Research: a viable and meaningful career alternative for occupational therapists.

Abstract

A research career can be rewarding, meaningful and from our unique occupational therapist lens can, and has, contributed to transforming practice and policy. It is a viable but often invisible alternative to a clinical or traditional lecturer role. In reflecting on my career pathway, that currently includes an NHMRC career development research fellowship, I also interviewed several other occupational therapists who have achieved national research fellowships. Nearing et al. (2015) talk of the importance of meaningful, authentic and relevant research and research experiences in forming a scientist identity and sustaining motivation to pursue and persist in research careers. We all highly value the meaningful outcomes of our sustained research programmes which were motivated by a passion for wanting to make a difference. My fall prevention programmes for older people are implemented worldwide and my LiFE programme, embedding balance and strength training into daily activities, has challenged our philosophy of finding ways of doing things easier to incorporating environmental challenges and habit change to improve and maintain functional capacity. Leeanne Carey's SENSe programme, where once we accepted poor stroke outcomes for those with sensory impairment, occupational therapists now have a proven method to improve lost abilities. Leanne Sakzewski's cohesive reviews of intervention models in upper limb therapy for children along with a focus on skills development in the delivery of evidence-based upper limb interventions for children with cerebral palsy have demonstrated change in therapist behaviour and practice. And finally, Tammy Hoffmann's TIDieR statement and guide for describing interventions is narrowing evidence-practice gaps by facilitating the delivery of effective interventions. It is being used worldwide, across multiple disciplines, by journals, organisations and authors and peer-reviewers of trials and systematic reviews to improve the description of interventions, thus enabling evidence uptake. The journey of our career paths was marked by emersion into research, of seeking out and situating ourselves in a strong research environment, of seeking excellence in research and learning what that was. The pathway requires many challenges in creating and sustaining, that track record where we have that competitive edge to compete with our national scientists for grants and research support. Good mentorship has been an essential enabler that asked of us the right reflective questions and supported our transition from clinician, clinician researcher or lecturer research to researcher leading our own independent research programme. A research career opens up opportunities for travel, for international and national networks and collaboration which spirals into more grant opportunities and accelerates innovation. But prominent in all our stories is the multidisciplinary nature of our work- and this exposure goes beyond allied health where we mix with a vast range of scientific disciplines – from biomechanics to neuroscientists to engineers to health economists. This brings richness and depth and a scientific quality to our discipline that strengthens our work, brings an occupational therapy lens to other disciplines and in turn strengthens the scientific basis and value of our work. We believe our work is contributing to the narrowing of what we have observed as a clinical-research divide and that real change values relationships and finding that ‘meeting place’. This place is where we actively work towards shared decision making (Hoffmann, Montori & Del Mar, 2014), of helping therapists make the connections between evidence and practice, of involving consumers to understand the real benefits and how to communicate and engage at a policy level. In occupational therapy as in any discipline we have embedded habits, roles and traditions that new evidence can sometimes shake. For example, therapists may feel reluctant or even guilty taking time to conduct reviews and audits which, when enabled, can lead to practice change. Partnerships and stakeholders are crucial to enabling change but translation also involves new skills and facilitating confidence to change or enhance our practice. We have consistently produced very practical outcomes with manuals, resources and multi-modal training approaches, perhaps a reflection of occupational therapy itself where the detail is in the doing. A driver for us all continues to be creating a community of support and building research capacity that is embedded within our discipline. We strive to ‘build layers’ and to collaborate with clinicians and partners. Further, we now recognise the imperative in any research project to plan for translation and sustainability from the beginning. This is our hard learned lesson and essential for the future of our discipline.