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McCarron L, Watson S, Parsons D, Robinson L, O'Brien L, Puri A, Stabler A. Research capacity and culture: a survey of Australian Orthopaedic Association members. J Orthop Surg Res 2024; 19:674. [PMID: 39428481 PMCID: PMC11492767 DOI: 10.1186/s13018-024-05108-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2024] [Accepted: 09/23/2024] [Indexed: 10/22/2024] Open
Abstract
BACKGROUND Strong research capacity and culture (RCC) within professional groups predict engagement in high-quality research and the integration of evidence into practice. However, factors affecting RCC participation and development are currently unknown in Australian Orthopaedic Surgeons. STUDY DESIGN Cross-sectional survey. METHODS All Australian Orthopaedic Association members were invited to complete the individual domain of the validated Research Capacity and Culture tool. RESULTS One hundred and sixty-three Australian Orthopaedic Association members (9%) provided survey answers. Survey findings indicated that AOA members scored moderate or high for most RCC domains (14 out of 15). Barriers to the completion of research included a lack of time, other work roles taking priority, and a lack of funds for research. CONCLUSION The Australian Orthopaedic Association members surveyed in this study demonstrated adequate research skills and experience, although reported they could benefit from additional support securing funding and navigating specific research tasks. Increasing future collaboration with academic institutions and clinician-researcher roles may enhance the output of high-quality orthopaedic research in Australia.
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Affiliation(s)
- Luke McCarron
- Bond Institute of Health and Sport, Occupational Therapy Department, Level 4, 2 Promethean Way, Robina, QLD, 4226, Australia.
- Australian Research Collaboration on Hands, QLD, 4213, Mudgeeraba, Australia.
- Orthopaedic Department, Gold Coast Hospital and Health Service, 1 Hospital Blvd, QLD, 4215, Southport, Australia.
| | - Steven Watson
- Orthopaedic Department, Gold Coast Hospital and Health Service, 1 Hospital Blvd, QLD, 4215, Southport, Australia
| | - Dave Parsons
- Curtin School of Allied Health, Curtin University, Kent St, WA, 6102, Bentley, Australia
| | - Luke Robinson
- Department of Occupational Therapy, Monash University, Moorooduc Highway, VIC, 3199, Frankston, Australia
| | - Lisa O'Brien
- Department of Nursing and Allied Health, Swinburne University of Technology, John St, VIC, 3122, Hawthorn, Australia
| | - Arvind Puri
- Orthopaedic Department, Cairns and Hinterlands Hospital, 165 The Esplanade, QLD, 4870, Cairns, Australia
| | - Annabelle Stabler
- Orthopaedic Department, Gold Coast Hospital and Health Service, 1 Hospital Blvd, QLD, 4215, Southport, Australia
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Pang M, Sayner A, McKenzie K. Continuing professional development training needs of allied health professionals in regional and rural Victoria. Aust J Rural Health 2024; 32:763-773. [PMID: 38812452 DOI: 10.1111/ajr.13141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/08/2024] [Accepted: 05/13/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVE The aim of the study was to identify continuing professional development (CPD) needs of allied health professionals (AHP) in regional and rural Victoria. DESIGN This study was an online cross-sectional design conducted between December 2022 and February 2023. SETTINGS AND PARTICIPANTS AHPs employed at a large multi-site regional public health service providing acute, subacute, community and outpatient care in Victoria, Australia. MAIN OUTCOME MEASURE(S) The online questionnaire included four sections investigating satisfaction of CPD, prioritised topics for CPD, preference for CPD sourcing and perceived capabilities in delivering education. To investigate prioritised topics of CPD, a tool was adapted from the Hennessy Hicks Training Needs Analysis questionnaire to align with allied health (AH) career pathways. For organisational alignment, a second questionnaire was sent to AH managers. RESULTS The response rate was 17% (53/316 AHPs) from members of 10 AH professions. The median years of clinical experience for participants was between 2 and 5 years. Participants with 6-10 years of clinical experience reported the lowest level of satisfaction. Research and education were identified as areas of highest training need. Self-perceived competence in education delivery was proportionately lower in areas of assessment, developing digital learning and constructive alignment. CONCLUSION CPD needs for AHPs in a regional and rural health service were shown to vary by career stage and weighted towards developing research and education delivery capabilities. Findings from this study may support public health sector and policy investment in CPD opportunities to support horizontal career progression opportunities, a balance of internal and externally sourced professional development and strategic investment in education delivery capabilities.
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Affiliation(s)
- Michael Pang
- Grampians Health, Federation University, Ballarat Central, Victoria, Australia
| | - Alesha Sayner
- Grampians Health, Deakin Rural Health, Western Alliance, Geelong, Victoria, Australia
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McMahon R, Pain T, Dick F, Tench S. Development of a team-specific research strategy using a modified Delphi method in a regional public hospital dietetics department. Aust J Rural Health 2024; 32:789-800. [PMID: 38822645 DOI: 10.1111/ajr.13145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/02/2024] [Accepted: 05/19/2024] [Indexed: 06/03/2024] Open
Abstract
OBJECTIVE Evaluate research capacity and culture among regional hospital dietitians, develop a team specific research strategy, and build research skills of novice researchers. METHODS The Research Capacity in Context Tool was used to assess current research capacity and culture at organisational, team and individual levels. Results were analysed using descriptive statistics and content analysis of free text responses. A modified Delphi method gained consensus regarding research capacity building. DESIGN Mixed method study. SETTING Dietetics department of a regional tertiary hospital (Modified Monash Category 2). PARTICIPANTS All clinical dietitians currently employed within the hospital (n = 20) regardless of employment duration. MAIN OUTCOME MEASURES Self-rated response to research capacity and culture to produce a dietetics-specific research strategy. RESULTS Fifteen dietitians (75%) completed the Research Capacity in Context Tool. The overall mean score was highest at an organisational level at 7.9 (IQR 2), and lowest at team and individual levels at 4.3 (IQR 2.7) and 4.9 (IQR 3.3) respectively. Common barriers to research included time, lack of skills, knowledge and support. Using the modified Delphi method 39 statements relating to research capacity building met consensus and informed the creation of a research strategy. CONCLUSION The results of the Research Capacity in Context Tool from this regional study reflect those reported in the literature at metropolitan sites. A dietetic-specific research strategy was developed to assist with increasing research capacity at a team and individual level in a regional setting. Evaluation of long-term outcomes post implementation will be the subject of further research.
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Affiliation(s)
- Rachel McMahon
- The Townsville Hospital and Health Service, Douglas, Queensland, Australia
| | - Tilley Pain
- The Townsville Hospital and Health Service, Douglas, Queensland, Australia
- James Cook University, Douglas, Queensland, Australia
| | - Felicity Dick
- The Townsville Hospital and Health Service, Douglas, Queensland, Australia
| | - Susan Tench
- The Townsville Hospital and Health Service, Douglas, Queensland, Australia
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Cordrey T, Thomas A, King E, Gustafson O. Evaluating the perceived impact and legacy of master's degree level research in the allied health professions: a UK-wide cross-sectional survey. BMC MEDICAL EDUCATION 2024; 24:750. [PMID: 38997702 PMCID: PMC11241887 DOI: 10.1186/s12909-024-05582-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/21/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Post graduate master's degree qualifications are increasingly required to advance allied health profession careers in education, clinical practice, leadership, and research. Successful awards are dependent on completion of a research dissertation project. Despite the high volume of experience gained and research undertaken at this level, the benefits and impact are not well understood. Our study aimed to evaluate the perceived impact and legacy of master's degree training and research on allied health profession practice and research activity. METHODS A cross-sectional online survey design was used to collect data from allied health professionals working in the United Kingdom who had completed a postgraduate master's degree. Participants were recruited voluntarily using social media and clinical interest group advertisement. Data was collected between October and December 2022 and was analysed using descriptive statistics and narrative content analysis. Informed consent was gained, and the study was approved by the university research ethics committee. RESULTS Eighty-four responses were received from nine allied health professions with paramedics and physiotherapists forming the majority (57%) of respondents. Primary motivation for completion of the master's degree was for clinical career progression (n = 44, 52.4%) and formation of the research dissertation question was predominantly sourced from individual ideas (n = 58, 69%). Formal research output was low with 27.4% (n = 23) of projects published in peer reviewed journal and a third of projects reporting no output or dissemination at all. Perceived impact was rated highest in individual learning outcomes, such as improving confidence and capability in clinical practice and research skills. Ongoing research engagement and activity was high with over two thirds (n = 57, 67.9%) involved in formal research projects. CONCLUSION The focus of master's degree level research was largely self-generated with the highest perceived impact on individual outcomes rather than broader clinical service and organisation influence. Formal output from master's research was low, but ongoing research engagement and activity was high suggesting master's degree training is an under-recognised source for AHP research capacity building. Future research should investigate the potential benefits of better coordinated and prioritised research at master's degree level on professional and organisational impact.
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Affiliation(s)
- Terry Cordrey
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK.
- Centre for Movement, Occupational, and Rehabilitation Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK.
| | - Amanda Thomas
- Barts Health NHS Trust, Royal London Hospital, London, E1 1BB, UK
| | - Elizabeth King
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Centre for Movement, Occupational, and Rehabilitation Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK
| | - Owen Gustafson
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Centre for Movement, Occupational, and Rehabilitation Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK
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Harrall K, Louise Sinnott E, Roebuck Saez L, Clunie G. Could you give me a leg up …? Models, frameworks and support structures to help aspiring clinical academic speech and language therapists. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:876-901. [PMID: 37966102 DOI: 10.1111/1460-6984.12969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/28/2023] [Indexed: 11/16/2023]
Abstract
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.
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Affiliation(s)
- Kate Harrall
- East Suffolk and North Essex NHS Foundation Trust, Colchester, UK
| | | | | | - Gemma Clunie
- Imperial College Healthcare NHS Trust, London, UK
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Stormon N, Lawrenson P, Rahmann A, Eames S, Gavin N. Exploring strengths and weaknesses in health services research culture and capacity. AUST HEALTH REV 2024; 48:82-90. [PMID: 38219279 DOI: 10.1071/ah23241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/14/2023] [Indexed: 01/16/2024]
Abstract
Objective Fostering a research culture and enhancing research capacity within the workforce is essential for any health service aiming to provide evidence-based care. This study aims to explore the research culture and capacity in a community health service setting and provide a comparison to previous published research in other health service settings. Methods Participants were invited to complete a survey consisting of demographics and the Research Capacity and Culture (RCC) tool. Median and interquartile ranges were calculated for each RCC item and compared to three Australian and one international comparison. Results A total of 73 staff members from Metro North Community and Oral Health service participated. The team-level scores for the RCC were overall the lowest. Comparison to previously published research using the RCC indicated marginally higher scores for individual-level items in our study across all domains. Individual-level items were very weak to weakly correlated with the team and organisation-level RCC items. Strong to very strong correlations were found between a majority of the team and organisation-level items. Conclusions Team-level scores were substantially lower when compared to individual and organisational levels. The item 'team leaders that support research' was positively correlated with various organisation-level items, indicating that if the respondent perceived the team leader as a low supporter of research the respondent perceived several organisation items also poorly. As an important stakeholder in enabling research in a health service, organisations should investigate the challenges experienced by team leaders in facilitating research and the support or training they may need.
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Affiliation(s)
- Nicole Stormon
- Queensland Health, Metro North Health, Community and Oral Health, 19th Avenue, Brighton Health Campus, Brighton, Qld 4017, Australia; and School of Dentistry, Oral Health Centre, The University of Queensland, Herston Road, Brisbane, Qld, Australia
| | - Peter Lawrenson
- Queensland Health, Metro North Health, Community and Oral Health, 19th Avenue, Brighton Health Campus, Brighton, Qld 4017, Australia; and School of Health and Behavioural Sciences, The University of Queensland, Services Road, Brisbane, Qld, Australia
| | - Ann Rahmann
- Queensland Health, Metro North Health, Community and Oral Health, 19th Avenue, Brighton Health Campus, Brighton, Qld 4017, Australia; and School of Allied Health, Australian Catholic University, Nudgee Road, Banyo, Qld, Australia
| | - Sally Eames
- Queensland Health, Metro North Health, Community and Oral Health, 19th Avenue, Brighton Health Campus, Brighton, Qld 4017, Australia
| | - Nicole Gavin
- Queensland Health, Metro North Health, Community and Oral Health, 19th Avenue, Brighton Health Campus, Brighton, Qld 4017, Australia; and School of Nursing and the Metro North Health Nursing and Midwifery Academy, Queensland University of Technology, Herston Road, Brisbane, Qld, Australia
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Stirling R, Hudson S, Ross J, Deans E, Tibbetts J, Day C, Deacon R, Dunlop A, Lintzeris N. Understanding the research capacity of alcohol and other drugs services in New South Wales, Australia. Drug Alcohol Rev 2024; 43:265-277. [PMID: 38009912 DOI: 10.1111/dar.13776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 10/06/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Enhancing health system research capacity can support improved quality care. This study assessed the research capacity of public local health district (LHD) and non-government organisation (NGO) alcohol and other drug (AOD) services, at the organisational, team and individual level. Research barriers and motivators were also examined. METHODS Staff from LHD and NGO AOD treatment services in New South Wales completed an online survey using the Research Capacity and Culture (RCC) tool. Overall median research capacity scores are presented for the RCC subscales (organisational, team and individual). Comparisons were conducted by service type (LHD/NGO), geographical location (metropolitan/rural) and affiliation with a research network (yes/no). Qualitative questions explored barriers and motivators to research at individual and team levels. RESULTS Of 242 participants, 55% were LHD-based and 45% NGO-based. Overall RCC scores indicated moderate research capacity at all levels. Organisational capacity (Med = 6.50, interquartile range [IQR] = 3.50) scored significantly higher than the team (Med = 5.00, IQR = 6.00) and individual level (Med = 5.00, IQR = 4.25). No differences in RCC scores existed between NGOs and LHDs. Metropolitan AOD services scored higher research capacity at the organisational level (Med = 7.00, IQR = 3.00) than rural services (Med = 5.00, IQR = 5.00). LHDs affiliated with a research network scored significantly higher at the organisational, team and individual level than non-affiliated LHD services. Key research barriers were inadequate time and funding. Motivators included skill development and problem-identification requiring change. DISCUSSIONS AND CONCLUSIONS AOD services in New South Wales have moderate research capacity. Identified barriers and motivators can be used to target responses that enhance capacity and improve treatment outcomes.
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Affiliation(s)
- Robert Stirling
- Network of Alcohol and other Drugs Agencies, Sydney, Australia
| | - Suzie Hudson
- Network of Alcohol and other Drugs Agencies, Sydney, Australia
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Joanne Ross
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
- NSW Ministry of Health, Sydney, Australia
| | - Emily Deans
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
- Youth Solutions, Sydney, Australia
| | - Joel Tibbetts
- The Matilda Centre, The University of Sydney, Sydney, Australia
| | - Carolyn Day
- Speciality of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, Sydney, Australia
| | - Rachel Deacon
- Sydney School of Medicine (Central Clinical School), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Drug and Alcohol Services, South East Sydney Local Health District, Sydney, Australia
- NSW Drug and Alcohol Clinical Research and Improvement Network, Newcastle, Australia
| | - Adrian Dunlop
- NSW Drug and Alcohol Clinical Research and Improvement Network, Newcastle, Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle and Hunter Medical Research Institute, Newcastle, Australia
- Health Transformation Research Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Nicholas Lintzeris
- Speciality of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Drug and Alcohol Services, South East Sydney Local Health District, Sydney, Australia
- NSW Drug and Alcohol Clinical Research and Improvement Network, Newcastle, Australia
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Dickens GL, Avantaggiato-Quinn M, Long SJ, Schoultz M, Clibbens N. Mental Health Nurses' and Allied Health Professionals' Individual Research Capacity and Organizational Research Culture: A Comparative Study. SAGE Open Nurs 2024; 10:23779608241250207. [PMID: 38746076 PMCID: PMC11092560 DOI: 10.1177/23779608241250207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/20/2024] [Accepted: 04/10/2024] [Indexed: 05/16/2024] Open
Abstract
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.
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Affiliation(s)
- Geoffrey L. Dickens
- Department of Nursing Midwifery and Health, Northumbria University, Newcastle Upon Tyne, UK
- Cumbria Northumberland Tyne & Wear NHS Trust, Newcastle Upon Tyne, UK
| | | | - Sara-Jaye Long
- Cumbria Northumberland Tyne & Wear NHS Trust, Newcastle Upon Tyne, UK
| | - Mariyana Schoultz
- Department of Nursing Midwifery and Health, Northumbria University, Newcastle Upon Tyne, UK
| | - Nicola Clibbens
- Department of Nursing Midwifery and Health, Northumbria University, Newcastle Upon Tyne, UK
- Cumbria Northumberland Tyne & Wear NHS Trust, Newcastle Upon Tyne, UK
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Birdi GK, Wong G, Upthegrove R, Higgs S, Walsh A, Ahern A, Allen K, Howe J, Habib H, Nixon K, Oduola S, Maidment I. A Realist Evaluation of Social Care Practitioners' Experiences With and Understanding of Applied Healthcare Research. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241248130. [PMID: 38785261 PMCID: PMC11127571 DOI: 10.1177/00469580241248130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/16/2024] [Accepted: 04/01/2024] [Indexed: 05/25/2024]
Abstract
Social care practitioners are often under-represented in research activity and output. Evidence-based practice enables social care practitioners to develop/engage the skills to evaluate evidence and be more actively involved in research. REalist Synthesis Of non-pharmacologicaL interVEntions for antipsychotic-induced weight gain (RESOLVE) is a NIHR-funded study where realist synthesis is used to understand and explain how, why, for whom, and in what contexts non-pharmacological interventions help service users, with severe mental illness, to manage antipsychotic-induced weight gain. Social care practitioners are a key part of the team providing care for people living with severe mental illness and therefore supporting antipsychotic-induced weight gain. The current study, RESOLVE 2, uses realist evaluation and RESOLVE as an illustrative example to help understand why and how social care practitioners engage (or not) with research. Semi-structured, audio-recorded interviews will be undertaken with a purposive sample of approximately 20 social care practitioners working with people who have severe mental illness, are treated with antipsychotics, and have experienced weight gain. Participants will be recruited from NHS Trusts and recruitment avenues such as social media and personal networks. Topics discussed during interviews will include barriers and facilitators to engagement in research, current, and past engagement as well as recommendations for researchers and other practitioners. Interview recordings will be transcribed verbatim and analyzed using realist evaluation which will allow in-depth causal explanations for research engagement. Better understanding of research engagement by social care practitioners will allow for evidence-based practice and better patient outcomes within these settings.
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Affiliation(s)
| | | | | | | | | | - Amy Ahern
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Katherine Allen
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Jo Howe
- Aston University, Birmingham, UK
| | | | - Karen Nixon
- Midlands Partnership NHS Foundation Trust, Stafford, UK
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Cundale K, McDonald SP, Irish A, Jose MD, Diack J, D'Antoine M, Owen KJ, Hughes JT. Improving equity in access to kidney transplantation: implementing targeted models of care focused on improving timely access to waitlisting. Med J Aust 2023; 219 Suppl 8:S7-S10. [PMID: 37839027 DOI: 10.5694/mja2.52099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/14/2023] [Indexed: 10/17/2023]
Affiliation(s)
- Katie Cundale
- National Indigenous Kidney Transplantation Taskforce, South Australian Health and Medical Research Institute, Adelaide, SA
- Adelaide Medical School, University of Adelaide, Adelaide, SA
| | - Stephen P McDonald
- Adelaide Medical School, University of Adelaide, Adelaide, SA
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA
| | | | - Matthew D Jose
- University of Tasmania, Hobart, TAS
- Royal Hobart Hospital, Hobart, TAS
| | - Jillian Diack
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA
| | - Matilda D'Antoine
- National Indigenous Kidney Transplantation Taskforce, South Australian Health and Medical Research Institute, Adelaide, SA
| | - Kelli J Owen
- Adelaide Medical School, University of Adelaide, Adelaide, SA
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA
| | - Jaquelyne T Hughes
- Rural and Remote Health, Flinders University, Darwin, NT
- Royal Darwin Hospital, Darwin, NT
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King E, Cordrey T, Gustafson O. Exploring individual character traits and behaviours of clinical academic allied health professionals: a qualitative study. BMC Health Serv Res 2023; 23:1025. [PMID: 37741969 PMCID: PMC10517465 DOI: 10.1186/s12913-023-10044-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/17/2023] [Indexed: 09/25/2023] Open
Abstract
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.
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Affiliation(s)
- Elizabeth King
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK.
- Centre for Movement, Occupational, and Rehabilitation Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK.
| | - Terry Cordrey
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Centre for Movement, Occupational, and Rehabilitation Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK
| | - Owen Gustafson
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Centre for Movement, Occupational, and Rehabilitation Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK
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Beldham-Collins R, Halkett GKB, Knight K, Gebski V, Wright C. Australian radiation therapist's research capacity and culture: investigating the extent of assistance required to build research capacity. J Med Radiat Sci 2023. [PMID: 37727142 DOI: 10.1002/jmrs.723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/15/2023] [Indexed: 09/21/2023] Open
Abstract
AbstractIntroductionBuilding 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.MethodsPractising 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.ResultsSurvey 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.ConclusionThis 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.
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Cordrey T, King E, Gustafson O. Allied health professionals' research capacity: open to interpretation? BMC Health Serv Res 2023; 23:640. [PMID: 37316869 DOI: 10.1186/s12913-023-09678-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 06/08/2023] [Indexed: 06/16/2023] Open
Abstract
Allied health professional research capacity and culture has been the focus of growing research interest of late. The recent study by Comer et al. represents the largest survey of allied health research capacity and culture to date. We congratulate the authors on this work and would like to raise some discussion points in relation to their study.The authors have interpreted their research capacity and culture survey results using cut-off values to indicate a degree of adequacy in relation to perceived research success and/or skill level. To our knowledge, the constructs of the research capacity and culture tool have not been validated to an extent that would enable such an inference to be made.Comer et al. describe perceived individual research success and/or skill as adequate, but the rating of skills in areas necessary for the conduct of original research, such as writing research protocols, ethics submissions, securing funding, and writing for publication range from median scores one to three, which is considered 'less than adequate' on the interpretation scale used by the authors.The survey results for the individual and organisational domains reported in Comer et al. are comparable to other similar studies. However, they uniquely conclude research success and/or skill to be adequate in both domains, which is contrary to the interpretation of the other studies.The interpretation of allied health professional research success and skill offered by Cromer et al. differs from studies with similar results and is contrary to previous reports of insufficient research capacity in terms of research trained and active practitioners within these professions in the UK.
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Affiliation(s)
- Terry Cordrey
- Oxford Allied Health Professions Research and Innovation Unit, Head of Therapies Office, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK.
- Centre for Movement Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK.
| | - Elizabeth King
- Oxford Allied Health Professions Research and Innovation Unit, Head of Therapies Office, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Centre for Movement Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Owen Gustafson
- Oxford Allied Health Professions Research and Innovation Unit, Head of Therapies Office, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Centre for Movement Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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Chalmers S, Hill J, Connell L, Ackerley SJ, Kulkarni AA, Roddam H. Allied health professional research engagement and impact on healthcare performance: A systematic review protocol. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:959-967. [PMID: 36354267 DOI: 10.1111/1460-6984.12812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 09/23/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Existing evidence suggests that clinician and organization engagement in research can improve healthcare processes of care and outcomes. However, current evidence has considered the relationship across all healthcare professions collectively. With the increase in allied health clinical academic and research activity, it is imperative for healthcare organizations, leaders and managers to understand engagement in research within these specific clinical fields. This systematic review aims to identify the effect of engagement in research by allied health professionals (AHPs) and organizations on healthcare performance. METHODS This systematic review has a two-stage search strategy. The first stage will be to screen a previous systematic review examining the effectiveness of engagement in research in health and social care to identify relevant papers published pre-2012. The search strategy used in the previous review will then be rerun, but with a specific focus on allied health. This multi-database search will identify publications from 2012 to date. Only studies that assessed the effectiveness of allied health engagement in research will be included. All stages of the review will be conducted by two reviewers independently, plus documented discussions with the wider research team when discrepancies occur. This systematic review protocol follows the EQUATOR reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols (PRISMA-P). DISCUSSION The findings of this review will make a significant contribution to the evidence base around the effect of allied health engagement in research on healthcare performance. It will provide insights for clinicians and managers looking to understand the consequences of developing AHP research capability and capacity. The findings of this review will also aim to make recommendations for future evaluation approaches for engagement in research interventions. TRIAL REGISTRATION This systematic review protocol has been registered with PROSPERO, registration number CRD42021253461. WHAT THIS PAPER ADDS What is already known on the subject This study will provide valuable evidence for professionals and policymakers seeking to understand engagement in research in the allied health disciplines. Where supported by the data, there may be recommendations for future research regarding specific variables to be considered when planning and evaluating engagement in research in allied health practice. What this paper adds to existing knowledge A previous systematic review identified a positive association between clinician and organization engagement in research and improved processes of care and health outcomes. The reviews' findings have been used as a justification for clinicians and organizations to increase research capacity. That review evaluated literature published before 2012 and the studies that were identified predominantly reported on engagement in research by medics and nurses. An updated review is now required to include research published since 2012. This review will specifically focus on the effect of engagement in research within allied health disciplines. What are the potential or actual clinical implications of this work? Research activity among AHPs is gaining momentum. Given this growth in AHP research activity and the rise in dedicated clinical academic roles, a contemporary review to identify the specific effect of AHP engagement in research on healthcare performance is prudent. The findings will inform clinicians, clinical managers and leaders of the potential impact of research activities by AHP clinicians and organizations. This will support the planning and development of initiatives focused on research capacity, capability and culture within allied health.
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Affiliation(s)
- Sophie Chalmers
- Allied Health Research Unit, School of Health Sciences, University of Central Lancashire, Preston, UK
- Integrated Community Services Division, Bolton NHS Foundation Trust, Bolton, UK
| | - James Hill
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| | - Louise Connell
- Allied Health Research Unit, School of Health Sciences, University of Central Lancashire, Preston, UK
| | - Suzanne J Ackerley
- Allied Health Research Unit, School of Health Sciences, University of Central Lancashire, Preston, UK
| | - Amit Arun Kulkarni
- Research and Outcomes, Royal College of Speech & Language Therapists, London, UK
| | - Hazel Roddam
- Education and Quality Directorate, Health Education England, Manchester, UK
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15
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Migliorini C, McDowell C, Turville M, Bevilacqua J, Harvey C. Research capacity and culture in an Australian metropolitan public mental health service: scoping the skills and experience of social workers and occupational therapists. BMC MEDICAL EDUCATION 2022; 22:864. [PMID: 36517812 PMCID: PMC9749178 DOI: 10.1186/s12909-022-03936-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
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.
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Affiliation(s)
| | - Caitlin McDowell
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Megan Turville
- NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, Australia
| | - JoAnne Bevilacqua
- NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, Australia
| | - Carol Harvey
- Psychosocial Research Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
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16
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Schmidt D, Duncanson K, Webster E, Saurman E, Lyle D. Critical realist exploration of long-term outcomes, impacts and skill development from an Australian Rural Research Capacity Building Programme: a qualitative study. BMJ Open 2022; 12:e065972. [PMID: 36600329 PMCID: PMC9743409 DOI: 10.1136/bmjopen-2022-065972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Research capacity building programmes usually only examine short-term outcomes, following up participants after 1 or 2 years. Capacity building in health research requires a long-term view to understand the influence and impact of capacity building endeavours. This study examined long-term outcomes for individuals regarding the maintenance and use of research skills and the conduct of real-world research in a rural area. We also explored the changes individuals had seen in their career, work team or organisation as a result of this training. DESIGN A qualitative study underpinned by critical realism and based on interviews and focus groups with graduates of the Rural Research Capacity Building Programme (RRCBP), a researcher development programme that has been delivered since 2006. SETTING Rural and remote areas of New South Wales, Australia. PARTICIPANTS 22 graduates of the RRCBP from the 2006 to 2015 cohorts (20 female, 2 male). All were experienced rural-based health workers at the time of training. RESULTS Focus groups and interviews yielded three themes about capacity building outcomes: (1) developed research capable individuals; (2) embedded research capability into teams and (3) real-world research that makes a difference within an organisation. CONCLUSIONS Research training improved graduates' skill, experience, confidence and employability. Research capable individuals enabled others, enhancing team research capacity and raising the profile of research within their organisation.Training in research, alongside tangible organisational support for research activity, creates real-world impacts for policy and clinical practice. Providing ongoing opportunities for researchers to undertake research would enhance return on investment and assist with retention of experienced staff.
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Affiliation(s)
- David Schmidt
- Rural and Remote Portfolio, NSW Health Education and Training Institute, Gladesville, New South Wales, Australia
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kerith Duncanson
- Rural and Remote Portfolio, NSW Health Education and Training Institute, Gladesville, New South Wales, Australia
| | - Emma Webster
- School of Rural Health, The University of Sydney, Dubbo, New South Wales, Australia
| | - Emily Saurman
- Department of Rural Health, The University of Sydney, Broken Hill, New South Wales, Australia
| | - David Lyle
- Department of Rural Health, The University of Sydney, Broken Hill, New South Wales, Australia
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17
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Raschke N, Bradbury J, Yoxall J. Perceptions of research capacity in public health organisations: comparison of NSW metropolitan and non-metropolitan Local Health Districts. AUST HEALTH REV 2022; 46:746-755. [PMID: 36396128 DOI: 10.1071/ah22100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 10/14/2022] [Indexed: 11/19/2022]
Abstract
Objective The aims of this study were to explore and compare the perceptions of research capacity and culture (RCC) in metropolitan and non-metropolitan New South Wales (NSW) Local Health Districts (LHDs). Methods The Research Capacity and Culture Tool was delivered online to clinicians and health managers. A 10-point Likert scale of success or skill at organisational, team and individual level of research capacity was used. An independent t -test assessed differences in domain means between non-metropolitan and metropolitan LHDs. Results A total of 1243 participants responded. Responses to the survey indicated the perception of individual's research skills were greater than the perception of RCC at both the team and organisational levels. Participants from metropolitan locations had significantly higher mean scores across all three domains compared with non-metropolitan locations (P Conclusion Results indicated the perception of individual's research skills were greater than the team and organisational levels. Participants from metropolitan locations had significantly higher perceptions of RCC across all three domains compared with non-metropolitan locations. This was the largest study to date in Australia investigating RCC in NSW LHDs, and the first study to explore multiple professions across multiple organisations while comparing metropolitan and non-metropolitan settings. This research may inform targeted strategies for building research capacity in NSW LHDs.
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Affiliation(s)
- Nicole Raschke
- Mid North Coast Local Health District, Port Macquarie, NSW, Australia
| | - Joanne Bradbury
- Faculty of Health, Southern Cross University, Gold Coast, Qld, Australia
| | - Jacqui Yoxall
- Faculty of Health, Southern Cross University, Gold Coast, Qld, Australia
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18
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McEvoy PM, Horgan B, Eadon OL, Yong MJ, Soraine J, Chiu VW. Development of a research capacity and culture tool for people with lived experience of mental health challenges. Aust N Z J Psychiatry 2022; 57:865-874. [PMID: 36120943 DOI: 10.1177/00048674221125597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study investigated research capacity and culture in people with lived experience of mental health challenges by developing a quantitative tool that measures capacity to engage in research. METHOD A cross-sectional, correlational methodology was employed, which comprised of three phases: lived experience consultations for item development (n = 15), item refinement (n = 20) and tool piloting. Items were adapted from, and extended, an existing research capacity and culture tool for healthcare workers. People (N = 112) with lived experience as mental health consumers, carers, peer workers and/or advocates aged 18-75 years took part in the tool piloting survey. RESULTS Overall, participants rated their individual research capacity and culture skills as moderate (mean = 5.41, standard deviation = 2.04). The most commonly reported barriers to research engagement related to lack of knowledge, familiarity or experience with the research process. The most commonly reported enablers were altruistic, such as using their experiences to improve services and help others. Research capacity and culture significantly correlated with current research activities (rs = 0.25-0.41; ps < 0.05), but not with being a research participant (r = 0.09; p > 0.05), suggesting that building research capacity of people with lived experience requires them to be active members of research teams. CONCLUSION The Lived Experience research capacity and culture tool developed in this study revealed that people with lived experience of mental health challenges are intrinsically motivated to engage in research to improve consumer outcomes. The tool may be useful to assess self, research team and organisational preparedness to conduct genuinely co-designed research, and to assess changes in lived experience research capacities and culture over time.
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Affiliation(s)
- Peter M McEvoy
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia.,enAble Institute, Curtin University, Bentley, WA, Australia.,Centre for Clinical Interventions, North Metropolitan Health Service, Nedlands, WA, Australia
| | - Ben Horgan
- enAble Institute, Curtin University, Bentley, WA, Australia.,Consumer and Community Involvement Program, Western Australian Health Translation Network, Nedlands, WA, Australia.,Department of Health, Research and Innovation Office, Perth, WA, Australia
| | - Olivia L Eadon
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia
| | - Marcus Js Yong
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia
| | - Jacqueline Soraine
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia
| | - Vivian W Chiu
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia.,enAble Institute, Curtin University, Bentley, WA, Australia
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Brandenburg C, Raatz M, Ward L. What is known about clinician researcher careers in allied health? A scoping review of the last decade. J Health Organ Manag 2022; ahead-of-print. [PMID: 35452578 DOI: 10.1108/jhom-12-2021-0441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
| | - Madeline Raatz
- Metro South Hospital and Health Service, Woolloongabba, Australia
| | - Liz Ward
- Metro South Hospital and Health Service, Woolloongabba, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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20
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Veziari Y, Kumar S, Leach MJ. An exploration of barriers and enablers to the conduct and application of research among complementary and alternative medicine stakeholders in Australia and New Zealand: A qualitative descriptive study. PLoS One 2022; 17:e0264221. [PMID: 35180276 PMCID: PMC8856519 DOI: 10.1371/journal.pone.0264221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 02/06/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Most studies examining complementary and alternative medicine (CAM) stakeholder engagement with evidence-based practice have relied on quantitative research methods, which often fail to capture the nuances of this phenomena. Using qualitative methods, this study aimed to explore the experiences of CAM stakeholders regarding the barriers and enablers to the conduct and application of research. METHODS This research was guided by a qualitative descriptive framework. CAM practitioners and researchers of multiple CAM disciplines from across Australia and New Zealand were invited to share their personal perspectives of the study phenomena. Semi-structured interviews were conducted via Zoom, which were audio-recorded and transcribed verbatim. Rigour strategies were applied to ensure the credibility of results. The transcript was analysed using thematic analysis. RESULTS CAM stakeholders identified an array of barriers and enablers to the conduct and application of research within their disciplines. The barriers and enablers that emerged were found to be inter-connected with two similar constructs: capacity and culture. Captured within the construct of capacity were five themes-lack of resources, inadequate governance/leadership, lack of competency, bias directed from outside and within CAM, and lack of time for research. Within the construct of culture were two themes-intrinsic perceptions in CAM, and lack of communication within and outside CAM. CONCLUSIONS Promoting evidence-based practice and engaging with research in CAM continues to face challenges. This study, for the first time, has highlighted the multitude of interlinked barriers that confront CAM stakeholders when engaging with research. These findings highlight the need for a concerted and targeted approach to tackle these challenges.
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Affiliation(s)
- Yasamin Veziari
- UniSA Allied Health & Human Performance, University of South Australia, North Terrace, Adelaide, South Australia, Australia
| | - Saravana Kumar
- UniSA Allied Health & Human Performance, University of South Australia, North Terrace, Adelaide, South Australia, Australia
| | - Matthew J. Leach
- Southern Cross University, National Centre for Naturopathic Medicine, East Lismore, New South Wales, Australia
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21
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Cordrey T, King E, Pilkington E, Gore K, Gustafson O. Exploring research capacity and culture of allied health professionals: a mixed methods evaluation. BMC Health Serv Res 2022; 22:85. [PMID: 35039018 PMCID: PMC8764821 DOI: 10.1186/s12913-022-07480-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 01/04/2022] [Indexed: 11/24/2022] Open
Abstract
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.
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Affiliation(s)
- Terry Cordrey
- Oxford Allied Health Professions Research & Innovation Unit, Oxford University Hospitals NHS Foundation Trust, OX3 9DU, Oxford, UK. .,Centre for Movement, Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, OX3 0BP, Oxford, UK.
| | - Elizabeth King
- Oxford Allied Health Professions Research & Innovation Unit, Oxford University Hospitals NHS Foundation Trust, OX3 9DU, Oxford, UK.,Centre for Movement, Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, OX3 0BP, Oxford, UK
| | - Emma Pilkington
- Oxford Allied Health Professions Research & Innovation Unit, Oxford University Hospitals NHS Foundation Trust, OX3 9DU, Oxford, UK
| | - Katie Gore
- Oxford Allied Health Professions Research & Innovation Unit, Oxford University Hospitals NHS Foundation Trust, OX3 9DU, Oxford, UK.,Centre for Movement, Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, OX3 0BP, Oxford, UK
| | - Owen Gustafson
- Oxford Allied Health Professions Research & Innovation Unit, Oxford University Hospitals NHS Foundation Trust, OX3 9DU, Oxford, UK.,Centre for Movement, Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, OX3 0BP, Oxford, UK
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22
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Brandenburg C, Ward EC. "There hasn't been a career structure to step into": a qualitative study on perceptions of allied health clinician researcher careers. Health Res Policy Syst 2022; 20:6. [PMID: 35000610 PMCID: PMC8743061 DOI: 10.1186/s12961-021-00801-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022] Open
Abstract
Background There are many demonstrated benefits for health service organizations engaging in research. As a result, growing numbers of clinicians are being encouraged to pursue research as part of their clinical roles, including in allied health (AH). However, while the benefits of having clinician researchers embedded in AH services have been well established, the career needs of those engaged in these dual roles are poorly understood. The aim of this study was to examine perspectives of the career pathway for AH clinicians engaged in “clinician researcher” roles within Australian health services. Methods A qualitative descriptive study was conducted, utilizing semi-structured interviews. Purposive sampling was used to ensure selection of varied locations, professions and role types. Results were analysed using thematic analysis. Trustworthiness was established using regular peer debriefing during theme development, and respondent validation of final themes. Results Fifty-seven AH clinician researchers, including those who did and did not have research as a formal component of their current role, participated in semi-structured interviews. Key themes were as follows: (1) clinician researchers prefer roles which are embedded in health services; (2) current opportunities for clinician researcher roles in health are insufficient; (3) there are deficiencies in the pathway for clinician researcher careers; (4) clinician researchers are not always valued or incentivized by health services; (5) the current career challenges impair the viability of clinician researcher careers; and (6) the clinician researcher career path has been improving, and there is hope it will continue to improve. Conclusion This study outlines a number of weaknesses in the current career structure and opportunities for AH clinician researchers in Australian health services. In particular, while there are strong intrinsic drivers to pursue this dual career, extrinsic drivers are poorly developed, including a lack of job opportunities, an unstable career pathway and a lack of valuing or incentivizing this career choice within health services. This often means that clinician researchers feel compelled to choose between a research or clinical career, leading to loss of this valuable combined skill set. The findings of this research may assist health services in developing and supporting improved clinician researcher career pathways. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-021-00801-2.
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Affiliation(s)
- Caitlin Brandenburg
- Centre for Functioning and Health Research, Metro South Health, Queensland Health, Brisbane, Australia.
| | - Elizabeth C Ward
- Centre for Functioning and Health Research, Metro South Health, Queensland Health, Brisbane, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Harper KJ, Taylor SL, Jepiuh M, Mino P, Huynh Tran A, Tam WY, Harris C. An observational cohort study to determine the impact of research capacity building strategies implemented in an Australian metropolitan hospital occupational therapy department. Aust Occup Ther J 2021; 69:190-204. [PMID: 34951032 DOI: 10.1111/1440-1630.12782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/14/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Research capacity building enhances the abilities of individuals and is critical within health systems for quality patient care and promotes a culture of excellence within the occupational therapy profession. A research capacity building toolkit was proposed identifying strategies to support allied health professionals to undertake research. This study evaluated participant-reported outcomes of research capacity building toolkit implementation in an occupational therapy department. METHODS An observational pre-post-cohort study at a tertiary hospital with volunteer occupational therapists using the standardised Research Capacity in Context Tool (RCCT) and an author-designed quality improvement (QI) survey was employed. The RCCT measures research capacity and culture at organisation, team and individual levels. Semi-structured interviews were used to elicit reflections regarding participant experience. RESULTS All levels of the toolkit were implemented successfully. The response rate was 59% (n = 36) at baseline and 49.1% (n = 26) at follow-up. Eighty-five percent of participants held direct clinical roles. Nine clinicians participated in the interviews. There were significant improvements in the estimate mean for the organisation (6.51 [2019] compared with 8.13 [2020], p = <0.001) and the team (5.52 [2019] compared with 7.15 [2020], p = 0.001). The individual level did not significantly change with an estimate mean of 4.20 in 2019 increasing slightly to 4.84 in 2020 (p = 0.128). This was supported by the QI survey where improvements were noted in the department but not at an individual level. The qualitative findings verified the components of the toolkit including 'supporting clinicians in research', 'working together', 'valuing research for excellence' and reflected the importance of 'individual attributes'. CONCLUSION The toolkit supported the implementation of specific strategies to enhance research capacity and culture. Improvements within the organisation and team were evident; however, these were not seen at an individual level. Further research about the contribution of individual-related factors and processes to the building of research capacity is required.
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Affiliation(s)
- Kristie J Harper
- Occupational Therapy Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Susan L Taylor
- Occupational Therapy, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Madelynn Jepiuh
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Pamela Mino
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Alice Huynh Tran
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Wai Yin Tam
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Courtenay Harris
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
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Frakking T, Craswell A, Clayton A, Waugh J. 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. J Multidiscip Healthc 2021; 14:2755-2766. [PMID: 34629876 PMCID: PMC8496547 DOI: 10.2147/jmdh.s330647] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/09/2021] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Thuy Frakking
- Research Development Unit, Caboolture Hospital, Queensland Health, Caboolture, Queensland, 4510, Australia.,Centre for Clinical Research, School of Medicine, The University of Queensland, Herston, Queensland, 4029, Australia
| | - Alison Craswell
- School of Nursing, Midwifery and Paramedicine, University of Sunshine Coast, Sippy Downs, Queensland, 4556, Australia
| | - Anne Clayton
- Women, Children & Family Service Line, Nursing Executive, Caboolture Hospital, Queensland Health, Caboolture, Queensland, 4510, Australia
| | - John Waugh
- School of Clinical Medicine, The University of Queensland, St Lucia, Queensland, 4067, Australia.,Department of Paediatrics, Caboolture Hospital, Queensland Health, Caboolture, Queensland, 4510, Australia
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Newington L, Alexander CM, Wells M. Impacts of clinical academic activity: qualitative interviews with healthcare managers and research-active nurses, midwives, allied health professionals and pharmacists. BMJ Open 2021; 11:e050679. [PMID: 34620661 PMCID: PMC8499282 DOI: 10.1136/bmjopen-2021-050679] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To explore the perceived impacts of clinical academic activity among the professions outside medicine. DESIGN Qualitative semistructured interviews. SETTING AND PARTICIPANTS There were two groups of interviewees: Research-active nurses, midwives, allied health professionals, healthcare scientists, psychologists and pharmacists (NMAHPPs) and managers of these professions. All participants were employed in a single, multisite healthcare organisation in the UK. ANALYSIS Interview transcripts were analysed using the framework method to identify key themes, subthemes and areas of divergence. RESULTS Four themes were identified. The first, cultural shifts, described the perceived improvements in the approach to patient care and research culture that were associated with clinical academic activity. The second theme explored visibility and included the positive reputation that clinical academics were identified as bringing to the organisation in contrast with perceived levels of invisibility and inaccessibility of these roles. The third theme identified the impacts of the clinical academic pathways, including the precarity of these roles. The final theme explored making impact tangible, and described interviewees' suggestions of possible methods to record and demonstrate impact. CONCLUSIONS Perceived positive impacts of NMAHPP clinical academic activity focused on interlinked positive changes for patients and clinical teams. This included delivery of evidence-based healthcare, patient involvement in clinical decision making and improved staff recruitment and retention. However, the positive impacts of clinical academic activity often centred around individual clinicians and did not necessarily translate throughout the organisation. The current clinical academic pathway was identified as causing tension between the perceived value of clinical academic activity and the need to find sufficient staffing to cover clinical services.
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Affiliation(s)
- Lisa Newington
- Surgery and Cancer, Imperial College London Faculty of Medicine, London, UK
- Therapies, Imperial College Healthcare NHS Trust, London, UK
- Nursing Directorate, Imperial College Healthcare NHS Trust, London, UK
| | - Caroline M Alexander
- Surgery and Cancer, Imperial College London Faculty of Medicine, London, UK
- Therapies, Imperial College Healthcare NHS Trust, London, UK
| | - Mary Wells
- Surgery and Cancer, Imperial College London Faculty of Medicine, London, UK
- Nursing Directorate, Imperial College Healthcare NHS Trust, London, UK
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Crombie A, Borkowski D, Gardner M, Masman K, Howlett O. Understanding the research capacity and culture of a regional allied health workforce. Aust J Prim Health 2021; 27:397-403. [PMID: 34551853 DOI: 10.1071/py20260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 05/13/2021] [Indexed: 11/23/2022]
Abstract
The aim of this study was to understand the research capacity and culture of a regional allied health workforce over time. A cross-sectional study design was used, with data collected using the validated Research Capacity and Culture (RCC) tool. The results were compared with an earlier administration of the RCC survey. The findings demonstrate that allied health professionals (AHPs) perceive that the organisation's capability of conducting research is at a higher level than that of teams and individuals. Over a 4-year period the profile of the research culture of an allied health workforce in a regional health service was described similarly. The highest rated motivator for conducting research (to develop skills) and barrier to conducting research (other work roles take priority) were unchanged between 2018 and 2014. AHPs have maintained the previous viewpoint that there is research capacity at the health service and opportunities to develop the research culture. The findings of the 2018 data compared with the 2014 data highlight that specific and targeted research capacity-building strategies need to be used in order to create an active and vibrant research culture.
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Affiliation(s)
- Angela Crombie
- Bendigo Health, Research and Innovation, PO Box 126, Bendigo, Vic. 3552, Australia
| | - Donna Borkowski
- Bendigo Health, Physiotherapy Department, PO Box 126, Bendigo, Vic. 3552, Australia
| | - Marcus Gardner
- Bendigo Health, Clinical Learning and Development, PO Box 126, Bendigo, Vic. 3552, Australia
| | - Kevin Masman
- Bendigo Health, Research and Innovation, PO Box 126, Bendigo, Vic. 3552, Australia
| | - Owen Howlett
- Bendigo Health, Research and Innovation, PO Box 126, Bendigo, Vic. 3552, Australia; and La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, Vic. 3552, Australia; and Corresponding author.
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Building Capacity in Health Professionals to Conduct Quality Improvement: Evaluation From a Collaborative Interorganizational Program. J Nurs Care Qual 2021; 36:229-235. [PMID: 33079817 DOI: 10.1097/ncq.0000000000000520] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Toronto Academic Health Sciences Network Health Professions Innovation Fellowship Program began in 2014 as a pilot initiative among 4 academic teaching hospitals in Toronto, Ontario. The purpose of the Program was to cultivate applied leadership, interprofessional collaboration, and quality improvement capacity among health professionals. PURPOSE This article reports on the evaluation findings from the initial year as well as an update on current program status and sustainability. METHODS A formative evaluation was conducted focused on the impact on clinical practice, participant skill development, participant experience, and cross-organizational partnerships. Data were collected through a focus group, interviews, and pre- and postsurveys. RESULTS Data from the initial pilot showed increases in leadership practices, project management, and quality improvement knowledge, with changes in leadership practices being significant. Positive changes in clinical practice at both the individual and unit/team levels and capacity for building relationships were also reported. Since the pilot, more than 160 participants from 15 health professions and 9 organizations have participated. Several graduates have taken on leadership roles since their participation in the Program. CONCLUSIONS Health care organizations wishing to advance academic practice may benefit from implementing a similar collaborative program to reap benefits beyond organizational silos.
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Brandenburg C, Noble C, Wenke R, Hughes I, Barrett A, Wellwood J, Mickan S. Relationship Between Research Culture and Research Activity of Medical Doctors: A Survey and Audit. J Multidiscip Healthc 2021; 14:2137-2150. [PMID: 34408428 PMCID: PMC8364349 DOI: 10.2147/jmdh.s319191] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 07/21/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To describe the research capacity and culture, and research activity (publications and new projects) of medical doctors across a health service and determine if the research activity of specialty groups correlated with their self-reported "team" level research capacity and culture. METHODS Cross-sectional, observational survey and audit of medical doctors at a tertiary health service in Queensland. The Research Capacity and Culture (RCC) validated survey was used to measure self-reported research capacity/culture at organisation, team and individual levels, and presence of barriers and facilitators to research. An audit of publications and ethically approved research projects was used to determine research activity. RESULTS Approximately, 10% of medical doctors completed the survey (n= 124). Overall, median scores on the RCC were 5 out of 10 for organisational level, 5.5 for specialty level, and 6 for individual level capacity and culture; however, specialty-level scores varied significantly between specialty groups (range 3.1-7.8). Over 80% of participants reported lack of time and other work roles taking priority as barriers to research. One project was commenced per year for every 12.5 doctors employed in the health service, and one article was published for every 7.5. There was a positive association between a team's number of publications and projects and their self-reported research capacity and culture on the RCC. This association was stronger for publications. CONCLUSION Health service research capacity building interventions may need a tailored approach for different specialty teams to accommodate for varying baselines of capacity and activity. When evaluating these initiatives, a combination of research activity and subjective self-report measures may be complementary.
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Affiliation(s)
- Caitlin Brandenburg
- Clinical Governance, Education and Research, Gold Coast Hospital and Health Service, Southport, QLD, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Christy Noble
- Clinical Governance, Education and Research, Gold Coast Hospital and Health Service, Southport, QLD, Australia
- Faculty of Medicine, University of Queensland, St Lucia, QLD, Australia
- School of Medicine, Griffith University, Southport, QLD, Australia
| | - Rachel Wenke
- Clinical Governance, Education and Research, Gold Coast Hospital and Health Service, Southport, QLD, Australia
- School of Allied Health Sciences, Griffith University, Southport, QLD, Australia
| | - Ian Hughes
- Clinical Governance, Education and Research, Gold Coast Hospital and Health Service, Southport, QLD, Australia
| | - Anthony Barrett
- Clinical Governance, Education and Research, Gold Coast Hospital and Health Service, Southport, QLD, Australia
| | - Jeremy Wellwood
- Clinical Governance, Education and Research, Gold Coast Hospital and Health Service, Southport, QLD, Australia
| | - Sharon Mickan
- Clinical Governance, Education and Research, Gold Coast Hospital and Health Service, Southport, QLD, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
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Veziari Y, Kumar S, Leach M. Addressing barriers to the conduct and application of research in complementary and alternative medicine: a scoping review. BMC Complement Med Ther 2021; 21:201. [PMID: 34266441 PMCID: PMC8281683 DOI: 10.1186/s12906-021-03371-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 06/25/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Over the past few decades, the popularity of complementary and alternative medicine (CAM) has grown considerably and along with it, scrutiny regarding its evidence base. While this is to be expected, and is in line with other health disciplines, research in CAM is confronted by numerous obstacles. This scoping review aims to identify and report the strategies implemented to address barriers to the conduct and application of research in CAM. METHODS The scoping review was undertaken using the Arksey and O'Malley framework. The search was conducted using MEDLINE, EMBASE, EMCARE, ERIC, Scopus, Web of Science, The Cochrane Library, JBI and the grey literature. Two reviewers independently screened the records, following which data extraction was completed for the included studies. Descriptive synthesis was used to summarise the data. RESULTS Of the 7945 records identified, 15 studies met the inclusion criteria. Using the oBSTACLES instrument as a framework, the included studies reported diverse strategies to address barriers to the conduct and application of research in CAM. All included studies reported the use of educational strategies and collaborative initiatives with CAM stakeholders, including targeted funding, to address a range of barriers. CONCLUSIONS While the importance of addressing barriers to the conduct and application of research in CAM has been recognised, to date, much of the focus has been limited to initiatives originating from a handful of jurisdictions, for a small group of CAM disciplines, and addressing few barriers. Myriad barriers continue to persist, which will require concerted effort and collaboration across a range of CAM stakeholders and across multiple sectors. Further research can contribute to the evidence base on how best to address these barriers to promote the conduct and application of research in CAM.
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Affiliation(s)
- Yasamin Veziari
- UniSA Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, SA 5000 Australia
| | - Saravana Kumar
- UniSA Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, SA 5000 Australia
| | - Matthew Leach
- National Centre for Naturopathic Medicine, Southern Cross University, Military Road, East Lismore, NSW 2480 Australia
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Abstract
OBJECTIVES A key barrier in supporting health research capacity development (HRCD) is the lack of empirical measurement of competencies to assess skills and identify gaps in research activities. An effective tool to measure HRCD in healthcare workers would help inform teams to undertake more locally led research. The objective of this systematic review is to identify tools measuring healthcare workers' individual capacities to conduct research. DESIGN Systematic review and narrative synthesis using Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist for reporting systematic reviews and narrative synthesis and the Critical Appraisals Skills Programme (CASP) checklist for qualitative studies. DATA SOURCES 11 databases were searched from inception to 16 January 2020. The first 10 pages of Google Scholar results were also screened. ELIGIBILITY CRITERIA We included papers describing the use of tools/to measure/assess HRCD at an individual level among healthcare workers involved in research. Qualitative, mixed and quantitative methods were all eligible. Search was limited to English language only. DATA EXTRACTION AND SYNTHESIS Two authors independently screened and reviewed studies using Covidence software, and performed quality assessments using the extraction log validated against the CASP qualitative checklist. The content method was used to define a narrative synthesis. RESULTS The titles and abstracts for 7474 unique records were screened and the full texts of 178 references were reviewed. 16 papers were selected: 7 quantitative studies; 1 qualitative study; 5 mixed methods studies; and 3 studies describing the creation of a tool. Tools with different levels of accuracy in measuring HRCD in healthcare workers at the individual level were described. The Research Capacity and Culture tool and the 'Research Spider' tool were the most commonly defined. Other tools designed for ad hoc interventions with good generalisability potential were identified. Three papers described health research core competency frameworks. All tools measured HRCD in healthcare workers at an individual level with the majority adding a measurement at the team/organisational level, or data about perceived barriers and motivators for conducting health research. CONCLUSIONS Capacity building is commonly identified with pre/postintervention evaluations without using a specific tool. This shows the need for a clear distinction between measuring the outcomes of training activities in a team/organisation, and effective actions promoting HRCD. This review highlights the lack of globally applicable comprehensive tools to provide comparable, standardised and consistent measurements of research competencies. PROSPERO REGISTRATION NUMBER CRD42019122310.
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Affiliation(s)
- Davide Bilardi
- Nuffield Department of Medicine, University of Oxford Centre for Tropical Medicine and Global Health, Oxford, UK
- Fondazione Penta Onlus, Padova, Italy
| | - Elizabeth Rapa
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Sarah Bernays
- School of Public Health, University of Sydney-Sydney Medical School Nepean, Sydney, New South Wales, Australia
- Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Trudie Lang
- Nuffield Department of Medicine, University of Oxford Centre for Tropical Medicine and Global Health, Oxford, UK
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Oulton K, Wray J, Kelly P, Khair K, Sell D, Gibson F. Culture, cognisance, capacity and capability: The interrelationship of individual and organisational factors in developing a research hospital. J Clin Nurs 2021; 31:362-377. [PMID: 34046965 DOI: 10.1111/jocn.15867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/31/2021] [Accepted: 04/26/2021] [Indexed: 11/30/2022]
Abstract
AIM To share our experience of implementing a programme of interventions aimed at building research capacity and capability of nurses and allied health professionals in a specialist children's hospital. BACKGROUND Clinicians at the forefront of care are well positioned to lead on research to improve outcomes and experiences of patients but some professional groups continue to be underrepresented. Inequities persist alongside robust national infrastructures to support Clinical Academic Careers for non-medical health professionals, further highlighting the need to address local infrastructure and leadership to successfully build research capacity. DESIGN An evolving programme of inquiry and analysis was established in one organisation, this included targeted interventions to mitigate barriers and enable research capacity and capability. METHODS An all-staff survey was conducted in 2015 to understand the existing research culture. Interventions were put in place, evaluated through a second survey (2018), and focus group interviews with staff who had accessed interventions. RESULTS Respondents demonstrated high levels of interest and commitment to research at the individual level which were not always harnessed at the organisational level. Inequities between professional groups existed in terms of training, time to undertake research and opportunities and outputs. Follow-up revealed continuing structural barriers at an organisational level, however at an individual level, interventions were reflected in >30 fellowship awards; major concerns were reported about sustaining these research ambitions. CONCLUSIONS Success in building a research-active clinical workforce is multifactorial and all professional groups report increasing challenges to undertake research alongside clinical responsibilities. Individuals report concerns about the depth and pace of cultural change to sustain Clinical Academic Careers and build a truly organisation-wide research hospital ethos to benefit patients. RELEVANCE TO CLINICAL PRACTICE The achievements of individual nurses and allied health professionals indicate that with supportive infrastructure, capacity, cognisance and capability are not insurmountable barriers for determined clinicians. We use the standards for reporting organisational case studies to report our findings (Rodgers et al., 2016 Health Services and Delivery Research, 4 and 1).
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Affiliation(s)
- Kate Oulton
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Paula Kelly
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Kate Khair
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,Haemnet, London, UK
| | - Debbie Sell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Faith Gibson
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,School of Health Sciences, University of Surrey, Guildford, Surrey, UK
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Newington L, Wells M, Adonis A, Bolton L, Bolton Saghdaoui L, Coffey M, Crow J, Fadeeva Costa O, Hughes C, Savage M, Shahabi L, Alexander CM. A qualitative systematic review and thematic synthesis exploring the impacts of clinical academic activity by healthcare professionals outside medicine. BMC Health Serv Res 2021; 21:400. [PMID: 33926441 PMCID: PMC8082861 DOI: 10.1186/s12913-021-06354-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/31/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There are increasing opportunities for healthcare professionals outside medicine to be involved in and lead clinical research. However, there are few roles within these professions that include time for research. In order to develop such roles, and evaluate effective use of this time, the range of impacts of this clinical academic activity need to be valued and understood by healthcare leaders and managers. To date, these impacts have not been comprehensively explored, but are suggested to extend beyond traditional quantitative impact metrics, such as publications, citations and funding awards. METHODS Ten databases, four grey literature repositories and a naïve web search engine were systematically searched for articles reporting impacts of clinical academic activity by healthcare professionals outside medicine. Specifically, this did not include the direct impacts of the research findings, rather the impacts of the research activity. All stages of the review were performed by a minimum of two reviewers and reported impacts were categorised qualitatively according to a modified VICTOR (making Visible the ImpaCT Of Research) framework. RESULTS Of the initial 2704 identified articles, 20 were eligible for inclusion. Identified impacts were mapped to seven themes: impacts for patients; impacts for the service provision and workforce; impacts to research profile, culture and capacity; economic impacts; impacts on staff recruitment and retention; impacts to knowledge exchange; and impacts to the clinical academic. CONCLUSIONS Several overlapping sub-themes were identified across the main themes. These included the challenges and benefits of balancing clinical and academic roles, the creation and implementation of new evidence, and the development of collaborations and networks. These may be key areas for organisations to explore when looking to support and increase academic activity among healthcare professionals outside medicine. The modified VICTOR tool is a useful starting point for individuals and organisations to record the impact of their research activity. Further work is needed to explore standardised methods of capturing research impact that address the full range of impacts identified in this systematic review and are specific to the context of clinical academics outside medicine.
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Affiliation(s)
- Lisa Newington
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK.
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
| | - Mary Wells
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Adine Adonis
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Lee Bolton
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Layla Bolton Saghdaoui
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Margaret Coffey
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Jennifer Crow
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Olga Fadeeva Costa
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Catherine Hughes
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Matthew Savage
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Lillie Shahabi
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Caroline M Alexander
- Imperial College Healthcare NHS Trust, Education Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
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Wenke R, Noble C, Weir KA, Mickan S. What influences allied health clinician participation in research in the public hospital setting: a qualitative theory-informed approach. BMJ Open 2020; 10:e036183. [PMID: 32819986 PMCID: PMC7443264 DOI: 10.1136/bmjopen-2019-036183] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Using theoretical frameworks from implementation science, we aimed to systematically explore the barriers and enablers to research active allied health professionals (AHP) participating and leading research in the hospital setting. DESIGN A qualitative interview study informed by behaviour change theory. SETTING Single Australian tertiary hospital and health service. PARTICIPANTS We recruited a convenience sample of 21 AHPs working within a hospital who were seeking to actively participate in/or lead research within their workplace. DATA COLLECTION Semistructured interviews explored perceived barriers and enablers to research participation, informed by the 14 domains of the theoretical domains framework (TDF). Transcribed interviews were deductively coded and mapped to the TDF. A deeper level of inductive coding was used to identify emergent themes that influenced behaviour change, according to the three key constructs of: capability, opportunity and motivation (COM-B). RESULTS Barriers and enablers to research participation were identified within nine predominant domains of the TDF. Most enablers to engaging in research related to the motivation or opportunity constructs of the COM-B. These enablers included positive beliefs about the consequences of research participation, enabling social influences, peer support and motivation for skill development and to inform practice. Predominant barriers related to environmental context and resources (eg, reduced funding or time), emotional responses of being overwhelmed and perceptions of reduced capability. CONCLUSION This study identified key barriers and enablers to behaviour change related to AHPs participating and/or leading research. Motivation and opportunities to participate in research may be enabled by maximising social influence opportunities, reiterating beliefs about positive consequences of research and considering AHP's emotional responses. Implementation science frameworks may provide a more systematic and holistic understanding of factors which influence research participation including enhancing knowledge, motivation and opportunity.
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Affiliation(s)
- Rachel Wenke
- Allied Health Services, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Christy Noble
- Office of Medical Education, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Kelly A Weir
- Allied Health Services, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Sharon Mickan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Hollis R, Ersser SJ, Iles-Smith H, Milnes LJ, Munyombwe T, Sanders C, Swallow V. A Feasibility Study Of Administering The Electronic Research And Development Culture Index To The Multidisciplinary Workforce In A UK Teaching Hospital. J Multidiscip Healthc 2019; 12:935-945. [PMID: 31819468 PMCID: PMC6875253 DOI: 10.2147/jmdh.s218630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/11/2019] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Rachel Hollis
- The Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Heather Iles-Smith
- Research and Innovation, Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | | | | | - Cilla Sanders
- School of Healthcare, University of Leeds, Leeds, UK
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35
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Kidd JC, Colley S, Dennis S. Surveying Allied Health Professionals Within a Public Health Service: What Works Best, Paper or Online? Eval Health Prof 2019; 44:226-234. [PMID: 31462081 DOI: 10.1177/0163278719870568] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
- Joanna C Kidd
- Faculty of Health Sciences, 4334The University of Sydney, Sydney, New South Wales, Australia.,1511South Western Sydney Local Health District, Liverpool, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Sue Colley
- 1511South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Sarah Dennis
- Faculty of Health Sciences, 4334The University of Sydney, Sydney, New South Wales, Australia.,1511South Western Sydney Local Health District, Liverpool, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
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