Creating Sparks
In the October 2011 Networking Pages of Primary Health Care Research and Development, we reflect on the 2011 SAPC Annual Scientific Meeting held this year in Bristol.
A packed and varied programme brought people together to share ‘breaking news’ in primary care teaching and research.
But conferences are about more than dissemination of new work. They offer opportunities for activities not easily achieved by others forms of communication and scholarly activity. Conferences should be a ‘festival for ideas’: stimulating new conversations and new thoughts as well as critiques of existing ideas.
We asked a handful of Conference goers to send us a few words on 'something that made me stop and think'. And used their responses to explore the range and nature of 'sparks' that were generated at this year's meeting.
You can read the full PHCRD article by clicking here (scroll down to the Networking section). SAPC Members who still need to activate their PHCRD membership can do so by clicking here.
Conversations at the Conference clearly supported SAPC's goal to enhance primary care through academic excellence: offering new ideas on clinical practice, but also stimulating critical reflection
Changing Patient Care through knowledge and reflection
"The translation of research into everyday clinical practice was a strong point of SAPC and why I will be attending again next time." (Satinder Singh)
"A presentation by McCowan et al from Dundee University highlighted yet another factor to consider when making the often complex decision to prescribe or discontinue aspirin in patients at risk of adverse side effects. In the light of good evidence suggesting Aspirin is protective against development of colorectal cancer, they asked if aspirin might also improve survival when prescribed post-diagnosis. [Their results suggested an association between aspirin use and reduced colorectal specific mortality]. While further studies are needed to prove a causal link, in the meantime I’ll be weighing this into the balance with patients when assessing the risk-benefit of aspirin." (Elizabeth Bates)
"I attended the seminar on Domestic Violence, I suppose rather unrealistically, in an attempt to gain a “tool” or “framework” that would equip me to handle this very complex and difficult presentation. Instead, I was surprised to find that little evidence-based guidance is available on how to respond to women who report intimate partner abuse. This is despite the fact that many women seek help from healthcare providers. In some cases, women had experienced negative encounters with GP’s. In one study, signs of domestic violence had been “medicalised” by the GP. Other primary care physicians reinforced the patient’s own internal barriers to disclosure, such as shame and self-blame. I was challenged and encouraged by the resultant debate: Much work is taking place in Australia and the UK to determine barriers to disclosure, and to develop tools for training in primary care. For now, I will eagerly await these results, and will be more aware of my role in referring, supporting, and empowering victims of domestic violence." (Dawn Jackson)
Issues of Identity?
These contributions to enhancing primary care depend on work to support, promote and develop the discipline of academic primary care. Sparks revealed here relate to issues of identity.
“As I walked into the Great Hall at the University of Bristol…there was hardly a seat left in the hall and the room was buzzing from the chattering of people who were full of excitement at attending this annual conference. Personally, the thing that made me stop and think at the SAPC conference was realising the contribution of primary care research to patient care. I felt proud to be part of this special community.” (Sonal Nicum)
"For me, an early career research and SAPC conference debutant, Bristol 2011 was not only an opportunity to present my own work but also develop my own understanding about what academic primary care is and where I fit in? It was through the special interest groups that I developed a much deeper understanding of the state of the science itself. I relished the creative atmosphere, tempered only by scepticism and a willingness to separate speculation from observation. I left the conference feeling that academic primary care is a way of thinking as much as a body of knowledge.” (Greg Irving)
Whilst the Conference enhanced identity for some, it created a sense of challenge for others:
“As a person coming from another country the congress passed on another experience than just reading British research papers, which I regularly do. Especially two things I like to mention: My impression has been that UK- researchers are so much focused on health care research and only a few do research on – as we call it – the specialities of generalism, the core of General practice work. In Germany the same starts to happen due to the funding policies and a selection of researchers not stemming from General practice. Second, the discussion on the "personal patient – is it still possible or old fashioned” - made me wonder, what, and if, British and German General Practice still have core values in common. In a country as Germany with nearly as many specialists as GPs in extramural these are essential: giving-up “the personal patient”, the personal continuity, would be the end of General practice.” (Harald Abholz)
Issues of identity were particularly prominent in the discussions of a possible new 'multidisciplinarity in primary care' Special Interest Group.
“There is a general recognition that the majority of Academic Primary Care Departments include only a minority of academic general practitioners, and the bulk of the research and a large amount of teaching is delivered by individuals without a medical background. Nonetheless much of SAPC business has focused on academic GPs. To explore the need for and possible ways of redressing the balance in SAPC, the SAPC executive suggested the need for a Special Interest Group should be explored. A breakfast meeting was held at the 2011 SAPC meeting in Bristol to come to a consensus about the need for, and goals for such a group. A variety of issues were discussed, including structural barriers to career progression and the need to feel affiliated to have a professional home. A clear tension between identifying with a discipline of academic primary care, and stronger opportunities for career progression within people’s ‘original’ discipline was identified. Discussions about this group are ongoing and will be posted on the website ” (Christine Bond and Sandra Eldridge)
This issue of a tension between a personal sense of identity within primary care and where opportunities for career progression lie is arguably a challenge for the wider discipline?
The reflections offered here, and in our PHCRD article, are informing discussions for the 2012 Conference: about how we best use the Scientific Meeting to both support and stimulate new sparks.
We welcome your thoughts and comments. Click on to the 'Academic Primary Care' thread on our Discussion Forum to post your comments.
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