BackgroundIncreasing numbers of people living with a long-term health condition are putting personal health information online, including on discussion boards. Many discussion boards contain material of potential use to researchers; however, it is unclear how this information can and should be used by researchers. To date there has been no evaluation of the views of those individuals sharing health information online regarding the use of their shared information for research purposes.ObjectiveTo explore the views of contributors to online diabetes discussion boards with regards to if (and how) they feel their contributions to boards should be used by health researchers.MethodsA qualitative approach was employed using online semistructured asynchronous (email) interviews. Interpretative description methodology was used to assess the interview transcripts, and quotations were extracted and anonymized to support each theme.Results26 interviews were carried out. Participants agreed that forum posts are in the public domain and that aggregated information could be freely used by researchers. This was agreed to be a good way of ensuring that the view of people living with diabetes is being heard in research. There was no consensus on the need for permission to use individual information, such as quotations, with some people happy for this to be freely used and others feeling that permission is necessary.ConclusionsParticipants acknowledged the dichotomy of having placed information into the public domain in an unrestricted way, with some interviewees also wanting to retain control of its use. The Internet is a new research location, and rather than trying to apply traditional ethical norms to this new genre, a new modus operandi is required. The authors propose introducing new norms for presenting research carried out with online discussion boards.

This paper describes the evaluation of a two-day simulation training programme for staff designed to improve inpatient care and compassion in an older persons' unit. ObjectiveThe programme was designed to improve inpatient care for older people by using mixedmodality simulation exercises to enhance empathetic and compassionate care. MethodsHealthcare professionals took part in a) a one-day human patient simulation course with six scenarios and b) a one-day ward-based simulation course involving five one-hour exercises with integrated debriefing. A mixed-methods evaluation included observations of the programme, confidence rating scales and follow-up interviews with staff at 7-9 weeks post-training. ResultsObservations showed enjoyment of course but some anxiety and apprehension about the simulation environment. Staff self-confidence improved after human-patient simulation (t= 9; df = 56; p<.001) and ward based exercises (t= 9.3; df= 76; p<.001). Thematic analysis of interview data showed learning in teamwork and patient care. Participants thought that simulation had been beneficial for team practices such as calling for help and verbalising concerns and for improved interaction with patients.Areas to address in future include widening participation across multi-disciplinary teams, enhancing post-training support and exploring further which aspects of the programme enhance compassion and care of older persons.Published in BMJ Quality and Safety, 22, 6, 495-505 Ross, Anderson, Kodate et al. (2013) 3 ConclusionThe study demonstrated that simulation is an effective method for encouraging dignified careand compassion for older persons by teaching non-technical skills which focus on team skills and empathetic and sensitive communication with patients and relatives.

BackgroundFibromyalgia syndrome (FMS) is a long-term condition that affects between 1 and 5% of the general population and lies within the spectrum of medically unexplained symptoms (MUS). FMS can be difficult to diagnose and is usually done so as a diagnosis of exclusion. There is continuing debate regarding its legitimacy excluding other causes of symptoms. It is known that the diagnosis and management of MUS, including FMS, receives little attention in medical curricula and attitudes towards patients with FMS amongst medical professionals and trainees can be negative. The purpose of this study was to investigate how attitudes and perspectives of undergraduate medical students towards FMS are acquired during their training.MethodsQualitative interviews with 21 medical students were conducted to explore their views on FMS, encounters with patients with FMS, and where learning about FMS occurs. Participants were recruited from two English medical schools and the study was approved by two University Ethics committees. Interviews were digitally recorded with consent and data analysed thematically, using principles of constant comparison.ResultsThe data were organised within three themes: i) FMS is a complex, poorly understood condition; ii) multiple sources for learning about FMS; and iii) consequences of negative attitudes for patients with FMS.ConclusionUndergraduate medical students have limited understanding of, and are sceptical over the existence of FMS. These attitudes are influenced by the ‘hidden curriculum’ and witnessing attitudes and actions of their clinical teachers. Students interpret a lack of formal curriculum teaching around FMS to mean that it is not serious and hence a low priority. Encountering a patient, friend or family member with FMS can increase knowledge and lead to altered perceptions of the condition.Teaching and learning about FMS needs to be consistent to improve knowledge and attitudes of clinicians. Undergraduate students should be exposed to patients with FMS so that they better understand patients with FMS.