The research capacity and culture of Australian podiatrists

Enablers and Barriers of Research Engagement Among Clinician Researchers: Nursing, Allied Health and Medical Professionals

Background

In response to the increasing involvement of nursing, allied health and medical professionals in research within clinical service roles, understanding the varying research capacities across public health institutions and professions is crucial. This study aims to explore the lived experiences of conducting research among nursing, allied health and medical health professionals within a tertiary public hospital setting in New South Wales (NSW). The focus is on identifying barriers and enablers to research engagement.

Methods

Research active health professionals across nursing, allied health and medical professions were invited to participate in a semi-structured interview to discuss enablers and barriers experienced whilst conducting research. All interviews were transcribed verbatim, conceptual and thematic analysis of the interviews was conducted.

Results

Nine allied health professionals, eight nurses/midwives and thirteen medical officers were interviewed. Key themes were categorised as barriers or enablers. The ethics regulatory process was identified as a strong barrier in all professions, other commonly identified barriers were lack of time to conduct research and lack of funding. Researchers reported difficulties knowing where to obtain assistance and support when required. Mentorship was the most common enabler identified by all three professions. In addition, a positive research culture and organisational support and assistance within the organisation were seen as strong enablers.

Conclusion

This research provides insight into the barriers and enablers for active clinician researchers across three professional groups. We have identified priority areas to increase research capacity within our health care organisation and will focus on training in the ethics regulatory process and mentorship along with infrastructure support to strengthen the positive research culture across all professions.

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.

Mental Health Nurses' and Allied Health Professionals' Individual Research Capacity and Organizational Research Culture: A Comparative Study

Introduction

Healthcare professionals have development needs related to their consumption, use, and practice of clinical research. Little is known about these issues in mental health services specifically.

Objectives

A survey of healthcare staff working in an NHS Mental Health and Disability Trust in England was conducted to describe research capacity and culture compared with previously reported samples, and to examine subgroup differences.

Methods

An online questionnaire was utilized. The main measure was the Research Capacity and Culture tool comprising measures of individual's perceived research skills and of team and organizational research culture. Previous studies using the same measure were systematically identified, and pooled results, weighted by sample size, were calculated. Analyses were descriptive (current sample versus previous results) and inferential (comparisons between demographic and professional groups within the current sample).

Results

N = 293 people completed the survey. The median item scores were poorer than those of pooled samples from studies reporting median item scores on 39/51 (76.5%) occasions and poorer than those pooled samples of studies reporting mean item scores on 51/51 (100.0%) occasions. Individual capability for research was in the 'less than adequate' range more than in previous samples (71.4% vs. 42.9%). For team culture items, the proportions were 84.2% vs. 78.9%, while most responses about organizational culture were in the 'adequate' range (55.6% vs. 66.7%). Staff >20 years employment had poorer perceptions of team and organizational culture.

Conclusion

Perceptions of individual research capacity and team and organizational culture were poor compared with previous studies, most of which were conducted in non-mental health settings. There is need for development of research capacity and culture in mental health services including opportunities to develop basic research skills through to strategic developments to promote clinical academic careers. There is considerable room for improvement in the way organizations support research and signpost opportunities.

Australian radiation therapist's research capacity and culture: investigating the extent of assistance required to build research capacity

Introduction

Building research capacity within the radiation therapist workforce/profession is essential to guarantee research is embedded into core practices. Assessment of current capacity levels within organisation, department and individual domains needs to occur to establish a baseline and ensure research capacity building (RCB) strategies will be targeted successfully. This exploratory study aimed to identify the areas within each domain where radiation therapists would benefit from extra research assistance, that being research support and process changes, particularly in relation to the workplace and health sector.

Methods

Practising radiation therapists (RTs) within Australia were recruited through professional organisations and invited to complete the online Research Capacity Culture Tool (RCCT). The survey was conducted using Qualtrics with data exported to SPSS.V27 for analysis. Descriptive statistics and the Industry Specific Item Interpretation for Policy and Strategy were used to analyse and report the results.

Results

Survey participation rate was 121/2640 (4.6%). Within the Organisation and Department domains, the most research assistance was required in infrastructure (n = 92–37) and support (n = 66–45) categories, respectively. Participants from private sector (Organisation: 42.7%, Department: 53.7%) and metropolitan centres (Organisation: 32.6%, Department: 47.5%) required a higher rate of assistance when compared to their counterparts in both categories. The individual domain showed similar levels of assistance required across health sectors and work locations. Workplaces showed similar levels of complexity of research activity; private sector (62.5%) recorded the highest level of no research activity.

Conclusion

This study has provided insight into how the research capacity and culture of organisations and departments in which individuals' work will influence their abilities and opportunities to perform research.

Promotion of research culture among radiographers in one UK NHS trust through journal club activities - An autoethnographic study

INTRODUCTION

The poor research culture within the radiography profession can be addressed through initiatives such journal club activities. The role of a research radiographer is best suited to drive achievement of journal club outcomes for research culture improvement; however, the cultural environment of healthcare providers presents challenges. This is an autoethnographic account of a research radiographer in promoting research culture among diagnostic radiographers in a single UK NHS trust through journal club activities.

METHODS

The study adopts an analytical autoethnography methodology to critically analyse reflective accounts of the research radiographer's experiences and the interplay with the cultural environment in which the experiences occurred. The reflective accounts are supported by locally collected data during a 10-month period of the journal club and published literature.

RESULTS

The establishment of the journal club received encouraging support from the senior management, university academics, library services and radiography professionals. There are initial signs of research culture improvement among participants of the journal club as observed through engagement in research related activities. However, cultural challenges including lack of time to explore gaps in research evidence, and prioritisation of clinical duties over research related activities, may have affected the achievement of expected outcomes of the club.

CONCLUSION

The research radiographer is well placed to encourage research culture within the clinical imaging department through targeted initiatives such as journal clubs. The long-term contributions of such initiative to departmental efficiency and quality service delivery should encourage optimum support to actualize expected outcomes.

IMPLICATIONS FOR PRACTICE

Encouragement of journal clubs as a means of improving research culture within clinical radiography teams, driven by research radiographers. Encouragement of management support for the achievement of set outcomes of journal clubs.

The research interest, capacity and culture of NHS staff in South East Scotland and changes in attitude to research following the pandemic: a cross-sectional survey

BACKGROUND

The UK National Health Service (NHS) is ideally placed to undertake research. The UK Government recently launched its vision of research within the NHS to improve research culture and activity amongst its staff. Currently, little is known about the research interest, capacity and culture of staff in one Health Board in South East Scotland and how their attitudes to research may have changed as a result of the SARS-CoV-2 pandemic.

METHODS

We used the validated Research Capacity and Culture tool in an online survey of staff working in one Health Board in South East Scotland to explore attitudes to research at the organisation, team and individual level together with involvement in, barriers to and motivators to engage in research. Questions included changes in attitude to research as a result of the pandemic. Staff were identified by professional group: nurses/midwives, medical/dental, allied health professionals (AHP), other therapeutic and administrative roles. Median scores and interquartile ranges were reported and differences between groups assessed using the Chi-square and Kruskal-Wallis tests with P < 0.05 accepted as statistical significance. Free-text entries were analysed using content analysis.

RESULTS

Replies were received from 503/9145 potential respondents (5.5% response), of these 278 (3.0% response) completed all sections of the questionnaire. Differences between groups were noted in the proportions of those with research as part of their role (P = 0.012) and in being research-active (P < 0.001). Respondents reported high scores for promoting evidence-based practice and for finding and critically reviewing literature. Low scores were returned for preparing reports and securing grants. Overall, medical and other therapeutic staff reported higher levels of practical skills compared with other groups. Principal barriers to research were pressure of clinical work and lack of time, backfill and funds. 171/503 (34%) had changed their attitude to research as a result of the pandemic with 92% of 205 respondents more likely to volunteer for a study themselves.

CONCLUSION

We found a positive change in attitude to research arising from the SARS-CoV-2 pandemic. Research engagement may increase after addressing the barriers cited. The present results provide a baseline against which future initiatives introduced to increase research capability and capacity may be assessed.

Research capacity and culture in an Australian metropolitan public mental health service: scoping the skills and experience of social workers and occupational therapists

BACKGROUND

Investment in a clinical research culture appears to be associated with benefits for consumers, staff, and overall organisational performance. The validated 55-item Research Capacity and Culture (RCC) tool was developed specifically to gauge the research capacity and culture of health professionals and workplace settings within which they work. Results of some individual studies suggest that professional discipline and workplace setting may impact RCC results however it has never been used in a dedicated public mental health setting. Therefore, this study will explore the research capacity and culture of allied mental health clinicians (Part 1). Another aim is to explore potential connections between workplace settings, locations and disciplines based on published RCC-based data to help signpost potential impediments to service improvements (Part 2).

METHODS

Part 1: An RCC-based online survey canvased Australian Social Workers and Occupational Therapists (n = 59) based in a metropolitan public mental health service. Non-parametric analyses explored links between research-related experience and participant characteristics. Part 2: Comparative analyses explored the potential influence of workplace settings and professional disciplines on published RCC results.

RESULTS

Part 1: Overall, the research capacity and experiences of mental health Social Workers and Occupational Therapists seemed modest. Discipline was statistically associated with level of research-activity experience, weighted towards occupational therapy; demographic characteristics were not. Only two items in the RCC were rated high; many more items were rated low. Part 2: Published studies exploration found no link between RCC ratings and workplace location, setting, or professional discipline. Sampling biases and use of modified, non-validated RCC versions likely impacted the results.

CONCLUSIONS

Allied mental health clinicians may not be sufficiently experienced, knowledgeable, or confident with a range of research-related activities given the emphasis on workforce research capability in policy and practice nowadays. This may be commonplace across health-based organisations. We recommend the systematic implementation of research training programs in (mental) health services, and a 'whole-of-service levels' approach be used i.e., transform policy, culture and leadership as well as provide practical resources with individual training. Potential benefits include a positive impact on organisation functioning, clinicians' confidence and practice, and improved consumer outcomes.

What is known about clinician researcher careers in allied health? A scoping review of the last decade

PURPOSE

Although the benefits of clinician researchers for health services are now more clearly recognised, their career development is not well understood. Hence, the purpose of this paper, a scoping review, is to determine what has been discussed in the literature about career opportunities for allied health (AH) clinician researchers in health services.

DESIGN/METHODOLOGY/APPROACH

A structured literature search was completed in December 2020 for literature published 2010-2020 in English. A total of 2,171 unique abstracts were found and screened by two reviewers and 206 articles progressed to full text screening.

FINDINGS

Forty-six studies were ultimately included; however, only two of these had aims directly related to AH clinician researcher careers, with the remainder containing only incidental data on this topic. Over half (56.5%) of the included studies were conducted in Australia, with a variety of AH professions represented. In terms of research design, 52.2% used cross-sectional survey designs, while case studies and qualitative research designs were also common. Key observations were that varying terminology and definitions were used, and there was little information about the inclusion of research in clinical positions or opportunities for formal clinical researcher positions in health services. There was some evidence to support that there are limited career opportunities after PhD completion, and that current career pathways are insufficient. There was conflicting evidence on whether engagement in research is beneficial for clinical career progression.

ORIGINALITY/VALUE

This review highlights a lack of research on this topic and outlines future directions to better support career pathways for AH clinician researchers.

Exploring research capacity and culture of allied health professionals: a mixed methods evaluation

Background

Despite the myriad benefits of research to patients, professionals, and organisations, fewer than 0.1% of the Allied Health Professions workforce are employed in clinical academic roles. Identified barriers include a lack of role modelling, management support, funding, and availability of clinical academic roles. Research capacity building is critical to improving Allied Health Professional research capability. The aim of this evaluation was to explore the current research capacity and culture of Allied Health Professionals to inform future tailored research capacity building strategies at a local level.

Methods

A mixed methods evaluation of research capacity and culture was conducted within the Allied Health Professions department of a large National Health Service Foundation Trust using an online research capacity and culture questionnaire, followed by focus groups. Staff were recruited using a purposive method with the questionnaire and subsequent focus groups completed between July and September 2020. Data from the questionnaire was analysed using simple descriptive statistics and after inductive coding, focus group data was analysed thematically.

Results

93 out of 278 staff completed the questionnaire and 60 staff members attended seven focus groups. The research capacity and culture survey reported the department’s key strength as promoting clinical practice based on evidence (median=8, range=6-9). A key reported weakness of the department was insufficient resources to support staff research training (med=4, 3-6). Respondents considered themselves most skilled in finding relevant literature (med=6, 5-8) and least skilled at securing research funding (med=1, 1-2). Greater than half of the respondents (n=50) reported not currently being involved with research. Five themes were identified from the focus groups: empowerment; building research infrastructure; fostering research skills; access for all; and positive research culture.

Conclusions

Allied Health Professionals recognise the benefits of research at teams and departmental level, but marginally at an individual level. Local research capacity building strategies should aim to address the role, responsibilities and barriers to Allied Health Profession research development at an individual level. To ensure all staff can engage, research infrastructure and empowerment are essential.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-07480-x.

A Bibliometric Evaluation of Worldwide Research of the Podiatry Field from 1965 to 2017

BACKGROUND

To identify the strengths and weaknesses in a given research area, it is necessary to analyze the published literature. International studies on podiatry research productivity are scarce. This study aimed to analyze scientific productivity in the area of podiatric medicine from 1965 to 2017.

METHODS

This was a retrospective, observational, bibliometric study. The MEDLINE database was used to identify research published between 1965 and 2017. Literature searches were performed in 2010 and 2017 through RefWorks, and research production per year, author, document type, country, institution, journal, and language were calculated. Podiatry's contribution to global scientific production was measured by calculating the ratio of podiatry publications to total production, and Price's law was applied to analyze the temporal evolution. Author productivity index, coauthorship, geographic distribution, and the distribution by institution type and journal (Bradford's law) were analyzed.

RESULTS

The MEDLINE search yielded 1,256 publications, representing 4.75 articles per 100,000 publications in global scientific research. The growth rate followed Price's law after linear adjustment. The 2,229 identified authors presented a transience index of 85.73%; 0.38% were highly productive authors. The coauthorship index increased from 1.40 in 1965 to 5.80 in 2017. The most common document type was the journal article, whereas 2.1% were clinical trials. Only one document reported a controlled clinical trial. The United States led scientific production, with 77.15% of the documents; 60.5% of the publications were concentrated in four journals.

CONCLUSIONS

Podiatry is still an emerging research field, and literature is concentrated in a small number of journals, categorized into different subjects.

Policymakers' Research Capacities, Engagement, and Use of Research in Public Health Policymaking

The use of research in public health policymaking is one of the prerequisites for successfully implemented health policies which have better population health as an outcome. This policy process is influenced by the actors involved under the policy umbrella, with inter-related contextual factors and specific structural and institutional circumstances. Our study investigates how policymakers’ research capacities influence the use of research in the health policy process and identify areas where capacity-building interventions give the most meaning and impact. Furthermore, we investigate policymakers’ research engagement and use this to inform public health policy in the public sector in Denmark. We collect and report data using Seeking, Engaging with, and Evaluation Research (SEER) methodology. Policymakers are reported to have research capacity, but it is questionable how those competences have actually been used in policymaking. Decision-makers were often not aware or did not know about the existing organizational tools and systems for research engagement and use and two third of respondents had not been part of any research activities or had any collaboration with researchers. Overall, research use in public health policymaking and evaluation was limited. As a conclusion, we propose that capacity-building interventions for increasing research use and collaboration in EIPM should be context-oriented, measurable, and sustainable in developing individual and organizational competences.

Evaluation of Research Capacity and Culture of Health Professionals Working with Women, Children and Families at an Australian Public Hospital: A Cross Sectional Observational Study

Background

There is limited evidence for use of the Research Capacity and Culture tool across multidisciplinary health professionals. We explored using the Research Capacity and Culture tool among multidisciplinary health professionals at an Australian secondary hospital.

Methods

A cross-sectional observational study where online and paper-based surveys of the Research Capacity and Culture tool were disseminated between November 2020 and January 2021. Descriptive analyses of demographic variables and Likert scale items were summarized using median and inter-quartile ranges. Differences between organization, team and individual domains were checked using a Friedman test. Post-hoc Wilcoxon signed rank tests determined specific differences between domains.

Results

Seventy-six multidisciplinary health professionals (female, 89.3%) reported overall perceptions of research success/skills highest in the organization (median 6), followed by the team (median 5) and individual domains (median 3.5). Only 21.3% agreed that research activities were a part of their role description. Mean scores across professions were highest for Medicine (5.47), Midwifery (4.52), Nursing (4.47) and Allied Health (3.56), respectively, for the team domain. Individual domain scores across all professions were below 50%. Commonly reported barriers to research were “lack of time for research,” “other work roles taking priority” and “a lack of skill.” “Developing skills” was the most common personal motivator.

Conclusion

Multidisciplinary health professionals reported the highest overall perception of research success/skills in the organization domain. Medical health professionals perceived research success/skills highest compared to nursing, midwifery and allied health professionals.

Medical Educators' Perceptions of Research Culture in a Faculty of Health Sciences: A South African Study

Phenomenon: In South Africa, as with many other developing countries, a call has been made for institutions of higher learning to participate in more research and set the pace for societal transformation. At the Faculty of Health Sciences (FoHS), University of the Free State (UFS), numerous strategic efforts are focused on supporting and stimulating research. An essential prerequisite for the success of these vital efforts is to be aware of the research culture within the academic faculties. A peculiarity of medical colleges in South Africa is that medical faculties are in partnership with the government through the academic training hospitals; hence, staff appointment occurs through a joint structure with both the provincial Department of Health and the National Health Laboratory Services. So far, no known study has investigated research culture in this context (joint staff appointment). Approach: This study included elements of case study evaluation and improvement-oriented evaluation. We distributed to 242 educators a structured questionnaire to obtain perceptions of aspects of research, research processes, and existing research culture in the FoHS, UFS. Suggestions on how to improve the research culture also were obtained. The structured questionnaire was self-administered, consisted of closed and open-ended questions grouped into five main sections, and was distributed electronically and manually (hard copy) to participants. Findings: One-hundred-eleven questionnaires were returned (46% response rate). Motivation to do research varied by school and included career advancement (77%, School of Allied Health Professions); change the situation (80%, Academic support); develop individual skillset (67%, School of Nursing) and improve patient care (62%, School of Medicine). Perceived factors affecting research culture included limited funding and allocated time for research, minimal leadership support for research, and absence of research-related support structures as well as minimal teamwork/collaboration. Frustration was the most reported (negative) emotion (25%). Participants suggested that encouraging teamwork among staff, reducing workload to allow time for research, establishing a mentorship program, providing training on deficient skills, and more support from leadership would improve research culture. Insights: This present study reveals some of the factors that impact negatively on research, research culture, and productivity in a medical college in a resource-limited setting. While the benefits of joint staff appointment cannot be overemphasized, our findings highlight that the complex interplay between employers/stakeholders result in poorly executed joint appointment scheme/models (i.e., competitive approach) and creates numerous challenges that negatively impact research productivity and research culture. Recommendations suggested herein can be implemented by the FoHS and other medical colleges in similar contexts to improve research productivity and foster an enabling research culture.

The biopsychosocial-digital continuum of foot orthosis practice and research: the VALUATOR model

Foot orthoses have been used for decades despite uncertainty surrunding their therapeutic efficacy. Orthoses have been used exclusively to affect neuro-biomechanical input and outcome variables, however, there is emerging evidence that therapeutic efficacy may be affected by a psychological stimulus. Critical appraisal of the literature highlights that there is no holistic model upon which foot orthosis practice is taught, practised nor investigated. This paper introduces a conceptual model of foot orthosis practice (Value Based Foot Orthosis Practice (VALUATOR) model) that embraces a broader range of factors that are pertinent to orthosis practice, incorporating contemporary health service behaviours and values into orthosis practice for the first time.Within the VALUATOR model, foot orthosis design and clinical value is considered along a bio-psycho-social-digital continuum that reflects the reality of foot orthosis practice. The model contextualises the variable outcomes that are observed in research and practice within 6 key areas: 1) value, 2) person-centered approach, 3) zone of optimal bio-psycho-social stress, 4) bio-psycho-social assessment, 5) monitoring, 6) primary and secondary clinical strategies.The VALUATOR model is targeted at students, lecturers, scientists and practitioners and includes carefully chosen terminology to support a robust basis for educational and scientific discussion. It is believed that it provides a contemporary viewpoint and a structured conceptual metaphor that builds on existing evidence from a wide range of sources, invites constructive intellectual debate, and is anchored in the experiences of practitioners too. Stress testing the VALUATOR model will help determine its model and support further developments and evolution of orthotic practice in a evidence based way.

A conceptual framework for contemporary professional foot care practice: ''The value based digital foot care framework''

BACKGROUND

A small minority of countries around the globe have podiatry as a recognized profession, hence, there are considerable differences among these countries when it comes to the curricula, the duration of training and legislation regulating the profession. The growth in research led evidence based practice, and the emerging digital landscape of health care practice, occur alongside trends in disease and health behaviours that strongly impact on foot health. As such, the changing complex role of the podiatrist requires critical reflection on current frameworks of practice and whether they are fit for purpose. This commentary presents a conceptual framework which sets the scene for further development of concepts in a podiatry context, reflecting contemporary health care beliefs and the changing expectations of health care and society. The proposed conceptual framework for podiatry practice utilizes the metaphor of an electronic circuit to reflect the vast and complex interconnections between factors that affect practice and professional behaviours. The framework helps in portraying and defining drivers of practice, actual practice as well potential barriers for current and future practice. The circuit emphasis the interconnectedness/interaction of three clusters: 1) internal factors, 2) interaction factors, 3) external factors.

CONCLUSION

Whatever promise this new framework holds, it will only be realised through conscious development of community consensus, respectful dialogue, constructive critical appraisal, and maintaining passion and focus on improving the health of people with foot related problems.

Actual and perceived knowledge of research ethics guidelines in a sample of public health clinicians

BACKGROUND

The conduct of research by clinicians is vital to maintain evidence-based practice and currency of clinician knowledge. However, the ability to conduct valid research is contingent on several factors including the knowledge of research ethics guidelines applicable within the researcher's location.

AIMS

To compare the actual and perceived knowledge of research ethics guidelines in a sample of healthcare clinicians in a public health service.

METHODS

A prospective cross-sectional design utilising an anonymous online survey.

RESULTS

Of the 432 valid responses, 8% were totally well calibrated on perceived and actual knowledge. A further 9% were totally miscalibrated on all items. The remaining 83% of respondents were variously miscalibrated on 1-4 items. The majority of miscalibrated responses represented overconfidence.

CONCLUSIONS

Clinicians are not as knowledgeable as they think about research ethics. This has implications for help-seeking behaviours within this population and highlights challenges for stakeholders in the provision of research support and education.

Assessment of Health Research Capacity in Western Sydney Local Health District (WSLHD): A Study on Medical, Nursing and Allied Health Professionals

Background

Research should inform clinical decision-making and evidence-based practice for all health professionals. To build research capacity among all health professionals, there is a need to measure the levels of research capacity and identify the gaps and needs of health-care professionals. The aim of the study was to better understand the research culture and capacity of health professionals (medical, nursing and allied health) in Western Sydney Local Health District, Sydney, Australia.

Methods

A research capacity and culture tool (RCCT) survey was electronically distributed to all health staff in WSLHD. Data were collected between November 2016 and January 2017. Participants were surveyed through a 10-point Likert scale that measured research capacity at the individual, team and organisational levels.

Results

A total of 393 health staff responded to the study: allied health practitioners (46.3%), nursing staff (35.4%) and medical practitioners (18.3%). Females made 76% of the sample, and 54% were aged between 35 and 54 years. Individual responses were different across professions, with an average median score for medical 6.3 (95% CI 5.8-6.9), allied health 5.3 (95% CI 4.9-5.7) and nursing 4.5 (95% CI 4.1-5.0) after adjustment for age and gender. Team responses for medical staff (average median score 5.9 95% CI 5.3-6.4) were higher than allied health (4.1 95% CI 3.7-4.6) and nursing (4.3 95% CI 3.8-4.8), after adjusting for age and gender. However, there were no differences between the three professions for the organisational responses. Allied health and nursing staff were less confident in obtaining research funding, submitting ethics applications, writing for publication and mentoring colleagues about research.

Conclusion

This study demonstrates the individual research capacity for medical, allied health and nursing professionals are different. Research capacity building needs to be individually tailored to the specific needs of each profession. This research will inform future capacity building activities and training for health professionals in a large public health organisation of Sydney, Australia.

A Feasibility Study Of Administering The Electronic Research And Development Culture Index To The Multidisciplinary Workforce In A UK Teaching Hospital

Purpose

The study aims were: (i) to convert the Research and Development Culture Index (a validated rating instrument for assessing the strength of organizational Research and Development culture) into electronic format (eR&DCI), and (ii) to test the format and assess the feasibility of administering it to the multidisciplinary (allied health professionals, doctors and nurses) workforce in a National Health Service Hospital (NHS) in the United Kingdom (UK) by trialing it with the workforce of the tertiary Children’s Hospital within the organization.

Population and methods

The eR&DCI was emailed to all professional staff (n=907) in the Children’s Hospital. Data were analyzed using IBM SPSS Statistics 22.

Results

The eR&DCI was completed by 155 respondents (doctors n=38 (24.52%), nurses n=79 (50.96%) and allied health professionals (AHPs) n=38 (24.52%)). The response rate varied by professional group: responses were received from 79 out of 700 nurses (11%); 38 out of 132 doctors (29%) and 38 out of 76 AHPs (50%). Index scores demonstrated a positive research culture within the multidisciplinary workforce. Survey responses demonstrated differences between the professions related to research training and engagement in formal research activities.

Conclusion

This is the first study to assess the feasibility of assessing the strength of an organization’s multidisciplinary workforce research and development (R&D) culture by surveying that workforce using the eR&DCI. We converted the index to “Online Surveys” and successfully administered it to the entire multidisciplinary workforce in the Children’s Hospital. We met our criteria for feasibility: ability to administer the survey and a response rate comparable with similar studies. Uptake could have been increased by also offering the option of the paper-based index for self-administration. Results of the survey are informing delivery of the research strategy in the Children’s Hospital. This methodology has potential application in other healthcare contexts.

Surveying Allied Health Professionals Within a Public Health Service: What Works Best, Paper or Online?

Poor response rate, self-selection bias, and item noncompletion negatively impact the generalization of results from surveys. This study examined differences in these factors between a paper and online survey among allied health clinicians. Clinicians within a large local health district were initially invited to complete the Research Capacity in Context Tool online via an e-mail link. Following a lower-than-expected response rate, potential selection bias, and item noncompletion, the survey was readministered in paper form to the same cohort of clinicians 6-12 months later. The response rate to the paper survey was higher than to the online survey (27.6% vs. 16.5%). Selection biases were evident, characterized by seniority and discipline: Junior clinicians responded at rates significantly less than expected to the online survey but as expected to the paper survey. Occupational therapists, speech pathologists, and podiatrists responded more highly to the online survey, while other disciplines responded more highly to the paper survey. The rate of item noncompletion was higher for online than paper survey (6.72% vs. 3.8% questions not completed, respectively), with patterns of noncompletion also differing. These data suggest paper surveys are likely to produce less biased and more generalizable data from allied health clinicians.

Proliferation of the WReN spider, an instrument to measure health professionals' experience of research: a bibliographic study

BACKGROUND

In 1997 the "Wessex Research Network (WReN) Spider" was developed and validated to assess the research experience of general practice based researchers. This bibliometric study traces the use and development of this instrument over 15 years.

METHODS

We performed a bibliographic search to identify all the citations of the original article since 2002.

RESULTS

Thirty one relevant papers were found. Publications were classified according to whether they used (N = 18) or cited (N = 13) the WReN Spider. The majority of these papers came from Australia (N = 18) and 10 papers focussed on the research training of Allied Health Professionals. The WReN Spider was used in 12 studies to assess baseline experience before a training intervention or to compare before and after training scores. The WReN Spider was often (N = 9) modified to additionally assess interest, confidence or interest in up-skilling in each of its 10 limbs. It was also often (N = 14) used in tandem with open ended questions to gain a more detailed understanding of people's research skills, or with additional questions focussing on the research context, culture and team. None of the papers confirmed the validation of the WReN Spider, although it was applied in contexts that differed from the one in which it was developed.

CONCLUSIONS

The WReN Spider continues to be used to measure the research experience of health care practitioners, but it is frequently enhanced with other questions to look at the wider issues of research success, including collaborators, resource and environment.

Research culture and capacity in community health services: results of a structured survey of staff

Developing research capacity is recognised as an important endeavour. However, little is known about the current research culture, capacity and supports for staff working in community-based health settings. A structured survey of Division of Community Health staff was conducted using the research capacity tool. The survey was disseminated by email and in paper format. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed thematically. In total, 109 usable responses were received, giving a response rate of 26%. Respondents were predominately nurses (n=71, 65.7%), with ~50% reporting post-graduate vocational qualifications. The highest levels of skills or organisational success were in using evidence to plan, promote and guide clinical practice. Most participants were unsure of organisational and team level skills and success at generating research. Few reported recent experience in research-generating activities. Barriers to undertaking research included lack of skills, time and access to external support and funding. Lack of skills and success in accessing external funding and resources to protect research time or to 'buy-in' technical expertise appeared to exacerbate these barriers. Community health staff have limited capacity to generate research with current levels of skill, funding and time. Strategies to increase research capacity should be informed by knowledge of clinicians' research experience and interests, and target development of skills to generate research. Resources and funding are needed at the organisational and team levels to overcome the significant barriers to research generation reported.

Evaluation of the research capacity and culture of allied health professionals in a large regional public health service

Purpose

The first aim of this study was to evaluate the current research capacity and culture among allied health professionals (AHPs) working in a large regional health service. The second aim of this study was to undertake principal component analyses (PCAs) to determine key components influencing our research capacity and culture.

Patients and methods

As part of a cross-sectional observational study, the Research Capacity and Culture (RCC) tool was administered to AHPs working in Gold Coast Health to measure self-reported research capacity and culture across Organization, Team, and Individual domains, including barriers to and motivators for performing research. An exploratory PCA was performed to identify key components influencing research capacity and culture in each of the three domains, and the results were compared with the findings of a previous study performed in a large metropolitan health district.

Results

This study found moderate levels of research capacity and culture across all domains, with higher scores (median, IQR) reported for the Organization domain (7,5–8) compared to the Team (6,3–8) and Individual domains (5,2–7). Two components were identified in each domain. Components in the Organization domain included “research culture” and “research infrastructure”; components in the Team domain included “valuing and sharing research” and “supporting research”; and components in the Individual domain included “skills for conducting research” and “skills for searching and critiquing the literature”. These components were found to be highly correlated with each other, with correlations between components within each domain ranging from 0.459 to 0.702.

Conclusion

The results of this study reinforce the need for an integrated “whole of system” approach to research capacity building. Ongoing investment in tailored support and infrastructure is required to maintain current areas of strengths and build on identified areas of weakness at the level of organizations, teams, and individual AHPs, and consideration should also be given as to how support across these three levels is integrated.

Research capacity building frameworks for allied health professionals - a systematic review

Background

Building the capacity of allied health professionals to engage in research has been recognised as a priority due to the many benefits it brings for patients, healthcare professionals, healthcare organisations and society more broadly. There is increasing recognition of the need for a coordinated multi-strategy approach to building research capacity. The aim of this systematic review was to identify existing integrated models and frameworks which guide research capacity building for allied health professionals working in publicly funded secondary and tertiary healthcare organisations.

Methods

A systematic review was undertaken searching five databases (Medline, CINAHL, Embase, AustHealth and Web of Science) using English language restrictions. Two authors independently screened and reviewed studies, extracted data and performed quality assessments using the Mixed Methods Appraisal Tool. Content and thematic analysis methods were used to code and categorise the data.

Results

A total of 8492 unique records were screened by title and abstract, of which 20 were reviewed in full-text. One quantitative study and five qualitative studies were included, each of which describing a research capacity building framework. Three interconnected and interdependent themes were identified as being essential for research capacity building, including ‘supporting clinicians in research’, ‘working together’ and ‘valuing research for excellence’.

Conclusions

The findings of this systematic review have been synthesised to develop a succinct and integrated framework for research capacity building which is relevant for allied health professionals working in publicly funded secondary and tertiary healthcare organisations. This framework provides further evidence to suggest that research capacity building strategies are interlinked and interdependent and should be implemented as part of an integrated ‘whole of system’ approach, with commitment and support from all levels of leadership and management. Future directions for research include using behaviour change and knowledge translation theories to guide the implementation and evaluation of this new framework.

Trial registration

The protocol for this systematic review has been registered with PROSPERO. The registration number is CRD42018087476.

Electronic supplementary material

The online version of this article (10.1186/s12913-018-3518-7) contains supplementary material, which is available to authorized users.

Characterising the research profile of the critical care physiotherapy workforce and engagement with critical care research: a UK national survey

OBJECTIVE

To characterise the research profile of UK critical care physiotherapists including experience, training needs, and barriers and enablers to engagement in critical care research. 'Research' was defined broadly to encompass activities related to quantitative and qualitative studies, service evaluations, clinical audit and quality improvements.

DESIGN

Closed-question online survey, with optional free-text responses.

SETTING

UK critical care community.

PARTICIPANTS

UK critical care physiotherapists, regardless of clinical grade or existing research experience.

RESULTS

268 eligible survey responses were received during the 12-week study period (21 incomplete, 7.8%). Respondents were based in university-affiliated (n=133, 49.6%) and district general (n=111, 41.4%) hospitals, and generally of senior clinical grade. Nearly two-thirds had postgraduate qualifications at master's level or above (n=163, 60.8%). Seven had a doctoral-level qualification. Respondents reported a range of research experience, predominantly data acquisition (n=144, 53.7%) and protocol development (n=119, 44.4%). Perceived research training needs were prevalent, including topics of research methods, critical literature appraisal, protocol development and statistical analysis (each reported by ≥50% respondents). Multiple formats for delivery of future research training were identified. Major barriers to research engagement included lack of protected time (n=220, 82.1%), funding (n=177, 66.0%) and perceived experience (n=151, 56.3%). Barriers were conceptually categorised into capability, opportunity and motivation themes. Key enabling strategies centred on greater information provision about clinical research opportunities, access to research training, secondment roles and professional networks.

CONCLUSIONS

UK critical care physiotherapists are skilled, experienced and motivated to participate in research, including pursuing defined academic research pathways. Nonetheless wide-ranging training needs and notable barriers preclude further involvement. Strategies to harness the unique skills of this profession to enhance the quality, quantity and scope of critical care research, benefiting from a multiprofessional National Clinical Research Network, are required.

Barriers to participation in medical research from the perspective of researchers

BACKGROUND

The first step toward organizing research activities is to obtain a correct perception of available capabilities. This study was conducted to investigate the researchers' views about barriers affecting research activities.

METHODS

This descriptive, cross-sectional study was conducted using the census method. The population consisted of the faculty members of Birjand University of Medical Sciences in 2014. The research tool was a questionnaire in six areas of financial, facility, professional, scientific, personal, and organizational- managerial barriers. The results were analyzed using descriptive statistics and Friedman test.

RESULTS

Faculty members confirmed that although all barriers affected research activities, organizational-managerial barriers (3.73 ± 0.63) had the greatest and scientific barriers (3.15 ± 0.93) had the lowest effect, respectively. The results of Friedman test showed that there is a significant difference between the mean values of factors related to various barriers affecting research activities from the viewpoint of the participants' answers.

CONCLUSIONS

Research activities are affected by numerous barriers. Strategies, such as empowering researchers, employing new technologies in the creation of research teams, and benefiting from research experts in various stages of research, may have a positive effect on the removal of the barriers.

Key factors influencing allied health research capacity in a large Australian metropolitan health district

OBJECTIVE

The aim of this study was to identify key factors affecting research capacity and engagement of allied health professionals working in a large metropolitan health service. Identifying such factors will assist in determining strategies for building research capacity in allied health.

MATERIALS AND METHODS

A total of 276 allied health professionals working within the Sydney Local Health District (SLHD) completed the Research Capacity in Context Tool (RCCT) that measures research capacity and culture across three domains: organization, team, and individual. An exploratory factor analysis was undertaken to identify common themes within each of these domains. Correlations were performed between demographic variables and the identified factors to determine possible relationships.

RESULTS

Research capacity and culture success/skill levels were reported to be higher within the organization and team domains compared to the individual domain (median [interquartile range, IQR] 6 [5-8], 6 [5-8], 5 [3-7], respectively; Friedman χ2(2)=42.04, p<0.001). Exploratory factor analyses were performed to identify factors that were perceived by allied health respondents to affect research capacity. Factors identified within the organization domain were infrastructure for research (eg, funds and equipment) and research culture (eg, senior manager's support for research); within the team domain the factors were research orientation (eg, dissemination of results at research seminars) and research support (eg, providing staff research training). Within the individual domain, only one factor was identified which was the research skill of the individual (eg, literature evaluation, submitting ethics applications and data analysis, and writing for publication).

CONCLUSION

The reported skill/success levels in research were lower for the individual domain compared to the organization or team domains. Key factors were identified in each domain that impacted on allied health research capacity. As these factors were different in each domain, various strategies may be required at the level of the organization, team, and individual to support and build allied health research capacity.

Research culture in a regional allied health setting

Research evidence is required to guide best practice, inform policy and improve the health of communities. Current indicators consider allied health research culture to be low. This study aimed to measure the allied health research culture and capacity in a Victorian regional health service. The Research Capacity and Culture tool was used to evaluate research capacity and culture across individual, team and organisation domains. One-way ANOVA was used to determine differences between allied health professions, whereas responses to open-ended questions were themed using open coding. One hundred thirty-six allied health professionals completed the survey. There were statistically significant differences in the organisation domain between social work, physiotherapy and occupational therapy professions; in the team domain, between social work and all other professions. Motivators for conducting research included providing a high-quality service, developing skills and increasing job satisfaction. Barriers included other work roles taking priority, a lack of time and limited research skills. Multi-layered strategies including establishing conjoint research positions are recommended to increase allied health research culture in this regional area.

Research culture in allied health: a systematic review

Research evidence is required to guide optimal allied health practice and inform policymakers in primary health care. Factors that influence a positive research culture are not fully understood, and nor is the impact of a positive research culture on allied health professionals. The aim of this systematic review was to identify factors that affect allied health research culture and capacity. An extensive search of 11 databases was conducted in June 2015. Studies were included if they were published in English, had full-text availability and reported research findings relating to allied health professions. Study quality was evaluated using the McMaster Critical Review Forms. Fifteen studies were eligible for inclusion. A meta-analysis was not performed because of heterogeneity between studies. Allied health professionals perceive that their individual research skills are lower in comparison to their teams and organisation. Motivators for conducting research for allied health professionals include developing skills, increasing job satisfaction and career advancement. Barriers include a lack of time, limited research skills and other work roles taking priority. Multilayered strategies, such as collaborations with external partners and developing research leadership positions, aimed at addressing barriers and enablers, are important to enhance allied health research culture and capacity.