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

BACKGROUND

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

METHODS

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

RESULTS

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

DISCUSSION

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

TRIAL REGISTRATION

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

Does equestrian knowledge and experience influence selection and training practices for showjumping horses?

Selection and training methods for showjumping horses are largely anecdotal, and performance analysis has been proposed as a method for scientifically improving competitive outcomes. To employ performance analysis in showjumping, an understanding of the tacit and explicit knowledge and practices of equestrians is required to identify relevant performance indicators. This study aimed to examine the knowledge and practices of equestrians with varying levels of experience (advanced and novice) for selecting horses, based on evaluation of movement, and training showjumping horses using an original questionnaire. It was hypothesised that differences would be present between advanced and novice responses. The questionnaire was composed of closed-end and follow-up open-end questions and 225 equestrians (66.7% advanced, 33.3% novice) participated. Closed-end responses from advanced and novice groups were analysed separately using Chi-Squared tests and open-end responses were subjected to thematic and content analysis. Closed-end responses showed significant within-group preferences (P<0.0001) for specific movement traits and training methods and between-group response differences <13% revealed that advanced and novice groups displayed similar preferences. Thematic analysis indicated different preferences for movement traits when selecting showjumping horses, as well as differences in the level of tacit knowledge between advanced and novice groups. Advanced equestrians placed greater emphasis on aesthetic forelimb traits than novice equestrians, who emphasised traits that they may be less capable of influencing, such as hindlimb impulsion and position of the horse at take-off. An emphasis on hindlimb movement and flatwork/non-jumping exercises for showjumping training was observed across both groups. Understanding equestrian tacit knowledge and its application is fundamental for developing research that is relevant to equestrians. Findings from this study may form a basis for research to identify relevant, objective performance indicators for performance analysis in showjumping, with the ultimate goal of improving competitive performance and welfare for equine athletes.

An evaluation of Fracture Liaison Services in the detection and management of osteoporotic fragility fractures: A narrative review

OBJECTIVES

To evaluate the current evidence for whether Fracture Liaison Services are being utilised effectively in the UK to aid in the prevention of fragility fractures.

KEY FINDINGS

Radiological under-reporting and non-standardised assessment of fragility fractures still persist, with low numbers of patients undergoing a risk assessment and treatment for secondary prevention of fracture. In order to improve care for these patients, the reporting of vertebral fractures must be improved and standardised in order to identify patients at increased risk of secondary fragility fractures. Fracture Liaison Services determine the need for anti-resorptive therapy for the prevention of future fragility fractures. Targeted treatment of at-risk patient groups has been shown to reduce the risk of further fracture.

CONCLUSION

Fracture Liaison Services have been shown to be cost effective, while reducing the risk of secondary fractures, but they are not currently offered by all NHS providers.