Abstract
As a former Clinical Research Nurse, Clinical Trials Manager, academic health services researcher, and clinical trial participant, I have long been interested in, and exercised by, the lack of integration of clinical research in everyday clinical practice. The work presented in this paper does much to explore and address these issues and will surely be of great interest to those familiar with longstanding organisational and cultural barriers.
Despite acknowledgment that research-active hospitals achieve better patient outcomes, that nursing is an academic discipline, and that the involvement of nurses in the recruitment and management of patients in clinical trials can enhance both recruitment rates and study integrity, barriers remain to promoting staff awareness of, and engagement in, clinical research.
The perception persists that undergraduate nurse education does not place sufficient emphasis on research and that a nursing clinical-academic career path remains less well defined than that available to the medical profession. This lack of parity between research and clinical practice, in both educational and experiential spheres, perpetuates the myth that research is not only a ‘specialist’ activity but a mysterious one. Further, introduction of specialist research roles intended to attract nurses to this area of practice may have inadvertently strengthened barriers by fuelling a perception of ‘elitism’.
Acknowledging these and other difficulties, the authors outline the development of a range of initiatives aiming to promote transparency and greater understanding of nursing research roles, whilst simultaneously demystifying research and its associated concepts. The initiatives offer both depth and breadth of coverage and potential impact, encompassing all grades and including therapeutic disciplines beyond nursing, recognising the importance of a dedicated facilitatory role, and the benefits of networking and collaboration. By facilitating greater understanding of research principles and processes, these initiatives may also enhance working relationships between clinical and research staff, and ultimately, improve recruitment, retention and management of research participants, and effect timely implementation of research findings.
Initiatives such as those described here, can be instrumental in ensuring both study integrity and participants’ safety. It is essential that all healthcare professionals involved in the care of (potential) research participants have at least a basic level of ‘research literacy’ even if this is not the primary focus of their role. Clinical and research teams can only command the patients’ confidence and trust if they can lead by example regarding their perception of each other’s capabilities.
Limitations regarding the brevity of the reporting period and the lack of formal evaluation of impact are noted by the authors, who plan to address this with future cohorts. Inevitably, given the impact of COVID-19, compromises and adaptations were necessary; nevertheless, learning so far can be implemented in future stages and in the roll-out of these initiatives. The authors also note that work so far was limited to one health service; whilst plans for further development within this single health service should be welcomed, more ambitious plans for roll-out across the country should be explored and supported.