Clinician researcher career pathway for registered nurses and midwives: A proposal

A narrative review of Master's programs in midwifery across selected OECD countries: Organizational aspects, competence goals and learning outcomes

Shifting midwifery education to a university level is of great importance for healthcare systems worldwide by preparing graduates for current and future challenges. Some of them referring to management, research and teaching tasks as well as advanced practitioner roles, require competences that can only be acquired in a Master's program. The objectives of this narrative review are to outline the differences and commonalities of organizational aspects of Master's programs in selected OECD countries and to point out the competence goals and learning outcomes they are based on. Fifteen Master's programs in twelve OECD countries were identified and analyzed. Considering the organizational characteristics, differences are found in admission requirements and qualification levels, while similarities relate to the awarded title (MSc). All programs aim to develop abilities for research to advance midwifery practice. Leadership and management abilities are addressed through effective teamwork and communication. The programs' aims are to develop abilities for midwifery education tasks. Whereas competence goals mostly align across the programs, they are addressed differently through various learning outcomes. Development and enhancement of Master's programs in midwifery are needed by focusing on core elements, such as common competence goals. It is equally important to adapt them to national healthcare and educational systems.

Could you give me a leg up …? Models, frameworks and support structures to help aspiring clinical academic speech and language therapists

BACKGROUND

Increasing research capacity and capability for the speech and language therapy (SLT) profession is a key national strategic driver, with many speech and language therapists (SLTs) aspiring to a clinical academic (CA) career. There are known benefits but also acknowledged challenges with this career path, including limited funding opportunities and a poorly established career trajectory.

AIMS

To present models, frameworks and support structures that can be used by aspiring SLT CAs to chart research knowledge and skills, and plan career development. Organisational models are also presented to facilitate SLT CA career development and research capacity-building.

METHODS & PROCEDURES

A narrative review was conducted using a literature search of published peer-reviewed journals across four electronic databases: Medline, CINAHL, AMED and Embase, with additional search for grey literature through internet searches. Search results were screened against eligibility criteria by two researchers, with full-text articles retrieved and reviewed by four researchers independently.

RESULTS & DISCUSSION

The database search and grey literature search combined identified 610 records. Full-text screening of 66 records resulted in 19 articles or grey literature sources being included within the narrative review.

MAIN CONTRIBUTION

This paper details models, frameworks and support structures pertinent to SLTs that can be used at an individual and organizational level to assist CA skill development and career paths.

CONCLUSION & IMPLICATIONS

The national climate is looking positive for aspiring SLT CAs. The time is now to take the initiative and use the support structures available to show our CA value and develop the necessary skills outlined within these resources to fulfil our ambitions.

WHAT THIS PAPER ADDS

What is already known on the subject Interest in CA careers within the SLT profession is increasing. Whilst there are known benefits to embedding research within clinical practice, barriers exist including the strategic and operational steps individuals can take to make the career path a reality. What this study adds This narrative review has searched the literature for CA models, frameworks and support structures created for nurses, midwives and allied health professionals. These tools are presented and discussed, with special consideration and focus to the SLT profession. What are the clinical implications of this work? This paper will provide SLTs with the tools to support their personal CA career development as well as advocate for CA roles within their teams and organisations. Organisational models are also presented to support SLT managers to foster a CA path for workforce development.

Using the making Visible the ImpaCT Of Research (VICTOR) questionnaire to evaluate the benefits of a fellowship programme for nurses, midwives and allied health professionals

BACKGROUND

There is increasing emphasis in the UK on developing a nurse, midwife and allied health professional (NMAHP) workforce that conducts research. Training for clinical academic careers is provided by the National Institute for Health and Care Research (NIHR). However, the low number of successful applicants suggested there were barriers to achieving this. The Centre for Nursing and Midwifery Led Research (CNMR) launched a fellowship programme in 2016 to backfill two days a week of NMAHPs' time for up to a year, to give them time to make competitive applications to the NIHR.

AIM

To report a study evaluating the CNMR fellowship programme.

DISCUSSION

The making Visible the ImpaCT Of Research (VICTOR) tool ( Cooke et al 2019 ) was developed to describe the organisational impact of research. The 2016-17 CNMR fellows completed VICTOR and their responses were analysed using a framework approach. The analysis found the main benefits of participating in the programme were protected time for research, opportunities to develop collaborations, increasing intra- and inter-professional awareness of NMAHPs' research, peer-reviewed publications, and conference presentations. Challenges included a lack of support from line managers, limited value placed on NMAHPs' research and failure to backfill posts.

CONCLUSION

There were some challenges with the fellowship programme, but all recipients found it to be a positive experience and undertook significant scholarly activity.

IMPLICATIONS FOR PRACTICE

A contractual agreement must be established to foster committed partnerships between higher education institutions (HEIs) and the NHS. HEIs and the NHS should conduct frank discussions of the challenges encountered in fellowship programmes. Positive initiatives and outcomes in tertiary education and clinical settings should be shared to improve fellows' experiences and enhance partnerships between HEIs and the NHS. Job descriptions should include time allocation to review fellowship candidates' applications regardless of outcome. The showcasing of research successes and the benefits of NMAHP research must evolve to secure organisational 'buy in', which is the precursor to widening access to clinical academic pathways.

Exploring stakeholders' perspectives on the adaptation of the Living Lab approach to dementia care: A qualitative study

Collaborative research can promote knowledge translation and help to link care practice and research. Academic-practice partnerships enable joint research projects in collaboration between care professionals, researchers, patients, and other stakeholders. This qualitative study was conducted during the adaptation phase of the Living Lab Dementia, an academic-practice partnership for collaborative research on long-term dementia care. The aim was to explore stakeholders' perspectives on linking care practice and research in a sustainable, research-focused partnership. Data were collected in fifteen qualitative interviews with representatives from three stakeholder groups: nursing care professionals, people with dementia, and nursing researchers. Thematic Framework Analysis resulted in five themes: (1) Access, (2) Expectations, (3) Shaping the collaboration, (4) Linking Pins, and (5) Participation. The findings suggest that care professionals expect support in implementing research results into practice. Researchers should take the lead in shaping the collaboration and create opportunities for stakeholders to get involved.

Midwife led randomised controlled trials in Australia and New Zealand: A scoping review

BACKGROUND

Midwives are the largest workforce involved in caring for pregnant women and their babies, and are well placed to translate research into practice and ensure midwifery priorities are appropriately targeted in researched. Currently, the number and focus of randomised controlled trials led by midwives in Australia and New Zealand is unknown. The Australasian Nursing and Midwifery Clinical Trials Network was established in 2020 to build nursing and midwifery research capacity. To aid this, scoping reviews of the quality and quantity of nurse and midwife led trials were undertaken.

AIM

To identify midwife led trials conducted between 2000 and 2021 in Australia and New Zealand.

METHODS

This review was informed by the JBI scoping review framework. Medline, Emcare, and Scopus were searched from 2000-August 2021. ANZCTR, NHMRC, MRFF, and HRC (NZ) registries were searched from inception to July 2021.

FINDINGS

Of 26,467 randomised controlled trials registered on the Australian and New Zealand Clinical Trials Registry, 50 midwife led trials, and 35 peer-reviewed publications were identified. Publications were of moderate to high quality with scores limited due to an inability to blind participants or clinicians. Blinding of assessors was included in 19 published trials.

DISCUSSION

Additional support for midwives to design and conduct trials and publish findings is required. Further support is needed to translate registration of trial protocols into peer reviewed publications.

CONCLUSION

These findings will inform the Australasian Nursing and Midwifery Clinical Trials Network plans to promote quality midwife led trials.

How a better understanding of nursing research roles may help to embed research into clinical structures

BACKGROUND

Despite efforts to build research capacity within nursing there are growing concerns about the lack of funding and support for nurses who wish to pursue a career in research.

AIM

To explore how research capacity within the nursing profession can be increased.

DISCUSSION

The disparity in opportunity and support for such roles is a barrier to the growth of nursing research. This article examines the nomenclature that exists around nursing roles in research, including those of clinical research nurse, nurse researcher and clinical nurse academic, and the challenges associated with each of these roles. The authors reflect on their career paths, specifically the transition from clinical research nurse to nurse researcher.

CONCLUSION

To grow research capacity within the nursing discipline, organisations must provide opportunities for research at all career stages, promote the fundamental role that research plays in the quality of patient care and highlight career pathways and roles in nursing research.

Enablers and barriers to progressing a clinical academic career in nursing, midwifery and allied health professions: A cross-sectional survey

AIMS AND OBJECTIVES

This study aimed to understand the routes by which nurses, midwives and allied health professionals (NMAHPs) pursue and sustain a research career and the enablers and barriers to career progression.

BACKGROUND

Robust evidence is central to practice and professional decision making of NMAHPs, with generation and translation of research arguably best led by those clinically active. Whilst countries like the UK and USA have fellowship schemes to support research career development, anecdotal reports suggest barriers exist in translating these opportunities into sustainable clinical academic careers.

DESIGN

Online survey.

METHODS

An online questionnaire addressing career choices, facilitators/barriers and support was emailed to 1074 past applicants (doctoral and post-doctoral) to National Institute of Health Research fellowship schemes (awarded and rejected) in England between March and May 2017; 231 responded (25.6%). Study reporting adheres to STROBE checklist.

RESULTS

Overall, 134 doctoral and 96 post-doctoral applicants participated; two-thirds were from allied health professions. Most were early in their research career. Interest in research was most frequently sparked by interaction with people in research positions. Nearly half had their first research experience during their BSc project; though less often for nurses/midwives/health visitors (37.5%) than other NMAHPs (51.6%). The award of a fellowship resulted in higher likelihood of being research-active (doctoral level). Nearly three quarters pursuing a clinical academic career indicated 'clearer career paths' and 'greater integration across clinical and academic departments' were desirable. Most common barriers related to research roles, availability of positions and funding.

CONCLUSIONS

Fellowship schemes are important to NMAHPs' research careers, but there are serious challenges to establishing and sustaining a career.

RELEVANCE TO CLINICAL PRACTICE

Lack of a clear model of career progression, at national and local level, and barriers to creating joint posts impacts on capacity of clinical academics to strengthen integration of research with practice.

Embedded researchers in Australia: Survey of profile and experience across medical, nursing and midwifery and allied health disciplines

AIMS AND OBJECTIVES

This study explores embedded researcher's age, qualifications, research environment and experience in healthcare and academic organisations in Australia and makes comparisons across three core professional disciplines of nursing and midwifery, medicine and allied health.

BACKGROUND

The embedded researcher model, where a researcher is embedded as a core member of the clinical team, offers promise to support the implementation of research evidence into practice. Currently, there is a lack of clarity about how the model has been adopted across the three largest professional disciplines in Australian health care.

DESIGN

A cross-sectional survey was designed and reported, using the STROBE Statement.

METHODS

A purposive sample of embedded researchers was invited to participate in an exploratory online survey. Embedded researchers worked, or had worked, for a minimum of 30% of their time, in a healthcare organisation doing research or building research capacity. Participant responses were extracted from the survey and imported into SPSS for analysis.

RESULTS

Perspectives of 100 Australian embedded researchers were compared across nursing and midwifery (36%, n = 37), allied health (35%, n = 36) and medicine (26%, n = 27). Professional differences are reported in respondents' qualifications and experience, employment conditions and their research cultures and environments. Comparatively, most nursing and midwifery embedded researchers were older, more clinically experienced than allied health respondents, who were more research qualified. Medical-embedded researchers are typically older, more clinically experienced and focussed on producing personally relevant clinical research. Nursing and midwifery embedded researchers reported doing clinical research within their teams, as well as research capacity building, management and clinical practice roles.

CONCLUSIONS

Embedded researchers describe different career trajectories across the three largest professional disciplines in Australian health care.

RELEVANCE TO CLINICAL PRACTICE

Embedded researchers from different professional disciplines enact their work differently. It appears that when they engage in research capacity building via a range of management and networking roles, embedded researchers contribute to their organisation's research culture and receive greater recognition for their achievements.