Remember that the role of the tutor can be said to be ‘to advise, to encourage and to warn’. In the last analysis, the project is your own and you must be prepared to take ownership of it and be prepared to defend every word that you have written. Although your tutor may not be as acquainted with the specialist literature base as you are, the advice that is given is not to be disregarded lightly. The tutor may well suggest particular lines of enquiry that you should consider very carefully - but in the last analysis, what is offered is advice and not instructions as to how to undertake your project.

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6. How do I plan out what I intend to do ?

It is always a good plan before you meet your tutor to come along armed with the following information:

(a) Most important! A title and suggested plan for your project. This could well be in the form of your anticipated chapter headings (say Ch. 1 to Ch. 6 with a sentence or so of explanation for each one. )

Some of these chapter headings may suggest themselves naturally e.g.

Chapter 1 Introduction (Why the subject is of interest)

Chapter 2 Literature Review (What we know about the subject from the literature base)

Chapter 3 Development

Chapter 4 Further development

Chapter 5 Case study or small scale research (interviews, questionnaires etc.)

(NB be careful that your research carries forward the themes of your project and is not seen as a ‘last –minute
add on’)

Chapter 6 Conclusions (The next step, way ahead)

(b) A list of the sources that you have already consulted.

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7. How much tutorial support may I expect to receive ?

You should appreciate that one-to-one tutorial support is both expensive and time-consuming - on the other hand, you are entitled to receive the appropriate amount of tuition, given that you are now in the third year of a degree programme.

The tutorial support you will receive comes in two forms:

(a) Class sessions One at commencement to help to get you oriented

One (optionally) at a mid-sessional point

One immediately prior to the writing up period

(b) Individual tutorials 6 * 30 mins over the academic year (3 hours in total)

Some students may need somewhat more or less help than these guidelines suggest - but you should bear in mind that the Business Studies team will each be a tutor to 15- 20 students and we aim to provide an equitable service to each student.

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Specifics

8. Literature review

This is a particularly important part of the project as you are demonstrating to the readers of your project that you are familiar with the major themes, issues and debates to be found in the literature which informs your project.

A literature review aims to inform the reader the state of knowledge concerning a particular topic area as represented by recognised scholars and researchers. The sources that you consult for a literature review are principally:

(a) Books around the subject area (the more recently published, the better)

(b) The periodical literature i.e. articles in the academic journals

(c) The Internet may itself help you with both (a) and (b) above as well as providing you with other sources of information. However, be warned that there is no quality control on the net i.e. almost anybody can publish anything they like. Academic books and articles will have been through a process known as peer review in which other academics will have commented on the quality of the published material before it sees the light of day but similar quality control mechanisms do not apply on the web (unless, of course, you are accessing the normal academic literature through the web rather than just browsing web pages in general)

You should use the resources of the Library to help you to ascertain:

(a) how to find abstracts or indexes to a particular source of literature. CD-ROMs are likely to help you to locate the relevant literature here - but you may then have the problem of actually retrieving it

(b) The resources of the Internet. However, do be careful of your use of the Net - the information you download may be ‘ephemeral’, not particularly academic or not ‘quality checked’ before it is posted.

Although the prime aim of a literature review is to inform the reader of the current ‘state of knowledge’ of your chosen theme, you will gain additional credit by being evaluative as well as descriptive. The more you can contextualise the literature, comment on the strengths and weaknesses of particular approaches and critically appraise your source material, the more credit you will gain.

Conventionally, the literature review is the first substantive chapter of your Project i.e. placed immediately after your introduction which is ‘scene-setting’. Although this chapter will be heavily referenced, this should not imply that were will not also be references that you will make to other sources of literature throughout the remainder of your project. The literature review is essentially a critical summary of the principal themes within the field - not an exposition of everything that has ever been written about the subject.

For examples of a literature review, you should

(a) browse books or articles which typically contain a literature review

(b) look at the section of the article by Mike Hart The Quantification of Patient Satisfaction entitled Dissatisfaction with the conduct of the patient satisfaction survey (provided in the appendices). This is essentially a literature review condensed to one section of the article - there are approximately a dozen reference there contained within the 400 words of a 5000 word article. Your own literature review will be correspondingly larger, forming as it does the first substantive chapter

(d) You can use the resources of the web (particularly http://www.google.com/) to give you additional advice in this area should you need it.

It is not difficult to find good examples of literature reviews. Most academic research papers will start off with a ‘literature review’ section and textbooks almost by definition will give you an overview of the concerns of the field. Try to make ensure though that your literature review is up-to-date, topical and extensive ( for example you should aim at a minimum of 20-30 references in this section of your work).

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9. Researching and gathering material for your Project

Throughout your project, you will be used to using the library (and other libraries) extensively - final year students writing their Final Year Project are likely to use the resources of the Library to the full. But there are other ways in which you can help yourself e.g.

(a) browsing in bookshops (either in reality or through the web such as www.amazon.co.uk) is a good way to ascertain what is recently published in the field - you do not actually have to buy what you see (although it is worth while buying a particularly good source)

(b) wise use of the Internet (although this will typically be an adjunct to your other search efforts). The search engine www.google.co.uk seems to be a particularly starting point for many and is worth checking regularly throughout the year as new material appears. Remember to exercise a degree of academic caution about the material gained from the net i.e. is the authority a credible one?

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10. Managing your Project

Phases of your project planning

Any large scale piece of work needs to be planned and your project is no exception. Researching and writing a project can have its frustrations, principally because you may have difficulties locating some of the source materials or what seemed to be a promising line of enquiry turns out to be a dead-end. Most projects follow phases similar to that outlined below:

Initial phase - reading around the intended subject area, finding and refining the exact subject of your enquiry. For many, this can be the most frustrating part of the exercise - the solution is to keep reading and to some extent browsing and this process of browsing-reading-reflection will your initial ideas to develop a sharper focus. For example, you could have started off wanting to cover a very broad topic such as Motivation at Work but after refinement your ideas may well have become Job Satisfaction in White Collar Occupations or even Job Satisfaction in the Financial Services industry. Most projects start off being somewhat too ambitious in scope and after consultation with your tutor may need to be refocused into a more manageable shape.

Literature review phase - this is likely to be the first substantial part of the project and requires you to document and contextualise the academic literature which informs your project. If you have started your project in October, then it is ideal to have this phase completed by Christmas, if possible.

Development phase - here, your research and ideas may be developing quite rapidly. You may well be drafting out chapters at the rate of about one every fortnight and you will be engaged in a process of both refining ideas and committing yourself to paper.

Empirical research phase - some students may like to demonstrate their initiative/ research skills by undertaking a detailed examination of a case study or conducting some small-scale investigations capturing data through the most appropriate means (interviews, questionnaires, documentary data). An empirical research phase is likely to run alongside the development phase above and may need careful planning. Gaining permissions, piloting questionnaires, gathering data all take longer than you might initially think.

Data analysis phase - any originally collected data needs to be analysed and does not speak for itself. You will need to be able to demonstrate that you understand the most appropriate tools of analysis (e.g. statistical hypothesis testing of quantitative data, techniques of qualitative data analysis.) You may well need to consult a methodology text again at this point to remind yourself how such tools are to be deployed. Your tutor(s) should be able to point you in the right direction at this point - but the data analysis, interpretation and ‘linkages’ with the rest of the project should not be seen as an afterthought that has just been tagged onto the project as a whole.

Writing up phase - in this phase, you turn your drafts of individual chapters into a polished whole. Your completed document will have to conform to certain technical specifications, detailed below, and will contain sections that you may not have had to cope with in shorter length documents such as formal title pages, acknowledgements, indexes, appendices and the like. It is important that you leave yourself enough time for careful proof-reading and consideration of your finally completed document.

Managing your time

It is a good idea to devote a regular session each week (one morning, afternoon, evening) or a complete day for your literature searching/browsing. You will probably need to allocate another session for notetaking from relevant sources. Aim to make sure that you have accomplished something at the end of every session so that you have a sense of progress.

C Top Tip Photocopy relevant articles and then day-glo the relevant phrases etc.

C Top Tip Set yourself arbitrary time-limits for each source that you are commenting upon e.g. ½ hour for each source so that you do not get too bogged down.

C Top Tip Ensure that you have good biographical details of your sources. A card index might be useful here - and easy to keep sorted in alphabetical order.

C Top Tip Keep two backups of your project files (on two separate floppies). Backup after every chapter orsection. Keep one backup near your computer and another in a safe place (your bedroom?). It is most unwise to keep a backup of your work on a ‘friend’s computer’

Progressive focusing

Do not expect your progress to be unilinear - the initial stages may take a certain amount of time and you may not feel that you are making much progress on the project until you reach the stage at which your ideas have been clarified and your literature sources are accessible.

Always have your initial plan in mind and be prepared to refine it in the light of subsequent searches/researches.

Remember that as you read more, your ideas will become progressively refined - and as your ideas become more refined, this then guides in what direction to read. This whole process is known as progressive focusing or progressive refinement.

Techniques to aid progressive focusing

Œ Are there natural breaks in the data ?

(e.g. NHS before/after the market reforms

The city before/after deregulation (‘Big Bang’)

pre-1979, post 1979 (election of Thatcher government) )

Are there key reports, White Papers in the area ?

Ž Is there a key piece of legislation in the area ?

Is there a single influential book which is the natural starting point ?

In a progressive focusing technique, you may wish to adopt a scheme such as the following:

¨ What is the background to the issue (i.e. how did it become an issue or become part of the agenda of business, politics ?

¨ Are there key reports, events ?

¨ What is the major point of the legislative framework (if relevant) ?

¨ How have plans been implemented ?

¨ Is it possible to evaluate the success/failure of a policy ?

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11. Mid-Year Review

You will be asked to present a progress report on your project in the middle of the academic year (typically in week 15 of Semester 1). In your progress report, you should be able to delineate and defend the major themes of your project, indicate the shape of your project as a whole and be explicit about the progress made to date. A typical progress report will contain:

(a) Outline worked in some detail

(b) Evidence of a completed literature review

The mid-year review will be either to your tutor or in the form a 5 minute presentation to your peers (together with one side of A4 indicating your progress).

The mid-year review is compulsory and will be graded by your tutor. This grade will help your tutor in arriving at a final grade when your work comes to be graded after its submission.

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12. Methodology

In your project, you should include a justification of how you decided to investigate the Project in the way in which you did. You may think of your methodology in both general terms and specific terms:

(a) general (your lines of approach e.g. why you chose to investigate the project in the way in which you did. Was it completely desk-based or did you choose to undertake case studies, more particular investigations ? )

(b) specific If you have undertaken some field work (questionnaires, interviews, case-studies) you should include several paragraphs that justify your choice of methods. These should demonstrate methodological awareness gained from other parts of your course e.g. how and where you sampled, the theoretical reasoning that lay behind your choice of method and so on. This is part of the Project in which the methodological principles you have been taught in the course can be demonstrated.

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COLLECTING PRIMARY DATA

1. QUESTIONNAIRES

Compose the questionnaire with care, noting the different types of question it is possible to have: (References are to the TURBOSTATS statistical package)

Type Variable Typical Data

Categorical GENDER 1,2

(TS-FREQ1)

Continuous SALARY 10000

(TS-STATS)

Multiple Frequencies MEDIA +10111

(TS-MFREQ)

(Open Ended) THEMES +10111

(TS-MFREQ)

Ranked FACTORS 1,2,3,4,5

(TS-FREQ1,TS-STATS)

Scaled S_FACTOR 1,2,10

(TS-FREQ1,TS-STATS)

Hypothesis Tests

Cross-Tabulations, Chi-square TS-CROSS

‘T’-tests TS-STATS

Ranked TS-FRIED

Scaled TS-ANOVA

Multiple Frequencies KS-TEST

Your questionnaire analysis should contain:

· a statistical description of every question (normally frequency distributions)

· Selected hypotheses

· Details of sampling

· Details of covering letter

· Details of response rate (+ efforts to maximise)

· Examples of questionnaire itself

· (Perhaps DATA and LABELS files)

It is important that you show a degree of methodological expertise i.e. be aware of the strengths, limitations of this method of gathering data.

Remember that your questionnaire will often be in the form of a PILOT for what you would do if you had the time and resources for a more detailed enquiry (most appropriate

to a post-graduate enquiry)

Important: If you intend to collect some data by questionnaire, then it is very important that you

Œ Have it checked out by a tutor before its distribution

Obtain the necessary permissions beforehand

Ž Think how the results are going to be analysed and incorporated into the report

Your Final Year Project Report should also contain

& Methodological considerations (why this method of data collection was chosen in preference to another e.g. collecting data by interviews)

& Evidence of having been piloted

& Enough cases to make analysis worthwhile (generally about 30)

& An indication that the sample size may have needed to be restricted because of the practicalities of being a Final Year student (if you were a full-time postgraduate student, you would have more time and resources to do it properly)

& Evidence that you can demonstrate the methodological principles at work

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2.         INTERVIEWS

            What are the practicalities of recording the data:

            Note-taking (your own notes, complete with good quotations)

            Tape recording (but the tape has to be transcribed, to turn it into hard copy!)

Data has to be transcribed - how is this best done ?

(Best done within hours)

How is data to be analysed ?

· By thematic analysis

· By choice of selected quotes (e.g. ‘A representative view was…’ ‘A minority view was…’)

· Make connections with the rest of the literature and the rest of the project

Give details of sampling, location etc.

Sample selection, response may have to be justified in similar terms to a quantitative survey

Preserve anonymity

i.e. not Mr. Jones but Mr. D_____, a Customer Services manager etc.

Get all necessary permissions

This may not be as easy as it sounds

Promise to show material

Typically, showing the relevant chapter will suffice…

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3. APPROACHING ORGANISATIONS

· Only do so after other efforts on your part

· Be aware that busy professionals may not necessarily have time for you and/or be inundated with requests

· Materials often have to be paid for (+P&P)

· Offers to visit an organisation may be useful

· Ask to speak to Information Department, External Relations Department etc.

Helpful if you are fairly limited in your requests for information…

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ANALYSING PRIMARY DATA

Quantitative data

· Remember that every question needs an answer !

· Remember different types of data : Categorical (simple categories)

Multiple frequencies (tick all that apply)

Continuous (statistics)

Ranked data (preferences)

Scaled data (1-5, or 1-10)

Open-ended questions

Hypothesis tests

There are many potential tests to perform - only choose one or two but select them with care and show in your text/ commentary that you can interpret the output!

When you perform hypothesis tests, note the difference between statistical significance and social scientific significance..

	Statistical significance	Social scientific significance
Differences in heights of male v.female students	Yes	No
Differences in rates of mental illness of unemployed v employed	No	Yes

Use of Graphics

Remember that ‘a picture is worth a thousand words’ but :

· Use a spreadsheet to perform the graphics for you

· be careful to ensure that it does illuminate and not obscure

· label it carefully and cross-reference to the text

Analysis of open-ended questions…

These are best analysed as if they had been Multiple Frequencies (tick all that apply) type of questions...

Read through all of the responses and discern that four themes seem to emerge from the analysis i.e.

Socialising,clubs,sport,music,other)

e.g. 1 “I spend my spare time in the following way...”
            Socialising, going to clubs, playing badminton
            ..........................................................................………….
            (Themes: Socialising,clubs,sport,music,other)

(+11100) can be used for computer analysis, (1 indicates a tick, 0 indicates no tick)

e.g. 2 “I spend my spare time in the following way...”
Horseriding, playing rugby, listening to music,
............................................................………………………

(Themes: Socialising,clubs,sport,music,other)

(+00111)

e.g. 3 “I spend my spare time in the following way...”
            Clubbing, socialising, reading magazines
            ..........................................................................……………
            (Themes: Socialising,clubs,sport,music,other)

(+11001)

Notes:

1. Do not have too many categories: 3-5 is sufficient

2. Have ‘Other’ as a general category for odd responses

3. If you are only analysing by one theme (e.g. Positive

Negative, Neutral, Mixed) then you can use a simple TS-FREQ1 analysis instead.

Qualitative data

This will generally be in the form of interview data but it could be in other forms e.g. field-notes written up at the time of placement experience.

There are TWO major types of analysis:

1. As a source of quoted material, in which you might indicate its typicality e.g.

‘ a commonly expressed view was the following’

“The whole exercise was extremely hard work but fruitful

as we learnt a lot from it”

(Second Year Female student)

Notice the reduced point size, single line spacing, attribution

2. A thematic analysis

In such an analysis, you might analyse the text of interviews for the prevalence of certain themes. For example, in a survey of customers for trainers, we could discern the following:

	Price	Styling	Availability	Status symbols
Respondent 1	Affordable	High	Easy	Prevalent
Respondent 2
Respondent 3
etc.

Documents

1. Documents are evidently a source of data - that is why we use them in projects

and research reports.

2. However, documents are themselves data and we need to ask several questions of them :

· Who wrote the document ? (e.g. Govt. department, pressure group, research body)

· What was the purpose of the document ? (to campaign? inform? )

· Who were the intended readers of the document ? (general public, ‘already converted’)

· How much reliance can we place upon the data ?

3. We need to utilise skills traditionally associated with the historian to ascertain the context of the document. The same is true also of books i.e. they may reflect the concerns of the time e.g.

John Bowlby : Child Care and the Growth of Love (1954)

needs to be put into the context of post-war Britain with a predominantly conservative culture with women’s place in the home’

4. Documents do not have to be published i.e. they can be any source of textual data and as such they could include any of the following - diaries, memos, ‘internal’ office documents, correspondence, newspaper cuttings, transcripts of interviews etc. Whatever the document, try to date it and contextualise it if at all possible..

Be prepared to comment upon the accuracy, themes and the context of the documents that you are using. This indicates that you are using your own powers of analysis and judgement.

Case Studies

A case study is often deployed to illustrate some of the general principles outlined in the main body of the dissertation ‘in action’

1. Of necessity, there will need to be a certain amount of descriptive material but keep this to the minimum and avoid the impression of ‘padding’

2. Analyse your case study in the form of themes e.g. organisational structures, role definitions, personal relationships

3. Make the necessary linkages (cross-references) with both:

· the literature base of the project itself

· the themes that inform the rest of the project

· any other studies that have been made in this area

4. Comment on the typicality (or lack of it) of the case study material. You may need to justify why that particular case-study was used in more theoretical terms even if the reason for its selection was essentially an opportunistic one…

5. Some external examiners are pleased to see the ways in which students have utilised their own work experiences particularly if it contains material of a reflective or self-critical nature.

6. The dissertation is one for a degree in Business Studies - make appropriate references to the wider themes current in the literature e.g. globalisation, flexible labour markets, etc.

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WRITING UP 1

GRAMMATICAL POINTS

1. Develop a simple, terse style - avoid long sentences

2. Pay particular attention to VERBS- make sure that:

Each verb must have a subject ( and/or indirect object)

(e.g. I kicked the cat

We went to college )

Do not confuse finite verbs with adjectival clauses

(e.g. ‘Assuming that the proportion of GDP spent on social welfare remains constant and that a new Labour Government does not increase the proportion with an increase in taxes’

is not a sentence. We would need to complete this with a finite verb i.e.

‘..increases in taxes, poverty will remain endemic in the UK’

3. Make sure that subjects take appropriate cases of the verb

e.g. ‘Recent governments in its concern for international competitiveness and with a concern for the forthcoming election displays no particular concern…

4. Read an up-to-date textbook of English Grammar to help you…

SPELLING

1. Spelling checkers are only helpful up to a point…

(‘I do not know weather the whether will be fine’)

is not flagged up as an error in Word 6.0/7.0

2. Use a good, up-to-date dictionary every day..

Ø Good - Collins, Oxford (preferably 100,000+ words )

Ø Up-to-date so that it contains new concepts, new usages e.g.

additionality, awesome, balti, cache memory, ethnic cleansing, grunge, luvvie, multimedia, politically correct, techno, wild card

Ø Every day most professionals do!

3. Use a thesaurus to check for word alternatives

4.         Be aware of the fact that some words differ between ‘American’ and ‘English’ English             e.g.

            organization    (USA)              organisation (UK)

            fulfill               (USA)              fulfil     (UK)

5. Be aware of ‘false friends’ i.e. words that you think you know the meaning but are easy to confuse

homogenous means similar in kind or nature, uniform; homogeneous means similar because of common ancestry…

6. Be aware of inconsistencies in English..

co-operate, co-operative (hyphenated), uncooperative (is not)

7. Excellent source!

Inman,Colin(1994), The Financial Times STYLE GUIDE, London, Pitman Publishing,

8. Most mis-spelled words !

(mis-spelled) seperate, arguement, buisness

(correct spelling) separate argument business

STYLISTIC CONVENTIONS

1.         Avoid the use of the first person but do not be frightened of expressing your own opinions and considered views…

            ‘It could be argued that….’

            (more strongly) ‘The present author would argue that..’

2. Spell out abbreviations the first time that they are used.
(You may need to provide a glossary as well)

3. Remember that a paragraph is a unit of thought, not of length i.e. one paragraph = one idea

WRITING UP 2

PLAGIARISM

Definition

Plagiarism is the act of lifting an extract from another source, word for word (or nearly word for word) without demonstrating that it is a quotation or citing its source. The effect of plagiarism is that the words are effectively ‘stolen’ and passed of as having been written by the dissertation author.

Any assessed work which is found to be plagiarised, deliberately or not, will fail

What is legitimate ?

1. Short quotations i.e. a phrase

2. Longer quotations of a sentence or so, provided that they are duly attributed ( to the author) and referenced ( to the page)

What is not legitimate ?

1. Evidently, extended passages

2. Not quite so evidently, passages in which a few words have been changed, making it

appear that the ‘lifting’ is less blatant than it is.

How to avoid plagiarism

1. If you see a paragraph, or a line of argument that exactly

expresses what you intend to say then …

· Précis the line of argument i.e. put the sense of the paragraph or section in your own words

· Then, convey the essence or the kernel of the author with an attributed quotation

2. Be aware of the fact that plagiarism is quite easy for experienced tutors to detect

Consequences of plagiarism

1. Obviously the most severe is that the dissertation is failed, the degree is failed, you leave without a degree..

2. Even one small instance of plagiarism ( or suspicion of it) can cast doubt over the whole of the project.

NON-SEXIST and NON-RACIST LANGUAGE

1. Be aware of the style ‘he or she’ ‘she or he’

‘s/he’ used to be used quite regularly ( but the use of this may now waning ?)

2. Be aware of the fact that many of the terms in use may well be value-laden and there may be no clear consensus as to the current terminology.

3. Establish what your own particular position is going to be in any particular area and then be consistent in your usage.

4. Be aware of the fact that whilst not appearing to be ‘politically incorrect’ some of the suggested terms may appear ridiculous…

history herstory

girl pre-woman

woman person of gender

black person of colour

5. Some terms have come a long way towards acceptance:

humankind (replaces mankind)

Inuit (replaces Eskimo)

GOOD PRESENTATION AND ILLUSTRATION

1. The importance of a good presentation is hard to over-emphasise i.e. how you say and

present material can be as important as what you say…

2. When you start to write up, then…

· Make good use of ‘white space’

· Look at the styles in other, well laid-out
documents, including past dissertations

· Take a pride in your presentation

· Do not be tempted to use too many ‘fancy’ fonts

· Refine your word-processing skills so that you know how to alter margins etc.

· Be aware of a ‘binding margin’

3. Chapter 28 of: Coolican,H : Research Methods and Statistics in Psychology (2^nd edition ) whilst geared towards psychology students contains some useful advice and examples.

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DOCUMENT LAYOUT

General Principles

· A4 paper,Margins (Top, Bottom, Left,Right.....1”)

· Leave Binding Margin of ½” ( or LHM of 1½”)

· Line spacing of 1.5
(but 1.0 within extended quotations extending over several lines)

· Use a formal Font e.g. Times Roman, point size 12-13)

This is a demonstration of Times Roman 12 (in bold)

· It is permissible to use a non-serif font as a heading

· Headings should be emboldened, blank line left after each one (you may increase the point size slightly)

e.g.

This is a new point {Times New Roman, Bold, 14 pt}

Notice that this is the start of the next paragraph, not indented to the left
( which appears to be the modern convention) {Times New Roman, 12 pt}

{ one blank line}

This is the start of a new paragraph…

More specialised layouts

Chapman and Hall ‘Instructions for Authors’ document may provide a useful source with much detailed information.

Most relevant sections: 3 Text;

4 Figures;

5 Tables;

6 References

Word-processing notes

Ø Know your word-processor intimately!

·      You may well be using specialised functions such as:
hanging indents (e.g.           xxxxxxxx
                                           xxxxxx
                                           xxxxxx)

· foreign accents (e.g. résumé)

· margin release (to make space for a table) etc.

Ø Buy a book for your preferred word-processor

It may be the only way to find out how to perform certain specialised functions.

Ø Take frequent backups ( on several disks)

Ø Be careful over ‘Search and Replace’ functions

Ø Proof-read on paper and not just on screen

Ø Spelling checkers may only have a limited validity

Ø Grammar Checks/ Thesaurus may also have dangers!

Ø Be consistent throughout a document

Use italics

· for imported phrases e.g. .. the French bacalauréate

· to indicate multiple authors e.g. Garrat et.al. (1994) )

· for emphasis

e.g.1. the term consumer audit has been deployed by Rigge

e.g.2. there are generally two modes of redress (voice verses exit)

(emphasis added)

· for important sources e.g. in the Patient’s Charter we see that..

Bullets

· Make sure that your bullet points are indented

· They are especially useful in the case of lists and so on but be careful not to overdo them (lest it look like ‘padding’)

‘Hard’ v ‘Soft’ carriage returns

· A ‘hard’ carriage return signifies the end of a paragraph (¶)

When you press ENTER then all of the formatting associated with a paragraph is associated with the ¶ sign (in Word for Windows)

· If you want to start a new line but within a paragraph, then you need a ‘Soft’ carriage return which will start a new line but keep you within the paragraph ( and not generate extra bullet points for example) You generate a soft carriage return with
SHIFT+ENTER

Page View

Page View is especially useful to see how the text is to look on the screen. Although your word-processor should look after :

· widows (last line by itself at top of a page)

· orphans (last line by itself at the bottom of a page)

there may be occasions when you want to check out the position manually. For example, you might not want a few lines of quotation to be spread over two pages. Use Page View to check for this…

Page Breaks

You can force a page break generally with CTRL+ENTER ( in Word for Windows). This may be especially useful if you want the whole of a table to be on the following page…

Appendices etc.

Do not have your appendices too voluminous - they should not be more then about ten pages as a general guide. Many projects will not need to have an appendix at all. Your appendices should contain any additional evidence that helps a reader to validate the work you have done but should not necessarily contain all of your data (e.g. raw interview transcripts, every completed questionnaire.) If you have reduced all of your questionnaire data to a single one-page data file, then this is worth putting in the appendix.

Suitable items for appendices may be:

· Copy of questionnaire, if deployed

· Specialised figures, tables, results, forms

· Glossary of terms

Indexes

You may not have time to index your document, but it would add to a professional presentation if you do.

Indexing is time-consuming and tedious - the software available to you may be more trouble than it is worth !

If you index, the aim should be for the reader to find their way to a concept/word/phrase quickly and easily.

Contents Pages

You should always have a contents page. This needs to be the very last job of all in the document production (because you evidently need the rest of the document to be page numbered before you can construct the contents pages) You may wish to include the sub-sections of each chapter as well (view the examples in the Appendices)

{Example of the start of a Contents Page}

CHAPTER 1 : Quality in Health Care

Introduction 4

The Prevalence of the Quality Concept 4

Approaches to Quality 9

Quality in Healthcare 17

Methods of Working

There are 2 basic methods of working:

1. Establishing basic layout and styles in one’s preferred word-processor and then producing the document chapter by chapter

(This is slower and you will need to produce constant corrections as you change your mind and reorganise, your tutor makes suggestions etc.)

2. Using any word-processor to produce rough drafts and then rely upon a major ‘tidying up’ job at the end, once imported into the word-processor of your choice…

(This is faster in the short run but you do have a major ‘tidying up’ job to do when the project is completed. However, it may be quicker in the long run as well)

Make frequent back-ups

As your dissertation gets more and more complete, it becomes more and more precious. It is much more valuable than the medium it is stored upon! Take several backups (e.g. on three separate disks!!)

Always proof-read well !

1. Allow yourself the time to proof-read well.

2. Proof-read on paper rather than on the screen

3. Use a dictionary and thesaurus constantly to check basic /alternative spellings and meanings

4. Ask a friend (upon whom you can rely!) to give you their advice on what you have written

5. Reading passages aloud to yourself is not a bad idea! If you have to pause for breath in the middle of a sentence, it is probably too long! In such a case, break down into smaller sentences.

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Principles of Referencing Style (Harvard)

1. At the end of a sentence…

e.g. A recent development is the deployment of users as part

of the training procedures in an attempt to shape attitudes and behaviour of managers (Moore,1995).

This approach is represented in the ‘classic’ writers upon TQM (e.g. Deming,1996; Crosby,1979; Juran,1988; Feigenbaum,1983; Ishikawa,1985; Oakland,1989).

One of the most significant findings of the evaluation of TQM in the NHS indicated that there “had been a general shift from professional and technical toward ‘customer oriented’ views of quality” (Joss and Kogan, 1995, p.73).

2. Within a sentence..

As Walsh (1995a) argues, the definition of public service quality…

An interesting way in which the outcomes-structure-process model has been deployed is by McGlynn et. al. (1988) in the context of mental health services.

3. Attribution of a quotation

As Blau’s classic study of an employment bureaucracy

points out:

An instrument intended to further the achievement of organisational objectives - statistical records- constrained interviewers to think of maximising the indices as their major goal, sometimes at the expense of these very objectives.

(Blau, 1963, p.46).

Bibliographies

Books

Pollitt,C. (1993a) Managerialism and the Public Services (2^nd edition),Oxford, Blackwell.

Popay,J. and Williams,G. (eds) (1994) Researching the People’s Health, London, Routledge.

Lodge,M. (1981) Magnitude Scaling, Sage University Paper Series on Quantitative Applications in the Social Sciences, No.25, Newbury Park, Ca, Sage.

Articles/Chapters in Books

Hart,M.C.(1995c) ‘An “ecological” critique of Total Quality Management - a case study from NHS Outpatient Clinics’ in Kanji,G.(ed),Total Quality Management, London, Chapman and Hall.

Reports

DHSS(1983) Enquiry into NHS Management (The Griffiths Report), London, HMSO.

Department of Health(1995), The Patient’s Charter & You, London, HMSO.

Department of Health(1992a) Health of the Nation (Cmnd.1986), London, HMSO.

House of Commons Committee of Public Accounts(1991),NHS Outpatient Services [HC270-i], 27 February, London, HMSO.

Bicanic,J. (1993), Waiting Times Study (unpublished report), Swansea, Singleton Hospital.

Periodicals

Roberts,S. (1990), ‘Why are we waiting?’, Nursing, 4(10):29-31.

Stevens,L. (1995), ‘What the Patients said’, Health Services Journal,19 January:29.

Newspapers

Moore,W. (1995), ‘Lessons from the bedside’, The Guardian (newspaper),

Society section, 6 December 1995, p.6.

Conference papers

Pollitt,C. (1992) ‘The struggle for quality: the case of the NHS’, Paper read to UK Political Studies Association, Queens University, Belfast.

Berman.E.M. (1995) ‘Ethics and Cynicism in Modern Public Administration’, paper read to European Group of Public Administration Annual Conference, Erasmus University, Rotterdam, 6-9 September.

Quotations

A phrase

Deming argues that one potential source of bias in all survey work is ‘bias of the auspices’ (Deming,1944).

An extended quotation

In Deming’s own words:

Bias of the auspices likely stems from a conscious or unconscious desire on the part of the respondent to take sides for or against the organisation sponsoring the survey, but perhaps ore to protect his own interests which may vary
with the sponsoring agency.

(Deming(1944) in Denzin(1978) p.239).

Studies quoted within studies

.. by way of comparison, a large American sample (n=37,000) had a mean of 45 minutes in 1977-78 (quoted in Rosander,1985, p.77).

Using others to support your own argument

The point that measurement by itself cannot improve quality is also made by Gaster (1995, p.108).

Multiple references

Studies of laboratory life (Latour and Woolgar,1979) and of the workings of the drug industry (Abraham,1995) indicated that even ‘normal’ scientific work is suffused with values which may reflect social and political agendas, such as a desire for market dominance or scientific recognition.

Always quote as exact a reference as you can, complete with page numbers, so that readers can read the actual passage for themselves.

Accuracy!

Strive for the greatest possible accuracy possible - do not trust to memory !

All of the following contain critical errors which casts doubts in the reader’s mind whether the material has been read…

e.g. the Beverage Report which laid the foundation of
the Welfare State….

e.g. As The Patients’ Charter indicates…

e.g. (1983) Enquiry into NHS Management
(The Griffith Report), London, HMSO.

e.g.       Osborn,D. and Gaebler,T. (1992) Reinventing
            Government: How the Entrepreneurial Spirit is
            Transforming the Public Sector, Reading, Mass.,
            Addison-Wesley.

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Importance of proof reading

Why proof-read a document ?

· To spot obvious grammatical errors

· To correct spelling

· To correct sentence structure (which may include breaking up into simpler sentences)

· To check complete consistency in the way in which you have used:

¨ fonts

¨ indents

¨ quotations,

¨ citations etc.

· To check that references are written consistently and are quoted in the bibliography.

· To check margins have been correctly set (particularly ‘gutter’ or ‘binding’ margin)

· To check the ‘flow’ of the argument

· As a very last task, to ensure that the document is correctly page numbered and that the contents page enables a reader to locate any Chapter/section correctly

How is one to proof-read ?

· The most single principle is to
proof-read on paper, not on screen.

· Evidently, you have to read it very slowly, avoiding the temptation to ‘skim-read’. Read at one half to one third of your normal speed.

· You may need to allow yourself more than one proof-read (i.e. do not assume that you ‘trapped’ all of the errors in a first proof-reading)

· Allow yourself plenty of time to proof-read a document (e.g. an hour or so)

· After a while, the author is not a good proof-reader (as you know what to expect and you can miss errors)

· One psychological ploy is to say to oneself

‘there are at least three errors on this page and
it is my job to find them’

· If you can, get a friend to proof-read a document for you.

(However, be careful to ensure that your proof-reader is at least as competent as you are - otherwise, they may suggest incorrect changes that may make a document worse rather than better)

· Remember that you may have to allow yourself time to get access to printing facilities to run off the corrected pages (or even a complete document!)

· Remember that the aim of proof-reading is to present a polished, competent, well-produced document that ‘reads well’

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Cross-referencing

1. Ensure that every reference in the text is included in the alphabetical References (or Bibliography) at the end. Conversely, every reference in the References should have been referred to in the text. Some authorities would make a distinction between a List of References and a Bibliography (i.e. sources which you have read but to which there is no specific reference). However, this is potentially confusing so the following advice is given:

2. Aim for a style in which there is a 1:1 corresponding between the references in the text and the List of References at the end of the work. Every reference in the text can be found in the List of References and all entries in the List of References can be found at some point in the text. This follows the convention of the normal academic paper.

3. Page numbers are not necessary when you are quoting an article (as they always be included in the references).

4. Note that authors are referred to only by their last name in the text but by last name, Initials in the references.

5. Titles of books and articles are not normally given in the text (except that Government White Papers are generally quoted in the text e.g. The Citizen’s Charter).

6. You may have referred to material that has informed your general line of argument and be tempted to put these into the Bibliography. This is best avoided as it looks suspiciously like padding !

7. (You should be able to find some point in the text at which you can make an explicit reference to show that you have consulted the work in question).

8. Some examiners dislike too many long extracts in the text as they imply a lack of analysis and suggest a ‘magpie’ approach to a review chapter.

9. Examiners look for the use made of references to develop the major ideas of the dissertation. They indicate that you are engaging in a ‘dialogue’ with the literature in the field.

10. It is possible to over-reference! Sentences littered with references may trivialise the whole - avoid an approach which is in the form:

Jones(1996) said this whilst Smith(1995) said that.

11. Are the major references to the field included ? An examiner may look for what is not included as a guide to the quality of the whole.

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Appendices

· Appendices follow the bibliography.

· Typically, they include:

¨ Research instruments (such as copies of a blank questionnaire, a summary of the statistical data set, extracts from interviews, diaries)

¨ Longer statistical tables that would inhibit the ‘flow’ of the text. It is legitimate to include a condensed or edited version of a table in the text but to include the full version of the table in the appendix.

¨ Anything that usefully adds depth to the discussion

· Appendices need to be numbered (Appendix I, Appendix II) etc. and you may wish to name them as well e.g.
(Appendix I - Copy of Questionnaire)

· Do not let them dominate the presentation - remember that their function is to provide background, illustrative material.

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Timing

It is always evident whether a document has been carefully proof-read or has been ‘dashed off’ at the last moment.

You should be at the proof-reading stage at least a week before the final submission date - one day before is insufficient

Pressure on crucial resources (printing, binding) will only intensify in the few days before the submission date.

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Hand-in date

Generally, it is the Monday of Week 9 (or the day following it if it is a Bank Holiday). Keep in mind 1st May as the general date by which a project needs to be submitted but it may a day or so generally.

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Formalities

You are required to hand in two bound copies of the dissertation.

(Therefore you need to have three copies of the dissertation run off, i.e. 2 copies plus your own reference copy)

Binding does not need to be professional but spiral-binding is used by many students. Binding can be performed for you by Reprographic at a reasonable cost.

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Title Page

Conform to the specifications i.e. see sample Title Page

Take pains that you get all of these details correct - think of the

impression that it will make.

Choose a formal font e.g. Times New Roman (Font Size 14,18)

King Alfred’s College of Higher Education

School of Social Sciences

BA(Hons) Degree in Business Management with Business Communications

BA(Hons) Degree in Business Administration

BA(Combined Hons) Degree- Field of Business

Final Year Project

Dissertation title

Author

Date

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Cover

Choose the cover appropriate to your degree!

Ensure that the following details are entered:

Copy Number (1,2) in top Right Hand Corner

Title which should correspond exactly
with the title on the title page

Student’s name should be forename + last name
(e.g. John Smith)

Year Current Year

Supervisor get the details right !)

Number of words must be entered !

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Word Count

Normally 9,0000-11,000 words (excluding bibliography and appendices)

Use the word counter in your word-processor

(Otherwise, count a few typical pages and ‘multiply up’)

Over or under-length projects will be penalised!

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Abstract

You are not required to produce an abstract. If you do, it should be of the order of 200 words (maximum)

Acknowledgements / Dedication

This is conventional but…..

· Do not be tempted to make them too ornate or ‘flowery’

· It is conventional to acknowledge those who have been particularly supportive in terms of advice, access to source materials etc. but not persons who may have typed up the document ( if not yourself)

Order of contents

· Cover Sheet

· Title Page

· Acknowledgements / Dedication (own page)

· Abstract

· Table of Contents

· Body of Project

· Bibliography

· Appendices

Marking of Projects

1. There are 2 internal markers ( of whom one is your tutor)

2. The two markers will submit an agreed mark. In the event of disagreement, other markers may be deployed. If academic differences cannot be reconciled, then the project will be seen by the External Examiner whose decision may be regarded as final.

3. Write your project knowing that it will be read by at least two internal examiners and probably the External Examiner as well.

4. Traditionally, a good project can help to ‘nudge’ a candidate over the
II(i)/I(ii) boundary.

It is particularly important in the event of awarding a First Class Degree.

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Endnote !

· The submission date dead-line is not normally negotiable.

In the case of hospitalisation, death of a near relative or other good cause, then make application in advance to the Head of School supplying complete documentation (e.g. consultant’s letter, Police Crime Report Number, copies of death certificates etc.)

NB Only the Head of School may authorise a late submission. This is rarely granted!

· If there is a any doubt concerning the originality or authenticity of a Project, then the project will probably form the major part of any subsequent Viva Voce examination…

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Useful books......

Hussey,J. and Hussey, R. (1997), Business Research - a practical guide for undergraduate and postgraduate students, Basingstoke, Macmillan

Luck, M. (1999), Your Student Research Project, Aldershot, Gower Publishing

Sharp, J.A. and Howard, K. (1996), The management of a student research project (2nd edition), Aldershot, Gower Publishing

Bell, J. (1993), Doing your Research project (2nd edition), Buckingham, Open University Press

Edwards, A. and Talbot, R. (1994), The hard-pressed researcher,Harlow, Longman

Denscombe, M. (1998), The good research guide for small-scale research projects, Buckingham, Open University Press

Saunders, M., Lewis, P. and Thornhill, A. (2000), Reserach Methods for Business Students, Harlow, Pearson Education Ltd.

Hart, M.C. (1993), Survey Design and Analysis using TURBOSTATS, London, Chapman and Hall (out of print but see author!)

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Other useful documents...

1. Dissertation Handbook (Business Studies Department, Manchester Metropolitan University)

(available as: baba-mmu.doc either on desk or in the Public Folders)

2. “How to write a successful Final Year Project - a practical guide” (Mike Hart)

3. “How to write a bad assignment - a practical guide” (Mike Hart)

4. The Literature Review: a Few Tips on Conducting It (University of Toronto)

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Appendix 1 Final Year Project Supervision Meeting Record

Final Year Project Supervision Meeting Record

Name
Degree		AcademicYear
Working Title
Revised Title
Supervisor	Email:

Tutor copy and Student copy to be completed and initialled at each meeting...

Date of Meeting	Discussed	Action agreed for next meeting	Tutor Initials	Student Initials
..../..../....			............	............
..../..../....			............	............
..../..../....			............	............
..../..../....			............	............
..../..../....			............	............

fyp-form.doc Tutor copy: light blue Student Copy: yellow

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Appendix 2 Final Year Projects - Marking Guide

Final Year Projects - Marking Guide

	Inadequate (Fail)	Poor (3rd)	Satisfactory (2ii)	Good (2i)	Excellent (I)

Overall structure, flow and development of argument
Comment
Exposition of project topic
Comment
Exposition/understanding of underpinning theory
Comment
Depth and sophistication of analysis
Comment
Adequacy of literature review, location of problem to be addressed
Comment
Referencing and bibliography
Comment
Quality and fluency of expression
Comment
Quality of empirical work (if undertaken)
Comment
Methodology and planning
Comment
Overall
Comment

fyp_mc2.doc

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Appendix 3 How to write a successful Final Year project - a Practical Guide

How to write a successful Final Year project - a Practical Guide

Summary of points (to keep in front of you)

	Point	Elaboration

1.	Have a clear structure	5-6 chapters, not a series of sections
2.	Make good reference to the literature	Have a literature review chapter
3.	Make sure it is well-referenced	Harvard style, 1:1 correspondence
4.	Be intellectually engaged	Conduct a dialogue with the material
5.	Strive to be analytical	Minimise descriptive elements
6. *	Project manage your project	Utilise time-lines, deadlines
7.	Strive to write well	Spell-check, check grammar syntax
8.	Make any survey work connect	Empirical work should reflect themes
9.	Ensure survey work is methodologically sound	- Specify methodology - Give details of pilots, samples - good statistical analysis (e.g.hypothesis tests) - Interpret statistical tests
10. *	Examine other good examples	Imitate excellent features
11. *	Take advice from others	Find out what others consider good
12. *	Back up constantly	Write in chapters, back up constantly

* Points supplied by Alison McCrisken, BAMBA-PT (1998-2000), [First for project]

Mike Hart

Business and Informatics Group

School of Management and Social Sciences

King Alfred’s College

fyp_succ.doc/18.9.2000

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Appendix 4 Example of an article

1998 “The Quantification of Patient Satisfaction”

Paper presented to:

Third International Conference:

Strategic Issues in Health Care Management

University of St. Andrews, April 2-4 1998

Published in :

Davies, H.T.O., Malek, M., Neilson, A. and Tavakoli, M. (eds) (1999), Managing Quality and Controlling Costs:Strategic Issues in Health Care Management pp. 68-88, Ashgate Publishing

ISBN 0 7546 1004 7

The Quantification of Patient Satisfaction

Mike Hart

Professor of Business and Informatics

King Alfred’s University College, Winchester

SO22 4NR

Tel: +44 (0) 1962 827379

Fax: +44 (0) 1962 827506

email: basmhart@wkac.ac.uk

The Quantification of Patient Satisfaction

Abstract

It is increasingly recognised that patients and their carers should be given a voice in the assessment of the quality of the provision of services that are offered to them within the NHS. The most typical method of eliciting patient satisfaction is by a questionnaire, typically administered after in-patient treatment in a hospital (but not after other episodes of treatment).

However, there are severe doubts whether such traditional methods measure anything other than 'hotel services' and their construction reflects the interests of the producers rather than the consumers of healthcare. An alternative approach may be to utilise standard methodologies such as the well-known SERVQUAL methodology and this paper reports on a SERVQUAL analysis of samples of outpatients in Leicestershire,UK and a comparable sample in Finland.

The SERVQUAL mode of analysis still reflects concerns which are essentially producer-led. The quest is therefore to determine those issues of satisfaction which are patient-oriented and this points the researcher in the direction of qualitative research methods such as focus groups and unstructured interviewing/questionnaires. However, these themselves could benefit from levels of quantification such that they could be used as a managerial tool for the improvement of the quality of service. Suggestions are made for ways in which the quantification of patient satisfaction measures may be refined.

The Quantification of Patient Satisfaction

Introduction

Whilst the tradition of ‘listening to the patients’ is almost as long as the NHS itself, the prominence given to the patient satisfaction survey can be traced back to the Griffiths report [DHSS,1983] which encouraged the use of market research to obtain consumers’ views. Purchasing authorities have been urged to pay heed more heed to locally expressed views of the quality of the service since the early 1990’s [NHSME,1992]. It has also been recognised for about the same length of time that in judging the quality of hospital services, the judgements of patients alongside their clinicians is an intrinsic part of the quality measurement process [Batalden and Nelson, 1990].

Patient satisfaction surveys are often seen as the natural outcome of the increase in consumerism, particularly as stimulated by Griffiths. However several authors point out that patient satisfaction surveys are used to fulfil other multiple objectives including Quality Audit (QA) of the quality of medical and nursing care on the one hand and the derivation of an outcome measure for the evaluation of care and the organisation of services on the other [Scott and Smith, 1994; Avis, Bond and Arthur, 1995].

Dissatisfaction with the conduct of the patient satisfaction survey

There is some concern, expressed cogently by Carr-Hill [1992] after his review of some 300 patient satisfaction surveys that the majority of them are producer-led

Once the fieldwork is over, there is considerable temptation to forget that what are confidently described as respondents' views are only their replies to questions devised by the researcher and not necessarily the patients' own views and priorities. Thus it is commonplace to observe that health service policy has been steered by providers' perceptions and definitions of good practice.

[Carr-Hill, 1992, p. 245]

Carr-Hill is also concerned with the many methodological inadequacies which he details as a result of his survey. These range from problems with the framing of the questions, the avoidance of evaluation of clinical practice, the inadequate ways in which samples relate to the populations from which they are drawn and the cavalier treatment of non-response rates. To this, we may add the fact that many patient surveys appear to be exhibit a halo effect in which satisfaction rates seem to be uniformly high at over 80%, perhaps reflecting a reluctance to criticise nurses [Carr-Hill, 1992; Fitzpatrick, 1991a, 1991b; Evason and Whittington, 1991; Ellis and Whittington, 1994; College of Health, 1994]. There are indications, however, that much more attention is now being paid to questionnaires in terms of both their construct validity [Baker and Whitfield, 1992] and their reliability/validity [Bamford and Jacoby, 1992; Eccles, Jaccoby and Bamford, 1992]. The timing and location of the survey may itself be a critical factor. In a study of particular relevance to a concern with outpatients [Carr-Hill, Humphreys and McIver, 1987], it is shown that there is a clear decay in satisfaction levels when patients are interviewed at home rather than in the outpatient clinic. But probably the greatest single source of dissatisfaction with the traditional survey is its superficiality. The most common method of data collection involves the use of pre-coded self-completion questionnaires [Batchelor, Owens, Read and Bloor, 1994; Scott and Smith, 1994]. But as Rigge has pointed out [Rigge, 1995]:

Handing out tick-in-the-box patient satisfaction questionnaires and then sitting smugly back if the results indicate that most patients are satisfied with the service they have received (as many such quantitative methods do) is no substitute for genuine consultation

[Rigge, 1995 p.26-27]

Measurement of Service Quality - the SERVQUAL methodology

Unlike the quality of goods, which can be measured objectively by such indicators as durability and number of defects, service quality is an abstract and elusive construct because of three features unique to services: intangibility, heterogeneity and inseparability of production and consumption.

The SERVQUAL methodology is primarily developed to measure satisfaction with service industries. The method is well-known in Total Quality Management circles. The approach starts with the hypothesis that service quality is critically determined by the difference between consumers’ expectations and perceptions of services. The method is predicated upon the gap to be discerned between clients’ expectations of a service and their perceptions of a service as actually experienced.

Research by Parasuraman, Zeithaml and Berry (1988) has shown that regardless of the type of service, consumers use basically similar criteria in evaluating service quality. The criteria fall into ten key categories which are labelled ‘service quality determinants’ as follows:

1. reliability, which involves consistency of performance and dependability.

2. responsiveness concerns the willingness or readiness of employees to provide service. It involves timeliness of service.

3. competence means possession of the required skills and knowledge to perform the service.

4. access involves approachability and ease of contact.

5. courtesy involves politeness, respect, consideration and friendliness of contact personnel.

6. communication means keeping customers informed in language they can understand and listening to them.

7. credibility involves trustworthiness, believability and honesty. It involves having the customer’s best interests at heart.

8. security is the freedom from danger, risk or doubt.

9. understanding/knowing the customer involves making the effort to understand the customer’s needs.

10. tangibles include the physical evidence of the service like physical facilities and appearance of personnel.

Only two of the ten determinants, tangibles and credibility, can be known in advance of delivery, the other determinants often only being evidenced once a service transaction has taken place. While customers may possess some information based on their experience or on other customers’ evaluations, they are likely to re-evaluate these determinants each time a service is given because of the heterogeneity of services. Two of the determinants, competence and security, consumers cannot evaluate even after service delivery and consumption.

The gap between expectations and perceptions may be analysed with respect to five dimensions. An examination of the content of the ten service quality items allows a construction of five dimensions in SERVQUAL, of which three are original list items (tangibles, reliability, responsiveness) and two are combined dimensions: (assurance including communication, credibility, security, competence and courtesy; empathy including understanding/ knowing customers and access). The final list of five dimensions and their concise definitions are as follows:

1) Tangibles: physical facilities, equipment and appearance of personnel

2) Reliability: ability to perform the promised service dependably and accurately

3) Responsiveness: willingness to help customers and provide prompt service

4) Assurance: knowledge and courtesy of employees and their ability to inspire trust and confidence

5 Empathy: caring, individualised attention the firm provides its customers

The last two dimensions contain items representing seven original dimensions (communication, credibility, security, competence, courtesy, understanding/knowing customers, and access) that did not remain distinct after the two stages of scale purification. Therefore, while SERVQUAL has only five distinct dimensions, they capture facets of all ten originally conceptualised dimensions.

In the questionnaires the dimensions are divided into a 22-item, 7-point scale. Dimensions may not be regarded as equally important. Each client may allocate points out of 100 to each of the five dimensions so that the instrument is sensitive to an individual’s perceptions of the relative importance of each dimension.

SERVQUAL has a variety of potential applications. It can help a wide range of service and retailing organisations in assessing consumer expectations about and perceptions of service quality. It can also help in pinpointing areas requiring managerial attention and action to improve service quality.

Application of SERVQUAL can be used to make comparisons globally over time. Moreover, it is possible to ascertain those elements of services in which the gap between expectations and perceptions is widest. The application of this instrument and the results of measurement allows possibilities of more specific management action to redress perceived shortcomings. Although well-developed and extensively used in USA, studies are only just commencing utilising the methodology within the UK and Finland.

Table 1

SERVQUAL RESULTS - Previous Studies

USA General Sample [1990]

Dimension Weight Perceptions Expectations Gap

──────────────────────────────────────────────────────────────────────

Tangibles 0.11 5.54 5.16 +0.38

Reliability 0.32 5.16 6.44 -1.28

Responsiveness 0.22 5.20 6.36 -1.16

Assurance 0.19 5.50 6.50 -1.00

Empathy 0.16 5.16 6.28 -1.12

Weighted averages [n=1936] 5.28 6.27 -0.99

Table 2

Scottish -Public Library Service [1995]

Dimension Weight Perceptions Expectations Gap

Tangibles 0.18 5.68 5.93 -0.25

Reliability 0.23 6.10 6.30 -0.20

Responsiveness 0.22 6.62 6.51 +0.11

Assurance 0.21 6.58 6.29 +0.29

Empathy 0.17 6.28 6.27 +0.01

Weighted averages [n= 368] 6.33 6.33 -0.00

(Source: Dalrymple, Donnelly, Wisniewski and Curry [1995] )

Table 3

Scottish -Home Help Service [1995]

Dimension Weight Perceptions Expectations Gap

Tangibles 0.17 5.28 4.72 +0.56

Reliability 0.20 5.91 5.47 +0.44

Responsiveness 0.21 6.33 5.74 +0.59

Assurance 0.21 6.40 5.93 +0.47

Empathy 0.21 6.06 5.62 +0.44

Weighted averages [n= 124] 6.03 5.33 +0.50

(Source: Dalrymple, Donnelly, Wisniewski and Curry [1995] )

SERVQUAL RESULTS - UK and Finnish Studies

Sampling Details

UK 72 completed questionnaires from four outpatient clinics in Leicestershire

(diabetes, paediatrics, general medical, enuresis)

Data collected: July, 1995

Finland 135 completed questionnaires from three clinics in Vaasa, Finland

(diabetes, paediatrics, general surgical)

Data collected: Jan-Feb 1996

Table 4

East Midlands, UK Outpatients [July 1995]

Dimension Weight Perceptions Expectations Gap

Tangibles 0.13 5.21 5.24 -0.03

Reliability 0.26 5.52 6.31 -0.79

Responsiveness 0.21 5.88 6.17 -0.29

Assurance 0.20 5.98 6.39 -0.41

Empathy 0.20 5.66 6.16 -0.50

Weighted averages [n= 72] 5.67 6.15 -0.48

Table 5

Vaasa,Finland Outpatients [Jan-Feb 1996]

Dimension Weight Perceptions Expectations Gap

Tangibles 0.18 5.64 6.03 -0.38

Reliability 0.21 5.51 6.04 -0.54

Responsiveness 0.20 5.73 6.12 -0.39

Assurance 0.22 5.83 6.23 -0.40

Empathy 0.19 5.74 6.08 -0.35

Weighted averages [n= 135] 5.72 6.14 -0.41

Table 6

Table of Significant Differences - UK and Finland

Dimension Weight Perceptions Expectations Gap

Tangibles p<0.0001 p=0.0080 p<0.0001 p=0.0228

Reliability p=0.0007 - p=0.0257 -

Responsiveness - - - -

Assurance - - - -

Empathy - - - -

Commentary

1. Note the similarity of the European data when compared with the American data.

2. Note also the overall similarity of the UK and the Finnish data

3. However, there are differences which are disguised within the data:

· Finnish patients place greater weight on Tangibles
(0.18 v. 0.14, p<0.0001)

· But British patients place greater weight on Reliability
(0.26 v. 0.21, p=0.0007)

· Finnish patients have a greater Perceptions of Tangibles
(5.64 v. 5.21, p=0.0080)

· Finnish patients have greater Expectations of Tangibles
(6.02 v. 5.24, p<0.0001)

· Finnish patients experience a greater gap (Perceptions-Expectations) for Tangibles

(-0.38 v.-0.03, p=0.0228)

· UK patients have greater Expectations of Reliability
(6.31 v, 6.04, p=0.0257)

The utility of the SERVQUAL model

The SERVQUAL methodology goes some way towards meeting the objection, noted before, that the issues raised in any instrument inevitably reflect the interests of the producers rather than the ultimate consumers of services, including health. The framers of the SERVQUAL methodology [Parasuraman, Zeithaml and Berry, 1985;1988; Zeithaml, Parasuraman and Berry, 1990] took pains to ensure that the elements of the instrument they devised were derived from a series of focused interviews and were then subjected to detailed factor analysis to discern the elements of the SERVQUAL scale. The standardised nature of the questions means that the instrument is particularly useful in comparative studies, such as a comparisons between different industries, societies or time periods. The essential simplicity of the approach, combined with the fact that it specifically relativises the context of satisfaction by addressing the issue of prior expectations, may be an explanation for its extensive use as a quality metric for service type industries. However, two fundamental objections can be made which may severely limit the potential of this type of approach - one on the conceptual level and the other on the methodology actually deployed.

The first of these objections relates to the ‘split’ which is discerned between expectations on the one hand and service delivery on the other. The weight given to the measurement of expectations implies that consumers (or patients in this instance) approach their encounters with medical professionals with a set of clearly articulated expectations. However, it is useful to see patient interactions with clinicians not as a series of one-off transactions but as a series of episodes linked together into a trajectory. The concept of a disease trajectory is evident in standard medical practice but in social scientific terms the notion of trajectory approaches the transactions in a more dynamic way, such that expectations of the next encounter are likely to be a function of previous encounters. Typically, when patients present themselves to clinical staff with a problem that requires resolution, then they are entering into a series of transactions which may involve dozens of different professionals extending over several years or, indeed, a life-time. One of the most typical trajectories might be as follows:

initial consultation - diagnostic tests - in-patient treatment - outpatient follow-up

and in such a trajectory (particularly in the case of in-patient treatment within hospitals) an individual, and the data relating to the individual, is processed by many personnel working in diverse occupational domains (manual occupations such as portering, clerical and administrative staff, medical, nursing and paramedical staff and so on). To attempt to capture the intricacies of such dynamics by the use of a single snapshot type instrument would appear to be over-ambitious. It has observed several times before that expectations might not be fully formed at the point of first contact with clinical staff and may be free-floating or even epi-phenomenal in that expectations start to arise out of the dynamics of the interactions with clinical staff [Locker and Dunt, 1978; Avis, Bond and Arthur, 1995; Linder-Pelz, 1982]. Measures of patient satisfaction are typically frozen in one point of time and do not (perhaps cannot) acknowledge the important of trajectories in the measurement of satisfaction.

The use and abuse of rating scales

A conventional 'orthodoxy' follows Stevens [1946] categorisation of scales into nominal,ordinal, interval and ratio. As Blalock [1979] explains:

"It is important to recognise that an ordinal level of measurement does not supply any information about the MAGNITUDE of the differences between elements. We know only that A is greater than B but cannot say how much greater. Nor can we say that the difference between A and B is less than that between C and D. We therefore cannot add or subtract differences except in a very restricted sense. For example if we had the following relationships:

───────┼───────────────┼─────────────────────┼──────┼─────

D C B A

we can say that the distance

__ __ __ __

AD = AB + BC + CD

__ __

but we cannot attempt to compare the distances AB and CD. In other words, when we translate order relations into mathematical operations, we cannot, in general, use the usual operations of addition, subtraction, multiplication and division. We can, however, use the operations 'greater than' and 'less than' if these prove useful.... (p.17).

One of the dangers of 'cookbook statistics' is the tendency to oversimplify the criteria and problems involved in making basic decisions in data analysis. It is impossible to over-emphasise the important point that, in any using any statistical technique, one must be aware of the underlying assumptions that the procedure requires. In the context of the present discussion, one of the first questions that must always be asked concerns the level of measurement that can legitimately be assumed" (p.24)

An alternative view is held by many behavioural scientists and by some statisticians [e.g Anderson,1972]. As Lord [1953], in an entertaining article observes, the statistical test can hardly be cognizant of the empirical meaning of the numbers with which it deals..

"Since the numbers don't remember where they came from, they always behave the same way, regardless"

On a more pragmatic level, Anderson argues, if the difference between parametric and ran-order tests was not great insofar as significance level and power are concerned, then only the versatility of parametric statistics meets the needs of everyday (psychological) research.

The argument, then, is often conducted between those who follow the 'conventionalist' position of Stevens [1946], Blalock [1979], Siegel and Castellan [1988] and the majority of textbook writers on the one hand and a more 'pragmatic' school on the other, who would maintain that the assumptions about scale type can probably be relaxed quite greatly without too much violence being done to the integrity of the data. In the case of psychological research, it could be that other sources of error (e.g. slightly different phrasing of questions) assumes much more significance as sources of error than arguments over scale type.

One of the most recent and informed papers in this debate is by Hand[1996] who draws distinctions between the representational, operational and classical measurement paradigms. Representational theory assigns numbers to objects to model their relationships. Operational theory, on the other hand, assigns numbers according to some consistent measurement systems and represents objects as congruent with the measurement system. Finally, classical theory involves the discovery of relationships between different quantities of a given attribute. There is, therefore, an assumption that there is a deeper reality which it is the aim of the analyst to discover - classical because traces of this approach can be found in the writings of Aristotle and of Euclid. The choice of test, therefore, is not so much a technical matter as a philosophical one - it depends on the nature of the model and the philosophy of science held by the investigator.

In the case of a rating scale attempting to measure satisfaction (pace SERVQUAL) then

it is possible that we could adopt one of the following positions:

(a) the measures are essentially ordinal. Whatever point on the scale is adopted, then we can assume that we can make statements which assign a degree of ordering but we cannot get involved in the mathematical operations of subtraction of one measure from another. So statements such as Satisfaction=Perceptions-Expectations ( the core of SERVQUAL)

are illegitimate.

(b) already not strictly forming a series of continuous data, a scale such as 7-point SERVQUAL scale inviting agreement/disagreement with a series of propositions can, for practical purposes, be assumed to be relatively monotonic. In the absence of evidence to indicate a large degree of skewness in the data, then the conventional parametric tests can be deployed as it has been shown that such tests can actually tolerate fairly large violations of the assumptions of normality of underlying distributions before they lose validity.

What kind of rating scales do individuals carry around in their heads ?

This critical area is under-researched, given the prevalence of rating scales in many different fields of social enquiry. In an attempt to throw some empirical light upon the question, the author gathered the following data from opportunistic samples of undergraduates:

Table 7

┌─────────────────────────────────────────────────────────────────────────┐

│ "How difficult would it be to receive elements of service that would │

│ move you : │

│ [1] From point 4 to point 5 ( or point 4 to point 3) on the scale ? │

│ [2] From point 3 to point 3 ( or point 5 to point 6) on the scale ? │

│ [1] From point 6 to point 7 ( or point 2 to point 1) on the scale ? │

├─────────────────────────────────────────────────────────────────────────┤

│ Completely Completely │

│ Satisfied Dissatisfied │

│ 1 2 3 4 5 6 7 │

└─────────────────────────────────────────────────────────────────────────┘

Table 8

┌──────────────────────────┬─────────────┬─────────────┬─────────────┐

│ N=76 │ Q1 │ Q2 │ Q3 │

│ (Opportunistic sample) │ N % │ N % │ N % │

├──────────────────────────┼─────────────┼─────────────┼─────────────┤

│ Very easy │ 46 61 │ 16 21 │ 18 24 │

│ Not particularly easy │ 22 29 │ 37 49 │ 17 22 │

│ Rather difficult │ 6 8 │ 20 26 │ 26 34 │

│ Very difficult │ 2 3 │ 3 4 │ 15 20 │

└──────────────────────────┴─────────────┴─────────────┴─────────────┘

A significance test was chosen to reflect the design that each respondent acted as his/her own control:

Table 9

┌────────────────────────────────────────────────────────────────────┐

│ Wilcoxon Signed Rank Test (measures the significance and the │

│ magnitude of change) │

├──────────────────────────┬────┬────────┬─────────────┬─────────────┤

│ │ N │ N for │ Wilcoxon │ P-Value │

│ │ │ test │ statistic │ │

├──────────────────────────┼────┼────────┼─────────────┼─────────────┤

│ Q1 v Q2 │ 76 │ 51 │ 1148.5 │ 0.000 │

│ Q1 v Q3 │ 76 │ 60 │ 1585.5 │ 0.000 │

│ Q2 v Q3 │ 76 │ 46 │ 791.0 │ 0.000 │

└──────────────────────────┴────┴────────┴─────────────┴─────────────┘

These data tend to suggest that the students in this sample appeared to find it more and more difficult to move from the central to the more extreme points of the scale, thus lending support to an 'increasing resistance' model of rating behaviour. From this we might infer that the 'psychological distance' differs when moving in the right hand portions of the scale rather than the left-hand portions of the scale. This also lends support to the observations that rating scales such as SERVQUAL may be fatally flawed. An alternative approach might be to follow that offered by Kind et. al. [1993] in which probabilities in a questionnaire are derived from cumulative frequency distributions and then converted into the corresponding z-scores based on a normal distribution.

The use of magnitude scaling

One possible solution to the philosophical and technical problems encountered above is to deploy the concept of magnitude scaling. In such an approach, drawn from classical psychophysics [Lodge, 1981], it is possible to:

· expose individuals to a stimulus (noise, light, drawing lines on a sheet of paper)

· then measure the responses (with appropriate instrumentation, or a ruler in the acse of straight lines)

· establish the cross-modalities by asking subjects to assign a magnitude to a series of (verbal) cues such as Neutral - Good -Very Good -Excellent

· take the geometric mean of the sample

· and thus establish a scale

The advantages of magnitude scaling lie in the fact that the scales are subject rather than analyst inferred. Nonetheless, their use is fraught with many practical difficulties. One of these is the fact that the scale is standardised on a population which may not reflect the actual sample or target population of the survey. The alternative is allow the sample enough time and/or resources to construct their own magnitude scale - this is often impracticable, however, when the target population might be patients who tend to be elderly and are only willing to be surveyed in the context of a hospital word or an outpatient department.

The quantitative analysis of open-ended responses

A more obvious way to measure the distribution of patient responses is to capture responses by the use of the most open-ended questions possible and then chart the distribution of the responses. The following example is drawn from a qualitative investigation of paediatric out-reach clinics, conducted by the author (n=64). The overall sample statistics are shown below.

Table 10

"What would you say was a good clinic ? "

VALUE N CUM_N PERCENT CUMPCT Barchart

Friendly staff 1 22 22 27.16 27.16 │▄▄▄▄▄▄▄▄ 22

Good consultation 2 21 43 25.93 53.09 │▄▄▄▄▄▄▄ 21

No long waiting time 3 17 60 20.99 74.07 │▄▄▄▄▄▄ 17

Nothing in particular 4 11 71 13.58 87.65 │▄▄▄▄ 11

Facilities for children 5 5 76 6.17 93.83 │▄ 5

Access, Convenience 6 3 79 3.70 97.53 │▄ 3

Better than ??? hospital 7 2 81 2.47 100.00 │ 2

What makes for a ‘good’ clinic session ?

The two factors mentioned that accounted for more than all other factors combined were the overall friendliness of the staff and the quality of the communication with the consultant. Parents were evidently anxious to get a diagnosis of the symptoms which had led them to the clinic in the first place. Representative comments are:

Dr. ___ makes the child feel relaxed and not agitated. The Dr. is always very friendly.

A ‘good’ clinic is when you are listened to and the doctor is interested in you. Then, you do not feel the clinic is a waste of time.

When the doctor tries to explain things to you and talks things through. This can help to alleviate my worries...

Some patients referred to the totality of the transactions that they held with clinic staff:

[A good clinic is.. ] the helpfulness of the staff. Nothing is too much trouble for them. You cannot really fault them at all..

After the friendliness of the staff and the communication with the consultant, the absence of a long waiting time was the third most mentioned factor:

[A good clinic is ] one that is easier for the children in the area.. it’s easier than [central hospital] where you usually have to wait a long time

NB 64 respondents mentioned 81 factors as some respondents mentioned more than one factor.

Here, standard content analysis is used to measure the different types of responses. These are then diagrammed using any statistical software package (in this case. MICROSTATS). The virtue of this approach is that patients are allowed to ‘speak for themselves’. The analyst can show the typicality of responses by using conventional statistical graphing measures whilst the choice of quotations can help to ‘bring alive’ the nature of the data collected.

Conclusions

The traditional instruments for the analysis of patient satisfaction are still being deployed, despite the many criticisms that have been made of them. This paper indicates the possibilities and the problems associated with deploying a conventional and widely known method of gap analysis such as SERVQUAL. The paper concludes by indicating that it is quite possible to collect and to analyse data which is consumer rather than producer-led and to deploy some of the tools of quantitative analysis associated with more conventional approaches in this area. It is possible that more work needs to be undertaken which marries together a more ethnographic or patient-centred approaches in which patients ‘speak for themselves’ with a degree of quantitative analysis which indicates the typicality of the responses.

Anderson. N.H. (1972) ‘Scales and Statistics: Parametric and non-parametric’ in Statistical Issues: A Reader for the Behavioural Sciences, Kirk, R.E. (ed)., Brooks/Cole, Monterrey.

Avis,M., Bond,M. and Arthur,A. (1995), ‘Satisfying solution? A review of some unresolved issues in the measurement of patient satisfaction’, Journal of Advanced Nursing,22: 316-322.

Baker,R. and Whitfield,M. (1992) 'Measuring patient satisfaction: a test of construct validity', Quality in Health Care, 1(2):104-109.

Bamford,C. and Jacoby,A. (1992) 'Development of patient satisfaction questionnaires: I. Methodological issues', Quality in Health Care, 1(3): 153-157.

Batalden,P. and Nelson,E. (1990) ‘Hospital Quality: Patient, Physician and Employee Judgements’, International Journal of Health Care Quality Assurance, 3(4): 7-17.

Batchelor,C., Owens,D.J., Read,M. and Bloor,M. (1994) 'Patient Satisfaction Studies: Methodology,Management and Consumer Evaluation', International Journal of Health Care Quality Assurance, 7(7): 22-30.

Blalock, H. M. (1979) Social Statistics [Revised 2nd edition],McGraw-Hill Kogakusha, London.

Carr-Hill, R. (1992), ‘The measurement of patient satisfaction’, Journal of Public Health Medicine, 14(3): 236-249.

Carr-Hill,R., Humphries,K. and McIver,S (1987) Wolverhampton: a picture of health, York, Centre for Health Economics.(mimeograph)

College of Health (1994) Consumer Audit Guidelines, College of Health.,London

Dalrymple,J.F., M. Donnelly, M. Wisniewski and A.C. Curry (1995), ‘Measuring service quality in local government’ in Total Quality Management, G.K. Kanji, Ed.,Chapman and Hall, London.

DHSS(1983), Enquiry into NHS Management, (The Griffiths Report), HMSO, London.

Eccles,M., Jacoby,A. and Bamford,C. (1992) 'Development of patient satisfaction questionnaires: II. Collaboration in practice', Quality in Health Care, 1(3): 158-160.

Ellis,R. and Whittington,D. (1994), 'Health Care Quality Assurance: Techniques and Approaches', Public Money and Management, 14(2):23-29.

Evason,E. and Whittington,D. (1991) 'Patient Satisfaction Studies:Problems and Implications Explored in a Pilot Study in Northern Ireland', Health Education Journal, 50(2): 73-77.

Fitzpatrick,R. (1991a) 'Surveys of Patient satisfaction:I-Important general considerations', British Medical Journal, 302: 887-889.

Fitzpatrick,R. (1991b) 'Surveys of Patient satisfaction:II-Designing a Questionnaire and Conducting a Survey', British Medical Journal, 302: 1129-1132.

Hand, D.J. (1996) ‘Statistics and the theory of measurement’, Journal of the Royal Statistical Society, Series A, 159(3), pp. 445-492.

Kind,P., Leese,B., Cameron, I. and Carpenter,J. (1993),’Quantifying Quality - Measuring Quality in the Provision of Health Care’ in Managerial Issues in the Reformed NHS, Malek,M., Vacani,P., Rasquinha,J. and Davey, P. (Eds)., John Wiley & Sons, Chichester.

Linder-Pelz,S. (1982) 'Toward a theory of patient satisfaction', Social Science and Medicine, 16: 577.

Locker,D. and Dunt,D. (1978) 'Theoretical and methodological issues in sociological studies of consumer satisfaction with medical care', Social Science and Medicine, 12: 283-292.

Lodge,M. (1981) Magnitute Scaling [Sage University Paper Series on Quantitative Applications in the Social Sciences No. 25], Beverly Hills, Sage

Lord, F,M. (1972) ‘On the statistical treatment of football numbers’ in Statistical Issues: A Reader for the Behavioural Sciences, Kirk, R.E. (ed)., Brooks/Cole, Monterrey.

NHS Management Exec.utive (1992), Local Voices - The Views of Local People in Purchasing for Health, EL(92)1, January

Parasuraman,A., Zeithaml,V. and Berry,L. (1985) 'A Conceptual Model of Service Quality and its implications for Future Research', Journal of Marketing, 49 (Fall): 41-50.

Parasuraman,A., Zeithaml,V. and Berry,L. (1988) 'SERVQUAL: A Multiple-Item Scale for Measuring Perceptions of Service Quality', Journal of Retailing, 64: 12-40.

Rigge,M. (1995) 'Does public opinion matter ? (Yes/No/Don't know'), Health Service Journal, 7 September: 26-27.

Scott,A. and Smith,R. (1994), ‘Keeping the Customer Satisfied: Issues in the Interpretation and Use of Patient Satisfaction Surveys’, International Journal for Quality in Health Care, 6(4),: 353-359.

Siegel, S. and Castellan.N.J. (1988) Nonparametric Statistics [2nd edition], McGraw-Hill, New York.

Stevens,S.S. ‘On the theory of scales of measurement’, Science, 103, 677-680.

Zeithaml,V., Parasuraman,A. and Berry,L. (1990) Delivering Service Quality, Free Press, New York.

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Appendix 5 Final Year Projects - Initial Planning document

Attached are three documents which you might like to consider when planning your own Final Year Project (FYP). The first two have been 'rescued' from Mike Hart's files and are provided by way of illustration.

1. Initial doodlings...

This document was actually written in the middle of the night when I had a quick brain-storm thinking about the major elements of a Ph.D

2. Plan of chapters with key bullet points

Within a day or so, the initial doodlings were tidied up into a series of chapter headings, with a few bullet points under each to indicate the major divisions of each chapter.

You should work on your own FYP plan as soon as you have undertaken the preliminary reading and present it a copy of it to your tutor at the start of your supervision.

This plan does not commit you in any way but it does provide both you and your tutor with a 'road map' indicating how you intend, at that stage, to go about your project. In practice, such plans are often revised as you make progress through the FYP.. Some chapters might get too large and have to be split into two whilst others, on reflection, can sensibly be combined into one.

3. Title page of completed dissertation

This is what the title page of the first draft of the dissertation looked like.

The lessons to be learnt from this are:

1. 'Large oaks from little acorns grow' i.e. very large project starts off with your thoughts on one sheet of paper (which you may subsequently revise) '

A fairly snappy title helps to concentrate your thought processes - can you describe the whole in one sentence ? For example, a friend or fellow course member asks '"What is your project about" and in one sentence you reply—Have a working title in mind and the final title can be applied at the completed draft stage.
Having a plan is psychologically reassuring because you can 'project manage' the whole by deciding to do one chapter a fortnight (or other timescale).
After your preliminary reading, it is better to get writing rather than wait until you have researched the whole...

initial.doc/27.11.2000

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Evolution of a project – initial doodlings

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Click here to download the .jpg file (and press Back in the browser window afterwards!)

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Evolution of a Project – initial plan of chapters

QUALITY IMPROVEMENT IN NHS OUTPATIENT CLINICS

CHAPTER 1 Quality in Healthcare

• General models of quality in healthcare

(Ranade,Ovretheit,Pollitt)

• Critique of the same (externalist, non-experiential)

• Government initiatives ('Working for Patients','Patients Charter',’League Tables’)

CHAPTER 2 Outpatient clinics - measuring the quality

• The MOPAL program

• Measurement problems

• implementation of IT solutions

CHAPTER 3 Outpatient clinics - implementing improvements

• Substantive improvements in clinics

• Policies to improve clinics

• Importance of culture change

CHAPTER 4 Policy Implications of measuring quality improvements

• Measuring the measurable

• Goal displacement

• Determination of quality

CHAPTER 5 TQM Models in Healthcare

• Viability of directly importing TQM models

• The 'ecological critique'

• Is it possible to reconcile the two ?

• Evaluation of applicability of TQM models in healthcare

CHAPTER 6 New directions in the measurement of quality in healthcare

• Role of the 'consumer'

• servqual and its results

• Application of servqual to Outpatients

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Evolution of a project - Contents page of completed project

TABLE OF CONTENTS

INTRODUCTION 1

CHAPTER 1 : Quality in Healthcare

Introduction 4

The Prevalence of the Quality Concept 4

Approaches to Quality 9

Quality in Healthcare 17

A survey of hospital discharge arrangements 25

(Paper 1) 26

CHAPTER 2 : Outpatient Clinics - measuring the quality

Background to the study 29

What was to be measured - and how ? 30

Some measurement and computational issues 32

The MOPAL system 33

Lessons learned from the monitoring exercise 34

The social context of data collection 34

The relevant variables ? 36

Data collected with a high degree of integrity ? 38

Data collected in a spirit of scientific disinterestedness ? 39

(Paper 2) 42

(Paper 3) 42

CHAPTER 3 : Outpatient clinics- implementing improvements

The outpatient clinic as an organisational arena 44

Improvements in Leicester General Hospital :

January 1992-March 1993 47

Comparison with other hospitals 50

Other substantive issues arising from the case study 52

Critical Incident analyses 53

(Paper 4) 57

CHAPTER 4 : Policy implications of measuring quality improvements

Measuring the measurable 59

Goal displacement 60

Waiting Times and the League Tables 61

League tables as a diversion 64

Performance Assessment and Performance Measurement 67

Producer and Consumer defined measures of performance 71

(Papers 5,6) 75

CHAPTER 5 : TQM Models in Healthcare

TQM in the public sector 78

TQM in Healthcare 80

Evaluation of TQM in the NHS 82

The decline and fall of TQM in the NHS ? 84

An 'ecological' approach to quality 86

(Papers 7-9) 90

CHAPTER 6 : New directions in the measurement of quality in

healthcare

The role of the consumer 92

Patient satisfaction surveys 93

Perceptions, Expectations and Patient Satisfaction 95

Interpretive approaches to satisfaction 98

The role of consumer audit 100

(Papers 10-12) 104

CHAPTER 7 : A qualitative investigation into outpatient clinic quality

The need for qualitative approaches to quality 107

Models of quality - are most measures of quality static ? 107

Fourth Generation evaluative methodologies 109

Qualitative study of Paediatric outreach clinics in Leicestershire 111

Sample Design and sampling details 111

Clinic Sampling Frame 112

Clinics selected for the Investigation 113

Data collection 113

Results 114

‘Time’ and ‘Trajectory’ in the organisation of a clinic 122

Episode distillation in Clinic Life 130

Elements of a qualitative model of outpatient experiences 132

Operationalisation of the qualitative model 137

CHAPTER 8 : Concluding observations

Quality Assurance or Monitoring a Quality Standard 139

An ecological approach to quality management 140

Further avenues for research 142

REFERENCES 145

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Appendix 6 The Literature Review: A few tips on conducting it

The Literature Review: A Few Tips On Conducting It

What is a review of the literature?

A literature review is an account of what has been published on a topic by accredited scholars and researchers. Occasionally you will be asked to write one as a separate assignment (sometimes in the form of an annotated bibliography--see the bottom of the next page), but more often it is part of the introduction to an essay, research report, or thesis. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available, or a set of summaries.

Besides enlarging your knowledge about the topic, writing a literature review lets you gain and demonstrate skills in two areas:

1. information seeking: the ability to scan the literature efficiently, using manual or computerized methods, to identify a set of useful articles and books

2. critical appraisal: the ability to apply principles of analysis to identify unbiased and valid studies.

A literature review must do these things:

1. be organized around and related directly to the thesis or research question you are developing

2. synthesize results into a summary of what is and is not known

3. identify areas of controversy in the literature

4. formulate questions that need further research

Ask yourself questions like these:

1. What is the specific thesis, problem, or research question that my literature review helps to define?

2. What type of literature review am I conducting? Am I looking at issues of theory? methodology? policy? quantitative research (e.g. on the effectiveness of a new procedure)? qualitative research (e.g., studies )?

3. What is the scope of my literature review? What types of publications am I using (e.g., journals, books, government documents, popular media)? What discipline am I working in (e.g., nursing psychology, sociology, medicine)?

4. How good was my information seeking? Has my search been wide enough to ensure I've found all the relevant material? Has it been narrow enough to exclude irrelevant material? Is the number of sources I've used appropriate for the length of my paper?

5. Have I critically analysed the literature I use? Do I follow through a set of concepts and questions, comparing items to each other in the ways they deal with them? Instead of just listing and summarizing items, do I assess them, discussing strengths and weaknesses?

6. Have I cited and discussed studies contrary to my perspective?

7. Will the reader find my literature review relevant, appropriate, and useful?

Ask yourself questions like these about each book or article you include:

1. Has the author formulated a problem/issue?

2. Is it clearly defined? Is its significance (scope, severity, relevance) clearly established?

3. Could the problem have been approached more effectively from another perspective?

4. What is the author's research orientation (e.g., interpretive, critical science, combination)?

5. What is the author's theoretical framework (e.g., psychological, developmental, feminist)?

6. What is the relationship between the theoretical and research perspectives?

7. Has the author evaluated the literature relevant to the problem/issue? Does the author include literature taking positions she or he does not agree with?

8. In a research study, how good are the basic components of the study design (e.g., population, intervention, outcome)? How accurate and valid are the measurements? Is the analysis of the data accurate and relevant to the research question? Are the conclusions validly based upon the data and analysis?

9. In material written for a popular readership, does the author use appeals to emotion, one-sided examples, or rhetorically-charged language and tone? Is there an objective basis to the reasoning, or it the author merely "proving" what he or she already believes?

10. How does the author structure the argument? Can you "deconstruct" the flow of the argument to see whether or where it breaks down logically (e.g., in establishing cause-effect relationships)?

11. In what ways does this book or article contribute to our understanding of the problem under study, and in what ways is it useful for practice? What are the strengths and limitations?

12. How does this book or article relate to the specific thesis or question I am developing?

Final Notes:

A literature review is a piece of discursive prose, not a list describing or summarizing one piece of literature after another. It's usually a bad sign to see every paragraph beginning with the name of a researcher. Instead, organize the literature review into sections that present themes or identify trends, including relevant theory. You are not trying to list all the material published, but to synthesize and evaluate it according to the guiding concept of your thesis or research question.

If you are writing an annotated bibliography, you may need to summarize each item briefly, but should still follow through themes and concepts and do some critical assessment of material. Use an overall introduction and conclusion to state the scope of your coverage and to formulate the question, problem, or concept your chosen material illuminates. Usually you will have the option of grouping items into sections--this helps you indicate comparisons and relationships. You may be able to write a paragraph or so to introduce the focus of each section.

Written by Dena Taylor, Director, Health Sciences.
Copyright 2000. All rights reserved. Writing Centre, and Margaret Procter, Coordinator, Writing Support, University of Toronto.

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Appendix 7 Harvard System - 2-page Quick Guide

Harvard System -
2-page Quick Guide

1.1 If the author’s name occurs naturally in the sentence the year is given in

parentheses:- e.g. In a popular study, Harvey (1992, p.556) argued that ...

1.2 If, however, the name does not occur naturally in the sentence, both name and year are given in parentheses:-

e.g. More recent studies (Bartlett,1996; James,1998) show that ...

1.3 When an author has published more than one cited document in the same year,

these are distinguished by adding lower case letters (a,b,c, etc.) after the year and

within the parentheses:-

e.g. Johnson (1994a) discussed the subject ...

1.4 If there are two authors, the surnames of both should be given:-

e.g. Matthews and Jones (1993) have proposed that...

1.5 If there are more than two authors the surname of the first author only should be

given, followed by et al :-

e.g. Wilson et al. (1997) conclude that...

1.6 If there is no originator then “Anon” should be used:-

e.g. A recent article (Anon,1993) stated that...

However, if it is a reference to newspapers where no author is given the name of the paper can be used in place of author or Anon whichever seems most helpful. You will need to use the same style in the reference list so the name of the newspaper may be more helpful.

e.g. The Times (1996) stated that....

1.7 If you refer to a source quoted in another work you cite both in the text:-

e.g. A study by Smith (1960, cited Jones 1994 p.24) showed that...

(You need to list the work you have used, i.e. Jones, in the main bibliography.)

1.8 Quotations:-

A short quotation of less than a line may be included in the body of the text in quotation marks but if it is longer start a new line and indent it. Include the page number if desired.

Single space the quotation (assuming your normal spacing is 1.5)

e.g.: .... so “good practices must be taught” (Smith,1996, p.15) and we should...

or: Theory rises out of practice, and once validated, returns to direct or explain the practice. (Stevens,1997, p.92)

· Your references should be in alphabetic order of author(s) at the end of your assignment.

· There should be a 1:1 correspondence between the works cited and the list of references i.e.

If it is cited in the text, then it must be included in the references at the end of your assignment

If you have included an item in your list of references then it must have been cited in the text (i.e. do not include books you may have read but have not cited in the text)

Your list of references should therefore only contain what you yourself have read.

Adapted by:

Mike Hart

Business and Informatics Group

King Alfred’s College, Winchester

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Appendix 8 Citing electronic sources of information-the University of Sheffield Library

Citing electronic sources of information- The University of Sheffield Library

Data is available in various formats apart from printed documents such as books and journals. Increasingly information is available in electronic form via a computer, on the Internet, CD-Rom, microform, film, television or radio. This guide sets out to provide examples of how to cite these electronic sources of information in the Harvard style. There is a separate document outlining how to cite printed material. The standard copyright law applies equally to electronic sources and any reference to other people's work should be acknowledged with citations in your text and inclusion in your reference list.

INTERNET SOURCES:

Individual works

Author/editor surname, Initial. (Year) Title [online].Edition. Place of publication, Publisher. Available from: URL[Accessed date].

Example:

Ward, R. (1997) Nursing and Health Care Resources on the Net[online]. 2nd edition. Sheffield, University of Sheffield. Available from: http://www.shef.ac.uk/~nhcon [Accessed 17 March 1998].

Include the year of publication in brackets, if no publication date is given write (No date).

Only mention an edition statement if the document clearly states that the pages have been rewritten rather than just updated. Most Web pages are updated on a regular basis. Date of publication is the date the pages were last updated.

The accessed date is when you viewed, downloaded or printed the Web page. This statement is necessary to allow for any subsequent changes which may be made to the page or if the page is no longer available.

The term publisher is used here to cover both the traditional idea of publisher of printed sources, as well as organisations responsible for maintaining sites on the Internet, such as the University of Sheffield.

Often information is put on the Internet by organisations without citing a specific author. In such cases, ascribe authorship to the smallest identifiable organisational unit (this is similar to the standard method of citing works produced by a corporate body) or start with the title.

Example:

The University of Sheffield Library (1997) The Library Service Charter [online]. Sheffield, University of Sheffield. Available from: ../services/charter.html [Accessed 17th March 1998].

Citing electronic journals

Author surname, Initial. (Year) Title of article. Journal title[online], Volume (part), location within the host. Available from:URL [Accessed date].

The "location within host" is the equivalent of page numbering used with printed sources. If the document does not include pagination an alternative may be used eg date, labelled part, or the the total number of lines, paragraphs or screens.

Example of an article from a journal available in print and electronic form:

Bradshaw, Ann (1998) Charting some challenges in the art and science of nursing. Lancet [online], 351 (9100), 438-40. Available from: http://www.thelancet.com/newlancet/sub/issues/vol351no9100/essay438.html [Accessed 24th March 1998].

Examples of articles from journals only available online:

Brown, M. A. (1996) Primary Care Nurse Practitioners: Do Not Blend the Colors in the Rainbow of Advanced Practice Nursing. OnlineJournal of Issues in Nursing [online], 1st August 1996. Available from: http://www.nursingworld/ojin/tpc1/tpc1_6.htm [Accessed 17th March 1998].

Gibbs, Graham (No date) Debate - Who Should Judge Portfolios? Deliberations [online], 2 paragraphs. Available from: http://www.lgu.ac.uk/deliberations/portfolios/gibbs1.html [Accessed 24th March 1998].

Citing a full text item from an Online bibliographical database:

Author surname, Initial. (Year) Title of article. Journal title.Volume (part), pages. Full-text [online]. Online database name on host [Accessed date].

Example of full text article from CINAHL via the Ovid Biomed service:

Newens, Andrew J. et al (1997). Changes in reported dietary habit and exercise levels after an uncomplicated first myocardial infarction in middle-aged men. Journal of Clinical Nursing 6(2), 153-160. Full-text [online]. CINAHL, Ovid Technologies Inc.[Accessed 28th May 1998].

Citing an abstract from an Online bibliographical database.

An abstract should only be cited if it has proved impossible to obtain the full text of the article and it is essential to your work to do so.

Author surname, Initial. (Year). Title of article. Journal title. Volume (part), pages. Abstract [online]. Online database name on host [Accessed date].

Example of abstract from CINAHL via the Ovid Biomed service:

Redman, G. M. (1997). LPN-BSN: education for a reformed healthcare system. Journal of Nursing Education 36(3), 121-7. Abstract [online]. CINAHL, Ovid Technologies Inc. [Accessed 28thMay 1998].

Citation from a database that includes citation instructions.

Sometimes the database instructs you on how to cite references. This might be at the end of the article. You must cite the reference as they state. Put in brackets at the end of the citation that this is the case.

Example of such a citation:

Renfrew MJ and Lang S. Early initiation of breastfeeding. (Cochrane Review) In: the Cochrane Library, issue 2. Oxford:Update Software;1998. Updated quarterly. (Citation as instructed)

Mailbase/Listserv email lists

These discussion lists generate email messages which are sent directly to the subscriber. Many lists will archive the messages sent. References to these messages should be treated in a similar fashion to journal references; using the list name in place of the journal title and the subject line of the message in place of the article title.

For "Available from" use the email address of the list administrator. These details, together with the author, will appear in the message header.

Author, (Day Month Year). Subject of message. Discussion list [online]. Available from: Mailbase/Listserv email address [Accessed date].

Examples:

Wright, S (20 March 1998) Team nursing in an acute psychiatric unit. Psychiatric- nursing [online]. Available from: http://www.mailbase.ac.uk/lists/psychiatric-nursing/1998-03/0209.html [Accessed 24th March 1998].

Harvey, R J (19 Mar 1998) Re: early onset dementia. Candid-dementia [online]. Available from: http://www.mailbase.ac.uk/lists/candid-dementia/1998-03/0012.html [Accessed 5th May 1998].

Please note that items may only be archived on discussion group servers for up to a year. A local copy could be kept by the recipient, who is giving the citation, but a note should be given to this effect. It is also in your interest to print a copy of potentially temporary sources in case you need to prove a source after it has been deleted/moved/changed.

Usenet newsgroups/Bulletin boards

Usenet newsgroups allow people with similar interests to read and post messages in a common location on the Internet.

Author (Day Month Year). Subject heading of message. Newsgroup[online]. Available from: Name of Usenet newsgroup [Access date].

Example:

Sanner, J S. (5 May 1998) Case Management. Sci.med.nursing[online]. Available from: news:sci.med.nursing [Accessed 5th May 1998].

If the author's name and initial is not given, use the email name.

Example:

medman64@worldnet.att.net (5 May 1998) Re: Case Management. Sci.med.nursing[online]. Available from: news:sci.med.nursing [Accessed 5th May 1998].

Personal email

If you wish to make reference to personal email messages then the following format is recommended. You should get a sender's permission to quote a message especially if you quote their email address.

Sender (Sender's Email address) (Day Month Year). Subject of Message. Email to recipient (Recipient's E-mail address).

Example:

McConnell, D. (D.McConnell@sheffield.ac.uk) (28th November 1997) Follow up to your interview. Personal email to L.Parker (l.a.parker@sheffield.ac.uk).

OTHER ELECTRONIC SOURCES

Audiocassettes, CD-Roms, Film, Microform, Radio Broadcasts,Television, and Videos

When citing one of the above items information about the nature of the item should be given where necessary after the title.

Example:

Peters, T. (1991) Tom Peters Live. [Audiocassette]. Boulder,USA, CareerTrack Publications.

Many CD-Roms, films, videos and broadcasts are the co-operative work of many individuals. These should either be cited with the title as the first element, or if there is an individual with clear responsibility for the intellectual content his name should be used e.g. the director.

Examples:

Pride and Prejudice. [Video]. (1997) London, BBC.

Encarta 98 Encyclopaedia. [CD-Rom]. (1998) New York, Microsoft Ltd.

Henderson, David. (1985) Reith Lectures. BBC Radio 3 and 4. Nov - Dec 1985.

ASSIA Plus [CD-Rom] (1987-to date) London, Bowker Sauer.

Individual items within a programme should be cited as contributions.

Example:

Thatcher, Margaret. (1986) Interview. In: Six O'Clock News.TV, BBC 1. 1986 Jan 29. 18.00hrs.

Tips and hints

You can use the computer to reduce the amount of typing and therefore, the potential errors which may occur, when referencing. It is possible to have more than one application running at a time and move between them, for example Word and Netscape.

To switch between applications press and hold down ALT while pressing TAB repeatedly to cycle through running applications. When you release TAB the application comes to the foreground. Alternatively press Control and Escape simultaneously to open the Task List. Select the application and then press Enter. If you have not yet opened Word, select Program Manager and open Word by double clicking on the appropriate icon.

When in Netscape or any other Web browser, highlight the location bar with the URL by clicking with the mouse and dragging over the text to be copied. A blue background will appear. Click onEdit and Copy. Switch to Word, position the cursor where you wish the text to go, click on Edit and Paste.

Acknowledgements:

The following documents have been used in the compilation of this guide and further information can be obtained from them.

Bournemouth University. Academic Services Group. Library and InformationServices. (1996) A Guide to Citing Internet Sources [online].Bournemouth, Bournemouth University. Available from: http://www.bournemouth.ac.uk/service-depts/newlis/LIS_Gen/citation/harvardsystint.html [Accessed 7th July 1998].

Crane, N. (1997) Bibliographic Formats for Citing ElectronicInformation [online]. Burlington, Vermont, University of Vermont. Available from: http://www.uvm.edu/%7encrane/estyles/ [Accessed 7th July 1998].

University of Sheffield Library (1998) Recording, citing andpresenting references [online]. Sheffield, University of Sheffield. Available from: http://www.shef.ac.uk/~lib/useful/refs.html [Accessed 7th July 1998].

For further information contact your Academic Liaison Librarian.

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Appendix 9 Rowley, J. (1999),Thirteen Tips for Successful Supervision of Undergraduate Dissertations

Author: Mike Hart

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Final Year Project Supervision Meeting Record

How to write a successful Final Year project - a Practical Guide

Point

Elaboration

1.

Have a clear structure

5-6 chapters, not a series of sections

2.

Make good reference to the literature

Have a literature review chapter

3.

Make sure it is well-referenced

Harvard style, 1:1 correspondence

4.

Be intellectually engaged

Conduct a dialogue with the material

5.

Strive to be analytical

6. *

Project manage your project

Utilise time-lines, deadlines

7.

Strive to write well

Spell-check, check grammar syntax

8.

Make any survey work connect

Empirical work should reflect themes

9.

Ensure survey work is methodologically sound

10. *

Examine other good examples

Imitate excellent features

11. *

Take advice from others

Find out what others consider good

12. *

Back up constantly

Write in chapters, back up constantly

The lessons to be learnt from this are:

CHAPTER 2 Outpatient clinics - measuring the quality

CHAPTER 3 Outpatient clinics - implementing improvements

CHAPTER 4 Policy Implications of measuring quality improvements

The Literature Review: A Few Tips On Conducting It

What is a review of the literature?

Ask yourself questions like these:

Ask yourself questions like these about each book or article you include:

Final Notes:

Acknowledgements: