Friday, August 21, 2015

APGF Mapping the Landscape, Journeying Together

FLASHBACK SERIES: Blog posts written during my medical school days at Pacific Northwest University - College of Osteopathic Medicine

by Kim Ha Wadsworth, OMS II

Today my research team received notification that our literature review proposal, “Evidence Synthesis of Shared Medical Appointment Implementation as a Humanistic Approach to Patient-Centered Experience” was selected for grant funding from the Arnold P. Gold Foundation. This is both humbling and exciting to be a part of the “Mapping the Landscape, Journeying Together2015-17 cohort!

I am honored to embark on this 18-month journey as Co-PI with my fellow researchers! The best part of the story is that I only had one week before the deadline to write and submit the research grant proposal.

It was Friday that I received notification of the Gold Foundation RFP, but I was getting ready to go camping for two weeks starting Sunday—my only chance for a short break after successfully completing first year medical school. The grant was a good fit for my research interest on shared medical appointments; so, I rolled up my sleeves and got to work.

I pulled all-niters Friday and Saturday to write the draft proposal, received comments Sunday morning from Dr. Hoverman, touched base with him by phone on my way out of town, and finished the remaining background research and grant writing while I was camping at Yellowstone National Park. I had to tether my laptop to my cell phone to get internet connectivity at the campsites (mostly at 1x speed, no 3G or 4G, ugh)!

Meanwhile, Dr. Hoverman got approval for our proposal from PNWU's Chief Research Officer on campus and e-mailed the team members' CVs to me. I aggressively edited, compiled and formatted the CVs to fit the grant's specifications. I had several e-mail exchanges, one phone call with PNWU's CRO and another to touch base with Dr. Hoverman.

Then, I finalized the research proposal and uploaded all of the required documents on Friday at 1:15 PM mountain time zone (ahead of the 11:59 PM ET deadline), while connected to the paid internet service at Lake Lodge near Bridge Bay Campground—I wasn't going to take any chances with a 1x tethered connection. I had no idea at that moment that we would receive the good news a couple of months later!

Here is an abstract of our research project:

Research team members:
Co-PI: Dr. Adam Hoverman, DO DTMH (Pacific Northwest University of Health Sciences)
Co-PI: Kim Ha Wadsworth, OMS II (Pacific Northwest University of Health Sciences)
Dr. Byron Haney, MD (Family Health Care of Ellensburg)
Anita Cleary, MLIS (Pacific Northwest University of Health Sciences)
Emily DuPlessis, MA (Central Washington University)
Dr. Tracy J. Andrews, PhD (Central Washington University)

Over the last 18 years, shared medical appointments (SMA) have proven an effective model for chronic disease management and preventive care. Several systematic reviews summarize the clinical, process and economic outcomes of SMAs, however no systematic synthesis of patient experience outcomes yet exists.

We aim to understand the opportunities, barriers and limitations to SMAs based on enhancing patient experience, an important component of the “quadruple aim,” specifically addressing: What works for patients? What doesn’t work? Why or why not? Our hope is these answers will guide future implementation and translational studies, in particular inclusion of SMAs within early, patient-centered, clinical experience in health professional education.

We will conduct a librarian-facilitated literature search of MEDLINE (PubMed), Cochrane Library, PsycINFO, CINAHL, Web of Science, and SSRN for peer-reviewed publications, using controlled vocabulary, keywords, and text words. We will also search grey literature, nonempirical reports and social science publications in an effort to identify knowledge gaps within these databases. We will exclude case studies and publications prior to 1997 along with studies focused on patients under 18 years old due to improved proxy measures needed for patient satisfaction in this age group. We will conduct a review of citation title / abstract by two independent reviewers to determine eligibility and data abstraction of full-text articles using a standardized form, also by two independent reviewers. When a meta-analysis is appropriate, we will use random-effects models to synthesize the available evidence quantitatively using 95 percent confidence intervals. For qualitative literature, we will identify and address research themes related to patient experience using thematic and textual narrative synthesis to provide context for extracted data.

Due to other priorities, Emily DuPlessis and Dr. Tracy Andrews are no longer part of our research team. We brought on my fellow PNWU-COM students, Trevor Archibald, OMS II in February 2016 and Allison Payne, OMS I in March 2016. They are great additions to our team as we continue with our rigorous literature review!