realist review protocol

10.1186/s13643-017-0415-9 They generally try to eliminate the effect of context rather than understand its impact. Roff S, McAleer S, Skinner A. Jagosh J, Macaulay AC, Pluye P, Salsberg J, Bush PL, Henderson J, Sirett E, Wong G, Cargo M, Herbert CP, Seifer SD, Lawrence W. Uncovering the benefits of participatory research: implications of a realist review for health research and practice. The Author(s). Wiese, A., Kilty, C., Bergin, C. et al. Methods: Realist review will be used to develop and refine a theoretical understanding of why, how, for whom, and in what circumstances post-ICU program impact ICU survivors' outcomes. This protocol outlines how realist review methods can be used to synthesise evidence on shared care for long-term conditions. AU - Lhussier, Monique. Development of a program theory for shared decision-making: a realist review protocol Syst Rev. Med Educ. external Cookies policy. Mirrors crossmark:CrosMarkDomains Remediating doctors’ performance to restore patient safety: a realist review protocol. 1. N2 - Objectives - Adolescent risk behaviours are a key health concern. internal The core research team is a multi-disciplinary group of researchers, clinicians and health professions educators. a realist review protocol Gill Windle1*, Samantha Gregory1, Andrew Newman2, Anna Goulding2, Dave O'Brien3 and Clive Parkinson4 Abstract Background: Arts-based activities are being increasingly suggested as a valuable activity for people living with dementia in terms of countering the negative aspects of their condition. The attribute platform is optionally allowed for situations in which multiple URLs must be specified. CrossmarkDomainExclusive The realist review will be structured according to Pawson's five practical steps in realist reviews: (1) clarifying the scope of the review, (2) determining the search strategy, (3) ensuring proper article selection and study quality assessment, (4) extracting and organising data, and (5) synthesising the evidence and drawing conclusions. Usual same as prism:doi Clinical workplaces are complex, dynamic systems in which learning emerges from non-linear interactions within a network of related factors and activities [23, 24]. AB - Introduction Supporting people subjected to sexual violence includes provision of sexual and reproductive healthcare. The review questions ask the following: How have people with diabetes and the wider community been involved in diabetes research? Working under poor conditions is linked to trainee stress and burnout, which may impact learning, humanism and professional identity formation [11, 27]. uuid:d9ca23c2-9948-4706-a90c-37ce46c34e6c PROTOCOL Open Access Development of a program theory for shared decision-making: a realist review protocol Gary Groot1*, Tamara Waldron1, Tracey Carr1, Linda McMullen2, Lori-Ann Bandura3, Shelley-May Neufeld1 and Vicky Duncan1 Abstract Background: The practicality of applying evidence to healthcare systems with the aim of implementing change is Improving best practise for patients receiving hospital discharge letters: a realist review protocol. 1 0 obj 2013;18:527–36. Conformance level of PDF/X standard If an alternate unique identifier is used as the required dc:identifier, then the DOI should be specified as a bare identifier within prism:doi only. Searching is iterative and as synthesis and theory refinement occur further searches may be necessary to test the emerging theory. We will adopt an iterative and explanatory approach to synthesis of the data. seriesEditorInfo Specifies the types of series editor information: name and ORCID of a series editor. As realist review methodology is complex and still evolving, this protocol outlines a detailed process to add to the evolution of this research methodology. Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R. RAMESES publication standards: realist syntheses. Mirrors crossmark:CrossmarkDomainExclusive URI SourceModified PlateNames Rycroft-Malone J, McCormack B, Hutchinson AM, DeCorby K, Bucknall TK, Kent B, et al. Text Educ Prim Care. true Weiss KB, Bagian JP, Nasca TJ. Article  A PRISMA-P checklist has been completed and is available as an additional file (see Additional file 1). PubMed  New York: Cambridge University Press; 2006. p. 47–60. Discussion. Realist review addresses these shortcomings by producing rich contextual information which policymakers and practitioners can apply to their own circumstances [29]. external Understanding how appraisal of doctors produces its effects: a realist review protocol. This protocol outlines how realist review methods can be used to synthesise evidence on shared care for long-term conditions. This study is funded by the Health Research Board, Ireland, award number MERG-1980; recipient Dr. Deirdre Bennett MB MPH MA PhD. JAMA. 3 0 obj Copyright 2015;20:843–56. N2 - Objectives - … internal Any discrepancies will be discussed and resolved among the core research team with reference to the wider research team if necessary. AW and CK contributed to the initial design and planning of the review. Wimmers PF, Schmidt HG, Splinter TA. 2013;88:1209–11. EditorInformation These findings will feedback into theory refinement. doi:10.1136/ bmjopen-2014-005466 Prepublication history for this paper is available online. Health care systems internationally are under strain, facing increasing demands with limited resources [18, 19]. The realist approach also starts with a … PubMed  Trapped By identifying causal mechanisms in PGMET, it may be possible to design clinical learning environments that are effective for learning, and create satisfactory working conditions for doctors in training. DOI B This review will increase our understanding of how P4P affects health systems and how health systems can be strengthened to deliver better care and key attributes of successful P4P programmes in different contexts. AU - Cooper, Christina. Zubair M, Chadborn NH, Gladman JRF, Dening T, Gordon AL, Goodman C. BMJ Open, 7(10):e017270, 10 Oct 2017 external Med Educ. The realist approach also starts with a sharpeni ng of. Reasons for exclusion of papers will be thoroughly documented to ensure transparency. Terms and Conditions, 10.1186/s13643-017-0415-9 converted Understanding how appraisal of doctors produces its effects: a realist review protocol..pdf (612.0Kb) PEARL deposit licence.pdf (74.73Kb) Date 2014. Acad Med. 1989;18:32–42. Note: Publication name can be used to differentiate between a print magazine and the online version if the names are different such as “magazine” and “” We have chosen realist synthesis as a methodology because of its suitability for researching complexity and producing answers useful to policymakers and practitioners. The review will follow the steps of a rapid realist review (RRR), as proposed by Saul et al. This realist synthesis will follow the steps and procedures outlined by Wong et al. ResourceRef issn We developed separate search strategies for understanding the scope, finding underlying theories, and identifying primary studies. DB will be the guarantor of the review. BMJ Open 2014;4: e005466. endobj Realist philosophy holds that outcomes of an intervention are not deterministic or simply linear but are context dependent. Medical education. Med Teach. Company Boor K, Van Der Vleuten C, Teunissen P, Scherpbier A, Scheele F. Development and analysis of D-RECT, an instrument measuring residents’ learning climate. Specific research questions are the following: What are the mechanisms by which postgraduate workplace learning results in its intended outcomes? Communities of practice theory [32] emphasises the importance of participation in practice and connection, recognition and belonging within a community. Dijkstra IS, Pols J, Remmelts P, Rietzschel EF, Cohen-Schotanus J, Brand PLP. Brennan, N. Bryce, M. Pearson, M. Wong, G. Cooper, C. Archer, J. Metadata Show full item record. Brown JS, Collins A, Duguid P. Situated vognition and the culture of learning. Acad Med. Integer publicationName Traditional systematic reviews of such interventions tend to have mixed results and do not explain how or why the intervention worked. database. external 2014;312:2385–93. 2013;309:1687–8. Using theory to identify CMO configurations focuses reviewers on the underlying and transferable aspects of programmes described rather than on their specific minutiae [30]. In: Dornan T, Mann KV, Scherpbier A, Spencer J, editors. Google Scholar. T1 - Protocol for a realist review of complex interventions to prevent adolescents from engaging in multiple risk behaviours. Methods. Your systematic review protocol should be complete before you submit your registration request . endstream The goal of the realist review will be to identify and refine a program theory for SDM through the identification of mechanisms which shape the characteristics of when, how, and why SDM will, and will not, work. Focussing the review question will be an iterative process consisting of exploration of the literature and relevant programme theories as well as consultation with experts and stakeholders. Regular meetings will be held with the wider project team to discuss and define the key aspects of the review, to ensure consensus on review focus. Title of the magazine, or other publication, in which a resource was/will be published. A realist review is a theory-driven systematic review informed by a realist philosophy of science, seeking to produce useful theory that explains observed outcomes, in terms of relationships between important contexts and generative mechanisms. AU - Shucksmith, Janet. 2015;10:171–5. Tsai J-C, Chen C-S, Sun I-F, Liu K-M, Lai C-S. Clinical learning environment measurement for medical trainees at transitions: relations with socio-cultural factors and mental distress. Methods Realist review is a theory-led approach to knowledge synthesis that provides an explanatory analysis aimed at discerning what works , for whom , in what circumstances , how , and why . 2005;27:326–31. 43. Realist review does not provide simple answers to complex questions. The review will use a six-step iterative process to develop a program theory for CPWs in hospitals: (1) development of a preliminary program theory; (2) search strategy and literature search; (3) study selection and appraisal; (4) data extraction; (5) data analysis and synthesis; and (6) stakeholder engagement. Deirdre Bennett ), geographical area in which the study was conducted, specific population and methodology used. J Health Organ Manag. Abstract: Introduction Discharge documents are important for transferring information from hospitals to the referring clinician; in the UK and many countries, this is often the patient’s general practitioner or family physician. in the RAMESES Publication Standards for Realist Synthesis and the Realist Synthesis RAMESES Training Materials. editorInfo There is a need to ensure an environment for safe and supported disclosure of sexual violence in these clinical settings. Issue 3. Text Consequently, in line with the realist review methodology, our screening process will be iterative and will allow for ongoing screening protocol changes. Article  Specifies the types of author information: name and ORCID of an author. The potential for such programmes to improve a broad range of … 2010;16:841–8. PROTOCOL Open Access Understanding the theoretical underpinning of the exercise component in a fall prevention programme for older adults with mild dementia: a realist review protocol Vicky Booth1*, Rowan Harwood2, Victoria Hood3, Tahir Masud2 and Philippa Logan1 Abstract Background: Older adults with mild dementia are at an increased risk of falls. external external This study will draw from the published literature and programme, and substantive, theories of workplace learning, to describe context, mechanism and outcome configurations for PGMET. Cambridge: Cambridge University Press; 1991. Postgraduate medical education and training (PGMET) is a complex social process which happens predominantly during the delivery of patient care. external This article presents the protocol for a realist review to shed light on for who, how and in what circumstances P4P works in low and middle income countries (LMIC). internal JAMA. Postgraduate medical education Unlike the search strategy of traditional systematic reviews, searches in realist synthesis do not aim to uncover every published paper addressing the topic, but rather to balance comprehensiveness with theoretical saturation. part 1 in a manner adapted from that reported by Brennan and colleagues . We have been funded by the Health Research Board (Ireland), the Medical Council of Ireland and the Irish Health Service Executive (National Doctors Training and Planning) to conduct a project comprised of three studies triangulating on the ways in which clinical learning environments shape postgraduate trainees’ learning. Brennan N 1, Bryce M 1, Pearson M 2, Wong G 3, Cooper C 2, Archer J 1. The DOI may also be used as the dc:identifier. Rates of diabetes in people with dementia are between 13 and 20 %. Searching will be iterative and will discontinue when sufficient evidence is found that it is reasonable to claim that the programme theory is coherent and plausible. 2014;96–B:1133–8. GTS_PDFXConformance Springer Nature. An initial programme theory for workplace learning in postgraduate medical education and training will be developed and expressed in realist terms. A complex intervention is one whose outcome is dependent on the interaction between its participants and their context; in this case, doctors in training and the clinical learning environment. Text DerivedFrom Wong G, Greenhalgh T, Westhorp G, Pawson R. Realist methods in medical education research: what are they and what can they contribute? 2017-01-17 In: Sawyer RK, editor. Searching will cease when sufficient evidence has been found to demonstrate the coherence and plausibility of the refined programme theory. First, our review is limited to the English language. PY - 2017/9/1. Promoting excellence: standards for medical education and training. name Note: PRISM recommends against the use of the #other value currently allowed in this controlled vocabulary. Bleakley A. Blunting Occam’s razor: aligning medical education with studies of complexity. We will look for predictable patterns (demi-regularities) to determine how similar mechanisms act in different contexts to generate outcomes. Pawson R, Greenhalgh T, Harvey G, Walshe K. Realist review—a new method of systematic review designed for complex policy interventions. Protocol for a realist review of complex interventions to prevent adolescents from engaging in multiple risk behaviours. Bag SeriesEditorInformation Protocol for a realist review of workplace learning in postgraduate medical education and training. default Amendment of PDF/A standard Seq Text Y1 - 2017/9/1. amd This process will be guided by programme and substantive theories. 2010;16:849–55. Delivery of patient care, adherence to working hours legislation, focus on patient safety and resource management are activities which may compete with, as well as generate, learning in clinical workplaces. CrossMarkDomains A structure containing the characteristics of a font used in a document We will also search the following journals by hand: Academic Medicine, Advances in Health Sciences, Graduate Medical Journal, Medical Education, Medical Teacher and Postgraduate Medical Journal. PROTOCOL Open Access The effectiveness and cost-effectiveness of shared care: protocol for a realist review Rebecca Hardwick1*, Mark Pearson1, Richard Byng2 and Rob Anderson1 Abstract Background: Shared care (an enhanced information exchange over and above routine outpatient letters) is Emerging findings will be challenged and contrary examples will be sought in the data and in theory. Na Fu Methods Realist review is a theory-led approach to knowledge synthesis that provides an explanatory analysis aimed at discerning what works , for whom , in what circumstances , how , and why . Gives the name of a series editor. Comments on the rigour and trustworthiness of the study will also be included. GTS_PDFXVersion A further aim of the review is to explore economic evaluations of shared care. Med Teach. Seq Text Text Author information. Bag Font This is a protocol for a realist review. Lucia Prihodova CrossMarkDomains Realist review protocol for understanding the real- … CB, PF, NF, MH, AH, BM, GO’K, LP, CK and DS reviewed and edited the drafts of the protocol and DB finalised the document. Inclusion and exclusion decisions will be based on whether the findings can contribute to theory testing and refinement and whether the methods used to generate findings are credible and trustworthy. uuid:dd00b59a-2d83-4bca-875c-3084860a3303 Postgraduate medical education and training (PGMET) is a complex social process which happens predominantly during the delivery of patient care. Effectiveness of clinical rotations as a learning environment for achieving competences. These factors may impact each other in unanticipated ways with unintended consequences. Wong BM, Holmboe ES. Dates of the planned realist review, from protocol design to completion, January 2019 to July 2020. Capping of working hours for doctors-in-training, driven by concerns for doctor wellbeing and patient safety, has resulted in a move to shift work and fewer total hours worked, raising concerns about unintended consequences for learning and delivery of care [22]. Bag AuthorInformation This theory will be refined as the review progresses and becomes more focussed. A reference to the original document from which this one is derived. pdf Abstract. %���� Art No.:CD006632. Although our protocol is comprehensively developed following well-established guidelines for realist synthesis [22, 25], there are limitations that need to be taken into account. Wong G, Westhorp G, Pawson R, Greenhalgh T. Realist synthesis. pdfx Health solutions to improve post-intensive care outcomes: a realist review protocol Syst Rev. Clinical workplaces are complex, dynamic systems in which learning emerges from non-linear interactions within a network of related factors and activities. 2013;2(1):12. The questions that will guide us selecting papers based on relevance are the following: Does the study relate directly to the clinical learning environment of medical trainees? These questions will ensure that the sources identified allow the team to make sense of the subject area, in order to develop, refine and test theories, and to support inferences made about mechanisms. Adv Heal Sci Educ. Understanding the impact of delegated home visiting services accessed via general practice by community dwelling patients: a realist review protocol Lay Summary There have been a number of recent policies concerning the organisation of primary health care, including GP Forward View 2016. Firstly, an electronic data extraction sheet will be used in order to record study identification details (authors, title, publication, etc. statement and 2017-01-17T19:32:51+08:00 AU - Carr, Susan Mary. It has also been recognised that environments which lead to good patient outcomes are also positive learning environments [16, 17]. Understanding how appraisal of doctors produces its effects: a realist review protocol. What factors create a humanistic doctor? Both MeSH (medical subject headings) and free text will be employed to ensure breadth and depth of coverage. Syst Rev 6, 10 (2017). Depicting the process will ensure that this review follows a literature informed and consistent methodology. 2 Identification of CMO configurations is informed by programme theory, or the underlying assumptions of how the intervention is supposed to work, and relevant middle range theories, in this case, theories of workplace learning. Text The following conceptual tools will be applied during this phase [30]; juxtaposing (“for instance, when one study provides the process data to make sense of the outcome pattern noted in another”), reconciling (identifying differences which explain apparently contradictory sets of findings). Clinical pathways : effects on professional practice, patient outcomes, length of stay and hospital costs (review). Agnes Higgins This can be a position at which the document has been changed since the most recent event history (stEvt:changed). This element provides the url for an article or unit of content. What are the important contexts which determine whether the different mechanisms produce their intended outcomes? This realist review protocol has not been registered in any database. name J Eval Clin Pract. Teunissen PW., DOI: Realist synthesis is an interpretative approach to the literature and the RAMESES Realist Synthesis Training Materials do not recommend using a strict checklist approach to quality, as this can lead to exclusion of relevant papers early in the process. pdfaid sn CrossmarkMajorVersionDate 2012;90:1–41. The results of this realist synthesis will be useful to policymakers and practitioners in PGMET, who will be able to apply the findings within their own contexts. Di Somma S, Paladino L, Vaughan L, Lalle I, Magrini L, Magnanti M. Overcrowding in emergency department: an international issue. Med Teach. Editor information: contains the name of each editor and his/her ORCID identifier. AM = Accepted Manuscript internal Economic evaluations are difficult to synthesise due to problems in accounting for contextual differences that impact on resource use and opportunity costs. Our funders have not been involved in the development of the protocol. Text Text We propose to conduct a realist synthesis of the literature to address the overarching questions; how, why and in what circumstances do doctors learn in clinical environments? EVoR = Enhanced Version of Record external A realist review is an interpretative theory-driven approach to synthesise evidence using multiple sources such as published studies, policy documents and grey literature.21 The realist approach acknowledges that interventions may work in some contexts but not others. A further aim of the review is to explore economic evaluations of shared care. %PDF-1.4 The social, cultural and material context for PGMET is the clinical learning environment (CLE) [1] which has been described as ‘the foundation of graduate medical education’ [2]. 2013;11:21. Registering reviews that are never performed is unhelpful to the research community and may discredit the research team. author JAMA. The projects' goals are to produce quality and publication standards and training materials for realist research approaches. Text 2046-4053 converted to PDF/A-2b Article  2010;85:1800–7. external Is the study rich enough in information on context, mechanism and outcomes? Experience, trajectories and reification: an emerging framework of practice based learning in healthcare workplaces. Tokuda Y, Goto E, Otaki J, Jacobs J, Omata F, Obara H, Shapiro M, Soejima K, Ishida Y, Ohde S, Takahashi O, Fukui T. Undergraduate educational environment, perceived preparedness for postgraduate clinical training, and pass rate on the national medical licensure examination in Japan. Complex interventions ‘often have multiple components (which interact in non-linear ways) and outcomes (some intended and some not) and long pathways to the desired outcome(s)’ [28]. Those tasked with the design and delivery of postgraduate medical education and training need to understand the relationship between the processes of medical workplace learning and these contextual elements in order to optimise conditions for learning. the URL). The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated. Text RAMESES I - (Realist And Meta-narrative Evidence Syntheses: Evolving Standards) developed quality and publication standards and training materials for realist reviews and the related approach of meta-narrative reviews.

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