Building research capacity in General Practice : Incorporating research as a component of GP vocational training

Aims & rationale/Objectives : Australian research shows that most GP registrar supervisors lack confidence to support registrar research projects and themselves have little or no research experience. Assisting registrars to develop critical thinking skills and an understanding of research methods sufficient to enable active use of these tools in general practice is one of the curriculum statements in the RACGP Training Program Curriculum. A University Department of Rural Health (UDRH) and a General Practice Education and Training (GPET) organisation formed a partnership to: Engage basic term registrars in group research and concurrent research skills training program; Improve research skills, confidence, and knowledge; and Contribute research findings relevant to general practice.

Methods : Registrars' initial research knowledge and confidence was measured by a questionnaire. In addition to a final focus group, feedback via evaluation forms was sought from the 11 registrars and two GPET supervisors at the conclusion of each research training session.

Principal findings : Approaches

Implications : Research skills development training and involvement in research can be successfully integrated into a GP vocational training program.

Revolt and discovery : towards an understanding of practice as research through Kristevan aesthetics

This paper will examine Kristeva’s conceptions of revolution and revolt to demonstrate the significance of her work for practitioners and researchers working in the emerging field of creative arts practice as research, a field of research that is burgeoning in the UK, Australia, Canada and Scandinavia. I will argue that Kristeva’ thought elaborates the aesthetic underpinnings of discovery and provides a rationale for the methodologies used in artistic research.

In her later work on interpretation, Kristeva places a greater emphasis on the need for analysis or theory, since the art and culture of revolt produce unfamiliar or mutant meanings that are difficult for audiences to grasp in terms of their potency for engendering social change and individual empowerment. However, she places the responsibility for this analysis and interpretation on the art critic. But what if (as is the case with the advent of artistic practice as research), the maker and the “critic” become one and the same? Can this shift in the status of artistic practice within the knowledge economy, be understood in terms of Kristeva account of the sense and nonsense of revolt? I will address these questions by revisiting aspects of Kristeva thinking on experience-in practice and examining her more recent and extended elaboration of revolutionary practice. The paper will explore how her thinking can provide practitioners with a framework for understanding creative arts research as the production of new knowledge. If as Kristeva argues, that art and literature are amongst the few means of revolt and renewal, it seems appropriate to turn to her thinking in order to articulate a rationale and argument for claiming that practice as research can operate as a driver of change and innovation in contemporary culture.

The first part of this task will involve tracing what Kristeva sees as three forms of revolt made possible through aesthetic experience. This will involve a closer examination of the notions of transgression and art as experience. Following on from this discussion, I will discuss how Kristeva’s work constitutes both an implicit and explicit critique of science allowing us to conceive of artistic research as an alternative and performative production of knowledge. Finally in this paper, I will apply and illustrate these ideas through an analysis of a selection of a number of research projects successfully completed by artistic researchers in Australia. I hope to show that artistic practice as a mode of enquiry, reveals the inextricable and necessary relationship between practice and theory, interpretation and making, art and life. I suggest that it is this interrelationship, that underpins what Kristeva describes as creative and revolutionary practice. In the context of creative arts practice as research, Kriteva’s account of experience–in-practice indicates that interpretation and analysis must fall to the practitioner-researcher himself or herself - rather than to another person who has been external to the procedures of making - to trace the significant experiential, subjective and emergent processes involved in the production of the work that allows it to reveal the new. This is necessary if the generative and revolutionary impact of artistic research is to be fully understood in the wider research arena.

An Eyre Peninsula report card : adaptation practice and research in the far west of South Australia

The formation of Natural Resource Management Boards in South Australia provided a robust and integrated, and well resourced, regional landscape planning quasi-­‐authority in South Australia that has had major beneficial outcomes to several SA regions in being able to better co-­‐ordinate long term and creative public and private land management strategies, as well as enable several unique research projects to be tackled that would not otherwise under traditional fragmented state government agency configurations and relationships.

"Flows and catchments" : a mixed method study utilising nvivo to facilitate cross-disciplinary collaboration incorporating practice-based research

This paper responds to the problem of how Practice-Based Research (PBR) can be usefully incorporated into a cross-disciplinary, Mixed Method project design, by considering a non-conventional use of the NVivo qualitative analysis software package. NVivo also proves valuable in maximising the creative-arts practice interdisciplinary potential within PBR itself. The ensuing discussion centres around Deakin University’s ‘Flows and Catchments’ research and teaching initiative.

Working at the nexus between public health policy, practice and research : dynamics of knowledge sharing in the Netherlands

Background
Joining the domains of practice, research and policy is an important aspect of boosting the quality performance required to tackle complex public health problems. “Joining domains” implies a departure from the linear and technocratic knowledge-translation approach. Integrating the practice, research and policy triangle means knowing its elements, appreciating the barriers, identifying possible cooperation strategies and studying strategy effectiveness under specified conditions.
This article examines the dynamic process of developing an Academic Collaborative Centre for Public Health in the Netherlands, with the objective of achieving that the three domains of policy, practice and research become working partners on an equal footing.
Method
An interpretative hermeneutic approach was used to interpret the phenomenon of collaboration at the nexus between the three domains. The project was explicitly grounded in current organizational culture and routines, applied to nexus action. In the process of examination, we used both quantitative (e.g. records) and qualitative data (e.g., interviews and observations). The data were interpreted using the Actor-Network, Institutional Re-Design and Blurring the Boundaries theories.
Results
Results show commitment at strategic level. At the tactical level, however, managers were inclined to prioritize daily routine, while the policy domain remained absent. At the operational level, practitioners learned to do PhD research in real-life practice and researchers became acquainted with problems of practice and policy, resulting in new research initiatives.
Conclusion
We conclude that working at the nexus is an ongoing process of formation and reformation. Strategies based on Institutional Re-Design theories in particular might help to more actively stimulate managers’ involvement to establish mutually supportive networks.

Medication adherence self-report instruments : implications for practice and research

Background: After an acute cardiac event, adhering to recommendations for pharmacologic therapy is important in achieving optimal health outcomes. Considering the impressive evidence base for cardiovascular pharmacotherapy, strategies for promoting adherence are less well developed. Furthermore, accessing reliable, valid, and cost-effective mechanisms of monitoring adherence in the research and clinical settings is challenging. Aim: The aim of this article was to review published self-report measures assessing and monitoring medication adherence in cardiovascular disease and provide recommendations for research into medication adherence. Methods: The electronic databases CINAHL, Medline, and Science Direct were searched using the key search terms medication adherence and/or compliance, cardiovascular, self-report measures, and questionnaires. The World Wide Web was searched using the Google and Google Scholar search engines, and reference lists of retrieved documents were reviewed. The search strategy was verified by a health librarian. Instruments were included if they specifically addressed medication adherence as a discrete construct rather than a disease-specific or a generic health status measurement. Findings: Despite of the problems with medication adherence identified in the literature, only 7 instruments met the search criteria. There was limited use of instruments across studies and settings to enable comparison across populations and extensive psychometric evaluation. Conclusions: Medication adherence is a complex, multifaceted construct dependent on a range of physical, social, economic, and psychological considerations. In spite of the importance of adherence in ensuring optimal cardiovascular outcomes, conceptual underpinnings and methods of assessing medication adherence require further discussion and debate.

A quandary in management practice: Academic research or consulting?

This paper compares the practice of academic action research against management consulting. Consulting is founded upon a body of underpinning knowledge drawn from a different perspective than action research. Nevertheless, consulting and action research, in practice, draw from similar methods of investigation. The difficulty in distinguishing action research from consulting adds to unique ethical problems in practice. In this paper, an ethics quandary is identified, defined and explored with implications for research practice. An example of an action research project is presented to highlight the potential ethical dilemma and conflict of interest points of
the investigation, whether as an academic or a consultant. The authors, by crystallising the boundaries of academic action research and consulting posit that, when designed and executed well, risk can be minimised to gather rich and deep insights into management practice.