Category Archives: Occupational Therapy

Holby City and the case of ‘dramatic licence’ leading to ‘minor deviation of accuracy’

Now although I might get a little indignant about the misconceptions of occupational therapy I can generally manage the ‘basket weaving’ and ‘fluffy bunny’ comments. What I’m not so fond of is cases where TV shows (especially medical ones) misrepresent our profession (hmm let’s think back to the OT who suddenly became a physio in Coronation Street – oh as well as having an affair with his client’s wife).

Now I don’t even watch Holby City but even I had to watch a recent episode when I saw the comments from OTs on social media. The episode shown on the 21st May had us all a little riled and a couple of us decided to complain.

Here is my comment to them:

The scene regarding the assessment of the lady Betty for Dementia was inaccurate in a number of ways.
Firstly the doctor said they would call Occupational health for a dementia screen (this should have been occupational therapy and was corrected to the later in the programme adding to confusion).
The suggestion was that all that can be done after screening is to arrange home help when there are a variety of interventions and strategies that can be employed. What a bleak, unhelpful view. Yes dementia is a cruel disease but there are ways to help people live with it.
The OT was in mid assessment and clearly hadn’t been, or properly introduced himself.
Not in right colour uniform – generally OTs wear bottle green trousers (this looked like a physiotherapy uniform).
He was sat a mile away from client on the chair – poor practice.
No privacy. You’d never do an MMSE with everyone watching on an open ward like that. It wouldn’t help get accurate results and would distress the client (as it did).

Well done for trying to demonstrate staff other than doctors and nurses but please encourage them to be accurate when doing so. Many occupational therapists I know expressed dismay with this scene and the mis-representation of our profession.

And here is their, in-my-view’ cop out response – do you think they addressed the issues I raised? Is this a case of a minor deviation from their “thorough” research for dramatic licence?

Thanks for your contact regarding ‘Holby City’ on 21 may.

I understand you had concerns with regards to the portrayal of occupational therapy which you felt misrepresented the profession.

Whilst we thoroughly research all our scripts and storylines, a certain amount of dramatic licence is occasionally used in order to keep the story moving forward. We appreciate that even the most minor deviation from accuracy can be irritating to some viewers, however with the number of characters in the show, and the amount of storylines running concurrently, we cannot always include the level of detail that some viewers would like us to.

I can assure you we appreciate your feedback and your complaint has been registered on our audience log. This log is made available to all members of the BBC, including the production team of ‘Holby City’ and senior BBC management. This ensures your comments and others we receive are considered across the BBC. Thanks again for taking the time to contact us.

To me thorough research would have been at a minimum:

  • The OT wearing the correct uniform
  • To have been called by the correct name or at least have a comment made about why occupational health was used, e.g. ‘why can’t they ever get our name right?’ (sadly this isn’t exactly inaccurate but I’m not entirely convinced that Holby City would have used that level of irony!)

I can almost forgive the rest, after all it’s not like many of the characters appear to behave particularly professionally.

Did you complain? Did your letter say the same?

So, I’m after your advice guys, what do we do now? Just leave it or…?

E is for…Ethics #AtoZChallenge

E is for… Ethics

Before I can start collecting data for my research I need to submit a research proposal to an ethical review board at my university.

The seven principles of ethical research as outlined by the College of Occupational Therapists (2003) are:

Minimising Potential Harm
Maximising Benefit
Respect/Equality/Partnership
Autonomy
Honesty, Integrity and Openness
Impartiality and Fairness
Confidentiality and Anonymity

So, as you can see, Ethics isn’t just about not hurting people, though of course that is very important. It is also about ensuring quality of work (e.g. that the methodology matches the aim/research question) and reviewing that even at the start of research the researcher has considered methods of disseminating that research (not just abandoning it in the thesis section of their university library).

I’m just going to highlight a couple of ethical challenges my research presents below. There is much more to consider than just these though.

Ethical challenges in Qualitative research

With qualitative research it can be very difficult at the start of the research to say exactly what the methods will look like because qualitative research often tends to be an interactive process which constantly involves depending on responses from participants. I am lucky in the fact that my university is used to dealing with qualitative research and therefore appreciates that the design will be emergent (Bailliard et al 2013). This is not, however, an excuse for me not to think about the detail. Bailliard et al (2013 p 160) suggest using a road map that highlights a general direction and goal but leaves some flexibility in the route. In terms of using a writing analogy I like to think of this as a rough but flexible plot outline.

When exploring people’s lives there is always the potential to bring up issues that they may find emotive or distressing and so it will be relevant to give advice on counselling services, etc. In fact I think it is important as a qualitative researcher to consider the same for yourself.

Ethical challenges in Autoethnography

When writing autoethnography (as I intend to) you will inevitably identify other people in your life in your writing. How to manage this will be something I need to consider (including issues such as asking them for consent). Even if names are changed, because I am naming myself, people who know me may be able to work out who those people are.
Because I am planning to work with others I need to address their anonymity – do they wish to be named and if so are they aware of potential consequences.
One way round some of these issues may be to create storied amalgams but then this may ‘interrupt’ the flow of the stories told by mixing up or leaving out crucial details that may be vital to developing a fuller understanding of issues.

Some General Practical Considerations
If you are asked to participate in research (I have been a few times now) – do check these things.
You should be given what is generally known as a ‘Participant Information Sheet’ which tells you about the research and what you will be expected to do. You should also be given the opportunity to ask any questions you don’t think have been covered.
Types of information that this commonly includes:
where ethical consent to undertake the research was gained,
details about the researcher and their qualifications,
details about the research aim/questions (though in some cases it may be appropriate to not go into too much depth here in case it influences the outcomes of the study),
details about what will happen to the information you share, e.g. how it will be stored, who will see it, how your confidentiality and anonymity will be protected,
the statement that you are free to withdraw from the study at any time without prejudice (this is especially important if you are participating in a clinical study).

Following reading this you should also be asked to sign a consent form.

Here’s a personal example: I participated in an asthma study where I had allergy testing and sat in a cubicle to try and induce my asthma symptoms. During routine medical checks they discovered a heart murmur and gave me relevant advice to get this all checked. They would have to have considered aspects like this when getting the study agreed. My murmur was all benign in case you were wondering.

References

Bailliard, A.L., Aldrich, R.M. and Dickie, V.A. (2013) Ethnography and the Transactional Study of Occupation. In Cutchin, M.P., and Dickie, V.A. (eds) (2013) Transactional Perspectives on Occupation. London: Springer, pp. 157 − 168.

College of Occupational Therapists (2003) Research Ethics Guidelines. London: College of Occupational Therapists.

So there we have it a whistle stop tour of research ethics.

Have you ever participated in research – did you receive a participant information sheet? How did you find participating in the research?

Have you ever gone to an ethical review board to conduct research? Can you share any hints or tips?

Do OTs Do Balance?

Saturday 27th October 2012 has been World Occupational Therapy Day and I am writing this in the closing minutes of the day which I celebrated by taking part in the special #OTalk organised by Gillian Crossley with Helen Rushton for the OT Global Day of Service on the role of Occupational Therapy in Public Health. I also attended a virtual classroom discussing Assessment and Social Media delivered by Merrolee Penman with Anita Hamilton. This was a test of the software for Tuesday 30th Virtual OT Conference which has the theme Occupational Balance.

My plan for earlier in the day was to read some of The Casual Vacancy and despite enjoying the first few pages my body decided to let my eyes droop and I had a snooze instead. Then I nipped out to meet some friends. Tomorrow I am staying in!

The OTs at Salford have come up with a fun quiz to review people’s Occupational Balance – they’ve called it Occubuzz and you can find it here – http://www.occubuzz.com/

Not surprisingly I found myself to be occupationally overloaded (hence the daytime snoozing). I decided to use some stick art to investigate why (inspired by the immensely talented Gillian).

I get interested in things really easily and find that I pick up things and then try and balance them along with my desire to watch TV, read, write, sleep etc – my PhD supervisor used the imagery of spinning plates this week which I have borrowed for my pictures.

But there comes a stage where this overload can become too much and things drop, and once you’ve dropped one thing, it can throw the balance of everything else off and you end up with broken plates.

So what I’m trying to do is OT myself and gradually I am putting some of the plates down to one side or sharing them with others. November’s plan is to prioritise creative writing by participating in NaNoWriMo and my PhD. I’ve still got a way to go so I’d call it an evolving process of finding the correct balance (as you can see by from today’s effort ;o) – but I get an extra hour in bed because the clocks go back shortly).

I was planning to write this in time to submit to Linda’s OT Blog Carnival but decided to prioritise and get some sleep. You can find the other wonderful entries here though -it does seem that balance is something that doesn’t come easily in today’s society (and OTs themselves need to work at this too).

So – who here finds themselves overloaded and what do you plan to put down/share?

If you already have great balance please share your secret.

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