A Queensland research support network in emergency healthcare

Moving from Interest to Engagement-Understanding the Research Capacity Building Needs of Rehabilitation Doctors

INTRODUCTION

Doctors working in rehabilitation settings have specialized clinical skills and experience, but research activity may be constrained by time pressures and inadequate current skills. This means missed opportunities to contribute to the evidence-base for better clinical practice and outcomes for people living with disabling, chronic complex conditions. This research aimed to understand rehabilitation doctors' research needs, experience, and aspirations to enable future training initiatives that are tailored to their practice context.

METHODS

This exploratory sequential mixed-method study comprised a survey followed by focus groups. Rehabilitation doctors from three health services in south-east Queensland, Australia completed an online survey incorporating the Research Spider to explore their research experience, confidence, interest, opportunity, and intent. Focus groups explored the survey results and participants' views regarding strategies to build research capacity.

RESULTS

The major findings were the gap between high research interest and low experience, confidence and opportunity; and fundamental research skills were identified as priority training topics. These findings support previous research. However, rehabilitation doctors may also have a self-expectation that, as competent clinicians, they should necessarily also be research-competent, and hold misperceptions regarding the shared nature of health services research.

DISCUSSION

Protected time and funding may enhance engagement with research to generate specialty-relevant evidence for practice. To this end, a research capacity building initiative in the form of a series of self-directed learning packages has been developed and implemented. A tailored workshop to strengthen rehabilitation doctors' research skills and engagement has also been developed for implementation.

Strengthening the clinical academic pathway: a systematic review of interventions to support clinical academic careers for doctors and dentists

OBJECTIVE

Evaluate existing evidence on interventions intended to increase recruitment, retention and career progression within clinical academic (CA) careers, including a focus on addressing inequalities.

DESIGN

Systematic review.

DATA SOURCES

Medline, Embase, Cochrane Controlled Register of Trials, PsycINFO and Education Resource Information Center searched October 2019.

STUDY SELECTION

Eligible studies included qualified doctors, dentists and/or those with a supervisory role. Outcomes were defined by studies and related to success rates of joining or continuing within a CA career.

DATA EXTRACTION AND SYNTHESIS

Abstract screening was supported by machine learning software. Full-text screening was performed in duplicate, and study quality was assessed. Narrative synthesis of quantitative data was performed. Qualitative data were thematically analysed.

RESULTS

148 studies examined interventions; of which 28 were included in the quantitative synthesis, 17 in the qualitative synthesis and 2 in both. Studies lacked methodological rigour and/or were hindered by incomplete reporting. Most were from North America. No study included in the syntheses evaluated interventions aimed at CA dentists.Most quantitative evidence was from multifaceted training programmes. These may increase recruitment, but findings were less clear for retention and other outcomes. Qualitative studies reported benefits of supportive relationships, including peers and senior mentors. Protected time for research helped manage competing demands on CAs. Committed and experienced staff were seen as key facilitators of programme success. Respondents identified several other factors at a programme, organisational or national level which acted as facilitators or barriers to success. Few studies reported on the effects of interventions specific to women or minority groups.

CONCLUSIONS

Existing research is limited by rigour and reporting. Better evaluation of future interventions, particularly those intended to address inequalities, is required. Within the limits of the evidence, comprehensive multifaceted programmes of training, including protected time, relational and support aspects, appear most successful in promoting CA careers.

SYSTEMATIC REVIEW REGISTRATION

Open Science Framework: https://osf.io/mfy7a.

Relationship Between Research Culture and Research Activity of Medical Doctors: A Survey and Audit

PURPOSE

To describe the research capacity and culture, and research activity (publications and new projects) of medical doctors across a health service and determine if the research activity of specialty groups correlated with their self-reported "team" level research capacity and culture.

METHODS

Cross-sectional, observational survey and audit of medical doctors at a tertiary health service in Queensland. The Research Capacity and Culture (RCC) validated survey was used to measure self-reported research capacity/culture at organisation, team and individual levels, and presence of barriers and facilitators to research. An audit of publications and ethically approved research projects was used to determine research activity.

RESULTS

Approximately, 10% of medical doctors completed the survey (n= 124). Overall, median scores on the RCC were 5 out of 10 for organisational level, 5.5 for specialty level, and 6 for individual level capacity and culture; however, specialty-level scores varied significantly between specialty groups (range 3.1-7.8). Over 80% of participants reported lack of time and other work roles taking priority as barriers to research. One project was commenced per year for every 12.5 doctors employed in the health service, and one article was published for every 7.5. There was a positive association between a team's number of publications and projects and their self-reported research capacity and culture on the RCC. This association was stronger for publications.

CONCLUSION

Health service research capacity building interventions may need a tailored approach for different specialty teams to accommodate for varying baselines of capacity and activity. When evaluating these initiatives, a combination of research activity and subjective self-report measures may be complementary.