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DISCUSSION

Developing a clinical research career

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Opportunities for nurses to become involved in clinical research are increasing, and a structure has been developed to support those new to research in getting started

Abstract

The National Institute for Health Research helps to promote clinical research careers for health professionals working in clinical practice, and has developed a structure to support new researchers. This article explains how nurses can get involved in clinical research and the support available to them.

Citation: Nicholson C (2016) Developing a clinical research career. Nursing Times; 112: 24, 16-18.

Author: Caroline Nicholson is senior lecturer, Florence Nightingale Faculty of Nursing and Midwifery, King’s College London.

Introduction

Clinical research is now considered a core part of the NHS and evidence shows NHS trusts engaged in research provide better overall care to patients (Ozdemir et al, 2015; Hanney et al, 2013). Patients and the public are becoming increasingly aware of clinical research and the potential benefits of participating in order to benefit from new treatments, interventions and medicines, or to benefit future patients.

NHS England (2016) has made its support for nursing research explicit in a new framework for nursing, midwifery and care staff, centred on 10 commitments – one of which is to “lead and drive research to evidence the impact of what we do”.

Patient and public involvement in clinical research is central to the purpose of The National Institute for Health Research (NIHR), the research arm of the NHS. The institute supports outstanding individuals conducting leading-edge research, focused on the needs of patients and the public.

Established in 2006, NIHR has been working for some time to understand how it can create an environment in which health professionals are attracted to clinical academic careers. It has also developed a guide to help aspiring clinical academics (excluding doctors and dentists) and their managers use opportunities in Health Education England (HEE) and the NIHR to support health professionals in combining clinical activity with patient-focused research (NIHR, 2016). Below is a summary of advice featured in this guidance.

Getting started

Training opportunities, such as taking advantage of internships offered by HEE or gaining experience supporting a research project can help you understand whether you are suited to clinical research. It can be useful to talk to patients about your ideas – and be receptive to their ideas too. Talking to established clinical academics can help you work out who could be your research partners. It is worth investigating whether you can shadow someone to gain insights into the research process. NIHR academic training advocates can offer advice (Box 1).

It is important to look beyond your professional group or specialty and find clinical academics across your organisation. There are many research training opportunities but HEE and NIHR personal awards are some of the most comprehensive, offering a full salary and bespoke training funding. Also look out for charity awards and local opportunities.

Research fellowship awards are competitive, so seek advice about where you need to start. For many clinicians lacking research experience, taking a Master’s degree in research (MRes) is the best starting place; these courses are designed to teach you how to undertake high-quality research and most of the formal teaching will be about research, rather than your clinical specialty. Approximately 50% of a MRes degree is project work, which enables you to learn from the experience of carrying out a substantial research project.

Box 1. The role of the academic training advocate

Professor Theresa Wiseman holds a joint role of clinical chair of Applied Health Research in Cancer Care and strategic lead for Health Service Research, The Royal Marsden NHS Foundation Trust, and the University of Southampton. She describes her role as an NIHR academic training advocate.

“It’s important all our care is based on evidence and that includes patients and their experiences. We can learn a lot from patients and make a difference to others by conducting and implementing research.

I’m a nurse and have more than 20 years of applied health research experience. My first specialist area was intensive care nursing. Then I transferred to cancer care – an area I have focused on since I did a PhD in the late 1990s.

The NIHR academic training advocates are a cohort of passionate and proactive researchers working both individually and as a group to act as ambassadors for health research careers. They promote the NIHR training and career opportunities and supporting and advocating for non-medical professions and for individuals who wish to begin or continue a research career. The role is about supporting people who are interested in a clinical academic career. Last year there were only six to eight advocates.

NIHR put out a call on its website and to universities and trusts asking people to apply for the role so they could expand the cohort. I thought it sounded interesting and decided to apply. I’m passionate about clinical academic careers and about research in practice – that research doesn’t just end up on a shelf or in a journal but it makes a difference to patients.

I had to write a CV and supporting statement; then I received an email to say I had been invited to join the cohort. All the advocates met in London to talk about the sorts of things we thought we could do to raise the profile of clinical academic careers.

We decided to develop a web page for the NIHR site and to develop short biographies about each research advocate for people to click on and find out more.

Since taking on the role last September I have been contacted by a couple of nurses asking for advice about clinical research. The first thing I advise nurses to do is have a look at their CV. If they have not been published they should start writing. They should also see what research has been done in their area of interest and consider what they could contribute to that area, join a research team and start meeting other researchers.

If they want to develop an NIHR application they need to bear in mind it can probably take between seven and 12 months. NIHR will be looking at the quality of applicants and their commitment to a research career, the quality of the project and its relevance to the NHS, and the quality of the institutions and the support and infrastructure to host the fellows.

I would encourage nurses to contact NIHR academic training advocates for advice if they are thinking of a clinical academic career.”

See further information

Building support networks

It is important to develop a clinical and academic network around you. You need to find out who the key people in your field are and who they work with. Clinically this can be your peers and colleagues and, importantly, your manager. The more support you can garner for your joint academic and clinical career the better.

Academically you need to repeat this process with key people in your area of research. Building networks, even at this early stage, can be helpful in developing a clinical academic research career. From these networks, you may create collaborations that will help build your own future research. Organisations such as the Council for Allied Health Profession Research (CAHPR) are a good starting point.

To embark on a clinical academic career it is important to become part of the wider research community. This may be within your trust, professional body or clinical area. Start engaging with researchers, to highlight your interest in research and your desire to progress your career.

Seek out clinical academics and ask them for advice. Most professional bodies have research officers who can help you; many are keen to encourage the next generation of researchers and can give you advice on what to do – and what not to do. Five minutes with the right academic can not only be inspiring, but also provide a snippet of advice that might help you avoid unnecessary work.

Finding a mentor – ideally someone outside your department, or even your organisation – is crucial; mentors give you a wider perspective of the academic and professional world and the options available to you beyond your current studies. If your organisation has a formal mentoring scheme then take advantage of it. Do not wait for someone to find you a mentor; be proactive and brave. Find someone you respect, admire and would like to emulate and ask them. If you are unsure what mentoring means or what a mentor does there are many resources to help you, such as the Mentorship for Health Research website.

Developing your skill set

You will have to develop new skills that will be different from your clinical skills but will complement them (Box 2). The role of researchers is different but it is also exciting and rewarding and can have a real impact on your clinical work.

Put some time into planning how you will become skilled academically. Learn to be self-aware about your skills and those you need to develop, but also seek advice from others on what you need to develop. Shadowing or observing a colleague can offer exposure to something you do not feel confident in, while volunteering to present to colleagues can hone presentation skills. You should also routinely document all your research training.

Box 2. Personal attributes of the clinical researcher

  • Tenacity
  • Willingness to learn from critique
  • Networking ability
  • Curiosity
  • Clinical experience
  • Ability to drive forward projects
  • Ambition
  • Courage
  • Willingness to learn new skills

Build your CV

Build your CV from the start. Publish articles even if they are not in academic journals; an article in a professional magazine demonstrates you can write well enough to be published. Submit abstracts, go to conferences and present your work as you go along.

Make sure you publish your Master’s degree project and, if possible, your degree project too. A strong track record of publications is vital to succeed, so start early and keep it up. Seek advice on what Master’s programme best fits with your career ambitions. Likewise, take advice if you are choosing a doctoral training award. Keep an eye out for bursaries and small grants – some funders offer small amounts of money for travel or attendance at meetings. Consider local charities that may fund small projects – these awards look good on a CV as they are competitive.

Applying for funding

Put some time into understanding the training available, such as internships, Master’s, PhD and post-doctoral courses. The Integrated Clinical Academic (ICA) Programme, funded by HEE and run by the NIHR, is one of the most recognised routes into a clinical academic career for many health professionals.

If you are preparing an application and have little or no previous experience, a successful application to a nationally awarded clinical fellowship or similar award will take at least a year to prepare. Panels are interested in you and your potential as a researcher, your project and its relevance to healthcare provision and the team you have bought together to support you. Your personal clinical and research training and development is an important part of the application.

Spend some time putting together a comprehensive training package that is unique to you and your learning needs in relation to your research. The panel will also be interested in how you continue to develop clinically and in the research culture within your trust. Pulling all this together takes time and different schemes will have different criteria by which they are assessed.

There is a great deal of information about the various schemes available from the team at the NIHR Trainees Coordinating Centre, who will advise on which are best for you. Staff at your local NIHR Research Design Service (RDS) can also help, so approach them as soon as you have an idea. They can advise on whether your project is within the NIHR remit – if it is not you will need to seek funding from other sources. The RDS can also advise on how to incorporate patient and public involvement and on the methodological aspects of your application. Talk to people who have been through the process and look on the NIHR website for previous fellowship holders.

Making a clinical academic training opportunity work

Talk to your clinical service manager as soon as you are thinking about taking your first steps in research; advance notice of your intentions will be appreciated, and your manager can look out for opportunities on your behalf. Start thinking of how to backfill your position if you are successful and about making the case to their manager to release your time. This is particularly important if you provide a specialist skill or service, individually or as part of a team – see NIHR (2016) for advice.

Also, talk to your research and development department leads. They may be important in helping you negotiate a feasible and effective balance between your clinical and academic workload.

Understand your manager’s and organisation’s challenges and interests – what issues are they facing at the moment? Could your research project help?

Could your project be linked to quality improvement initiatives? Be flexible – work with your manager to make this work for everyone. Clinical research is about making what you do better for patients, for management, and for the wider NHS.

Conclusion

There has never been a better time for nurses to become clinical academics and for nurses take a greater role in health services research. If you want to develop clinical care through research, lead and inspire others then it is time to get started.

Key points

  • There is increasing evidence that research-active NHS trusts provide better overall care to patients
  • To embark on a clinical academic career it is important to become part of the wider research community
  • It is vital to build your CV from the start, and publish articles even if they are not in academic journals
  • A successful application to a nationally awarded clinical fellowship or similar award will take at least a year to prepare
  • NIHR Academic Training Advocates support people who are interested in clinical academic careers
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