Capitalising on the transformational opportunities of early clinical academic career training for nurses, midwives and allied health professionals

An evaluation of the Newcastle upon Tyne Hospitals 4Ps Programme for the development of nurses, midwives and allied healthcare professionals' research skills

BACKGROUND

Research forms an important part of clinical practice for nurses, midwives and allied healthcare professionals (NMAHPs). However, it is known there is a lack of confidence in this community in the development and use of research skills. The 4Ps Programme is a bespoke research-training programme that focuses on four areas: place, project, person and plan.

AIM

To report an evaluation of the 4Ps Programme that used a survey to record the confidence levels reported by NMAHPs.

DISCUSSION

An increase in participants' confidence was observed across all modules in the 4Ps Programme. This exceeded the standard deviation in the 'place' session, demonstrating genuine improvement. It was not possible to demonstrate a significant improvement in all cases. Low response rates affected the quality of the data obtained in the study, which would have benefitted from a more targeted approach to questions and better enabled the tracking of individuals' improvement over the course of the programme.

CONCLUSION

Participation in bespoke, targeted training related to research could lead to an increase in NMAHPs' confidence in research-related activities. Efforts need to be made to refine the evaluation approach and improve response rates.

IMPLICATIONS FOR PRACTICE

The 4Ps Programme can improve research-related confidence. Improved and further longitudinal evaluation will assess its impact in developing future clinical academics.

Facilitators and barriers to undertaking research into the practice and delivery of clinical ultrasound: A qualitative investigation

INTRODUCTION

Increasing research productivity of clinicians can deliver benefits for healthcare organisations and those who work in them, but a notably larger proportion of ultrasound practitioners are interested in undertaking research than are actively engaged in it. This study aimed to understand this gap by investigating the facilitators and barriers to conducting research in professionals from multiple disciplines whose work is focused on clinical ultrasound.

METHODS

Current and prospective researchers from any discipline interested in or undertaking research into the practice and delivery of clinical ultrasound were recruited between March and June 2023. Participants completed semi-structured qualitative interviews with a researcher via video platform. Data were analysed using reflexive thematic analysis.

RESULTS

Twelve participants (8 women, 4 men) from a range of disciplines participated. Five themes were identified, which were: 1) research is a challenging path, 2) interpersonal networks fuel research, 3) research requires resources, 4) data collection challenges and 5) scientific curiosity. These suggested that 1) participants experienced research as a challenging career path; 2) formal and informal networks provided important knowledge and opportunities; 3) research was a resource-intensive activity, requiring time and funding, and other professional/clinical commitments often took priority; 4) data collection and applying for ethical approval were barriers requiring specialist knowledge to overcome; and 5) personal scientific curiosity and desire for achievement were key drivers motivating participants to continue in research.

CONCLUSIONS

Motivation for engaging in ultrasound research activity was mainly internal. Additional barriers and facilitators were external, including time, information and interpersonal networks.

IMPLICATIONS FOR PRACTICE

Organisations can increase the likelihood of research activity by ultrasound practitioners by providing allocated research time and social support networks. It may be particularly fruitful to focus on helping prospective researchers bridge the gap between 'novice' and 'beginner' phases.

A research internship scheme for nurses and its wider implications for clinical managers

There is growing evidence that clinical research activity is linked to better patient outcomes and that staff involvement in research is linked to enhanced morale and retention. Clinical managers have a pivotal role in supporting staff to engage with research, but they are not always given the means to do so and are not always aware of the benefits. In 2021 a research internship scheme was set up as a collaboration between two London NHS trusts and a university, enabling nurses and midwives to undergo training and undertake a range of research activities. Some participants experienced challenges in fitting internship activities around clinical duties despite the fact that the scheme was planned to give them protected time. This article describes the scheme, reports the findings of its evaluation at one of the two trusts, and discusses its implications for clinical managers in terms of how they can be supported to contribute to the development of a research culture.

Developing a career and education framework for advanced clinical practice in midwifery

INTRODUCTION

This study outlines the nature of Advanced Clinical Practice in Midwifery (ACPiM), reporting on a stakeholder analysis as part of a national project to develop a career framework for advanced practice in midwifery on behalf of the National Health Service (NHS) in England.

METHODS

Between June and July 2022, 31 advanced practice midwives were recruited across England within the NHS settings. Convenience sampling was used to identify midwives working as advanced practitioners, and those pursuing this career route. Focus group and one-to-one interviews were conducted, recorded, and transcribed. These stakeholder data were then analyzed using a reflexive thematic approach.

RESULTS

ACP midwives were active across many professional settings. The findings resulted in three themes: Midwifery autonomy, Desire for progression, and Avenues of support. Midwifery autonomy highlighted a midwifery desire to utilize specialist skills and expert decision-making to provide holistic care directly to women and families. Desire for progression highlighted that, regardless of career stage, midwives aspired to advance their practice requiring a range of pathways to fulfil career satisfaction and meet local population health needs. Avenues of support discussed the barriers and facilitators to progression, highlighting the need for service vision, a multi-disciplinary approach to facilitate support for individuals, and strong midwifery leadership.

CONCLUSIONS

Although the ACPiM role is desired by maternity institutions and organizations, midwives remain unclear about how to achieve this position, and employers remain unsure of how an ACPiM could transform services. If midwives are to successfully achieve ACPiM status, organizational support is needed to facilitate individuals drive for career progression, resulting in a strengthened workforce and improved patient experience.

The South West Clinical School model: an initiative to transform clinical academic career pathways

Background

The Clinical School Model connects professorial staff from the university directly to practitioners in the National Health Service to promote evidence informed practice and develop clinical academic careers. These are promoted widely, but strategic adoption into organisational culture and workforce plans are challenging to overcome.

Aims

To describe the development of the Clinical School Model in Cornwall and explore how it generates impact through staff engagement activities to support clinical academic career pathways. Structure, process and outcomes developments over the last 3-years are reported.

Methods

Donabedian's framework (structure, process and outcome) was used to report on the development and impact of the Clinical School Model.

Results

Structural and process activities are reported, illustrating strong foundations to embed clinical academic career pathway opportunities. In the absence of empirical reporting standards for such developments, quantitative and qualitative outcomes are reported against the Clinical School's 5-year strategic plan.

Conclusions

This paper responds to the lack of reported evidence on developing organisational infrastructure to address the clinical academics aspirations of nurses and their employers. This important contribution leads a call for more organisations to report to the evidence base, enabling shared learning and shaping future research.

Exploring individual character traits and behaviours of clinical academic allied health professionals: a qualitative study

BACKGROUND

Clinical academic allied health professionals can positively impact patient care, organisational performance, and local research culture. Despite a previous national drive to increase these roles, they remain low in number with no clear strategy for growth. Reported barriers to this growth cite organisational and economic factors with little recognition of the challenges posed to individuals. There is a lack of research to help allied health professionals understand the personal challenges of clinical academic training and practice. The aim of this study is to explore the character traits and behaviours of clinical academic allied health professionals to understand the individual attributes and strategies taken to pursue a career in this field.

METHODS

A semi-structured interview study design was used to collect data from aspiring and established clinical academic allied health professionals. Participants were recruited voluntarily through social media advertisement (aspiring) and purposively through direct email invitation (established). Participants were asked about their experience of pursuing a clinical academic career. The interviews were conducted virtually using Zoom and were audio recorded. The data were transcribed verbatim prior to reflexive thematic analysis. Informed consent was gained prior to data collection and the study was approved by the university's research ethics committee.

RESULTS

Twenty participants from six allied health professions were interviewed. We developed five themes: risk and reward, don't wait to be invited, shifting motivations, research is a team sport, and staying the course. Clinical academic allied health professionals demonstrated traits including inquisitiveness, intuition, motivation, and resilience. The source of their motivation was rooted in improving clinical services, conducting research, and personal achievement.

CONCLUSION

Clinical academic allied health professionals describe personal traits of high inquisitiveness, opportunism, motivation, and determination in pursuing their career ambitions. The tolerance of rejection, failure, and risk was considered important and viewed as an essential source for learning and professional development. Future research should concentrate on ways to reduce the over-reliance on individual strength of character to succeed in this field and explore programmes to increase the preparedness and support for clinical academics from these professions.

The value of allied health professional research engagement on healthcare performance: a systematic review

BACKGROUND

Existing evidence suggests that clinician and organisation engagement in research can improve healthcare performance. With the increase in allied health professional (AHP) research activity, it is imperative for healthcare organisations, clinicians, managers, and leaders to understand research engagement specifically within allied health fields. This systematic review aims to examine the value of research engagement by allied health professionals and organisations on healthcare performance.

METHODS

This systematic review had a two-stage search strategy. Firstly, the papers from a previous systematic review examining the effect of research engagement in healthcare were screened to identify papers published pre-2012. Secondly, a multi-database search was used to conduct a re-focused update of the previous review, focusing specifically on allied health to identify publications from 2012-2021. Studies which examined the value of allied health research engagement on healthcare performance were included. All stages of the review were conducted by two reviewers independently. Each study was assessed using the appropriate Joanna Briggs Institute critical appraisal tool. A narrative synthesis was completed to analyse the similarities and differences between and within the different study types.

RESULTS

Twenty-two studies were included, comprising of mixed research designs, of which six were ranked as high importance. The findings indicated that AHP research engagement appears related to positive findings in improvements to processes of care. The review also identified the most common mechanisms which may link research engagement with these improvements.

DISCUSSION

This landmark systematic review and narrative synthesis suggests value in AHP research engagement in terms of both processes of care and more tentatively, of healthcare outcomes. While caution is required because of the lack of robust research studies, overall the findings support the agenda for growing AHP research. Recommendations are made to improve transparent reporting of AHP research engagement and to contribute essential evidence of the value of AHP research engagement.

TRIAL REGISTRATION

This systematic review protocol was registered with the international prospective register of systematic reviews, PROSPERO (registration number CRD42021253461 ).

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.

Quality assurance in allied healthcare education: A narrative review

Introduction

There is no standard methodology for outlining the intricacies of allied healthcare education (AHE) or its quality. The profound misconception is that quality assurance (QA) in AHE is used on a "voluntary" basis. Given the absence of statutory regulatory mechanisms such as accreditation, validation, and audit by the peripheral agencies concerning QA, adoption of QA measures in AHE is not consistent, and it results in producing a subpar allied health workforce. This paper analyzes the need to include QA measures as an essential domain in evaluating the effectiveness of allied health professional education programs.

Method

A large database search was performed using pertinent terms, and a blueprint was developed for a meticulous literature review published between 2015 and 2021. Five hundred eighty-two articles were found and screened; a critical appraisal was performed for 22 peer-reviewed articles for relevant information.

Results

The literature review identified the need to use academic domains such as leadership, planning, delivery, and feedback as QA criteria to evaluate the efficiency of education and training in allied health professional education programs. Instructors and facilitators for specific knowledge and skill development and a description of their roles should also be used in QA evaluation.

Conclusion

Resources for effective learning and teaching in the allied healthcare domain are limited. This review highlights the significant need to include a QA system in AHE, considering the pivotal role of these students in supporting humankind, now and in the future. The findings contribute to the research by providing essential insights into current trends and focusing on existing research in AHE quality.

Ten years of NIHR research training: perceptions of the programmes: a qualitative interview study

OBJECTIVES

The UK National Institute for Health Research (NIHR) training programmes were created to build and sustain research capacity in healthcare. Following the training programme 10-year strategic review, this qualitative study aimed to deepen understanding of facilitators and barriers for those progressing through NIHR-supported research careers.

DESIGN

Semistructured qualitative study.

DATA COLLECTION AND ANALYSIS

Telephone interviews conducted between May and August 2017 were digitally recorded, transcribed and analysed using Framework Approach.

SETTING

UK National Health Service (NHS) Trusts, university medical schools, District General Hospitals, Integrated Academic Training Programme centres and Research Design Services across the North East, North West, South East and South West of England, London and the Midlands.

PARTICIPANTS

Fourteen women and eight men, of whom, 14 were previous or current NIHR personal awardees (seven doctors and seven allied health professionals (AHPs) or nurses) and eight were managers (staff within clinical or university training-related roles).

RESULTS

(1) NIHR awards were viewed as transformative for research careers; (2) however, there were perceptions of a biased 'playing field'. (3) Inequalities were perceived for AHPs and nurses, those outside of established research institutes and those in 'unfashionable' specialisms. (4) While support for NIHR awards contributed to a healthy research culture, (5) short-term awards were perceived as a barrier to continuing an independent research career.

CONCLUSIONS

Participants perceived many strengths of the NIHR training programmes in terms of developing individual careers and research capacity. Areas in which improvement could enhance the ability to attract, develop and retain researcher were identified. Our findings are of relevance to schemes in other countries, where healthcare researchers experience similar challenges. Further work is needed to overcome barriers and ensure equity of access to, and success within, clinical research training schemes to sustain the research workforce needed to address future global health challenges.

Neonatal nursing led research activity in the UK: a survey of current practice

Background

Neonatal nurses are ideally placed in practice to undertake research enhancing the care of families. More information is required, however, around neonatal nursing led research to advance leadership in this area. The aim of this study was to determine neonatal nursing led research activity within the UK.

Methods

The study used a web-based survey design and neonatal nurses were eligible if they were working at or towards Masters or Doctoral level qualification in the UK. The survey was distributed to members of the Neonatal Nurses Association, UK Schools of Nursing and shared on social media pages of authors and professional organisations. Results were analysed using descriptive and frequency statistics and content analysis.

Results

Of the 56 respondents, 14% (n = 8) had a Doctoral level qualification and 43% (n = 24) of participants held a Masters qualification. Lack of time and funding knowledge was the largest barrier to research. Only 30% (n = 3) of participants had a research mentor and only 18% (n = 3) were from a neonatal nursing background.

Conclusions

There are limited numbers of neonatal nurses undertaking or leading nursing research in the UK. Further support is required to enhance clinical academic career trajectories to ensure research is a viable pathway for future generations of neonatal nurses.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00719-8.

A qualitative study exploring experiences and challenges of combining clinical academic training with family life

BACKGROUND

Concerns are being expressed around the lack of diversity at higher levels of clinical academia. This study aimed to explore experiences and challenges associated with combining clinical academic careers with family life.

METHODS

Qualitative data were gathered from participants from 4 NHS Trusts and 2 universities in the East Midlands of England using online surveys and semi-structured interviews.

RESULTS

The survey was completed by 67 nurses, midwives and allied health professionals, and 73 medical clinical academic trainees. Interviews were conducted with 16 participants from each group including equal numbers of men and women. Caring responsibilities differed between the two study populations. Medical clinical academic trainees were younger and either had young children or were yet to start a family. In contrast, nurses, midwives and allied health professionals tended to be older when they embarked on a clinical academic career and often waited until their children were school-age or older. Similar concerns were raised regarding working part-time and childcare, and how their career prospects might be affected in terms of fulfilling promotion criteria and being able to relocate for work purposes. The occupation of their partners also featured in participants' experiences; those who shared childcare with someone who worked 'regular' hours, appeared to be better supported to combine a clinical academic career with family life. Gender stereotyping was identified in some reported experiences highlighting a need for appropriate mentorship and for positive role models who were able to demonstrate that it is possible to survive and thrive as a clinical academic with family responsibilities.

CONCLUSIONS

Although people manage to find ways to successfully combine clinical academic roles with family life, findings highlight a need to identify ways of supporting and encouraging trainees with caring responsibilities to ensure that they remain on the clinical academic pathway.

Clinical academic radiographers - A challenging but rewarding career

OBJECTIVES

To explain what a clinical academic career can be, what it can lead to for the individual, profession and most importantly the patient, and why these roles are so important to radiography.

KEY FINDINGS

Multiple challenges to the adoption of clinical academic careers exist, including achievable measurable outcomes, visibility & senior support, and balancing different time demands. Equally the rewards are wide ranging and can advance both the individual and profession through role extension opportunities, increased career progression, patient benefits, and academic and research skills.

CONCLUSION

Clinical academic careers can provide advantages for the individual, department, profession and most importantly the patient with advanced clinical practice through evidenced based research.

IMPLICATIONS FOR PRACTICE

Improving clinical academic careers within Radiography will promote research participation and increase radiographic roles in patient-centred research delivery and development. Combining evidenced based research with academic skills will lead to improved patient care and better clinical outcomes.

The rise and rise of NMAHPs in UK clinical research

Over the past decade, the role of nurses, midwives and allied health professionals (NMAHPs) have been transformed within the UK research community. Assisted by new funding opportunities and a recognition of their role in interdisciplinary working, NMAHPs are driving innovative patient care. Challenges still remain to maximise the potential of NHAMPs in clinical research; signposting opportunities to become involved in research, promoting clear career pathways and developing innovative roles with the NHS to attract and retain this community are critical.

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.