Recently, I submitted my PhD thesis!

This was a great and very memorable moment for me personally. I am yet to receive my results as the University is waiting on feedback from one of the two examiners. Once I do get my results, I will likely need to make some changes in response to the feedback from one or both examiners. So how did I get to wrapping up three years of complex and hard research work? And what was the impact of Covid-19 on my research and on my thesis?

Having consistent input from my supervisors during the three years of perpetual change was invaluable for ensuring when the ‘PhD boat’ needed to change direction, especially due to the Covid-19 pandemic, it didn’t go adrift. Their inputs also facilitated me to look for solutions myself, and pretty much always being able to sort one out with their guidance. This support gave me much confidence that despite what at times seemed like many odds against my being able to continue my project either in the way I had planned, or in the timeframe I had hoped, that there is definitely a likelihood that a path can actually be found. I am grateful also to the ARC Research Hub for Digital Enhanced Living for not only providing a full scholarship but also valuable professional development opportunities which very much helped to frame, and solve, some of the inherent challenges of conducting digital health research during Covid-19.

I began my PhD journey in 2019 on the topic of designing and developing a motivational chatbot for brain injury rehabilitation. From my work during my first year – in a pre-pandemic world – I established the rationale for my PhD and planned how it would be conducted. The emergence of Covid-19 restrictions in early 2020 aligned with the start of the second year of my PhD program. My plans were subsequently considerably upended regarding the ‘How’. Essentially, I needed to reconfigure how I would interact with (potentially vulnerable) stakeholders, conduct recruitment, and then support participants during their project participation. I launched into working with Zoom, phone and email, and in the meantime throwing out face-to-face meetings. This was challenging to implement, as about half of the participants for my project had some cognitive fatigue and/or other reasoning challenges; and using technology could inherently be more tiring for them than in-person communication. However, virtual contact did provide the benefit of having no travel requirements and certainly obliviated the risk of Covid-19 transmission.

Recruitment was somewhat slow for both the co-design workshops and the pilot trial on feasibility, and the overall number of participants recruited for the feasibility pilot trial were lower than expected. This was, perhaps, in part because the clinicians were busier than usual juggling the relatively fluid Covid-19-related requirements alongside their usual workloads; and similarly, clients were managing their rehabilitation recovery whilst also dealing with lifestyle disruptions and government enforced restrictions due to Covid-19. I had to decide to stay with my intended PhD timeframes as much as possible, despite difficulties with recruitment, and to lower my expectations regarding the number of participants recruited. This also required that I look at a broader range of literature that discussed similar areas of research to mine, with low sample sizes. Through this process, I gained a deeper insight into juggling ‘real-world’ limitations on research which could be dealt through careful choice of research design (for example, the use of Single Case Series design) and outcome measurements (for example, utilising validated measures for technology acceptability and usability, alongside validated clinical measures), with a preference for mixed methods approaches (which utilise qualitative feedback alongside the quantitative results to help form a more comprehensive appraisal of the study’s purposes). Hence by taking these approaches, I was able to achieve the overall aims and objectives for my PhD which were initially set at the end of the first year.

My thesis write-up then progressed in a structured way to summarise the stages of my PhD that included: the development of the initial chatbot prototype; in-house testing; co-design workshops with clients and clinicians; and finally a mixed methods feasibility pilot study. Results of the scoping review were aligned in a meaningful way to the other results of my thesis to paint a more thorough picture of developing a novel chatbot for brain injury rehabilitation. The thesis write-up was a very involved process over seven months – this period though also included concurrently finishing up other parts of my PhD research. A much needed boost during these later stages was to present my final PhD oral review. This oral presentation was delivered to my supervisors, an external examiner from within the university, the Higher Degrees Research Co-ordinator and extended audience. It was challenging to prepare, because it conveyed my whole PhD work within a 40-minute timeframe. For it though, I received excellent feedback, and this spurred me forward with the confidence that, yes, the project was sound and well-received, and I would achieve success with all my hard work finally paying off!

 

Written by:
Judith Hocking
ARC Industrial Transformation Research Hub for Digital Enhanced Living PhD scholarship recipient
Flinders University
NB: The author reserves the right to showcase/publish this blog piece elsewhere and/or in a different medium.

Editorial review by:
Dr Priya Rani, Associate Research Fellow (DELH & A2I2)
Kevin Hoon, Hub Manager