Abstract
BackgroundDeveloping research capability and capacity within the healthcare professions is a challenge throughout diverse international settings. Within England, the National Institute for Health Research aimed to address these challenges through the Integrated Clinical Academic (ICA) research careers escalator for nurses, midwives and allied health professionals. Poor academic progression has been identified in the advanced stages of the pathway, though progression from the earlier entry point (Internship) has not previously been investigated. A national evaluation of four completed Internship cohorts was undertaken to explore stakeholder perspectives and progression beyond the Internship programme.MethodsA mixed methods project used sequential qualitative and quantitative data collection phases commencing with two stakeholder focus groups (n = 10); the findings informed the development of an online survey distributed to previous cohorts of interns (n = 104), their managers (n = 12) and academic mentors (n = 36). Eight semi-structured interviews subsequently explored the challenges and opportunities afforded by the internships. Thematic analysis was used to review qualitative data from focus groups and interviews, with survey data analysed and displayed using descriptive statistics. Synthesis of data from each phase is displayed within the four level evaluation framework outlined within the New World Kirkpatrick® Training Evaluation Model.ResultsImportant regional differences exist yet the internships are highly valued by all stakeholders. Representation varied between different professions, with nursing and some service-based professions poorly represented. All interns successfully completed the programme (n = 104), with evidence of positive impacts on interns, colleagues and patient care. Balancing research commitments with clinical activity was challenging; middle managers were seen as gatekeepers to programme success. Progression to the next stage of the ICA pathway is highly competitive and was achieved by only a quarter of interns; access to mentors outside of the funded programme is vital for a successful transition.ConclusionsThe Internship programme succeeds in providing a range of important early experiences in research, though progression beyond the programme is challenging due, in part, to a widening gap between Internship and the next level of the ICA framework. Vital mentorship support to bridge this gap is threatened by a lack of time and funding; therefore, the pursuit of a clinical-academic career will continue to be elusive for many nurses and allied health professionals. A partnership approach to clinical academic support at institutional level is needed with several international models offering alternative strategies for consideration.
Highlights
Developing research capability and capacity within the healthcare professions is a challenge throughout diverse international settings
The Internship programme succeeds in providing a range of important early experiences in research, though progression beyond the programme is challenging due, in part, to a widening gap between Internship and the level of the Integrated Clinical Academic (ICA) framework
Vital mentorship support to bridge this gap is threatened by a lack of time and funding; the pursuit of a clinical-academic career will continue to be elusive for many nurses and allied health professionals
Summary
Developing research capability and capacity within the healthcare professions is a challenge throughout diverse international settings. Midwifery and the allied health professions (NMAHP) are, in combination, the largest staff group within health services, representing potential new capacity for clinical academic research in international health systems [1]. Traditional educational approaches including taught provision, informal mentorship and in-job training programmes may be effective in developing research awareness in early career healthcare staff; the implementation of clinical academic roles has required a more formalised approach. To facilitate the adoption of clinical academic roles within the NMAHP workforce, the National Institute for Health Research (NIHR) implemented the Integrated Clinical Academic (ICA) careers programme. The Internship is the entry level programme that offers an insight into clinical academic careers; it is open to registered NMAHP staff [2] without any formal research training and who are employed within the NHS. Recruitment is competitive and must show a clear potential for benefiting patients and the public
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