Sequential simulation (SqS) of clinical pathways: a tool for public and patient engagement in point-of-care diagnostics.

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Title: Sequential simulation (SqS) of clinical pathways: a tool for public and patient engagement in point-of-care diagnostics.
Authors: Huddy, JR
Weldon, SM
Ralhan, S
Painter, T
Hanna, GB
Kneebone, R
Bello, F
Item Type: Journal Article
Abstract: OBJECTIVES: Public and patient engagement (PPE) is fundamental to healthcare research. To facilitate effective engagement in novel point-of-care tests (POCTs), the test and downstream consequences of the result need to be considered. Sequential simulation (SqS) is a tool to represent patient journeys and the effects of intervention at each and subsequent stages. This case study presents a process evaluation of SqS as a tool for PPE in the development of a volatile organic compound-based breath test POCT for the diagnosis of oesophagogastric (OG) cancer. SETTING: Three 3-hour workshops in central London. PARTICIPANTS: 38 members of public attended a workshop, 26 (68%) had no prior experience of the OG cancer diagnostic pathway. INTERVENTIONS: Clinical pathway SqS was developed from a storyboard of a patient, played by an actor, noticing symptoms of oesophageal cancer and following a typical diagnostic pathway. The proposed breath testing strategy was then introduced and incorporated into a second SqS to demonstrate pathway impact. Facilitated group discussions followed each SqS. PRIMARY AND SECONDARY OUTCOME MEASURES: Evaluation was conducted through pre-event and postevent questionnaires, field notes and analysis of audiovisual recordings. RESULTS: 38 participants attended a workshop. All participants agreed they were able to contribute to discussions and like the idea of an OG cancer breath test. Five themes emerged related to the proposed new breath test including awareness of OG cancer, barriers to testing and diagnosis, design of new test device, new clinical pathway and placement of test device. 3 themes emerged related to the use of SqS: participatory engagement, simulation and empathetic engagement, and why participants attended. CONCLUSIONS: SqS facilitated a shared immersive experience for participants and researchers that led to the coconstruction of knowledge that will guide future research activities and be of value to stakeholders concerned with the invention and adoption of POCT.
Issue Date: 13-Sep-2016
Date of Acceptance: 20-Jul-2016
ISSN: 2044-6055
Publisher: BMJ Publishing Group
Start Page: e011043
End Page: e011043
Journal / Book Title: BMJ Open
Volume: 6
Issue: 9
Copyright Statement: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:
Sponsor/Funder: Imperial College Healthcare NHS Trust
London Deanery
Wellcome Trust
HCA International Limited
National Institute for Health Research
Wellcome Trust
Health Education North West London
Imperial College Healthcare NHS Trust
Imperial College Healthcare NHS Trust
National Institute for Health Research
Highland Biosciences Limited
Funder's Grant Number: RDOTH
CRFs / Harley Street Clinic
RDOTH 79560
Funder to provide
RDOTH 79560
RDB13 79560
BRU 6535
Keywords: Patient Engagement
Patient Simulation
Point-of-Care Testing
Volatile Organic Compounds
Publication Status: Published
Article Number: e011043
Appears in Collections:Division of Surgery
Faculty of Medicine

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