How to publish your PhD thesis in 6 easy steps

Whilst I am sure that there are many reputable companies who will publish your thesis out there, I wanted to share with you all how I published mine.

First of all, I believe that if you have a PhD then your work must be adding some original knowledge to the world. That means that your work is of value, and should therefore be published and disseminated widely. This is also true for students, whose work is of great value to the academic community.

See my post here about ‘Why Midwifery and Nursing Students Should Publish their Work and How’

But here, I wanted to map out one way to publish your thesis. It is the way I published mine.

Step one…

Publish background literature reviews to outline how you arrived at your research questions. Much of this work will summarize the first chapters of your thesis. It will also help you refine your ideas if you publish as you write.

My initial chapters were published as follows:

Pezaro, S The midwifery workforce:  A global picture of psychological distress – Article in Midwives: Official journal of the Royal College of Midwives (2016): 19:33

Pezaro S Addressing psychological distress in midwives. Nursing Times (2016): 112: 8, 22-23.

Pezaro, S., Clyne, W., Turner, A., Fulton, E. A., & Gerada, C. (2015). ‘Midwives overboard! ‘Inside their hearts are breaking, their makeup may be flaking but their smile still stays on. Women and Birth 29.3 (2016): e59-e66.

Step two…

Publish your ideas around the theories used in your work.

I did this by publishing a blog on theories of work-related stress. I also published a paper exploring the ethical considerations of what I was trying to do entitled ‘Confidentiality, anonymity and amnesty for midwives in distress seeking online support – Ethical?’. Opening this up for discussion meant that my thesis was much stronger overall.

Step three…

Publish your methods via research protocols.

Not only does this mean that you have claimed the idea for yourself in the academic world, but you also then get the benefit of a wider peer review of your work. I published the protocol of my Delphi study as follows:

Pezaro, S, Clyne, W (2015) Achieving Consensus in the Development of an Online Intervention Designed to Effectively Support Midwives in Work-Related Psychological Distress: Protocol for a Delphi Study. JMIR Res Protoc 2015 (Sep 04); 4(3):e107

Step four…

Publish each chapter of your work as you go.

Again, this gives your work added peer review in the process of developing your thesis. I published the two largest pieces of research in my thesis as follows:

Pezaro, S, Clyne, W and Fulton, E.A  “A systematic mixed-methods review of interventions, outcomes and experiences for midwives and student midwives in work-related psychological distress.” Midwifery (2017). DOI: http://dx.doi.org/10.1016/j.midw.2017.04.003

Pezaro, S and Clyne, W “Achieving Consensus for the Design and Delivery of an Online Intervention to Support Midwives in Work-Related Psychological Distress: Results From a Delphi Study.” JMIR Mental Health3.3 (2016).

Step five…

Publish summaries of your work for different audiences

Once you begin to pull together your entire thesis, you will begin to discuss the findings and arrive at certain conclusions. You can summarise these in a series of blogs and papers as you go. I published the following summary papers to reach both national and international audiences.

Pezaro, S (2018) Securing The Evidence And Theory-Based Design Of An Online Intervention Designed To Support Midwives In Work-Related Psychological Distress (Special Theme on Women in eHealth). Journal of the International Society for Telemedicine and eHealth. Vol 6, e8. 1-12.

Pezaro, S “The case for developing an online intervention to support midwives in work-related psychological distress.” British Journal of Midwifery 24.11 (2016): 799-805.

Step six…

Use info graphics to map out key points in your thesis

Once complete, your thesis will be published in full. Mine can be accessed here via the British Library and via Coventry University’s open collections. But it’s a mighty big document. Therefore, I produced the following infographic to map out my PhD journey for those looking for a shorter, yet engaging summary.

…and there you have it. A fully published PhD thesis via a variety of avenues. I hope that you enjoy publishing your PhD thesis, and that publishing it helps you to defend it.

Also…If you need a co-author, let me know!🎓😉

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 💚💙💜❤

How do you decide which type of review to use? a guide to beat the literature reviewing blues…

Recently, I have been in search of the perfect methodology for reviewing the literature. So many options…benefits, limitations and choices…I found it really hard to choose the right one.. Which reviewing methodology would Goldilocks choose? which one is just right for you?.. After all of my searching, I thought it my be useful to make a listed guide to what I have found…

So… first of all, what is a literature review?…as always, the academic community will debate around this subject… but feel free to browse my  ‘Guide to Literature Reviewing for Student Midwives & Student Nurses’ here

Perceived strengths.  The literature review method seeks to identify what has been accomplished previously, allowing for consolidation, for building on previous work, for summation, for avoiding duplication and for identifying omissions or gaps.

Perceived weaknesses.  Literature reviews lack an explicit intent to maximise scope or analyse data collected. Any conclusions they may reach are therefore open to bias from the potential to omit, perhaps inadvertently, significant sections of the literature or by not questioning the validity of statements made. Additionally, authors may only select literature that supports their world view, lending undue credence to a preferred hypothesis.

Grant, Maria J., and Andrew Booth. “A typology of reviews: an analysis of 14 review types and associated methodologies.” Health Information & Libraries Journal 26.2 (2009): 91-108.

But there are many types of literature review that can do much more than simply review the literature…so how do you know which one to choose?

In order to decide which type of review to use, you will need to decide what you are trying to do, find out, or achieve.

Trying to develop a new concept? theory? or model?

Then you may want to explore the use of a critical literature review methodology. This methodology allows you to demonstrate how you have not only extensively researched a topic, but that you can critically evaluate the literature and take new conclusions and interpretations from it. You can then present these new interpretations as a new hypothesis or model… sounds good right?

Search

Not systematic – You are searching to find the most relevant stuff.

Appraisal

No need to evaluate quality -You are looking for literature which is fit for purpose.

Synthesis

Usually narrative, but you can be creative with this.

Analysis

Needs to arrive at a new conceptual theory or hypothesis of some kind.

Cautions

Every conclusion you draw will be subjective – Others may not be able to repeat your process

Looking to identify gaps in research?

Then you may want to conduct a mapping review of the literature. This methodology allows you to map out and categorise the existing literature on a topic. From this you can identify what other kinds of reviews or research need doing, as you identify gaps in the literature.

Search

Can be systematic, but searching is usually bound by time constraints, so this can be determined in line with your scope.

Appraisal

No need to evaluate quality

Synthesis

Use tables and graphics

Analysis

Quantify the research found and outline study types – suggest areas of future research.

Cautions

Can be overly descriptive, try to characterise studies on more than the basis of study design

Want to combine statistical data to provide more precise results?

In this case you may consider doing a the meta-analysis (A type of analysis done within a literature review – so really, this is one component of or add on to a systematic review).

Search

Thorough, comprehensive, systematic – Can use funnel plot

Appraisal

Use quality appraisal to guide inclusion/exclusion and/or sensitivity analyses

Synthesis

Use tables, graphics and narrative

Analysis

Analyses measures of effect numerically

Cautions

Your review can only be as good as the included studies allow..also, there is little value in comparing very diverse study types.

Want to combine quantitative with qualitative?

If you want to explore a complex problem using both qualitative and quantitative literature, then a mixed-methods review is for you…

Search

Your strategy must capture both quantitative and qualitative research

Appraisal

Need to use an appraisal tool appropriate for both qualitative, quantitative and/or mixed-methods research

Synthesis

Use tables, graphics and narrative – Present qualitative and quantitative results separately

Analysis

Look for correlations, gaps in the literature and draw conclusions based on combined findings.

Cautions

Theoretical and methodological challenges in bringing together qualitative and quantitative studies

Need to assess what is already known about a topic?

A rapid review is for you.

Search

Determined by time constraints

Appraisal

Formal quality appraisal required

Synthesis

Use tables and narrative

Analysis

Look for directions of effect, and quality and quantity of the literature

Cautions

Doing things quickly…you always run the risk of bias and mistakes are more easily made

Want to know the size and scope of available research?

A Scoping review is for you..

Search

You may want to perform your search as a research in progress

Appraisal

No formal quality appraisal is required

Synthesis

Use tables and narrative.. you can also use commentary

Analysis

Look for directions for future research – Use this to form new research questions.

Cautions

This is not usually a final output…rather a means to an end

Want to address really current matters?

When you want to offer new perspectives on a current issue or point out a new area for further research, you may consider conducting a state-of-the-art review.

Search

Comprehensive and current

Appraisal

No formal quality appraisal is required

Synthesis

Use tables and narrative

Analysis

Present a current state of knowledge and list priorities for future research

Cautions

Beware of subject experts’ particularly idiosyncratic and personal perspectives on current and future priorities.

Want to systematically search for, appraise and synthesis research evidence?

If you are looking to do more than a just review or systematize the literature, then a systematic literature review is for you.

Search

Comprehensive exhaustive and systematic

Appraisal

Formal quality appraisal is required – This can be used to exclude research of poor quality

Synthesis

Use tables and narrative

Analysis

Present recommendations for future research based on what is known, what remains unknown, and what we are still unsure about…The review should answer a broad research question.

Cautions

Adhere to reporting guidelines for a strong output.

Want to create an accessible and usable document in relation to a broad issue?

If you would like to highlight reviews that address interventions and their results in relation to a broad issue, then an umbrella review is for you.

Search

Only searches for component reviews

Appraisal

Formal quality appraisal  for reviews is required

Synthesis

Use tables, graphics and narrative

Analysis

Present recommendations for future research based on what is known, what remains unknown, and what we are still unsure about…The review should consolidate all that is known about one broad issue.

Cautions

Requires the pre-existence of the narrower component reviews

Want to know what works, for whom, in what circumstances . . . and why?

If you want to unpack the mechanism(s) of how and why complex interventions thrive or fail, in particular setting(s), then the realist review methodology is for you!

Search

Highly detailed and systematic

Appraisal

Justify how judgments were made

Synthesis

Use tables, graphics and narrative – include information on the constructs analysed and describe the analytic process.

Analysis

Present the key findings with a specific focus on theory building and testing

Cautions

Ensure that the RAMESES (Realist And MEta-narrative Evidence Syntheses: Evolving Standards) guidelines and standards are adhered to for a strong output.

So…have we made a decision, are we sitting comfortably? are we ready to begin?…Let me know how you get on, and please share any additionally methodologies I may have missed.

If you are looking to publish a paper and would like me to join your team, I am always happy to be a co-author on your article in exchange for guidance and insight..Not sure how to do this?…see my post…’Why Midwifery and Nursing Students Should Publish their Work and How’ for further info.

Until next times, take care of yourselves…and each other 🌟🎓🌟

An exploration of mixed-methods research

What is Mixed-methods research?…. a mixture of methods? …or a multitude of methods in either one study or a succession of research?….Yes….it is a pickle.

What is mixed methods research?

I am on a learning curve (as always)…and I have been refining my understanding of mixed methods research…so what is mixed-methods research as I understand it now?

Firstly…what is a method?

I like to think of it as a recipe. Everyone knows a recipe for making a Victoria sponge…Eggs, sugar, butter, jam…and cream….But perhaps my method is different from your method..I add vanilla essence….you prefer yours with blackcurrant jam….We are both using a recipe or ‘method’ for making a Victoria sponge…

It’s just that the recipe or ‘method’ has both agreed standards… and modified versions.

So…in research terms, I used to think of mixed-methods as literally a mixture of methods used in a single study….perhaps questionnaires and interviews…or a focus group and a literature review…But there are others who have defined it differently. Basically…we are actually looking at a mixture of both qualitative and quantitative research in one study/paper…Here are some other definitions below from leaders in the field..

Pat Bazeley: I tend to distinguish between mixed methods and multimethod, although if I need a generic term, I used mixed methods. Multimethod research is when different approaches or methods are used in parallel or sequence but are not integrated until inferences are being made. Mixed methods research involves the use of more than one approach to or method of design, data collection or data analysis within a single program of study, with integration of the different approaches or methods occurring during the program of study, and not just at its concluding point. Note that I am not limiting this to a combination of qualitative and quantitative research only, but more broadly, combinations of any different approaches/methods/data/analyses.

 

Valerie Caracelli: A mixed method study is one that planfully juxtaposes or combines methods of different types (qualitative and quantitative) to provide a more elaborated understanding of the phenomenon of interest (including its context) and, as well, to gain greater confidence in the conclusions generated by the evaluation study.

 

Huey Chen: Mixed methods research is a systematic integration of quantitative and qualitative methods in a single study for purposes of obtaining a fuller picture and deeper understanding of a phenomenon. Mixed methods can be integrated in such a way that qualitative and quantitative methods retain their original structures and procedures (pure form mixed methods). Alternatively, these two methods can be adapted, altered, or synthesized to fit the research and cost situations of the study (modified form mixed methods).

 

John Creswell: Mixed methods research is a research design (or methodology) in which the researcher collects, analyzes, and mixes (integrates or connects) both quantitative and qualitative data in a single study or a multiphase program of inquiry.

 

Steve Currall: Mixed methods research involves the sequential or simultaneous use of both qualitative and quantitative data collection and/or data analysis techniques.

 

Marvin Formosa: Mixed methods research is the utilitization of two or more different methods to meet the aims of a research project as best as one can. The research project may be conducted from either one or two paradigmatic standpoints (mixed methodology study).

 

Jennifer Greene: Mixed method inquiry is an approach to investigating the social world that ideally involves more than one methodological tradition and thus more than one way of knowing, along with more than one kind of technique for gathering, analyzing, and representing human phenomena, all for the purpose of better understanding.

 

Al Hunter: Mixed methods is a term that is usually used to designate combining qualitative and quantitative research methods in the same research project. I prefer the term multimethod research to indicate that different styles of research may be combined in the same research project. These need not be restricted to quantitative and qualitative; but may include, for example, qualitative participant observation with qualitative in-depth interviewing. Alternatively it could include quantitative survey research with quantitative experimental research. And of course it would include quantitative with qualitative styles.

 

Burke Johnson and Anthony Onwuegbuzie: Mixed methods research is the class of research where the researcher mixes or combines quantitative and qualitative research techniques, methods, approaches, concepts or language into a single study or set of related studies.

 

Udo Kelle: Mixed methods means the combination of different qualitative and quantitative methods of data collection and data analysis in one empirical research project. This combination can serve for two different purposes: it can help to discover and to handle threats for validity arising from the use of qualitative or quantitative research by applying methods from the alternative methodological tradition and can thus ensure good scientific practice by enhancing the validity of methods and research findings. Or it can be used to gain a fuller picture and deeper understanding of the investigated phenomenon by relating complementary findings to each other which result from the use of methods from the different methodological traditions of qualitative and quantitative research.

 

Donna Mertens: Mixed methods research, when undertaken from a transformative stance, is the use of qualitative and quantitative methods that allow for the collection of data about historical and contextual factors, with special emphasis on issues of power that can influence the achievement of social justice and avoidance of oppression.

 

Steven Miller: Mixed methods is a form of evolving methodological inquiry, primarily directed to the human sciences, which attempts to combine in some logical order the differing techniques and procedures of quantitative, qualitative and historical approaches. At present mixed methods must devote itself to resolving a set of issues, both epistemological and ontological. The first must devote itself to what Miller and Gatta (2006) call the “epistemological link,” that is the rules and rationales which “permit” one to proceed mixed methodologically. The second must adhere to some form of “minimal realist” ontology, where either social reality is “One” but can be accessed by different methods separately or working in conjunction, or social reality is multiple in nature and can ONLY be accessed through mixed methods. Present day attempts to couch mixed methods within some broad notion of pragmatism are not satisfactory.

 

Janice Morse: A mixed method design is a plan for a scientifically rigorous research process comprised of a qualitative or quantitative core component that directs the theoretical drive, with qualitative or quantitative supplementary component(s). These components of the research fit together to enhance description, understanding and can either be conducted simultaneously or sequentially.

 

Isadore Newman: Mixed methods research is a set of procedures that should be used when integrating qualitative and quantitative procedures reflects the research question(s) better than each can independently. The combining of quantitative and qualitative methods should better inform the researcher and the effectiveness of mixed methods should be evaluated based upon how the approach enables the investigator to answer the research question(s) embedded in the purpose(s) (why the study is being conducted or is needed; the justification) of the study. (See Newman, Ridenour, Newman & DeMarco, 2003.)

 

Michael Q. Patton: I consider mixed methods to be inquiring into a question using different data sources and design elements in such a way as to bring different perspectives to bear in the inquiry and therefore support triangulation of the findings. In this regard, using different methods to examine different questions in the same overall study is not mixed methods.

 

Hallie Preskill: Mixed methods research refers to the use of data collection methods that collect both quantitative and qualitative data. Mixed methods research acknowledges that all methods have inherent biases and weaknesses; that using a mixed method approach increases the likelihood that the sum of the data collected will be richer, more meaningful, and ultimately more useful in answering the research questions.

 

Margarete Sandelowski: First, I think of this in terms of either a single primary research study or as a program of research. Then, I see mixed methods as something of a misnomer as mixing implies blending together. Mixed methods research, though, is more the use of different methodological approaches TOGETHER in a single study or single program of research. One cannot blend methods in the sense of assimilating one into the other. I use methods here to refer to larger inquiry approaches (e.g., experiments and grounded theory) which are themselves based in distinctive theoretical perspectives. Yet this sets up a problem too, as grounded theory, for example, can be “positivist” (a la Strauss & Corbin), “constructivist” (a la Charmaz), or “postmodern” (a la Clarke) in sensibility or influence. So, if a researcher is doing grounded theory (positivist style) and an experiment (positivist influence), are any methods actually being mixed? In other words, mixed methods research can be defined at the technique level as the combination of, e.g., purposeful & probability sampling, open-ended and closed-ended data collection techniques, and narrative and mutivariable analyses—i.e., in which anything can be used together (linked or assimilated into each other)—or it can be defined at a larger theoretical/paradigmatic level as using divergent approaches to inquiry together. I would not define mixed methods research as constituting ANY combination of 2 or more things, as any research involves the use of 2 or more of something and the use of experiment and survey is 2 things, but they are informed by one mind (typically positivist/objectivist/realist). We get tangled in words, do we not?

 

Lyn Shulha: By collaborative mixed method research, we will mean the purposeful application of a multiple person, multiple perspective approach to questions of research and evaluation. Decisions about how methods are combined and how analyses are conducted are grounded in the needs and emerging complexity of each project rather than in preordinate methodological conventions. . . . Within this context, methods can be “mixed” in a variety of ways. Sometimes, one method serves another in validating and explicating findings that emerge from a dominant approach. On other occasions, different methods are used for different parts of the issues being investigated, and in an independent way. In more complex cases, the methods and perspectives are deliberately mixed from the beginning of the process. The resulting interaction of problem, method, and results produce a more comprehensive, internally consistent, and ultimately, more valid general approach. What sets the most complex forms of collaborative mixed method research apart from other forms of inquiry is that findings depend as much on the researchers’ capacities to learn through joint effort and to construct joint meaning as on their expertise in conventional data collection and analysis techniques.

 

Abbas Tashakkori and Charles Teddlie: Mixed methods research is a type of research design in which QUAL and QUAN approaches are used in type of questions, research methods, data collection and analysis procedures, or in inferences.

 

Note: QUAL = qualitative research; QUAN = quantitative research

Source for quotes = Toward a Definition of Mixed Methods Research R. Burke Johnson University of South Alabama, Mobile Anthony J. Onwuegbuzie University of South Florida, Tampa Lisa A. Turner University of South Alabama, Mobile

There are also now reporting guidelines emerging for Mixed Methods studies (O’Cathain, Alicia, Elizabeth Murphy, and Jon Nicholl. “The quality of mixed methods studies in health services research.” Journal of Health Services Research & Policy 13.2 (2008): 92-98.)

Good Reporting of A Mixed Methods Study (GRAMMS)…Guidelines as follows…

(1) Describe the justification for using a mixed methods approach to the research question

(2) Describe the design in terms of the purpose, priority and sequence of methods

(3) Describe each method in terms of sampling, data collection and analysis

(4) Describe where integration has occurred, how it has occurred and who has participated in it

(5) Describe any limitation of one method associated with the present of the other method

(6) Describe any insights gained from mixing or integrating methods

Mixed methods research is more specific in that it includes the mixing of qualitative and quantitative data, methods, methodologies, and/or paradigms in a research study or set of related studies. One could argue that mixed methods research is a special case of multimethod research.

 

 

If you are looking to publish a paper and would like me to join your team, I am always happy to be a co-author on your article in exchange for guidance and insight..Not sure how to do this?…see my post…’Why Midwifery and Nursing Students Should Publish their Work and How’ for further info.

So until next time… look after yourselves & each other…then …in the words of Bob Marley…go ahead and stir it up….🎓💜🌟

The 5 stages of academic rejection grief

An academic career has been described as a journey filled with brutal, unrelenting rejection. I frequently find myself having to pick myself up from rejection. It is hard.

In academia..your peers will be some of the most intelligent, creative and driven people in the world. – I have found this to be very true. I am in awe of them all.

Additionally, from the inside, all you ever see is tweets and Facebook posts about how everyone else is winning awards, being featured by the press, or getting cited a thousand times.….Yes. I am constantly celebrating the achievements of my peers…. this is wonderful!…but yes… this does make my own rejections even harder.

Whether it is a paper in a journal, a grant application, your viva or an idea that you have lovingly nurtured and come to love and cherish, there are 5 stages of rejection grief that are more or less inevitable (for me anyway).

Having your work rejected can feel like you have just spent a lifetime nurturing and rearing a beloved child, only to find out that it has grown into an evil and murderous human being in need of ‘Major revisions’!

1. Denial and isolation

This is wrong. It cannot be. I was so certain that my work was beautiful!…I don’t want to talk about it 😦

2. Anger

How dare the reviewer pull apart my work in this way…do they know nothing???!!

3. Bargaining

OK, I will take a look at the revisions. I will accept comment 4 and 5, but I’m not doing what reviewer 3 wants!

4. Depression

Gah!….these revisions are so laborious and depressing.

5. Acceptance

Oh…OK…phew… it is done. I am happy with it. I am at peace and ready to resubmit!

Feedback is golden…but it can be challenging to accept…it feels like rejection….but we are all actually moving forward ..all of the time. See here about the importance of feedback. I don’t believe that managers, reviewers or examiners are out to get us (not all of them anyway)….and so we must remember that none of this is personal. It is not a rejection of you as an entity, it is a very subjective point of view which may actually improve the work you do.

Try to portray humility and gratitude…Rather than any knee jerk feelings…

“I’m sorry… you’ve got major revisions to do”

Work that needs major revisions? How will people judge that? How will I be judged? is everything I thought I knew a lie?..what would another reviewer have said? (Most of the time the reviewers all want different things in any case)!

Self doubt, career doubt, black and white thinking and a feeling of doom sets in. ‘I am not good enough’…I begin to catastrophise. But then I reflect…what is really behind success?

I think that my approach to revisions needs major revisions. I continue to work on these revisions daily….

Every piece of work that I have ever revised following feedback or rejection has improved. Yet every time…I have to put all of my toys back into my pram before I begin the process of making any changes. I go back and forward around the 5 stages of academic grief..round and around…but it always ends up fine in the end….mostly it ends up better.

I live in constant fear of rejection, failure and disappointing those who I respect most… But we must try to get over our fear of failure and rejection, or we loose the opportunities we have to learn and grow.

Remember…things always feel better in the morning…you will not always feel this way. The cure for academic rejection grief is not always instant success…it is compassion for both yourself and others.

Until next time, take care of yourselves and eachother ⭐🎓⭐

10 Tips for Success & Self-Care for Academics

Another guilt trip about the importance of self care and being successful? That is why many people will read blog posts like this. We know we should be practising self care and succeeding, but do we really know how to thrive?

(I could not find a concept analysis for either success or self care – please let me know if you do)

We must presume that both success and self-care mean something different to each and every one of us. I am no expert on these topics…. is anyone?…But I think I am pretty good at caring for myself now and working towards success…having learnt the hard way. So I thought I would share some of my hints and tips. Feel free to adapt them, use them, completely ignore them, or ridicule them as ‘poppycock’.

Most people will expect to hear things like:

• Take a bubble bath
• Watch your favorite film
• Curl up with a good book
• Work hard
• Network

But I am sure that you know about this kind of stuff already. So let’s look at self care and success for the academic, firstly by identifying the issues that some of us may face.

As an early career researcher, I am frequently told about the stereotyping and inequalities experienced by women in academia. I myself frequently worry about the insecurity of, and problems associated with being an early career researcher, especially a female one.…I worry about where I will find my next job, funding or co-author. I worry about whether I am making any impact at all and whether I will be able to reach my true potential as an academic in the current climate. Academic pressures are in no way restricted to those earlier in their career, many more established researchers are also feeling the strain. These experiences will undoubtedly result in some psychological distress for many academics. So what can we do both proactively and preventatively to improve the lives of ourselves and each other.

Research can seem like a lot of hard work for little reward.

Tip One: Keep your eye on the goal. Visualize yourself being happy, frequently. How would it feel to publish that paper? Get that fellowship? Collaborate on that project? Create your own self-fulfilling prophecy rather than focus on a possible spiral of doom.

How to do this? – Identify what makes you happy, or what will make you happy. Then do more of what makes you happy, or have a real go at getting what will make you happy. I personally love my research work. I know that many other academics feel the same way. Happiness to me is succeeding, making a difference  and making a real impact through my work. The stress I feel is associated with this not happening.

This stress and negative thinking serves no purpose unless it positively drives me towards my goal. Yet who wants to be whipped to the goal posts?  I use visualization as a driver for success. I see myself feeling and being the way I want to be…and I allow myself to believe that this vision will come true. This makes me much happier than thinking about the alternative. So I stick with it.

The practice of meditation may also assist you to work through your thoughts, direct them towards a more positive outlook and allow your goals to become meaningful and achievable.

As these tips continue, think about your own goals for happiness…whatever they may be…think about achieving them in relation to these tips and your own experiences.

I behave in the way I want to feel or be… Surely if I continue in this direction. Good things will come…

Tip Two: The problem of job insecurity for early career academics baffles me as Job security for early career researchers is a significant factor in helping research make an impact. Yet this seems to play on my mind recurrently. It is always a worry. However, worry really does nothing to resolve this issue, and only seeks to get in the way of my progress. In order to progress, I will need to ‘work smarter’ and embrace confidence in my own abilities. Worry and negative thinking has no place in this strategy.

Negative thoughts often lie, and so I swipe them away one by one by placing them on a train that is passing the station (Visualization) – I then sit for a little longer, and imagine the way I will feel and be once I reach my goals. My mood and stress instantly lifts once I do this. I am more confident and feel much stronger. I am ready to be happy.

 

Tip 3: Say No and be proactive – We need to look at what successful academics do. From my observations, they often say ‘No’ to anything that doesn’t suit their own focused agenda (they remove the ‘noise’ and toxicity), they ooze positivity, they are confident, they are assertive, they tell people what they need to succeed and they hang around with the most inspiring people. Therefore, the most obvious strategy is for us to do the same. Say ‘No’ to negativity, and to the people and things which do not enrich us as people. Let people know what you need in order to thrive. Embrace those you feel drawn towards as positive people.

Activity: Making the best of me…

1: Ask yourself how others can get the best out of you

2: Offer what you can realistically do

3: Communicate what inhibits your productivity with others

4: Actively describe what you need from others in order to thrive

Tip 4: Express gratitude and forgiveness for enhanced wellbeing. Not always easy, but worth investing in. This task not only unburdens your mind, but allows you to see all of the good things currently going on in your life. Regularly write down 5 things that you are grateful for. Also…try to forgive yourself, and others…often.

 

Tip 5: Address your work life balance as a fluid entity. I believe that the idea of a separate home and work life is changing. This is a good thing. It takes the pressure off and allows you to be a whole person, rather than one split in two…See yourself as a whole being, a working, living and family centred being. You cannot slice yourself into pieces.

See this blog -> ‘Work’ is a verb rather than a noun…it is something we do…not always somewhere we go…

Living in the ‘now’ rather than being at either home or work also allows us to enjoy more of ourselves and our lives. Notice where you are, what you are doing…Smell the flowers, look around you as you move, work, play and just allow yourself to ‘be’.

Tip 6: Eat Sleep move, repeat. It really is that simple, but utterly essential for optimum productivity, stress reduction, health and wellbeing. Eat nutritious food regularly, sleep 7-8 hours a night and move…Exercise, walk, swim, run, cycle…Be outdoors as often as possible.

Tip 7: Write. Write your thoughts, your feelings, your ‘to do’ lists, your ideas, your goals down regularly. This not only means that they are out of your head, allowing your mind to be quieter, they are also made real…They are good to share..and worth addressing (when you feel able).

Tip 8: Talk about who you are. There is a tendency to talk about work first. What we do, what we are working on and what we are planning to work on. Start new conversations with how you enjoy your hobbies or your favourite music. This lets other people know that you are indeed human, and it also gives you an identity other than your work persona. Be authentic. It is healthy for you, and others to know the real and whole you. You are fab 🙂

Tip 9: Help other people and accept help yourself. Lift one another up, support colleagues, show gratitude, offer support and guidance where you can. Be a mentor. Be a positive role model. Be the change you want to see in the workplace and accept all of this in return. This will not only make you feel good, it will change the culture of your workplace, and bring about reciprocity for everyone’s success.

(Image via http://www.libbyvanderploeg.com/#/lifteachotherup/)

Tip 10: Celebrate the successes of yourself and others. Yes. Focus on the great things that you and your colleagues have achieved. However big or small, these feelings of success will snowball into a self fulfilling prophecy, where you feel valued, supported and part of a team that cares. Some people will feel uncomfortable about doing this, and feel icky when they see others wallow in their own brilliance. But what is the alternative? We all talk about how rubbish we all are? How will that make us feel?…

Spend time reflecting on what you have achieved. Write them down…use these achievements to inform your own vision of yourself…This is who you are. You are great.

As long as the feelings of celebration and success are reciprocated and directed towards others as well as yourself….Let the high fives roll.

I do hope that these tips will resonate with some academics looking for something new to try. In the spirit of sharing, please feel free to add more tips below.

You deserve to be happy – Until next time, look after yourselves and each other ❤💙💜

 

Masterclass: 10 Top Tips for Winning a National Institute for Health Research (NIHR) fellowship award

This week, I have been engaging with National Institute for Health Research (NIHR) funders, in a ‘bid’ to learn more about the fellowships currently available to researchers. This masterclass was held at @unibirmingham, and it really was a great opportunity to speak to the funders and get some sound advice on how and what to apply for. In this blog I will share 10 top tips which have been formulated as a result of attending this masterclass. I hope this may help other applicants (like myself) to maximise their chance of success.

1. Firstly, know which type of award is best for you and your future plans and ideas. I will be applying for a post-doctoral fellowship as an early career researcher.

 

 

2. Contact the Research Design Service early…talk through your ideas, take advice and learn all you can. This service can point you towards other team members, experts to talk to and new ways of thinking. They can be involved at every stage of your application and they really do give great feedback.

3. Once you have the basics of your project together, think about designing the right team. If you are planning at RCT for instance, who is on your team who can help you with that? Do they have the right expertise? Seek out the right mentors, collaborate outside of your institution, start building relationships with people who you can work with throughout your fellowship (and hopefully throughout your career)! The NIHR want to see that you will be well supported to succeed.

 

What are the chances of success?

Competition is fierce! – Make sure you stand out!

 

4. Make your application logical, clear and really show that you can demonstrate the impact and trajectory of your research. How will you disseminate your research (other than papers and social media) – Could you make a film? Hold a dissemination event? Additionally, make sure you answer every section in detail and check your application against the current guidance materials.

See full and official NIHR guidance here

5. Set out your own personal career goals and create a comprehensive training plan. This is where most applications fail. This is not just a list of courses you will take. This is about who will mentor you, where you will learn, can you arrange a secondment? Work experience? International conferences? – How will you grow and develop into an independent researcher? – Why should they invest in you as a person?

 

 

6. How will you involve patients, end users and the public in your research? Patient and public involvement (PPI) will form a key component within your application, and should feature throughout your research plans. Involve is a great place to start. You can apply for a small £500 grant to carry out PPI activities before submitting your fellowship application, ask your regional RDS service for more details, and be sure to include the results of these activities within your application!

 

7.What if you get called for an interview? Make sure you know your application inside out (it may be a long time since you submitted your application – and you may be asked some really complex questions by people who are not experts in your field!)

 

 

8. Be sure to have mock interviews with your peers (they will be much harder on you than the interview panel). Challenge yourself, be willing to change your ideas in response to feedback. Embrace every opportunity to improve!

9. Be yourself. Yes you will be nervous, but the panel wants to see who they are investing in. Its OK to show personality and be ambitious. They want to invest in new talent, the research stars of the future. Show them your potential. Don’t be afraid to take criticism – engage in constructive dialogue throughout, yet leave the panel with a punchy take away message where they can see your potential and future trajectories.

10. Be on time – don’t miss deadlines, arrive early to the interview and be ready to showcase yourself and your ideas. The NIHR want to fund you…they want to spend tax payers money wisely. Leave them in no doubt that both you, and your project are worth it. You are the future the world needs to see!

 

See full and official NIHR guidance here

Until next time, look after yourselves & each other..💜

A reflection on the #MaternityReview & #NHSStaffSurvey

I just wanted to take an opportunity to reflect upon the Maternity Review published this week by Baroness Julia Cumberlege, Chair of the National #MaternityReview, and colleagues. I will also couple this with a reflection on the NHS Staff Survey in England, also published this week #NHSStaffSurvey

See the full NHS Staff survey here

See the full Maternity Review report here

 

Overall, I think the National Maternity Review report, ‘Better Births’ was received very warmly by all, including the #MatExp community. You can read the #RCOG response to National Maternity Review here. I certainly welcome the core recommendations as listed below:

#MaternityReview Recommendation 1: Personalised care, centred on women and families. Genuine choice, unbiased info.

#MaternityReview Recommendation 2: Continuity of carer: safe care, a relationship of mutual trust and respect

#MaternityReview Recommendation 3: Safer care, working together across boundaries, leadership for a safety culture.

#MaternityReview Recommendation 4: Better postnatal and perinatal mental health care – funding and provision

#MaternityReview Recommendation 5: Multi-professional working, breaking down barriers to safe and personalised care

#MaternityReview Recommendation 6: Working across boundaries to support personalisation, safety and choice.

#MaternityReview Recommendation 7: A fair and adequate NHS payment system for high quality NHS care

Also, please see @MaryNewburn1 for a great summary of #MaternityReview here-> http://marynewburn1.com/ 

However, there were a few sentences which had me a little worried, and helped me to reflect on my own work.

Firstly: “Providing health care is by nature demanding and stressful, but the NHS Staff Survey provides evidence that this affects maternity staff more than most.”

Here, it is wonderful to see the emotion/stress work done by midwives being acknowledged. It is recognised, and so we can now begin to respond to this. Also, the evidence that maternity staff are affected more than most highlights that perhaps the midwifery workforce is more in need of support than others? or at least that we should support the midwifery workforce as a priority group? It was always my vision that the work I would do would start with midwives, and then disseminate to other staff groups….Now we have evidence that this could be a wise choice.

The report also states that:

“Midwives are more likely to report feeling pressured at work than other NHS staff, with almost half recording having suffered from work-related stress”

Does this mean that more midwives are coming forward and reporting the consequences of these pressures? Psychological distress too? At the very least, we are seeing more recognition of the reality of midwifery work environments.

Lastly, we see that:

“More midwives and trainee obstetricians report feeling unsupported in the workplace compared with other clinicians, although midwives report feeling slightly more supported by their managers than in previous years”

This tells us that midwives are in need of support. The question remains to be what type of support is required? wanted? needed? By the sounds of things, any intervention of support could complement the current systems, as long as it is there!

This reassures me that I am working towards at least one sound solution to support midwives in psychological distress. An anonymous, online intervention…. In future, we may have more opportunities to illuminate how midwives are really surviving, thriving or diving in an evermore challenging profession.

We all want to put women at the centre of maternity care. However,  I remain convinced that this can only happen if the well being of midwives is also made a top priority.

Also this week, an annual staff survey answered by nearly 300,000 people

I was delighted to hear that in response to this survey, NHS England’s chief executive, Simon Stevens had said that “The best NHS employers know that staff well being and high-quality patient care are two sides of the same coin,” he said. How refreshing 🙂

Sadly,  about a quarter of the total NHS workforce found that a third felt they had experienced work-related stress. Yet there were also many encouraging improvements noted.

#NHSStaffSurvey

Danny Mortimer, chief executive of NHS Employers, said: “The variation in staff experience across the NHS remains a real concern for employers and boards will want to do more to address this.”

Chris Graham, director of research and policy at the Picker Institute and the survey’s chief investigator, said: “Too many staff complain about inadequate resources, staffing shortages, and the deleterious impact of their work on their own health and wellbeing. We call on all employers to closely review their results and take action to ensure staff are supported and listened to.”

With these new learnings in place. Lets hope that we can all create new narratives where the staff experience is prioritised alongside the patient experience. My intervention cannot come soon enough…I just need to finish this PhD first!

In terms of my own practice. I continue to reflect upon the same part of the NMC code in that we must all “be supportive of colleagues who are encountering health or performance problems”. The staff experience falls in line with this, in that we must all support staff well being in order to promote excellence in healthcare.

So until next time. Look after yourselves, and each other.

Who am I and what am I doing here?

Brief update: Deep in data for another week after the 2nd round of data collection ends. Fascinating results and insights coming through, but not quite ready for sharing/publication yet I am sorry to say. Conference season also seems to be upon us, and so I have been applying to various events where I can share my results with interested audiences across the UK. If you would like to see the data presented then why not come along to either the 2nd Behaviour Change Conference: Digital Health and Well being: 24 & 25 February 2016, the Midwifery Exchange; Thursday 4th February 2016 or the ‘Great Minds Don’t Think Alike’ – Nursing and Midwifery Conference, in January 2016. I will be there and hopefully at other conferences in the spring/summer of 2016 to share these insights and develop this project on to the next phase.

Another exciting adventure I have been having is with the National Elf Service, who disseminate high quality research for busy working professionals to update their knowledge on the go. I have always loved this project, and so now I have the opportunity to become a part of the project #Excited!…Anyhoo, as a part of their interview process, they had asked me why I may make a good elf. In answering this question they directed me to take a theory driven personality test. I found the results fascinating and would thoroughly recommend that everyone explore this resource too! I personally had never felt so very much understood. The description of me was almost word for word accurate. It was so empowering, that I wanted to write here a little about who I am.. and what I am doing here.

Who am I?

So apparently, I have the ENTP PERSONALITY (“THE DEBATER”) ,  ENTP = Extraverted – iNtuitive – Thinking – Perceiving – Also known as ‘The Visionary’ or ‘The Intuitive Seeker’. I am amazed at how accurately this personality type fits the description of me (warts and all). This discovery has also made me feel quite unique in the fact that this personality type supposedly only represents 3% of the female population.

Others labeled with this personality include Socrates, Barack Obama, Steve Jobs, Stephen Fry and Catherine the Great (Empress of Russia). Who knew?

Now that I have come uncomfortably close with my own strengths & weaknesses, I intend to spend time reflecting upon how I might use these personality traits to influence my own goals and projects in the real world. As I come closer to turning my vision for an online intervention, designed to support midwives in work related psychological distress into practice, I am confident that my enthusiasm and drive for success will take this project into the real world.

Why am I here?

Although my enthusiasm for change and improvement within the #NHS will never wain, I sometimes find myself wondering whether I am alone in such passions for #NHS staff well being. However, a quick conversation about my research, or a glance at Twitter always quickly let me know that this is not the case. I am constantly looking for people who I may identify with, or who may identify with me and what I am trying to achieve. I do this I think, in order to validate the purpose and worth of my research…to begin to understand why I am here and why I am doing what I do….I realise that many people are galvanising support for the cause and an appreciation for the need for change.

I am here because NHS staff need to be supported for the benefit of themselves and the patients they care for. The organisations they work for have at times been seen to blame the individual rather than the organisation as a collective when failings occur. This does nothing to improve candour, open learning or effective communications. Where punitive blame cultures exist, nothing can be improved. Staff are reluctant to speak out where a fear of retribution is apparent. As such, a trade off may be required if we are to allow staff to be kind to themselves, ask for help and improve the health of the service as a whole. Then I ask myself…is there anyone else who feels this way?

Then I came across this magnificent quote…

Good people do bad things

“The public mood may demand individuals to put in the stocks, but mature reflection acknowledges that there is a more complex debate to be had around the limits of obligation for professionals, the factors that motivate or discourage, the disempowerment that is inevitable in a more highly managed service and the promotion of virtue. These are beyond diktat, guidelines, unread protocols on hospital intranets and managerial exhortation. Intelligent kindness,5 medical humanities and the lessons of psychological experimentation may have more to offer.6” John Saunders

Ultimately I am here to promote the notion of kindness and compassion for #NHS staff. The need for a compassionate #NHS has been patient focused up until now. I am here to ensure that it also becomes staff focused. Who I am means that I am excited to find out why I am here. I look forward to fulfilling my potential and my duty to apply my research in a way which benefits society as a whole. To reflect is good. It keeps me focused and ‘in the now’. I am half way through this PhD journey already. Here’s to the next phase!

#BeTheChange

The ‘Magic’ #Resilience Pill

There are no consistent definitions for what resilience actually is, yet I am beginning to actively dislike the word. It is beginning to sound as though it might be the magic pill everyone within the #NHS might need to take in order to survive. I am not so sure.

We don’t know much about resilience, yet it has been suggested that healthcare professionals need to be supported, not trained in resilience. I am inclined to agree.

Resilience building has a hidden cost in that “By introducing this focus on developing ourselves into “happy”, “positive” leaders one could argue that we are merely buoying ourselves away from, and in effect delaying, what is inevitable – the call to deal with the reality of our current state of play.”

Having ‘resilience’ puts the ownership of survival upon the beholder….. Does this mean that “You have had your resilience training (or ‘pill’) therefore you should be resilient now”? …. Will there be no room to show anything other than a new found ability to ‘cope’?

The NHS is a challenging place to work, and healthcare professionals are doing their best to survive and deliver the compassionate care that they wish to give. So should we be making the NHS a less challenging place to work? or be toughening up those who work there to become ‘resilient’ to adversities?

This is going to be a relatively short post, but I wanted to write down a few analogies that may help us all in thinking about what ‘resilience’ may really mean for us.

If you were being punched repeatedly in the face, would you:

A) Try to become resilient to the pain?

or

B) Try to reduce/stop the punching?

Perhaps a bit of both, but you see my point. The girl in the street who gets attacked does not need to wear a longer skirt, fight back harder or scream louder. Her attacker needs to stop attacking her.

The danger comes when staff feel that they should become more resilient rather than seek support for any pain they may be suffering. NHS staff health is vital to safe and effective patient care, and we would all like to see staff engaging happily with their work.

Yet perhaps the ‘Magic’ #Resilience Pill may actually be the placebo that masks our incredibly valued sensitivity as healthcare professionals.

It has been suggested that:

“The notion of resilience in midwifery as the panacea to resolve current concerns may need rethinking. Resilience may be interpreted as expecting midwives ‘to toughen up’ in a workplace setting that is socially, economically and culturally challenging. Sustainability calls for examination of the reciprocity between environments of working and the individual midwife.”

Whatever the case, it is time to be kind to each other. Always.

What is the Future of Psychological Support for #NHS Midwives? My interview with @MidwifeDiaries

This blog was originally posted by Ellie from www.midwifediaries.com on June 2, 2015. We spoke in May 2015 about my research project and the issues surrounding midwives (and student midwives) in psychological distress.

She wrote :”Who is this researcher?”

This was me, a few weeks ago stumbling across a blog. This woman was sharp, driven, and had all her energy focussed on supporting the mental health of midwives.

She really got how unchallenged the assumption is that midwives are ok to keep going 24/7/365.

Sally Pezaro is doing her PhD on supporting midwives in psychological distress. Her project is exciting, and if it gets launched, will be something we can all use to keep healthy.

In this interview, we talk about why it’s so important to look after midwives, bullying in midwifery, and some strategies for mental wellbeing.

Most awesome quote from this interview: ‘Don’t give everything you have until your batteries run out‘. Yep – must put that on twitter.

Here are the links we discussed, ’cause I bet you’ll ask!

• Sally’s blog: www.sallypezaro.wordpress.com
• Raising Concerns Guidelines, from the NMC (there is an awesome video from a passionate nurse that’s so worth your time here!): http://www.nmc.org.uk/standards/guidance/raising-concerns-guidance-for-nurses-and-midwives
• The post on bullying I wrote, that led me to Sally’s research: Bullying In Midwifery: One Small But Mighty Trick

What’s Sally’s doing is so brilliant because she’s noticed something that is wrong in midwifery – and is doing something about it. Her project reminds me of that quote:

“Be The Change You Want To See In The World”

It’s so good to know that we do have researchers on our side, trying to make things better.

Now, Sally and I would love to hear from you. What’s your answer to the question I posed at the end of the interview?

“What do you find most challenging in looking after your mental health as a midwife, and what do you think could be changed to help with this, both on an organisational trust level, and on a personal level?”

Thanks so much in advance for all the kind, insightful and inspiring comments that are left. I’m excited to hear what you find hardest, and what could help you look after your mental health better.

As always, thank you for your time and attention, sharing and being so brilliant. MidwifeDiaries is turning into an incredible, supportive place for midwives, and I’m so grateful.

Ellie xxx

-> I would also like to add a link to the newest NMC Code (2015) as midwives can now use the power of the code to challenge psychologically unsafe professional behaviour in the workplace. The code now states that midwives must be supportive of colleagues who are encountering health or performance problems. Midwives also have a duty to care for themselves under this new code, so please do not feel guilty for giving self care. We must all work to create therapeutic working environments….

Five experiences are judged necessary for health. Primary emotional development, attachment, containment, communication, inclusion and agency. These can be deliberately recreated in therapeutic environments to form a structure for ‘secondary emotional development’. Failure to recognise the importance of these qualities of an environment can cause unhealthy, or frankly toxic, psychosocial environments in various settings (Haigh, 2013).

Haigh, R. (2013) ‘The quintessence of a therapeutic environment’, Therapeutic Communities: The International Journal of Therapeutic Communities, 34 (1): 6 – 15.