making choices, facing challenges
developing your research career in nursing, midwifery and the allied health professions
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2. the booklet and the website
3. how have we got here?
4. where do I start?
5. getting the answers...
6. what should I do next?
Illustrations by Graham Ogilvie, Ogilvie Design, www.ogilviedesign.co.uk.
The Scottish Executive and NHS Education for Scotland wish to thank Dr Martyn Jones, Associate Director, Social Dimensions of Health Institute, Universities of Dundee and St Andrews, for his contribution to the development of this booklet.
This booklet is based on the belief that clinical research and clinical practice are inseparable. Clinical research must influence clinical practice, and clinical practice must influence the clinical research agenda. Each shares the common objective of providing high-quality health care based on the most up-to-date and reliable evidence.
The days when capable professionals had to all but leave the clinical arena to pursue their research dreams should be consigned to history. The vision of the modern nurse, midwife and allied health professional (AHP) researcher is of someone who is not only actively involved in clinical practice, but is also seen to be vital to its development, delivery and evaluation.
Nursing, midwifery and the allied health professions demand that their practitioners work from a robust knowledge and evidence base. Yet we know that much practice is not based on research evidence. Instead, factors such as tradition, personal experience and preferences, cost and even individual foibles play a significant role in determining how practice is delivered. This is changing, but we still have some way to go before the professions can claim to be truly 'evidence-based'.
The professions now realise the importance of research to their development and to the delivery of quality care. Research strategies and action plans have been produced for nurses, midwives and AHPs in recent years, 1,2 and these have provided the driving force behind a number of exciting research-focused initiatives in Scotland. In addition, NHSScotland is encouraging the development of innovative, evidence-based practice that improves patient/client care and supports the drive to modernise services.
The climate is right, therefore, for enthusiastic, committed and motivated professionals to make their mark on clinical practice through pursuing a clinical research career. This booklet identifies a route-map for aspiring researchers, setting out some of the main issues they will have to consider and the key messages that will help them to make the right choices as they move forward.
You will see some cartoons placed throughout the text. These are accompanied by comments and advice from real nurses, midwives and AHPs in Scotland who have been through, or are going through, the route you are currently considering.
Nurses, midwives and AHPs already make substantial contributions to uni- and multidisciplinary research that informs decisions made by patients/clients, practitioners, managers and policy makers. With adequate support from NHSScotland and funding bodies, and with access to top-quality research training within Scotland's higher education institutions (HEIs), the influence of these vital front-line professionals will be even more telling in the future.
Some professionals opt to increase their understanding of research through personal study, attending short courses designed to boost research awareness, or taking a research module within a course of study at diploma or degree level. There is also a variety of levels at which they can become engaged with research, from being research workers and collaborators through to leading research projects as the principal investigator. 1
Increasing numbers of nurses, midwives and AHPs have explored these options in recent years, but not all routes lead to a defined career in research. That destination can only be reached through systematic, comprehensive training that not only prepares students to design, develop, deliver and evaluate their projects as part of a wider programme of focused research, but which also cultivates the research leaders of the future. And we believe that this kind of expertise can best be achieved by completing studies at PhD and postdoctoral levels.
2. the booklet and the website
No booklet could provide a comprehensive overview of everything you would need to know and consider as you ponder a future research career. Nor could it provide details of all the people and organisations who potentially could pave the way for you to take appropriate research training. The booklet can only focus on some of the key issues and point you in the direction of information and support to help you make the right choices for you.
Linked to this booklet, however, is an online resource that will enable you to access much more of the detail you will need to help you reach your decisions.
The website, which can be found at: www.nes.scot.nhs.uk, is a developing resource that offers a wealth of information and advice for aspiring researchers. It contains links to:
information on research consortia in Scotland, with links to HEIs in Scotland that show their areas of research interest/expertise, key contacts and entry requirements for postgraduate research training
descriptions of the research process and information about opportunities for nurses, midwives and AHPs to engage with the process within consortia
a guide to research governance frameworks
information on postdoctoral research opportunities
Chief Scientist Office fellowship opportunities
opportunities from the Health Foundation
research ethics committees
research interest groups, such as the Royal College of Nursing Research Society
contact details of some clinical experts within managed clinical networks in Scotland
results of the most recent research assessment exercise (RAE).
To take full advantage of the website, log on to www.nes.scot.nhs.uk and follow the instructions, which will guide you to the site.
3. how have we got here?
It's fair to say that there has been a lot of activity on the research front in Scotland in recent years.
The strategy for research and development in nursing and midwifery for Scotland, Choices and Challenges,3 was published in March 2002. The strategy identified nursing and midwifery research as a core contributor to the achievement of the Scottish Executive's plans for a healthy, caring Scotland.
Two key elements were central to the strategy: research consortia, and clinical/academic career pathways.
Research consortia* were seen as offering opportunities to develop a critical mass of skilled researchers capable of contributing to focused programmes of research. They would create a learning environment in which novice researchers could be nurtured.
Clinical/academic career pathways were defined as the key platform for the future development of nursing and midwifery research in Scotland. They would be based on high-quality research training at different career stages and would allow the nurse or midwife to maintain involvement in clinical practice through the creation of sustainable clinical/academic posts.
We now have three research consortia in Scotland, focused on combining the skills and experience of a range of institutions in devising planned programmes of research that aim to meet NHSScotland's agenda.
And clinical/academic career pathway models are being developed with ongoing work looking at ways to adapt career pathways to fit the needs of the professions, particularly in the context of Agenda for Change and the NHS pay modernisation agenda.
The allied health professions in Scotland took much encouragement from the development of Choices and Challenges and could see in it the germ seed of their own plans for fostering research and development. The subsequent Allied Health Professions Research and Development Action Plan,4 produced following a nation-wide consultation which identified research and development as a key priority for AHPs, built on the work undertaken to develop Choices and Challenges to address common issues of capacity and capability. It also focused on the need for a more robust evidence base to underpin professional interventions.
AHPs in Scotland have also built an extensive and very active clinical effectiveness and practice development forum (see: www.nhsscotland.com/cesahp/), supported by the NHS Quality Improvement Scotland Practice Development Unit. The forum has blossomed in the wake of the AHP clinical effectiveness project, 5 which focused on co-ordinating and evaluating clinical effectiveness support mechanisms for AHPs throughout the country.
Each of these documents and initiatives ties in with the national research strategy for NHSScotland, Research Strategy for Health and Healthcare,6 published by the Chief Scientist Office in July 2003. The strategy identified building capacity in nursing, midwifery and AHP research as one of the priorities for the next five years.
There is much more that has happened as a consequence of (and, indeed, as a precursor to) these strategies, action plans and initiatives. All in all, it adds up to a very favourable climate for nurses, midwives and AHPs who are interested in developing their potential as researchers.