“Will it make a difference?” How this one question changed my practice and my career.

December 4, 2017

I’ve just published my first research paper entitled: ‘Higher participation in physical activity is associated with less use of inpatient mental health services: A cross-sectional study.’ Three years ago this would have been beyond me. Here I’d like to tell you the story of how asking a simple question changed all that.

As a newly qualified physiotherapist, I hit the ground running applying the knowledge and skills I’d learnt to the patients I was now caring for. Like most folk in a new role, learning on the job played a big part in those early days. Coffee and lunch break chats with colleagues provided opportunities to discuss cases and ask questions about best practice and new and emerging ideas.

With time and the inevitable experience this brings, I started to question what we were actually doing, and more importantly, why? It was then I asked myself “Why am I doing this; Will it make a difference to my patients?”

I was surprised by the answers I found. Because for a lot of the things I was doing, I struggled to find evidence to support it. Not because the research evidence was poor – but because I couldn’t really tell if it was or wasn’t! That was when I realised my lack of skill in understanding, interpreting and applying research evidence. I decided to do something about it.

My journey into evidence-based practice

In order to really understand research, and better incorporate evidence into my everyday practice, I needed to start from scratch. And this is where the AHSN Fellowship and MSc in Evidence Based Healthcare came in.

I found out about the fellowship through an email from my team manager at the Oxford Health NHS Foundation Trust where I work as a mental health inpatient physiotherapist. I was apprehensive at first – wasn’t sure if I would be able to cope with the workload. I decided to go for it and it turned out to be a career changing decision.

Being a part-time course, it enabled me to study in my own time and continue working. A mix of face-to-face and online learning, each module was an immersive learning experience and provided me with the skills to ask relevant questions, find the best available evidence, appraise and apply it. They key thing is I now have a structure for each of these steps of EBM. These skills were then put to use in my own research study as part of my dissertation thesis.

Learning through doing

My MSc gave me the opportunity to answer a question important to my practice that the available evidence-base couldn’t. I work in inpatient mental health care and am aware of the large disparity in the physical health of people with enduring mental illness in comparison to the wider population. So much so, that having a mental illness comes with a risk of dying up to 20 years too early.

Many researchers have studied this trend and found that the risk factors for early death in people with mental illness include poor diet, sedentary behaviours and a lack of physical activity. Links between exercise and mental well being have been increasingly studied in recent years with improvements in markers of depression, quality of life and symptoms of psychosis being found in people who are more physically active.

One thing I couldn’t find much evidence for was the impact of physical activity and the use of inpatient mental health services. This question was important because hospital admissions are costly, increasingly strained and unpopular among my patients. So I set about answering it. My thesis study showed that people with enduring mental illness, who exercise more, spend less time admitted to inpatient mental health wards. The hope is that these novel findings will be a catalyst for further research into the link between physical activity and use of mental health services

What next?

Overall, the MSc in Evidence-Based Healthcare has equipped me with the knowledge, understanding and the confidence to effectively use research in my clinical practice. I intend to build on what I’ve learned during the MSc and continue to develop my research skills. I’m also passionate about sharing these skills with my colleagues and helping others to become more confident in reading, appraising and even carrying out research. I’m not sure exactly what my next step will be but I know that the MSc has opened many more doors for me so I’m excited about the future.

Joseph Korge Chartered Physiotherapist

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