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Posted Thu, 29 Jan 2015 14:51:34
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Applications are invited for a 3 year PhD studentship funded by Brighton & Sussex Medical School (BSMS), located at the Brighton University Campus, Falmer, Brighton. The title is: Nihilism, Stigma, and Computer Systems: What influences GPs’ use of codes and free text when recording consultations?
Primary care (GP) electronic patient records can be used in research studies to describe disease prevalence and aetiology, health service needs, prescribing practices, and side effects of medications. While these studies have a broad reaching impact, the quality of studies relies entirely on the choices made by the primary care team when recording information.
Records are created by primary care clinicians (GPs, nurses, etc) during the course of everyday consultations, with clinical purposes in mind. Clinicians can add information into their coding system or in the form of narrative text (consultation notes). Despite not knowing what type of information, or how much, is hidden in the text, research studies using primary care patient records have relied upon the coded information.
Better quality use of electronic patient records for research requires the researcher to understand the nature of clinicians’ recording so that they can make good quality predictions about what type of information will be found in text or codes, and how much reliance can be placed on the codes alone.
This studentship programme will investigate the following factors which may influence GPs’ use of codes or free text:
1. Types of disease – including stigmatised conditions
2. Demographics – including sexuality, age and ethnic status
3. Availability of treatment – including clinical nihilism
4. Work place determinants – including financial and time constraints
5. System determinants – ergonomics of the computer system
Two exemplar clinical areas will be studied: dementia and sexual health. The project will start with a systematic review of literature covering influences on GPs’ coding and recording, and will also investigate important conceptual issues such as stigma and shame in relation to health conditions, drawing on sociological and psychological literature. Secondly, field studies will be carried out, interviewing and filming consultations with GPs, using actors or written scenarios, to investigate recording practices and GPs’ underlying motives for coding the chosen clinical conditions. Thirdly, we will compare and contrast the results of field studies to the information found in electronic patient records of patients with the exemplar conditions. Finally the student will work towards establishing general principles for describing how much information is coded or in the text, by disease type or patient.
Applicants for this 3-year PhD funded by BSMS starting ASAP should possess or expect to be awarded a minimum of a First or Upper Second Class Honours degree (or equivalent) in Psychology, Social Sciences, Health sciences or similar. Both UK and EU citizens can apply (home fees and stipend will be paid for either UK or EU citizens). However, for non-native English Speakers, a minimum score of 7.0 at IELTS is required. Informal enquiries are very welcome and should be directed to Dr Elizabeth Ford ([log in to unmask]).
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