided Mindfulness Practice.

For a preliminary introduction to this topic – check out an earlier blog post on this topic entitled “Midwife Burnout: A Brief Summary“.

downtimes

Erin Wright, DNP, CNM, APRN-BC, led the conversation…Participants were diverse, and originated from Canada, Peru, US (Baltimore, Urbana, Birmingham, Atlanta, Buffalo), Ireland, UK (Coventry University and School of Healthcare Sciences Cardiff), Brazil, Montserrat, and Trinidad.

The full webinar can be accessed here.

Much of the research covered, has also been captured within my earlier narrative review: Pezaro, Sally, et al. “‘Midwives Overboard!’Inside their hearts are breaking, their makeup may be flaking but their smile still stays on.” Women and Birth 29.3 (2016): e59-e66.

However, there were some new and interesting comparisons made with more recent research here…

“Four common themes have been identified that traverse the different models of care. The NZ study provides insight into how case load midwifery can be sustainable enabling long term sustainability. The UK study highlights healthy resilient practices that enable practice. What remains uncertain is how models of care enable or disable sustainable long term practice and nurture healthy resilient behaviours within the different models of care”.

comparisons

“The notion of resilience in midwifery as the panacea to resolve current concerns may need rethinking as the notion may be interpreted as expecting midwives ‘to toughen up’ in a working setting that is socially, economically and culturally challenging.”

Sources (Crowther, Susan, et al. “Sustainability and resilience in midwifery: A discussion paper.” Midwifery 40 (2016): 40-48.)

So we are now much enlightened as to how and why midwives are experiencing distress, we also have some insights into how they try to cope (or not)…and where this distress may affect maternity services…but what we are yet to learn, is what may be most effective in supporting midwives in work-related psychological distress…although a few clues are emerging….

Mindfulness is coming forward as a potential tool of support..stress management, education and clinical supervision may also be of benefit to midwives in distress…But how, why and how much is not yet clear.

After exploring the literature in relation to psychological distress in midwifery populations, we were all invited to join in some mindfulness practice..What is mindfulness?

Image result for mindfulness

 

Feeling overwhelmed?…TRY….R.A.I.N

RRecognize What’s Going On

AAllowing: Taking a Life-Giving Pause

I—Investigating with Kindness

NNatural Loving Awareness

Source: Mindful.org

relation-ships

Recommended further reading

Youtube presenters:

  • Jon Kabat Zinn
  • Elisha Goldstein
  • Tara Brach
  • Sharon Salzberg

Websites/Audio Links:

Books: 

  • A Mindfulness Based Stress Reduction Workbook (Goldstein and Stahl)
  • Everyday Catastrophe Living (Jon Kabat Zinn)
  • Wherever you go there you are (Jon Kabat Zinn)
  • Mindfulness for Beginners (Jon Kabat Zinn)
  • Real Happiness (Sharon Salzberg)
  • The Mindful Nurse (Carmel Sheridan)

For more mindfulness exercises, visit the UCLA Mindfulness Awareness Research Center.

book-mark

Thanks for a very insightful and informative session!

Until next time…Look after yourselves & each other 🦄💫🎓

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An exploration of mixed-methods research

What is Mixed-methods research?…. a mixture of methods? …or a multitude of methods in either one study or a succession of research?….Yes….it is a pickle.

What is mixed methods research?

I am on a learning curve (as always)…and I have been refining my understanding of mixed methods research…so what is mixed-methods research as I understand it now?

Firstly…what is a method?

I like to think of it as a recipe. Everyone knows a recipe for making a Victoria sponge…Eggs, sugar, butter, jam…and cream….But perhaps my method is different from your method..I add vanilla essence….you prefer yours with blackcurrant jam….We are both using a recipe or ‘method’ for making a Victoria sponge…

It’s just that the recipe or ‘method’ has both agreed standards… and modified versions.

Image result for victoria sponge

So…in research terms, I used to think of mixed-methods as literally a mixture of methods used in a single study….perhaps questionnaires and interviews…or a focus group and a literature review…But there are others who have defined it differently. Basically…we are actually looking at a mixture of both qualitative and quantitative research in one study/paper…Here are some other definitions below from leaders in the field..

Pat Bazeley: I tend to distinguish between mixed methods and multimethod, although if I need a generic term, I used mixed methods. Multimethod research is when different approaches or methods are used in parallel or sequence but are not integrated until inferences are being made. Mixed methods research involves the use of more than one approach to or method of design, data collection or data analysis within a single program of study, with integration of the different approaches or methods occurring during the program of study, and not just at its concluding point. Note that I am not limiting this to a combination of qualitative and quantitative research only, but more broadly, combinations of any different approaches/methods/data/analyses.

 

Valerie Caracelli: A mixed method study is one that planfully juxtaposes or combines methods of different types (qualitative and quantitative) to provide a more elaborated understanding of the phenomenon of interest (including its context) and, as well, to gain greater confidence in the conclusions generated by the evaluation study.

 

Huey Chen: Mixed methods research is a systematic integration of quantitative and qualitative methods in a single study for purposes of obtaining a fuller picture and deeper understanding of a phenomenon. Mixed methods can be integrated in such a way that qualitative and quantitative methods retain their original structures and procedures (pure form mixed methods). Alternatively, these two methods can be adapted, altered, or synthesized to fit the research and cost situations of the study (modified form mixed methods).

 

John Creswell: Mixed methods research is a research design (or methodology) in which the researcher collects, analyzes, and mixes (integrates or connects) both quantitative and qualitative data in a single study or a multiphase program of inquiry.

 

Steve Currall: Mixed methods research involves the sequential or simultaneous use of both qualitative and quantitative data collection and/or data analysis techniques.

 

Marvin Formosa: Mixed methods research is the utilitization of two or more different methods to meet the aims of a research project as best as one can. The research project may be conducted from either one or two paradigmatic standpoints (mixed methodology study).

 

Jennifer Greene: Mixed method inquiry is an approach to investigating the social world that ideally involves more than one methodological tradition and thus more than one way of knowing, along with more than one kind of technique for gathering, analyzing, and representing human phenomena, all for the purpose of better understanding.

 

Al Hunter: Mixed methods is a term that is usually used to designate combining qualitative and quantitative research methods in the same research project. I prefer the term multimethod research to indicate that different styles of research may be combined in the same research project. These need not be restricted to quantitative and qualitative; but may include, for example, qualitative participant observation with qualitative in-depth interviewing. Alternatively it could include quantitative survey research with quantitative experimental research. And of course it would include quantitative with qualitative styles.

 

Burke Johnson and Anthony Onwuegbuzie: Mixed methods research is the class of research where the researcher mixes or combines quantitative and qualitative research techniques, methods, approaches, concepts or language into a single study or set of related studies.

 

Udo Kelle: Mixed methods means the combination of different qualitative and quantitative methods of data collection and data analysis in one empirical research project. This combination can serve for two different purposes: it can help to discover and to handle threats for validity arising from the use of qualitative or quantitative research by applying methods from the alternative methodological tradition and can thus ensure good scientific practice by enhancing the validity of methods and research findings. Or it can be used to gain a fuller picture and deeper understanding of the investigated phenomenon by relating complementary findings to each other which result from the use of methods from the different methodological traditions of qualitative and quantitative research.

 

Donna Mertens: Mixed methods research, when undertaken from a transformative stance, is the use of qualitative and quantitative methods that allow for the collection of data about historical and contextual factors, with special emphasis on issues of power that can influence the achievement of social justice and avoidance of oppression.

 

Steven Miller: Mixed methods is a form of evolving methodological inquiry, primarily directed to the human sciences, which attempts to combine in some logical order the differing techniques and procedures of quantitative, qualitative and historical approaches. At present mixed methods must devote itself to resolving a set of issues, both epistemological and ontological. The first must devote itself to what Miller and Gatta (2006) call the “epistemological link,” that is the rules and rationales which “permit” one to proceed mixed methodologically. The second must adhere to some form of “minimal realist” ontology, where either social reality is “One” but can be accessed by different methods separately or working in conjunction, or social reality is multiple in nature and can ONLY be accessed through mixed methods. Present day attempts to couch mixed methods within some broad notion of pragmatism are not satisfactory.

 

Janice Morse: A mixed method design is a plan for a scientifically rigorous research process comprised of a qualitative or quantitative core component that directs the theoretical drive, with qualitative or quantitative supplementary component(s). These components of the research fit together to enhance description, understanding and can either be conducted simultaneously or sequentially.

 

Isadore Newman: Mixed methods research is a set of procedures that should be used when integrating qualitative and quantitative procedures reflects the research question(s) better than each can independently. The combining of quantitative and qualitative methods should better inform the researcher and the effectiveness of mixed methods should be evaluated based upon how the approach enables the investigator to answer the research question(s) embedded in the purpose(s) (why the study is being conducted or is needed; the justification) of the study. (See Newman, Ridenour, Newman & DeMarco, 2003.)

 

Michael Q. Patton: I consider mixed methods to be inquiring into a question using different data sources and design elements in such a way as to bring different perspectives to bear in the inquiry and therefore support triangulation of the findings. In this regard, using different methods to examine different questions in the same overall study is not mixed methods.

 

Hallie Preskill: Mixed methods research refers to the use of data collection methods that collect both quantitative and qualitative data. Mixed methods research acknowledges that all methods have inherent biases and weaknesses; that using a mixed method approach increases the likelihood that the sum of the data collected will be richer, more meaningful, and ultimately more useful in answering the research questions.

 

Margarete Sandelowski: First, I think of this in terms of either a single primary research study or as a program of research. Then, I see mixed methods as something of a misnomer as mixing implies blending together. Mixed methods research, though, is more the use of different methodological approaches TOGETHER in a single study or single program of research. One cannot blend methods in the sense of assimilating one into the other. I use methods here to refer to larger inquiry approaches (e.g., experiments and grounded theory) which are themselves based in distinctive theoretical perspectives. Yet this sets up a problem too, as grounded theory, for example, can be “positivist” (a la Strauss & Corbin), “constructivist” (a la Charmaz), or “postmodern” (a la Clarke) in sensibility or influence. So, if a researcher is doing grounded theory (positivist style) and an experiment (positivist influence), are any methods actually being mixed? In other words, mixed methods research can be defined at the technique level as the combination of, e.g., purposeful & probability sampling, open-ended and closed-ended data collection techniques, and narrative and mutivariable analyses—i.e., in which anything can be used together (linked or assimilated into each other)—or it can be defined at a larger theoretical/paradigmatic level as using divergent approaches to inquiry together. I would not define mixed methods research as constituting ANY combination of 2 or more things, as any research involves the use of 2 or more of something and the use of experiment and survey is 2 things, but they are informed by one mind (typically positivist/objectivist/realist). We get tangled in words, do we not?

 

Lyn Shulha: By collaborative mixed method research, we will mean the purposeful application of a multiple person, multiple perspective approach to questions of research and evaluation. Decisions about how methods are combined and how analyses are conducted are grounded in the needs and emerging complexity of each project rather than in preordinate methodological conventions. . . . Within this context, methods can be “mixed” in a variety of ways. Sometimes, one method serves another in validating and explicating findings that emerge from a dominant approach. On other occasions, different methods are used for different parts of the issues being investigated, and in an independent way. In more complex cases, the methods and perspectives are deliberately mixed from the beginning of the process. The resulting interaction of problem, method, and results produce a more comprehensive, internally consistent, and ultimately, more valid general approach. What sets the most complex forms of collaborative mixed method research apart from other forms of inquiry is that findings depend as much on the researchers’ capacities to learn through joint effort and to construct joint meaning as on their expertise in conventional data collection and analysis techniques.

 

Abbas Tashakkori and Charles Teddlie: Mixed methods research is a type of research design in which QUAL and QUAN approaches are used in type of questions, research methods, data collection and analysis procedures, or in inferences.

 

Note: QUAL = qualitative research; QUAN = quantitative research

Source for quotes = Toward a Definition of Mixed Methods Research R. Burke Johnson University of South Alabama, Mobile Anthony J. Onwuegbuzie University of South Florida, Tampa Lisa A. Turner University of South Alabama, Mobile

Image result for mixed methods studies

There are also now reporting guidelines emerging for Mixed Methods studies (O’Cathain, Alicia, Elizabeth Murphy, and Jon Nicholl. “The quality of mixed methods studies in health services research.” Journal of Health Services Research & Policy 13.2 (2008): 92-98.)

Good Reporting of A Mixed Methods Study (GRAMMS)…Guidelines as follows…

(1) Describe the justification for using a mixed methods approach to the research question

(2) Describe the design in terms of the purpose, priority and sequence of methods

(3) Describe each method in terms of sampling, data collection and analysis

(4) Describe where integration has occurred, how it has occurred and who has participated in it

(5) Describe any limitation of one method associated with the present of the other method

(6) Describe any insights gained from mixing or integrating methods

Mixed methods research is more specific in that it includes the mixing of qualitative and quantitative data, methods, methodologies, and/or paradigms in a research study or set of related studies. One could argue that mixed methods research is a special case of multimethod research.

 

Image result for mixing bowl research

So until next time… look after yourselves & each other…then …in the words of Bob Marley…go ahead and stir it up….🎓💜🌟

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Reflecting on the #MaternalDeath report from @mbrrace as a midwife…💜

During the December of 2016, everyone involved in the provision of care for childbearing women (and the women themselves) began to reflect upon the findings of the latest Confidential Enquiry into Maternal Death. As a midwife, I am dedicated to supporting, protecting and caring for other midwives, childbearing women, babies their families. There is no doubt in my mind that these deaths have affected all of these groups profoundly, and society as a whole. But before we begin to reflect, let’s remember that the mortality surrounding childbirth (in the UK) is thankfully rare 

    

 

When we lose mothers…we also tragically effect babies…The Stillbirth and Neonatal Deaths charity (Sands) responds to new MBRRACE maternity report here

There is no doubt that we must learn from all of these  as the president of the explains here. Clearly there is much learning to do and many improvements to make. These key messages should remind us all to ask the question…start the conversation…notice the subtle clinical cues which alert us all to danger, react to risk and remain emotionally intelligent to the needs of childbearing women.

However, what struck me most was the sheer number of women who die from mental health related causes. The MBRRACE report found that “one in seven of the women who died during the period of review died by suicide. Although severe maternal mental illness is uncommon, it can develop very quickly in women after birth; the woman, her family and mainstream mental health services may not recognise this or move fast enough to take action”.

Image result for maternal mental health related deaths mbrrace

You can read the ‘expert’ reaction to MBRRACE-UK report citing mental health as main cause of perinatal death here. Maternal mental health matters – toolkit now available from for those developing a community perinatal mental health service.

Learning to save maternal lives and making change happen will not only improve the lives of mothers, babies and families. It will also improve the lives of midwives, as they will be better equipped to give the care they would like to give as their job satisfaction improves. When the psychological wellbeing of midwives is left uncared for, maternity services may see less safe maternity care. When we care for midwives, the safety and quality of maternity care may also improve. This will in turn contribute to a reduction in maternal mortality rates. So when we are looking to improve maternity care for women, their families and their babies, lets make sure that we also look to support those who are caring for them. It really is two sides of the same coin.

What can we promote?

= That it’s “OK to ask”

How can we support women & midwives? = With trust, compassion & respect

How can we improve safety?

= Evidence based care & excellent communication

 

Preventable maternal morbidity and mortality is associated with the absence of timely access to quality care, defined as too little, too late (TLTL)—ie, inadequate access to services, resources, or evidence-based care—and too much, too soon (TMTS)—ie, over-medicalisation of normal antenatal, intrapartum, and postnatal care.

Although many structural factors affect quality care, adherence to evidence-based guidelines could help health-care providers to avoid TLTL and TMTS.

TLTL—historically associated with low-income countries—occurs everywhere there are disparities in socio-demographic variables, including, wealth, age, and migrant status. Often disparities in outcomes are due to inequitable application of timely evidence-based care.

TMTS—historically associated with high-income countries—is rapidly increasing everywhere, particularly as more women use facilities for childbirth. Increasing rates of potentially harmful practices, especially in the private sector, reflect weak regulatory capacity as well as little adherence to evidence-based guidelines.

Caesarean section is a globally recognised maternal health-care indicator, and an example of both TLTL and TMTS—with disparate rates between and within countries, and higher rates in private practice and higher wealth quintiles. Caesarean section rates are highest in middle-income countries and rising in most low-income countries. Although researchers partly attribute the increase and variable rates to a shortage of clear, clinical guidelines and little adherence to existing guidelines, multiple factors—economic, logistical, and cultural—affect caesarean section rates.

Quality clinical practice guidelines need to be developed that reflect consensus among guideline developers, using similar language, similar strengths of recommendation, and agreement on direction of recommendations.

Strategies for enhanced implementation and adherence to guidelines need multisectorial input and rigorous implementation science.

A global approach that supports effective and sustained implementation of respectful, evidence-based care for routine antenatal, intrapartum, and postnatal care is urgently needed.

There is much work to be done. Until next time, take care of yourselves and each other 💜💙💛

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Why we should welcome feedback and listen to those who raise concerns in both healthcare and research

Criticism and feedback can feel uncomfortable to both give and receive. It can be an awkward exchange, where both parties may be reluctant to let their guard down, concede to oversights, reveal any flaws and relinquish any feelings of responsibility. It can also be incredibly frustrating on both sides.

Image result for writing frustration

But lets look at both sides of the coin rationally. Firstly, Why would someone offer feedback?

  • They want to make something better
  • They see an opportunity to improve something
  • They want to help you
  • They want something corrected
  • You, or someone else have asked them for feedback
  • They want to offer you their unique outsider/fresh eyes view of something that you may not be privy to.

These are all gifts, learning opportunities and avenues toward creating our best outputs. Here, we theorise that everyone who offers feedback has good intentions, which some may argue is unrealistic and naive. However, I am personally unwilling to lose out on the potentially invaluable gold dust of feedback for the sake of those who wish to meddle in mischief. The vast majority of those who enter both the healthcare and academic professions do so in order to contribute positively.

In order to feel valued and perform to the best of their abilities, healthcare staff must feel heard. This is the same for those in research. As such, whether we agree with the feedback we are given, it must be heard, examined, considered and then either acted upon or rebutted respectfully.

If you are doing your best, feel passionately about what you are trying to achieve and have worked hard to achieve something amazing, it can be hard to hear that there may be cracks in your work, despite all of your well intended efforts. You are also in the job to give your best and contribute positively. But you cannot know everything…so keep listening to those who have the ‘fresh eyes’ to see what you may not.

Image result for ICEBERG OF IGNORANCE

Denial only denies you an opportunity to do better.

Lets look outside the box:

What is going on here?

Restaurant owner:

  • Wants her food to be good
  • Believes she has done her best
  • Defensive and protective about her achievements

Customer & Gordon Ramsey:

  • Wants good food
  • Wants mistakes corrected
  • Wants things to be better
  • Wants to be helpful and constructive
  • Has a new ‘Fresh eyes’ perspective from outside the organisation

The negative response to this feedback could mean:

  • The customer probably won’t return to the restaurant
  • The customer will avoid offering any further feedback
  • A missed opportunity to make things better
  • The expert will at some point back away from offering further assistance
  • The restaurant may fail to reach its full potential

FYI – These restaurant owners always achieve great things for their restaurants once they listen and act upon feedback

Reflection: Can we apply these roles to some of the roles active healthcare and research? (Including our own)!

Don’t despair!… If you get everything right, all of the time, you miss new opportunities to learn

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Some of my early academic papers were really very terrible. Some of the work I do now is muddled at first. I make mistakes, everyone does. I am in no way perfect, nor do I alone have all of the skills to change the world. I need help. I welcome help and input from those who can fill in for the skills I do not have and the knowledge I cannot yet see. This is why I welcome feedback and listen to those who raise concerns. In fact I grab every opportunity to do so.

In exchange for this, my work improves, I see new opportunities to thrive, new ideas are generated and collective collaborations make our outputs much stronger. Success.

If I had been steadfast in feeling that because I was so passionate about the work I was doing, nothing could possibly be wrong with it, then I would have missed the chance to create something better. Yes, it used to be frustrating to hear criticism. But this frustration can be turned around.

Once you see that a criticism is not a personal attack, it becomes a welcome guest.

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More recently, I had a paper accepted ‘No revisions required’. I was worried. I wanted feedback, I wanted changes made, I wanted other people to weigh in on my work and check for anything I may have missed. This is because I knew it would be a stronger paper having been ripped apart and then put back together again….made better.

Everything I have ever done has always been made better when others have offered their ‘fresh eyed’ feedback. Here are my top tips for making the most out of feedback.

  • Welcome and invite it
  • Listen to it, consider it and evaluate it
  • Let down your defenses (It is not an attack – people want to help)
  • Feedback on your feedback – Tell them how it was used
  • Actively search for those who can offer a ‘fresh eyed’ perspective on your project
  • Never attack those who offer you valuable feedback (They will avoid doing it again!)
  • Know that it is OK not to be perfect, you cannot do everything all of the time
  • Avoid blinkered approaches like ‘I know what is best’ & ‘Nothing can be wrong because I worked so hard for it not to be’.
  • Offer your own feedback to others – It will not only help them, but it will make you feel good and contribute toward the collective goal!

We all want to be the best we can be. We need to role-model and make things better for everyone. We need to lift each other up with support and praise.

Let go of your defenses and welcome new opportunities for success.

Free stock photo of typography, school, training, board

Until next time, look after yourselves and each other 💙💜💚

 

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Masterclass: 10 Top Tips for Winning a National Institute for Health Research (NIHR) fellowship award

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This week, I have been engaging with National Institute for Health Research (NIHR) funders, in a ‘bid’ to learn more about the fellowships currently available to researchers. This masterclass was held at @unibirmingham, and it really was a great opportunity to speak to the funders and get some sound advice on how and what to apply for. In this blog I will share 10 top tips which have been formulated as a result of attending this masterclass. I hope this may help other applicants (like myself) to maximise their chance of success.

  1. Firstly, know which type of award is best for you and your future plans and ideas. I will be applying for a post-doctoral fellowship as an early career researcher.

 

Image result for NIHR FELLOWSHIP success rates

 

2. Contact the Research Design Service early…talk through your ideas, take advice and learn all you can. This service can point you towards other team members, experts to talk to and new ways of thinking. They can be involved at every stage of your application and they really do give great feedback.

3. Once you have the basics of your project together, think about designing the right team. If you are planning at RCT for instance, who is on your team who can help you with that? Do they have the right expertise? Seek out the right mentors, collaborate outside of your institution, start building relationships with people who you can work with throughout your fellowship (and hopefully throughout your career)! The NIHR want to see that you will be well supported to succeed.

 

What are the chances of success?

Competition is fierce! – Make sure you stand out!

Image result for NIHR number of applications and awards

 

4. Make your application logical, clear and really show that you can demonstrate the impact and trajectory of your research. How will you disseminate your research (other than papers and social media) – Could you make a film? Hold a dissemination event? Additionally, make sure you answer every section in detail and check your application against the current guidance materials.

See full and official NIHR guidance here

5. Set out your own personal career goals and create a comprehensive training plan. This is where most applications fail. This is not just a list of courses you will take. This is about who will mentor you, where you will learn, can you arrange a secondment? Work experience? International conferences? – How will you grow and develop into an independent researcher? – Why should they invest in you as a person?

 

 

6. How will you involve patients, end users and the public in your research? Patient and public involvement (PPI) will form a key component within your application, and should feature throughout your research plans. Involve is a great place to start. You can apply for a small £500 grant to carry out PPI activities before submitting your fellowship application, ask your regional RDS service for more details, and be sure to include the results of these activities within your application!

Image result for NIHR FELLOWSHIP

 

7.What if you get called for an interview? Make sure you know your application inside out (it may be a long time since you submitted your application – and you may be asked some really complex questions by people who are not experts in your field!)

 

 

8. Be sure to have mock interviews with your peers (they will be much harder on you than the interview panel). Challenge yourself, be willing to change your ideas in response to feedback. Embrace every opportunity to improve!

9. Be yourself. Yes you will be nervous, but the panel wants to see who they are investing in. Its OK to show personality and be ambitious. They want to invest in new talent, the research stars of the future. Show them your potential. Don’t be afraid to take criticism – engage in constructive dialogue throughout, yet leave the panel with a punchy take away message where they can see your potential and future trajectories.

10. Be on time – don’t miss deadlines, arrive early to the interview and be ready to showcase yourself and your ideas. The NIHR want to fund you…they want to spend tax payers money wisely. Leave them in no doubt that both you, and your project are worth it. You are the future the world needs to see!

 

See full and official NIHR guidance here

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Until next time, look after yourselves & each other..💜

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Midwife Burnout: A Brief Summary

This week I have seen midwife burnout rear its head more than a few times. This is an issue close to my heart and one I dedicate my research to on a daily basis. Being a registered midwife and having practised through turbulent times myself, I know how it feels to give all that you have and yet forget to put yourself first at any time. You become a burnt out midwife, unable to give the highest quality or safest maternity care.

Here’s how it may happen…

 

The recent National  Maternity Review highlighted that midwives were more likely than any other professional group to report feeling pressured at work. Also, levels of staff stress in the NHS are the highest of any sector and staff consistently report a lack of compassion shown to them from leaders and managers within their organisations.

I find this incredibly sad…. We want to care so much for women and their babies…yet we fail to care for ourselves and each other.

The latest  work-related stress guidance cites one of my paper’s, which claims that “Midwives are entitled to a psychologically safe professional journey”… This is wonderful to see…but will we ever see midwives being cared for in equal partnership with the women and families they care for?

A colleague of mine recently noted that ‘as soon as we say that patients come first…we immediately devalue the staff’….

This got me thinking….and writing this blog post.

In the midwifery news this week:

I have come across the following articles in one way or another…

The experience of professional burnout can be one of extreme personal pain which some midwives feel they may never recover from. Despite global recognition of the destructive phenomenon of burnout, midwives may not understand what was happening to them. They can feel judged as managing their practices poorly, experience isolated feelings of shame, and feel unable to disclose their escalating need for help.

Young, C. M., Smythe, L., & Couper, J. M. (2015). Burnout: Lessons from the lived experience of case loading midwives. International Journal of Childbirth, 5(3), 154-165.

My 3 latest papers have addressed the issue of midwife burnout and psychological distress in great detail…I shall be publishing more shortly… for further reading see:

Pezaro, S. The midwifery workforce:  A global picture of psychological distress – ARTICLEinMIDWIVES: OFFICIAL JOURNAL OF THE ROYAL COLLEGE OF MIDWIVES 19:33 · MARCH 2016

Pezaro S (2016) Addressing psychological distress in midwives. Nursing Times; 112: 8, 22-23.

Pezaro, S., Clyne, W., Turner, A., Fulton, E. A., & Gerada, C. (2015). ‘Midwives overboard! ‘Inside their hearts are breaking, their makeup may be flaking but their smile still stays on. Women and Birth. In press.

Midwife burnout is rarely understood…Yet one thing is clear, we really do need to find new ways to support each other and look after ourselves for the benefit of all midwives working within midwifery profession, and the families we care for.

This week I will continue to write my systematic literature review which aims to identify the nature and existence of interventions designed to support midwives in work-related psychological distress, and their effectiveness at improving the psychological well-being of midwives.

Once this is complete, we will be one step closer towards effectively supporting midwives in work-related psychological distress.

Until then, look after yourselves…and each other.