Objectives

1. Discuss course papers

2. Review selected qualitative methods

3. Discuss sensemaking

4. Demonstrate or observe small group process

5. List 10 facilitation skills

6. List 11 participation skills

School of PharmacyUniversity of Washington

Pharm 439: Community Service OutreachWinter 2007

Reflection and Final Paper

Objectives for the PapersExplore the intersection of pharmacy and anthropology.

oWhat can we learn from studying people and their cultures?oHow do our values influence what we observe and evaluate?oHow do our values influence the care we give our patients?

Explore qualitative research by applying selected methods to a community service site

Draft a proposal that pharmacy students across the country could adopt that would advance the quality of care for patients based a theme that arose during the course and your research about your service population.

Paper 1: Reflection•A reflection on what you have read in Mountain Beyond Mountains. What thoughts, feelings, or reactions has this book stimulated for you? Explore the intersection of pharmacy and anthropology.

•What can we learn from studying people and their cultures?•How do our values influence what we observe and evaluate?•How do our values influence the care we give our patients?

•Identify one qualitative method you think Kidder is using in Mountain Beyond Mountains and discuss how you can or are using a similar approach with your population in Pharm 439.

•As a consequence of the work you are doing in Pharm 439 (reading, small group discussions, working at a community resource site), state at least one question that arises for you.

•Cite two sources that help you gain insight into your question. Summarize these sources in no more than two paragraphs.

•Conclude with your thoughts on how you can apply what you learned to practice of pharmacy.

Final PaperDevelops the question from the reflection

•Proposes a solution, intervention, or an application for implementation by pharmacy students or pharmacists

•Use qualitative processes to develop proposal•Identify a theme in your reflections and data•Use quotes from your data to support your ideas•Use literature to support your observations or provide information to supplement your findings•Write about meaning and action

•Write for publication - the APhA journal.

•Format• Cite your references, at least 3 • Follow the publication guidelines for the Journal of American Pharmacy Association. (see also http://www.icmje.org/icmje.pdf)• Typed, double-spaced. Times New Roman, size 12 font. Numbered pages.• Stapled.• Cover sheet is on the BACK

Evaluation Criteria

Field Description Weight

Content Communicates to the reader a thoughtful approach to understanding the site, the people it serves, and your own reactions. Communicates a thoughtful attempt at exploring at least one element of qualitative research methods.Communicates a thorough understanding of Mountains Beyond Mountains as a source of qualitative research methodological ideas. Communicates a thorough understanding of the literature cited.Proposes a plan for pharmacy students and/or pharmacists to improve patient care based on the work you as a student have done in Pharm 439. Your work includes your research, experience, readings, small group discussions, and personal talents that are presently you.

50%

Organization Standard essay style with introduction, body, and conclusion sections. Correct spelling and grammar. Logical progression of arguments or development of ideasIdeas adequately supported by evidenceAll elements presentCitations follow APhA style.Language throughout the paper is appropriately professional. There is no colloquial phrasing, unless used as part of a quote.All elements present

50%

4 = superior effort, exceeds minimum expectations (e.g., more than 3 references; unique proposal, use of evidence);

3 = average effort (e.g., minor grammatical errors, limited typos; depth of understanding in some areas appears superficial; organization lapses at times but does not impede the reader’s

progress.

2 = less than average effort (e.g., organization, spelling, grammar are barriers to the reader’s appreciation and understanding of the content; elements are missing; citations are improperly displayed).

Minimum passing score: 75%.

Key

SENSEMAKING[1]

John Perkins, Ph.D.

Life teems with ambiguous situations where people must find their way without adequate preparation or complete information. A theoretical model called sensemaking describes how people reduce ambiguity, uncertainty or complexity. There are three perspectives[2] in sensemaking:

First person sensemaking includes all the ways a person can clarify attempts to understand concepts or a situation in private and while alone. First person sensemaking may include making lists or comparison tables, conducting independent research, recalling dreams, or taking long walks. This form of sensemaking also includes all the prior life experiences and education a person consciously or unconsciously draws upon while contemplating what he or she needs to make sense of.

Second person sensemaking involves person-to-person interactions and alternating cycles of rehearsal and performance. The essential feature of second person sensemaking is that participants can speak directly to one another, ask questions, and advance together in understanding.

Third person sensemaking means ways of making sense that affect people who are not part of the decision process in a direct, personally knowable way. It shows two different faces. One face of third person sensemaking subordinates people and their experiences. The influence of this perspective pervades our culture through the practice of speaking of “truth,” “facts,” and “knowledge” as though they existed independently from human understanding and interpretation.[3] It leads some to prefer impersonal “research” conducted and disseminated by authorities and experts. These authorities may even be long dead. The other face of third person sensemaking emerges from first and second person sensemaking to create a participative structure in which others can be invited to join. People who prefer this mode of sensemaking understand that the theories and practices of others serve only as guides.

[1] Weick KE. Sensemaking in organizations. Thousand Oaks, CA: Sage; 1995:4.[2] Torbert W. Developing courage and wisdom in organizing and in sciencing. Accessed at www2.bc.edu/~torbert-/11_97_coeur_grise.html, December 18, 1997.[3] Soros G. A failed philosopher tries again. Speech text. Accessed at www.soros.org.mk/osi/soros/en/patocka.htm, February 6, 1995.[4] Doctorow EL. E L Doctorow information from Answers.com. Accessed at www.answers.com/topic/e-l-doctorow, December 26, 2006.

Qualitative Methods

Making Field NotesReasons for Making Notes

1. To Enhance MemoryYou probably won’t remember the facts and details you need to write well if you don’t jot things down immediately. The usual process of making field notes is to do jottings as things are happening, and then to write up more complete notes as soon as possible, preferably later the same day.2. To Focus AttentionMaking notes is a way of focusing our limited attention. It’s a form of self-management.Writing field notes can help you see things, hear things, think things, feel things, and understand things that would never occur without focused attention. Your notebook becomes part of your mind, increasing your capacity to notice, remember, organize, reflect, and create.3. To Record ExperienceDocumenting experiences of both inner and outer worlds is a basic step of all the arts and sciences, the raw material of human progress. Converting experience to symbolic representation is the basis of all the disciplines. Though one reason for making field notes is to prepare you to create more finished products later, the notes themselves can become important historical documents.

© 2001 Michael Umphrey Montana Heritage Project

What To WriteObservations: Late season snowstorm, hundreds of trees damaged, trees already leafed out, weight of the snow broke limbs, virtually every streetFeelings: Mildly depressing to see yet more snow this late in the yearIdeas: [People have been worried about the ongoing drought. They were saved from this problem by a different problem: the worst storm damage in decades.]Questions: [What is record latest date for snow in this location?]

1. Observations• Select details that will most vividly capture the scene or event• Capture verbatim dialogue when possible; paraphrase; summarize• Note the physical setting

• describe the space, • noises, colors, equipment, • movements in the scene, numbers

• Note the speaker’s tones, gestures, facial expressions, emotions, reactions• Run a "sensory check". What information are you receiving from each of your five senses? © 2001 Michael Umphrey Montana Heritage Project

2. FeelingsYou might feel disgusted, exhilarated, discouraged, rejected, happy, bored, saddened, etc. The person who documents something is an important part of history, and how the person felt should be recorded.

3. IdeasThink of these as memos to yourself–ideas that you the observer are providing to you the writer, who will use all these notes to find a main theme and communicate it to a larger audience

4. Questions˜ Reminders to find other resources that are mentioned: people or articles˜ Reminders to ask a different source about a topic that needs more investigation    ˜ Questions about background information for a telling detail

Clinical Research*

• Center yourself in the setting – eye of the storm

• Focus on the questions that come into view

• Identify what is valued at the site AND what is missing, silent, ignorede.g., tension between care and competence

• Be participatory – include all in your inquiry

*Miller WL, Crabtree BF. (2000). Clinical research. InHandbook of Qualitative Research. Eds. Denzin NK & Lincoln YS. Thousand Oaks, CA. Sage.

Clinical Research, 2

• Preserve, celebrate anomalies The things that don’t fit are the “levers for

transformation” (p. 661)

• Allow “truth” to emerge; not be preconceived, defensive, forceful

• “Respect the plea for clinical action and the perceived need for coherence voiced by nearly all participants in the clinical world.”

Small Groups

Data Collection and Management

So, what do you think?