Research Internship Report
Bristol Medical School
Name: Iris Zoë van der Scheer
Student number: s2987074
E-mail: i.z.van.der.scheer@student.rug.nl
Course name: Res. Master’s Res. Internship Linguistics
Course code: LTR011M20
Supervisors: prof. dr. A.J. Koole (internal) & dr. R.K. Barnes (external)
Academic year: 2019-2020
Semester: 1
Degree programme: Master Linguistics (research)
Institution: University of Groningen
Date: 12/12/2019
Word count: 5293 (excl. references)
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Table of Contents
1. Introduction ... 3
2. Description of placement-providing organization ... 3
2.1 University of Bristol (UoB) ... 3
2.2 Bristol Medical School (BMS) ... 3
2.3 Out-of-Hours Prescribing: Enhancing Communication (OPEN) project ... 4
2.3.1 Theoretical background ... 4
2.3.2 Method and design ... 4
2.3.3 Aim of the study ... 5
3. Description of student’s tasks and responsibilities ... 5
3.1 Reading literature ... 5
3.2 Collecting the data ... 6
3.3 Transcribing the data ... 6
3.4 Categorising and analysing the data ... 6
3.5 (Academic) writing and speaking skills ... 8
3.6 Public engagement ... 9
3.7 (Skype) meetings with supervisor/team ... 9
3.6.1 Meetings with supervisors ... 9
3.6.2 Meetings with the members of the OPEN project ... 9
3.6.3 Meetings within BMS... 10
3.6.4 Additional meetings... 10
4. Evaluation of the placement ... 10
4.1 Relevance within the ReMa program ... 10
4.2 New knowledge and skills ... 11
4.3 Learning goals ... 11
4.4 Supervision at the placement ... 12
4.5 Further academic career ... 12
5. Conclusion ... 12
6. References ... 13
6.1 Articles/chapters ... 13
6.2 Software/websites ... 14
7. Appendix ... 15
7.1 Research log of the internship ... 15
3
1. Introduction
This report describes and evaluates the research internship I completed as a part of my Research Masters in Linguistics at the University of Groningen. The research internship is a mandatory component (20 ECTS) of the program and provides students with hands on experience with research in a different environment. During my bachelor’s in Communication- and Information Sciences, my interest in Conversation Analysis (CA) was sparked for the first time. Ever since I have been passionate about the method and tried to tailor my courses and research activities to it.
Around January 2019, I started looking for possible internships together with prof. dr. Tom Koole. After several meetings and discussions with him, it was clear that the internship should focus on CA and the application of this method in a medical context. First, we tried to find an internship at the University of York and University College London, but unfortunately due to policy- and regulation issues this did not work out. Luckily, in June we received an email from dr. Rebecca Barnes from the University of Bristol (UoB), which stated that she would be happy to be my supervisor. After several emails and a Skype conversation, we agreed that I would go to Bristol to work with dr. Barnes and her team on OPEN - a CA project on antibiotic prescribing in out-of-hours (OOH) consultations. My flight to the United Kingdom (UK) was on the 21st of August, which gave me some time to settle down and to get to know the city. I had never been in the UK before and was a bit reluctant to move here, but after living here for four months I have to admit I fell in love with the people, the city and the ciders. The internship started on the 2nd of September and ended on the 16th of December 2019. In addition, 5 ECTS in the form of a tutorial on transcribing were included. In total, the workload of the internship was 560 hours (1 ECTS = 280 hours), which means I worked full-time for 15 weeks. The workload of the tutorial is 140 hours and the activities are specified in the paper that was written for it.
First, I will provide a description of the organization and the specific project I contributed to. Second, the tasks that I performed and the responsibilities that were associated with it are described. Next, the evaluation and relevance of the internship are discussed. Lastly, concluding remarks on the internship (report) are given.
2. Description of placement-providing organization
2.1 University of Bristol (UoB)
The UoB is one of the most popular and successful universities in the UK. The university has a reputation for innovation since the founding in 1876. The research tackles different areas which are extremely relevant nowadays. Examples are infection and immunity, human rights, climate change, cryptography and information security. The aim is to bring together the best minds in individual fields, and to encourage researchers from different areas to work together to solve problems (University of Bristol, n.d.-b).
2.2 Bristol Medical School (BMS)
The BMS is a part of the UoB and is the largest and one of the most diverse schools in the university. The school comprises of two departments: Population Health Sciences and Translational Health Sciences (University of Bristol, n.d.-a). One of the locations of the former is Canynge Hall which is located close to the Clifton Down Station. In this building I shared an office with five other
researchers. I was based in the Centre for Academic Primary Care (CAPC), which is a part of the Population Health Sciences. CAPC is a member of the National Institute for Health Research School for Primary Care Research (NIHR SPCR). The OPEN project came out of the NIHR SPCR CA working Group and is a collaboration between primary care researchers in partnership with two out-of-hours care providers – BrisDoc (Bristol) and Partnering Health Limited (Southampton). The OPEN project team consists of social scientists, statisticians and academic general practitioners: prof. Geraldine Leydon (project lead Southampton), dr. Rebecca K. Barnes (project lead Bristol), prof. Fiona Stevenson, dr. Catherine Woods, prof. Michael Moore, dr. Gail Hayward, dr. Matthew Booker, dr. Beth Stuart and prof. Paul Little.
4 2.3 Out-of-Hours Prescribing: Enhancing Communication (OPEN) project
During my internship, the main focus was on the OPEN project. This project is a multidisciplinary collaboration between the UoB, University of Southampton (UoS), University of Oxford and University College London funded by the NIHR SPCR. The study investigates how communication between patients and out-of-hours practitioners can influence the prescribing of antibiotics in cases of common infections (University of Bristol, n.d.-c). The theoretical background is based on the protocol of the OPEN project.
2.3.1 Theoretical background
Antimicrobial resistance (AMR) is an increasing and serious threat to public health. This process occurs naturally over time, but the over- and misuse of antibiotics is accelerating this process. Previous research has focused on doctor-patient in-hours consultations rather than out-of-hours consultations. There is a growing recognition that research needs to examine the antibiotic prescribing across primary care sectors. This will enable the development of tailored interventions designed to promote prudent antibiotic prescribing practices.
It is stated that antibiotic prescribing in UK OOH services contributed to 56.6% of all the antibiotic prescribing in the other community settings in 2017. In OOH services in other parts of Europe, patients frequently present acute infectious diseases and antibiotics are often ‘overprescribed’. Previous work on prescribing in in-hours consultations has pointed to numerous clinical and social factors that might influence prescribing decisions. Examples are diagnostic uncertainty, patient/carer expectations for antibiotics and ways patient and doctors communicate about antibiotics during the consultation.
However, the understanding about how doctors deploy antibiotic management strategies in OOH settings is limited. The current project is a mixed methods observational study employing both qualitative and quantitative methods to understand how antibiotic treatment decisions are made in OOH primary care contacts.
2.3.2 Method and design
The project consists of the following three workstreams:
1. Literature review and documentary analysis (to define/understand the problem and its causes via a conceptual realist-informed literature review of the current frameworks for antibiotic prescribing)
2. A prospective observational study (to identify/characterise/describe communication strategies used in the treatment of common medical problems in telephone calls, appointments in primary care centres and home visits)
3. Qualitative development of communication training(s) (to develop communication training to promote prudent antibiotic prescribing practices in OOH consultations)
The internship mainly focused on the second workstream, because workstream 1 was complete and the project had moved into workstream two focusing on data collection during my internship. To be precise, my internship was focused on supporting data management, transcription and preparations for analysis. The figure below provides an overview of the workstream.
5 Figure 1. Overview of the OPEN project work stream 2
2.3.3 Aim of the study
The aim of the study is to understand the organisational, clinical and social context of prescribing patterns for common medical problems in OOH primary care and design tailored communication training to improve prudent prescribing practice. Unfortunately, preliminary results or conclusions are beyond the scope of this report, because the project has not reached the stage of analysis or
interpretation yet.
3. Description of student’s tasks and responsibilities
The tasks below are described in an order which is similar to the steps that are involved in CA research. However, some tasks were performed simultaneously or in a different order. 3.1 Background literature
Before the internship started, I read the OPEN project protocol to become acquainted with it. The protocol included information on funding, background, methods and ethics. During the first week of my internship, dr. Barnes and I decided that, given my research interests, it would be useful for me to become familiar with some of the key literature on doctor-patient communication (Heritage & Clayman (2010), Heritage & Robinson (2006) and Stivers (2007)).
Furthermore, dr. Barnes asked me if I wanted to collaborate with her and write a CA book chapter on doctor-initiated questions about patient prior self-treatment. I was extremely happy with this proposal and obviously agreed with it. This is one of the many opportunities I got during my internship and I will elaborate on the process later on in this report. In preparation for the writing of the book chapter I had to familiarise myself with relevant background literature as well (Jefferson (1988), Barnes (2018), Stivers & Barnes (2018), Barnes (2019), Edwards & Stokoe (2007) and Butler et al. (2010)). Some of the articles investigated similar phenomena in the same context, but other focused on how they function in other contexts.
As transcribing is an essential skill within the field of CA (Bolden, 2015) one my goals was to
improve this skill, which meant that I needed to also familiarise myself with the literature on that topic too (Hepburn & Bolden (2012; 2017), Lerner (2004), Bolden (2015)). The book by Hepburn & Bolden (2017) was very useful, because the chapters describe particular aspects of speech in greater detail. While I was reading the articles and (chapters of) books I took notes and saved them on my laptop so I can use them for future assignments or projects.
6 3.2 Collecting the data
One of the first steps that is (often) involved in a research project is the recording/collection of the data. The OPEN project is a mixed methods study which collects different types of data (both quantitative and qualitative). First, I helped out with the post-consultation surveys by printing out, preparing and sending out the surveys to participating patients and clinicians. I created an Excel sheet to keep track of the surveys that were (or were not) returned and whether we had to use other
communication channels as reminders. This experience showed me that there are a lot of
considerations that have to be taken into account in order to try and maximise return rates: which communication channel to use, how to address the participants, what do you (not) tell them? As a result, I gained experience with writing cover letters, information sheets, consent forms and other relevant documents.
3.3 Transcribing the data
As pointed out earlier, I followed an additional tutorial that concerned transcribing. As part of the assessment of this tutorial I have written a report, which describes the content in greater detail. For now, I will briefly explain the tasks I performed. The recordings of the home- and base visits are sent to a transcription service which returns verbatim transcripts of the recordings. In other words, these transcripts are only suitable for preliminary observations in that they do not contain the level of detail required for CA. Therefore, one of my tasks was to start transcribing some of the recordings according to CA conventions. This gave me the opportunity to improve my transcribing skills and at the same time be a valuable contribution to the project. Additionally, I had to transcribe some of the fragments for the book chapter that dr. Barnes and I wrote.
Another opportunity that I was given was to attend a CA transcription workshop organised by dr. Sikveland at Loughborough University. Around twenty people from all over the world attended the workshop. During the workshop he provided us with the basic knowledge that is needed to transcribe. For example, we learned how to identify transition relevant places (TRPs), turn constructional units (TCUs) and different types of silence. Interestingly, he used data from a British TV series to show how useful CA transcription can be. Next, we got the chance to practice with the information and transcribe some data ourselves using Audacity ® (Version 2.3.3). Furthermore, I got the chance to ask questions about the difficulties I encountered when transcribing myself. In addition, we discussed what would be the best way to try to obtain a PhD and what dr. Sikveland thinks are the
(dis)advantages of doing a PhD in the UK. 3.4 Categorising and analysing the data
The OPEN project was primarily focused on data collection while I was doing my internship. Therefore, it was useful for the researchers to have a rough estimation of what the data looks like. I created an Excel sheet with the variables and a code book which explains the different numbers used. The data was coded for the following variables:
- Participant ID - Type of encounter - Length of recording - Problem statement - Lobbying for antibiotics - Diagnosis
- Part where the diagnosis is explicitly mentioned - Outcome
- Part where the outcome is explicitly mentioned - Acceptance of the treatment recommendation
7 The categorisation gives a brief overview of the data and allows the researchers to make a rough estimation which recordings would be more or less suitable for analysis/training. I found it exciting to take a look at the data and wrote down interesting observations if they occurred. At the beginning of November, I created another Excel sheet with an overview of the participant information combined with the Adastra (OOH case record) data. The Adastra data consists of information that is given by the clinician during and/or after the consultation about the patient and his condition. The overview
included the following variables: - Study ID - Adastra number - Advice History - Consultation History - Consultation Diagnosis - Consultation Treatment - Consultation Clinician - Age group
I used this overview to chart participant age across the different types of data collected . Based on these visualisations the researchers could tailor subsequent data collection to potential gaps that were found. For example, 65+ year old people were underrepresented in the base visits and overrepresented in the telephone calls. However, generally it was observed that the data (at this time) was evenly distributed.
I also attended data sessions. A data session is described by Antaki et al. (2008) as: “a variety of CA group work in which participants listen to, or watch, a piece of recorded interaction and then analyse it (usually with reference to a transcript) in the traditional CA spirit of ‘unmotivated looking’.” (p.2). There were monthly Bristol CA group sessions with 10 to 15 people attending from different departments, and weekly data sessions based on OOH data with dr. Dooley, dr. Barnes, Lydia Holt (NIHR Pre-doctoral research fellow also attached to the OPEN project) and myself. The topic of the monthly data sessions was different every month. This was a great opportunity to learn about different types of data and how people might interpret these types of the data. During the weekly data sessions, we analysed data from the OPEN project or from the project dr. Dooley is working on, which focuses on OOH home visits to patients with dementia. These additional data sessions were organised to get a sense of the data even though the project is not at the stage of analysis.
The book chapter that dr. Barnes and I wrote will be featured in the book ‘Analysing Health
Communication: Discourse Approaches’ edited by Gavin Brookes and Daniel Hunt and published by Palgrave. As the title suggests, the book discusses several discourse methods that can be used to analyse health communication and we were offered the opportunity to write a chapter about the application of CA. Our chapter concerns doctors’ questions about patient self-care prior to the medical visit. The data that we used is drawn from an existing dataset of recorded primary care consultations called the One in a Million primary care consultations archive (Barnes, 2017). The first step was collecting fragments which included this type of question. Luckily, dr. Barnes had already coded most of the consultations that included this type of question which made it easier for me to find them. I found some additional fragments in the archive myself. As pointed out earlier, I had to transcribe some of the fragments. The next step was making collections for analysis. We distinguished two types of questions being used: question word interrogatives and yes-no interrogatives. Together we wrote the chapter. I contributed to the third section of the chapter the most. This section discusses original research which demonstrates the application of CA to health communication. To visualise the phases of the primary care consultation in which the specific phenomenon we investigated occurred I created a diagram, which is presented on the next page.
8 Writing a book chapter on the application of CA has taught me how to present it to people who might have never heard of the method and therefore present it in an accessible way. As a master’s student, I am used to writing reports in an academic writing style. Therefore, I am grateful I got the chance to write a book chapter for a more general audience. Furthermore, the literature I read whilst working on the chapter has taught me a lot about question design in general, the different phases of a primary care consultation and how questions can function in this context. And on top of these learning outcomes, this chapter will be my first research publication, which will (hopefully) enhance my visibility in the field.
Figure 2. Phase structure of the acute care primary visit (Heritage & Clayman, 2010, p. 105) including places where doctor-initiated questions about prior self-care might occur
3.5 (Academic) writing and speaking skills
The internship has improved my English writing- and speaking skills in both the academic field as well as in the daily life. The every-day exposure to English has not only taught me new words and phrases but has also introduced me to the different variants/dialects that exist in the English language. While I was reading literature, I translated the words that I did not know from English to Dutch and by doing this I extended my (academic) vocabulary in English. And as described above, writing the book chapter has improved my writing skills tailored to a different type of audience.
9 Another research activity that I performed was hosting one of the monthly Bristol CA group data sessions. It was my responsibility to prepare the transcripts, a recording and a short introduction about the data. The data that was used was the first base visit recording for the OPEN project. The people who attended the session gave some helpful feedback on the transcript and they were very impressed with the quality of the transcript. Personally, I think it was a useful experience which showed me the aspects that are involved in organising a data session, ranging from time management to writing the actual transcript.
In addition, I wrote an abstract and created a PowerPoint presentation about the book chapter that dr. Barnes and I wrote. Hopefully, I will present our chapter at the Junior Research Meet-up which will be organised next January in Groningen. Dr. Barnes gave me useful feedback on both the abstract and presentation, which she could use for future opportunities as well.
3.6 Public engagement
Another aspect that is relevant in the light of the research project is the public engagement that is linked to it. Dr. Barnes signed up for the FUTURES 2019 research fair and I prepared one of the activities. FUTURES is part of European Researchers’ Night and is an opportunity for people, of all ages, to get to know scientists and their research (FUTURES, n.d.). The activity was called ‘going to the doctors’ and children would be able to build a consultation by using large magnetic stickers with things doctors and patients might say or do. These stickers could be stuck on a magnetic board so visitors could make up their own consultation. Transcripts from the One in a Million archive (Barnes, 2107) were used to select turns at talk to be printed on different size stickers. A document containing different turns at talk was created. Examples of these turns are ‘So what’s the problem?’, ‘Do you take any medications for anything?’ and ‘I’d say probably yesterday’. In addition, a possible consultation using these turns at talk was formed. I also attended a meeting on behalf of dr. Barnes about the event. However, due to time constraints we were not able to realise this but preparing this activity gave me some insight in the public engagement aspect of the project.
I also got the opportunity to write a guest blog that will be posted on the Research on Language and Social Interaction (ROLSI) website. ROLSI is known as a key journal where CA research is
published. The blog post will focus on the research internship and my experience. This will contribute to my visibility in the field of CA and my ability to write a text for a different genre.
3.7 (Skype) meetings with supervisor/team 3.6.1 Meetings with supervisors
Dr. Barnes and I held daily or weekly meetings in her office or via Skype. During these meetings we discussed the progress of the internship and possible future directions. Prof. dr. Koole and I held bi-weekly Skype meetings. We discussed several topics during these meetings ranging from my progress regarding the internship as well as my life here in the UK. Halfway through the internship I arranged an interim evaluation via Skype with both dr. Barnes and prof. dr. Koole. Everyone was satisfied with the ongoing progress and we decided not to change anything in the placement plan.
3.6.2 Meetings with the members of the OPEN project
Every week there was a meeting arranged with (some of) the members of the OPEN project. Most of the time dr. Barnes, Lydia and I represented the UoB and dr. Leydon and dr. Woods represented the UoS. During these meetings we discussed the progress of the members and possible difficulties that we experienced. As said before, the project is a collaboration between different universities, but the largest part of the project is managed by the UoB and the UoS. It is therefore important to be up to date about the current state of the project on both sides. Before each meeting a sheet was circulated on which every member of the team gave an update about their tasks and asked possible questions. Additionally, there was arranged a face-to-face meeting with the whole team in Southampton.
10 3.6.3 Meetings within BMS
CAPC holds monthly meetings within the department. All the members of CAPC are invited and news about staff, papers, grants, conferences, projects and events is presented during these meetings.
Everybody who is working in the department can deliver some input for these meetings, which makes them interesting and interactional. In addition, the department organises a monthly social event called ‘CAPC coffee and cake’ which gives the staff the opportunity to chat with each other while eating some delicious (homemade) cake. In my opinion, this type of events is important to enhance the social contact between the members and give them some time to refresh their minds.
3.6.4 Additional meetings
I also attended a meeting of the Palliative and End of Life Care Research group. My master’s thesis (which I will start writing next February) will investigate palliative care data and dr. Barnes put me in contact with dr. Selman (Senior Research Fellow and co-lead of the UoB Palliative and End of Life Care Research group) who invited me to join this meeting. After I emailed her, she recommended other palliative care researchers who might be able to help me with (preparations for) my thesis. On the 29th of November I went to Oxford together with dr. Barnes to attend a meeting with members of one of the many projects she is working on. This project is a randomised controlled trial examining the effectiveness of a primary care intervention consisting of general practitioner/nurse promotion of e-cigarettes versus standard care for smoking reduction. The trial collected audio recordings of the intervention delivery for CA analysis and the team is currently exploring the extent to which clinicians delivered the intervention as planned, and how some clinicians were able to persuade resistant patients to try switching to e-cigarettes. There were four people who attended the meeting: dr. Rachna Begh (Trial lead), dr. Albury (CA postdoctoral researcher), dr. Barnes and me. We started the meeting with a data session focusing on ‘turnaround’ cases selected from the intervention recordings, which was interesting. After we had lunch, I even got the chance to get a glimpse of the centre of Oxford.
4. Evaluation of the placement
4.1 Relevance within the ReMa program
The research internship is a mandatory component in the second year of the master. One of the things I like about the internship is that the students have the possibility to tailor it to their own interests (which is also the case with courses within the master). My main interests lie in CA and health communication. During my bachelor and masters, I took several courses that were relevant for the internship:
- Conversation Analysis I and II
- Academic Writing and Presentation Skills - Health Communication
- CIS Methodology
- Communication Skills in Medical Interaction: Analysis, Education and Advice - Suggestions in the Operation Room
- Bachelor’s Thesis Communication and Information Studies (“When the listener talks” A conversation analytic research on the use of minimal responses by the incoming doctor in Intensive Care (IC) conversations)
The completion of these courses resulted in a strong theoretical basis for the internship. During the internship I got the chance to put the theoretical knowledge into practice. Thus, given my previous knowledge, experience and skills this internship was a logical choice.
11 4.2 New knowledge and skills
During the internship I have learned about (note that this is a non-exhaustive list): - Presenting research to the public (public engagement)
- Writing/planning a (scientific) book chapter - Working in an (interdisciplinary) team - Networking
- Writing/speaking in (academic English)
- Discussing difficulties/progress during meetings - Working with VLC media player
- Knowledge of transcription software such as Audacity - Citing using APA and Harvard referencing style - Setting up an efficient planning
- The policy and regulations related to research in the UK - Challenges researchers might face
- Working with Outlook - Writing a blog post
- Transcribing in English (according to CA conventions) - Implementing feedback
- Conducting quantitative data (surveys) - Working with Excel (to create tables/charts) - Postgraduate studies in Bristol
- Writing an abstract
- Translating findings into publishable conclusions - The UK primary care health system
4.3 Learning goals
This section will present the learning goals (taken from the Teaching- and Examination Regulations) that were described in the placement work plan and will describe to which extent the goals were achieved.
1.1 have general knowledge and understanding of several subdisciplines in linguistics, their interpretations, methodologies and techniques.
1.2 have thorough knowledge of at least one theoretical and methodological approach within linguistics. 3.1 to make us of the research results of others and evaluate these critically
By reading background materials I gained more knowledge and understanding of CA (1.1 and 1.2), particularly in a medical context. Next, working on a research project and applying my previous knowledge and skills taught me more about the method and analytic techniques of CA. For the writing of the book chapter and the final paper, I had to make us of the results of the articles and evaluate which parts would be the most relevant for the theoretical framework and analysis (3.1).
4.1 be able to participate actively in a research group working on an academic project 4.2 be able to work with other students and lecturers on an academic project
By being a member of the OPEN project, I learned what it is like to contribute to an ongoing research project within another environment (4.1 and 4.2). To be honest, I did not think of all the difficulties a researcher might face when working on such a project. Examples are that data collection can be extremely time-consuming and the dependency on other people/organizations. The work that I did during the internship was appreciated by the members of the project, which made me feel a valuable contribution. The atmosphere within the team was open and easy-going, which allowed me to ask questions or suggest ideas when I wanted to.
12 4.4 be able to participate in international academic debate in the chosen area of specialization and to present an academic problem convincingly in appropriate English, both orally and in writing
The part of this learning goal I wanted to focus on is the latter. As stated before, the research activities I undertook during the internship (e.g. writing the book chapter, organising the data session, making a presentation) have improved my academic speaking- and writing skills. In addition, I learned how to present my work in different genres.
5.1 be able to keep abreast of the latest developments in linguistics and broaden and deepen their own knowledge and understanding
The literature I read did not only focus on the key concepts within the field of doctor-patient communication, but some of the articles discussed relatively new phenomena within this context. In my opinion, the combination of ground theories and the latest developments in the field form a good preparation for future papers/projects within the medical context.
4.4 Supervision at the placement
This experience would not have been this great without the support of both my supervisors prof. dr. Koole and dr. Barnes. Tom, since my bachelor you have always encouraged me to fulfil my potential and eventually to apply for the research masters. You are always supporting me and giving me opportunities to pursue my goals in-depth. I enjoyed our bi-weekly skype meetings, because it reminded me of home, and we had the possibility to catch up.
Becky, I feel lucky to have you as my external supervisor during the internship. You did not only take on the role of a supervisor, but also of a mother and a friend. In my opinion, we are a great team, which even resulted in writing a book chapter together. Being abroad on your own can be challenging, but knowing I had these two people I could count on definitely made this less hard. Again, I want to express my gratitude to both my supervisors for being supportive, encouraging and helpful. I also want to thank all the members of the CAPC who welcomed me in their department, and I want to thank my roommates, friends and family with whom I spent my free time (on the weekends).
4.5 Further academic career
The internship gave me an insight in the daily life of a researcher, which allowed me to assess if I want to pursue an academic career after my graduation. In my opinion, it is appealing that a researcher can focus on one project and can independently plan and perform research activities. However, I have experienced that the researchers at the university experience a lot of stress and pressure and might have difficulty with combining their work with their personal life. Before starting the internship, I was not entirely sure if I wanted to apply for a PhD. These four months in the UK have showed me that I really enjoy working on a (CA) research project and therefore I would like to continue on this path.
5. Conclusion
All in all, I had a great time at the Bristol Medical School, and I have learnt a lot about the different aspects that are involved in being a researcher. The CA day that is organised at Loughborough University on the 16th of December marks the end of my internship. Personally, I think I could not have thought of a better way to close this chapter (for now), because both dr. Barnes and prof. dr. Koole will attend the event and the next day I travel home together with prof. dr. Koole. Furthermore, the internship has helped me with deciding what my ideal future plans would be and I hope to apply for a PhD program in the field of CA (ideally one which combines CA with health communication).
13
6. References
6.1 Articles/chapters
Antaki, C., Biazzi, M., Nissen, A., & Wagner, J. (2008). Accounting for moral judgments in academic talk: The case of a conversation analysis data session. Text & Talk, 28(1), 1-30.
Barnes, R.K. (2017) One in a Million: A study of primary care consultations. Dataset. https://doi.org/10.5523/bris.l3sq4s0w66ln1x20sye7s47wv
Barnes, R. K. (2018). Preliminaries to Treatment Recommendations in UK Primary Care: A Vehicle for Shared Decision Making?. Health communication, 33(11), 1366-1376. doi:
10.1080/10410236.2017.1350915
Barnes, R.K. (2019). Conversation Analysis of Communication in Medical Care: Description and Beyond, Research on Language and Social Interaction, 52(3), 300-315. doi:
10.1080/08351813.2019.1631056
Butler, C. W., Potter, J., Danby, S., Emmison, M., & Hepburn, A. (2010). Advice-implicative interrogatives: Building “client-centered” support in a children’s helpline. Social Psychology
Quarterly, 73(3), 265-287.
Bolden, G. (2015). Transcribing as Research: “Manual” Transcription and Conversation Analysis. Research on Language and Social Interaction, 48(3), 276-280.
doi:10.1080/08351813.2015.1058603
Edwards, D. & Stokoe, L. (2007) Self-Help in Calls for Help With Problem Neighbors, Research on Language and Social Interaction, 40(1), 9-32. doi: 10.1080/08351810701331208
Heritage, J. & Robinson, J.D. (2006). Accounting for the visit: giving reasons for seeking medical care. In Heritage, J., & Maynard, D. (Eds.) Communication in medical care: Interaction between primary care physicians and patients (pp. 48-85). Cambridge, UK: Cambridge University Pres
Heritage, J., & Clayman, S. (2010). Talk in action: Interactions, identities, and institutions (Language in society). Chichester, UK: Wiley-Blackwell. doi:10.1002/9781444318135
Hepburn, A. & Bolden, G. (2012). The Conversation Analytic Approach to Transcription. In Sidnell, J. & Stivers, T. (Eds.), The Handbook of Conversation Analysis (pp. 55-76). Chichester, UK: Wiley-Blackwell.
Hepburn, A. & Bolden, G. (2017). Transcribing for social research. London, UK: SAGE Publications. Jefferson, G. (1988). On the sequential organization of troubles-talk in ordinary conversation. Social Problems, 35(4), 418-441.
Lerner, G. (2004). Conversation analysis: Studies from the first generation. Amsterdam: John Benjamins Pub.
Stivers, T. (2007). Prescribing under pressure: Parent-physician conversations and antibiotics (Oxford studies in sociolinguistics). Oxford: Oxford University Press.
Stivers, T. & Barnes, R.K. (2018). Treatment Recommendation Actions, Contingencies, and Responses: An Introduction, Health Communication, 33(11), 1331-1334. doi:
14 6.2 Software/websites
Audacity ®: Free Audio Editor and Recorder [Computer application]. Version 2.3.3, retrieved Nov 2019 from https://audacityteam.org/
FUTURES. (n.d.). About. Retrieved 30 Oct. 19 from https://www.futures2019.co.uk/about/
University of Bristol (n.d.-a) About. Retrieved Oct. 30 2019 from http://www.bristol.ac.uk/medical-school/about/
University of Bristol (n.d.-b). Our research. Retrieved 30 Oct. 19 from http://www.bristol.ac.uk/university/research/
University of Bristol (n.d.-c). OPEN study gets green light to begin recording out-of-hours health care encounters. Retrieved 6 Nov. 19 from https://www.bristol.ac.uk/primaryhealthcare/news/2019/open-study.html
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7. Appendix
7.1 Research log of the internship
Date What did I do?
Week 1 - Familiarize with the data - Read background materials - Start categorising the base visits - Attend FUTURES 2019 meeting
- Prepare the magnets for the FUTURES event - Attend OPEN skype meeting
Week 2 - Continue reading background materials
- Improve the verbatim transcripts while categorising/analysing - Complete some Erasmus+ OLS exercises
- Attend meeting with Tom
- Read and highlight ANCAP coding manual Week 3 - Fill out documents for research passport
- Continue analysing base visits - Start transcribing the first base visit - Update and adjust CV
Week 4 - Continue transcribing
- Attend meeting palliative and end-of-life care research group - Attend CAB data session
- Continue reading background materials - Start selecting fragments for the book chapter Week 5 - Continue reading background materials
- Continue selecting fragments
- Attend data session and OPEN skype meeting - Attend skype meeting with Tom
- Write down observations of the fragments
- Set timestamps to the fragments and analyse in the light of the treatment recommendation
- Improve the transcripts on a basic level Week 6 - Continue reading background materials
- Continue transcribing
- Attend data session and OPEN skype meeting - Practice Harvard referencing style
- Start working on the draft of the book chapter Week 7 - Transcribe the fragments of the book chapter (CA)
- Attend interim evaluation with Tom and Becky - Attend OPEN meeting in Southampton
- Continue working on the book chapter - Work on the transcript of the base visit Week 8 - Continue reading background materials
- Continue working on the draft of the book chapter - Attend OPEN skype meeting and CAPC meeting - Make a start with the internship report
- Create diagram of phase structure of a consultation - Finish transcribing first 8 minutes of the base visit Week 9 - Prepare the data session
- Attend OPEN skype meeting - Organise CAB data session
- Merge Adastra data with participant data - Start transcribing telephone calls
16 - Continue working on the internship report and tutorial paper
- Give feedback on the draft of the book chapter Week 10 - Update the patient ID log
- Prepare the envelops with surveys/letters/info sheets - Guide the interviewees and help them where necessary - Continue working on the internship report
- Attend skype meeting with Tom
- Create an excel sheet with patient/clinician and whether they have returned the survey or not
- Continue transcribing the telephone call/base visit Week 11 - Continue transcribing the telephone call
- Send out the recording to the transcription services - Attend OPEN skype meeting
- Attend the OOH data session - Work on the tutorial paper
- Create pie charts of the age groups per dataset
- Create pie charts of the distribution of the base visits and home visits - Attend CAPC coffee and cake
- Read the draft of the book chapter again
- Work out a draft presentation and text of the book chapter Week 12 - Start writing an abstract of the book chapter
- Continue working on the presentation and text - Attend UoB postgraduate event
- Attend OPEN skype meeting
- Attend the CA transcription workshop
Week 13 - Continue working on the report of CA transcription workshop - Update the excel sheets
- Attend OPEN skype meeting - Finish draft of tutorial paper - Attend project meeting in Oxford - Attend skype meeting with Tom Week 14 - Update excel sheets
- Attend OPEN skype meeting - Finish draft internship report - Attend OOH data session - Attend meeting with Mike
- Prepare envelopes with surveys/letters/info sheets Week 15 - Finish the final tutorial paper
- Finish the final internship report - Attend CAB double data session - Help Lydia with the excel sheet/survey - Prepare 120 more envelopes/surveys - Attend CAPC meeting
- Attend CA day at Loughborough University
faculty of arts mobility office
Career Services Faculty of Arts, PO Box 716, 9700 AS Groningen, the Netherlands Tel.: +31 (0)50-363 5844; www.rug.nl/let/careerservices; stages.let@rug.nl
Evaluation form for placement providers
Placement provider: Dr Rebecca Barnes
Department: Centre for Academic Primary Care, Population Health Sciences City: Bristol
Country: UK
Name student: Iris van der Scheer
Placement period: 2nd September – 16th December 2019
Description of tasks
1. Which tasks have been performed by the student? (This concerns main tasks as described in the contract and possible other activities)
During the internship, Iris has been supporting my current research study on the management of common infections in out of hours care (The OPEN project). Her tasks have involved setting up, and participating in, weekly Skype meetings with our other core team members in
Southampton; helping prepare study information packs to be sent to eligible patients who have recently had advice calls with the Bristol out of hours service; helping prepare materials for, and sending out, follow-up surveys to study participants as well as monitoring return rates. Iris has also contributed to the study by producing spreadsheets summarising the different types of data we have collected to date including: number and types of visit recorded; types of clinician participating; patient/carer demographics; reason for the visit; and visit outcome. She has also transcribed a video-recorded primary care centre visit and an advice call audio-recording in preparation for analysis.
Iris has also been contributing to our monthly CA group data sessions and to more focused data sessions on data collected for the OPEN project and another project led by another member of my team on the management of patients with dementia during out of hours care. She also accompanied me to the University of Oxford and contributed to a data session there with colleagues working on a CA project analysing the delivery and receipt of an e-cigarette intervention for hardcore smokers in primary care.
Other activities have included preparing materials for future public engagement opportunities; and working closely with me on a small study of doctors’ questions about prior self-treatment that we wrote together for a methods chapter on CA to be published in a forthcoming book ‘Analysing Health Communication: Discourse Approaches’. For these tasks Iris was working with data from the ‘One in a Million’ primary care consultations archive held at the University of Bristol.
faculty of arts mobility office
Iris has also been reading key papers from the CA literature on transcribing and the analysis of communication in medical care. During her stay she has completed a CA transcription tutorial using data from the OPEN project. The latter task also involved attending a CA transcription workshop at the University of Loughborough.
2. To what extent has your organisation benefitted from the activities of the student and to what extent will you use the results?
O not at all O to some extent O sufficiently X to a large extent
Evaluation of the tasks
3. What is your opinion about the quality of the content of the reports, notes, publications, research, translations, etc. written by the student?
O insufficient O sufficient
O good
X excellent
4. What is your opinion about the student’s writing skills? O insufficient
O sufficient
O good
X excellent
5. What is your opinion about the student’s oral skills? O insufficient
O sufficient
O good
X excellent
6. What is your opinion about the student’s accuracy and thoroughness? O insufficient
O sufficient
O good
X excellent
7. What is your opinion about the pace at which the tasks were performed? O insufficient
O sufficient
O good
X excellent
8. What is your opinion about the student’s organisational skills? O insufficient
O sufficient
faculty of arts mobility office
X excellent
9. In general, what is your opinion about the quality of the student’s performance? O insufficient
O sufficient
O good
X excellent
Evaluation of the student's functioning
10. What is your opinion about the student’s ability to perform his/her tasks independently? O insufficient O sufficient O good X excellent
11. To what extent was the student interested in his/her tasks? O insufficient
O sufficient
O good
X excellent
12. To what extent was the student interested in other activities within your organisation? O insufficient
O sufficient
X good
O excellent
13. How did the interaction between supervisor and student develop? O badly
O not very well O well
X extremely well
14. How did the cooperation with co-workers develop? O badly
O not very well O well
X extremely well
15. What is your opinion about the student’s level of knowledge? O insufficient
O sufficient
O good
X excellent
16. To what extent did the student's attitude fit in with the work climate of your organisation?
faculty of arts mobility office
O sufficient
O good
X excellent
Additional questions
17. Have there been problems supervising the student?
O Yes, concerning ………..………
X No
18. In future, would you again offer a placement to a student of the Faculty of Arts? X Yes, because this has been a very positive experience
O No, because………..
19. Would you now or in the future appreciate a meeting with the supervising university lecturer or the placement coordinator of the Faculty?
O Yes
X No
20. Do you have further question or comments?
I am very glad to have met Iris. I wish her the best of luck in the future and hope she finds a PhD studentship following completion of her Masters and continues to flourish.
