Clinical Academic Career Pathways Research Articles

Engaging undergraduate medical and dental students with academic medicine: The Aberdeen INSPIRE summer school.

UK medical and dental school curricula limit opportunities for students to gain experience in research. This parallels a decline in the number of clinical academics. To address this at grass roots level, we organised and arranged a residential summer taster week; INSPIRE (Introducing New Skills to Promote Inspirational Research Experience)-Aberdeen). The purpose was to give first and second year medical and dental students who wished to explore a potential clinical academic career a taste of wet laboratory research and to gain experience in basic research skills. Seventeen students from eight different UK medical and dental schools attended this free residential course and were exposed to various laboratory techniques with clinical translation and application in diagnostic and therapeutic medicine. Students were given access to relevant online learning tools of the techniques being used beforehand and seminar style presentations were used to emphasise their clinical application. Students met daily with clinical academics from different specialities to give them a flavour of potential clinical academic career pathways and options. All students felt that the summer school helped them consider academic medicine as a career thus achieving our aim to inspire clinical academics of the future.

The South West Clinical School model: an initiative to transform clinical academic career pathways.

The Clinical School Model connects professorial staff from the university directly to practitioners in the National Health Service to promote evidence informed practice and develop clinical academic careers. These are promoted widely, but strategic adoption into organisational culture and workforce plans are challenging to overcome. To describe the development of the Clinical School Model in Cornwall and explore how it generates impact through staff engagement activities to support clinical academic career pathways. Structure, process and outcomes developments over the last 3-years are reported. Donabedian's framework (structure, process and outcome) was used to report on the development and impact of the Clinical School Model. Structural and process activities are reported, illustrating strong foundations to embed clinical academic career pathway opportunities. In the absence of empirical reporting standards for such developments, quantitative and qualitative outcomes are reported against the Clinical School's 5-year strategic plan. This paper responds to the lack of reported evidence on developing organisational infrastructure to address the clinical academics aspirations of nurses and their employers. This important contribution leads a call for more organisations to report to the evidence base, enabling shared learning and shaping future research.

Commentary: The South West Clinical School model: an initiative to transform clinical academic career pathways.

Commentary: The South West Clinical School model: an initiative to transform clinical academic career pathways.

A BLUEPRINT GUIDE: CLINICAL ACADEMIA

Clinical academic career pathways are a strategic priority for NHS England but primarily focus on developing clinical researchers, with midwifery teaching pathways particularly underdeveloped.1 Literature and personal experience suggests that becoming a clinical-academic is both unusual and driven by individuals rather than organisation process and strategy.1,2,3 Below I provide a case study of how I negotiated a clinical-academic role, an exploration of the surrounding literature to support this transition and a potential blueprint for other midwives considering a similar career move.

Commentary: Developing a clinical academic career pathway in a Community and Mental Health NHS Trust.

Implementing a clinical academic career pathway in nursing; criteria for success and challenges ahead

Developing a clinical academic career pathway in a Community and Mental Health NHS Trust.

Despite growing evidence of the impact that clinical academic (CA) staff have on patient care and clinical practice, there are disproportionately low numbers of nurses, allied health professionals (AHPs) and other healthcare professionals in CA joint roles, compared to their medical colleagues. To describe the initial development of a CA career pathway for nurses, AHPs and other healthcare professionals in a Community and Mental Health NHS Trust. Kotter's 8-Step Change Model was used to expand opportunities and research culture across an NHS Trust. A variety of capacity and capability initiatives at different academic levels were created to support CA development and to complement those available externally. These opportunities were underpinned by a research and development strategy, senior leadership buy-in, manager and clinical staff support, and targeted organisation-wide communication. The ongoing development of innovative CA opportunities in the Trust, alongside greater support for staff interested in pursuing CA careers, has resulted in a growing number of individuals successful in developing as CAs. This has led to a growth in research culture in the organisation and a greater understanding of what CA staff can bring to patient care, the clinical service and the wider organisation.

Future clinical academic midwife

Clinical academic career pathways for nurses, midwives and allied health professionals are a strategic priority for NHS England, and there has been significant investment in the National Institute of Health Research integrated clinical academic programme for non-medical healthcare professionals. Nurses, midwives and allied health professionals face numerous barriers to successfully building a clinical academic career. For those outside the integrated clinical academic programme, clinical academic career approaches are varied and often driven by individual practitioners rather than robust organisational processes or strategy. The vision of ‘future midwife’ is that midwives maximise opportunities in research and scholarship. However, there is little clarity about how these academic aspirations may be supported. This reflective lived experience discussion paper explores key issues around clinical academic midwifery careers, including how space for clinical academic midwives can be assured and the steps midwives can take to start to develop this rewarding and important career.

Interventions and strategies aimed at clinical academic pathway development for nurses in the United Kingdom: A systematised review of the literature.

To review interventions and strategies designed to progress UK clinical academic career pathways in nursing and identify barriers and facilitators to aid wider implementation. For over a decade, the UK political agenda has promoted the entry of nurses into clinical academic roles. Partnerships between the National Health Service and academia are known to increase nursing recruitment, retention and quality of care. However, there remains a lack of nurses working in these partnership roles. A systematised review was conducted. An electronic database search was carried out in PubMed, CINAHL, the British Nursing Database and PsychInfo for articles published between September 2006 to June 2020. A narrative approach to data synthesis was used, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Ten papers were included in the review. The authors reported a range of programmes, pathways and toolkits. Pathway outcome measures included numbers of nurses recruited onto clinical academic programmes, clinical academic programmes completed, nursing research outputs, impact on clinical practice and impact on nursing recruitment. Barriers and facilitators to pathway development included funding, clinical and research time constraints, infrastructure, strong and strategic clinical academic leadership and effective partnership working. The quality of the included studies was mixed; more high-quality, evidence-based programmes need to be developed and rigorously evaluated. The findings can inform nursing clinical academic research pathway development internationally, by identifying key drivers for success. Sustained and cohesive implementation of clinical academic research pathways is lacking across the UK. Strong, strategic leadership is required to enable progression of clinical academic nursing research pathway opportunities. Clinical nursing practitioners need to collaborate with external partners to enable development of clinical academic pathways within the nursing profession; this can lead to improvements in patient care and high-quality clinical outcomes.

What is a clinical academic? Qualitative interviews with healthcare managers, research-active nurses and other research-active healthcare professionals outside medicine.

To explore the concept of "clinical academic" from the perspectives of healthcare managers and research-active healthcare professionals outside medicine. Clinical academics are understood to be healthcare professionals who combine clinical and research responsibilities within their role. However, there is no agreed definition for this term either within or across nursing, midwifery and the other healthcare professions outside medicine. Qualitative service evaluation, reported using the COREQ checklist. Semi-structured qualitative interviews were conducted with a purposive sample of eight healthcare managers and 12 research-active clinicians within a UK hospital group. Interviews were audio recorded, transcribed verbatim and analysed using the Framework method. Clinical academics were described in four themes. Two themes explored the components of the role and the contribution of these individuals to their profession: combining clinical practice, research and education; and pushing boundaries. The third theme identified the clinical academic label as: a title that doesn't fit. The final theme examined a characteristic mindset of research-active clinicians. There were no clear differences in the perceptions of managers and research-active clinicians. Clinical academics were perceived as valuable members of their team and were able to push the boundaries to move their profession forward. Some research-active clinicians did not identify with the term "clinical academic" and for some managers and research-active clinicians, the term was viewed as jargonistic. A clear and accepted definition would aid development of clinical academic career pathways and identities. It would also assist in evaluating the impact of these roles. As clinical academic roles and opportunities are being developed across the professions outside medicine, it is important to have a shared common understanding of "clinical academic" to support the creation of career pathways and curricula, and to enable the evaluation of these roles.

Weaving a clinical academic career: Illuminating the method and pattern to follow

The benefits of developing occupational therapists as clinical academics are well recognised. They include improved healthcare outcomes and experiences for service users, efficiencies for organisations and increased prominence of occupational therapy within healthcare. Yet occupational therapists describe uncertainty about how best to navigate clinical academic career pathways. We suggest that occupational therapists can increase their research aspirations, confidence and capacity by following a four-step method, weaving together clinical, academic and personal development. We outline our view of clinical academic development as a process with flexibility to incorporate occupational therapists’ diversity of interests and circumstances. By demystifying and illuminating the process of clinical academic development, we believe that occupational therapists may be able to weave more clinical academic development opportunities into their careers and increase the profession’s research capacity.

Developing an infrastructure to support clinical academic careers.

Research and evidence-based practice underpins the delivery of high-quality patient care. Developing the research capacity and capability of nurses, midwives and allied health professionals requires a robust emphasis and the necessary support infrastructure to encourage and develop practitioners to follow a clinical academic career pathway. Clinical academic partnerships between higher education and healthcare institutions can offer a blend of required expertise with mutual benefits. This article reports on a recent Florence Nightingale Foundation and Council of Deans of Health Leadership Scholarship improvement project to establish an infrastructure to support the development of clinical academic roles to enhance the provision of evidence-based patient care in the North East of Scotland.

Combining clinical practice and academic work in nursing: A qualitative study about perceived importance, facilitators and barriers regarding clinical academic careers for nurses in university hospitals.

To obtain in-depth insight into the perceptions of nurse academics and other stakeholders regarding the importance, facilitators and barriers for nurses combining clinical and academic work in university hospitals. Combining clinical practice and academic work facilitates the use of research findings for high-quality patient care. However, nurse academics move away from the bedside because clinical academic careers for nurses have not yet been established in the Netherlands. This qualitative study was conducted in two Dutch university hospitals and their affiliated medical faculties and universities of applied sciences. Data were collected between May 2015 and August 2016. We used purposive sampling for 24 interviews. We asked 14 participants in two focus groups for their perceptions of importance, facilitators and barriers in nurses' combined clinical and academic work in education and research. We audiotaped, transcribed and thematically analysed the interviews and focus groups. Three themes related to perceived importance, facilitators and barriers: culture, leadership and infrastructure. These themes represent deficiencies in facilitating clinical academic careers for nurses. The current nursing culture emphasises direct patient care, which is perceived as an academic misfit. Leadership is lacking at all levels, resulting in the underuse of nurse academics and the absence of supporting structures for nurses who combine clinical and academic work. The present nursing culture appears to be the root cause of the dearth of academic positions and established clinical academic posts. A culture change would require a show of leadership that would promote and enable combined research, teaching and clinical practice and that would introduce clinical academic career pathways for nurses. Meanwhile, nurse academics should collaborate with established medical academics for whom combined roles are mainstream, and they should take advantage of their established infrastructure for success.

G227(P) Starting out on a clinical academic pathway: the experience of a newly – qualified nurse

Aim The development of clinical academic careers should continue to focus on both clinical and academic work, rather than pursuing one at the expense of the other. What remains a challenge is the articulation of new roles owing to the lack of clarity and shared appreciation of what they are and what they do. As these are relatively new roles, a shared understanding of the activities that clinical academic post holders might undertake have yet to be really clarified. The aim of this work is to reflect upon the experiential learning of a newly – qualified nurse and novice researcher. The focus is on the positive impact of research training on clinical development and vice versa. Methods A review of the current literature on the topic added to my personal reflection on the benefits and challenges of undertaking a clinical academic career. Results The literature suggests a lack of clearly defined clinical academic career pathways for nurses during the early stages of their career, which is a key recommendation of the Association of UK University Hospitals (2012). As a result of this, there is a paucity of newly – qualified and junior nurses embarking on a clinical academic pathway. Reflecting on my own experience soon after qualifying of combining a research role within a large research team with clinical practice, there are great benefits to developing both roles early in a career, although there can also be some challenges, one example being the time pressures of juggling two roles. Conclusion From my experience, I will discuss suggestions to help novice nurses participate in research activity and how to address some of the challenges I have faced, sharing real examples of the benefits. This pathway has been highly dependent on the collaboration between health services and higher education institutions, with support provided from both. I will discuss my support needs as a less experienced nurse juggling two multi-faceted roles. The literature and my personal experience indicate that there would be great benefits to patients, the nursing workforce, and academic and health institutions if more nurses step on to a clinical academic pathway earlier in their career trajectories.

Developing a clinical academic career pathway for nursing

Since the publication of the UK Clinical Research Collaboration's (UKRC, 2007) recommendations on careers in clinical research, interest has grown in the concept of clinical academic nursing careers, with increased debate on how such roles might be developed and sustained (Department of Health, 2012). To embed clinical academic nursing roles in the NHS and universities, a clear understanding and appreciation of the contribution that such posts might make to organisational objectives and outcomes must be developed. This paper outlines an initiative to define the potential practice and research contribution of clinical academic roles through setting out role descriptors. This exercise was based on our experience of a clinical academic career initiative at the University of Southampton run in partnership with NHS organisations. Role descriptors were developed by a group of service providers, academics and two clinical academic award-holders from the local programme. This paper outlines clinical academic roles from novice to professor and describes examples of role descriptors at the different levels of a career pathway. These descriptors are informed by clinical academic posts in place at Southampton as well as others at the planning stage. Understanding the nature of clinical academic posts and the contribution that these roles can make to healthcare will enable them to become embedded into organisational structures and career pathways.

Implementing a clinical academic career pathway in nursing; criteria for success and challenges ahead

Abstract Following the United Kingdom Clinical Research Collaboration’s (UKCRC) (2007) recommendations on careers in clinical research, there has been growing anticipation in the United Kingdom about the real potential for establishing career pathways for nurses and allied health professionals that will enable them to combine a focus on both clinical and academic roles. However, it is recognized that the implementation of this initiative will require charting largely untested waters, with issues ranging from establishing joint University: health service employment contracts, to harmonizing clinical and research roles and ensuring sustainability of funding for clinical academic posts. This paper will outline the implementation of a pilot clinical academic career initiative, which has been modelled on the UKCRC framework. We will illuminate the processes and structures employed and reflect on the factors that appear critical to the successful establishment of a clinical academic career pathway. Additionally, our experience has enabled us to identify challenges that will need to be addressed by a range of stakeholders if clinical academic careers are to flourish and deliver their potential at a national level as a modern career option for nurses and allied health professionals.

Implementing a clinical academic career pathway in nursing: criteria for success and challenges ahead

The UK Clinical Research Collaboration’s (UKCRC) proposals for new arrangements aimed at making it easier—or possible—for nurses and midwives to combine research and clinical careers have raised levels of excitement within the profession. On a good day, it feels like nursing and midwiferya are steadily becoming more research savvy, both in terms of the research-mindedness of those delivering and managing care and a growing capacity to get research grants, do useful research and supervise research students. And these proposals are part of the good news in that regard. On a not so good day, these initiatives feel piecemeal, hard to make sustainable and only going a very small way to realise the potential of research within and around nursing activity. There have been other capacity-building schemes. In the late 1960s, the English Department of Health and Social Security (DHSS) proposed and funded the ‘Study of Nursing Care’ programme of research, which produced seminal works and started the research careers of a number of individuals who became some of the profession’s first research leaders such as Jean McFarlane, the first Professor of Nursing in England. Further DHSS fellowships were awarded in subsequent decades also giving a significant boost to another wave of future research leaders. More recently, we have seen the Health Foundation Fellowship and Partnership schemes, which have funded the research (and leadership training) of around 30 young researchers, and a funding alliance between the English Department of Health and the Higher Education Funding Council for England aimed at developing research capacity in nursing and the Allied Health Professions. In Scotland, the predecessor bodies to the Scottish Funding Council continually invested in research in these professions and benefits have been identified in a number of scoping exercises such as that described by Alison Tierney summarised at http://www.sehd.scot.nhs.uk/cso/Publications/rm35/rm35-00.htm. The present UKCRC proposal, like the Scottish approach, has featured arrangements to enable and encourage the forming of links between universities and the Journal of Research in Nursing ©2008 SAGE PUBLICATIONS Los Angeles, London, New Delhi and Singapore VOL 00 (00) 1–3 DOI: 10.1177/ 1744987108101952

CLINICAL ACADEMIC CAREERS FOR NURSES: TIME FOR A RENEWED DEBATE

The global healthcare workforce that teaches and undertakes research is ageing, is in short supply and has little infrastructure to support career development. For health professionals, the first step to setting out on a clinical academic career is often unclear; indeed, many of the present clinical academic workforce have entered a career life as educators or researchers by serendipity. Various countries encounter difficulties in making professorial appointments and many institutions report poor shortlists for all teaching and research posts. Some comprehensive reports from the USA (http://www.aacn.nche.edu) and the UK (http://www.stlarhr.org.uk) document these concerns. In England our concerns moved us to establish a centre for Clinical and Academic Workforce Innovation at the University of Lincoln, through which we will undertake research in order to be able to shape and develop the careers of those who aspire to be educators or researchers. Our work to date has allowed us to hold an extensive nationwide discussion with health and social care professionals so as to determine the barriers to the development of clinical academic careers. In England, the government Department for Health and the Department for Education and Skills asked my team to undertake survey research work and produce a human resources plan that would address the critical issues that mitigate against successful clinical academic career development. We have produced some clinical academic career pathway models and our 15 recommendations are grouped around three issues: strategic drivers — matters that can be assisted by government and national policies (such as inequities in pay between clinicians and academics); employment practices and cultural changes (such as developing flexible career pathways and resolving inequities in pension rights); and the necessity for accurate labour market intelligence (we don't know with any accuracy how many educators and researchers we have!); funding to support career development was, and still is, seen as a critical issue (see http://www.stlarhr.org.uk for a full account). Since our multiprofessional work was completed, a career structure has been put in place for medicine and dentistry (UKCRC 2005) and other professions are now to be considered. A second project specifically for nurses and sponsored by our national director for Research and Development is being undertaken by my team, and is expected to be completed by May 2006. Investments that encourage the brightest and the best of our newly qualified nurses to become educators and researchers must be made. Also, those expert clinicians who wish to change careers must be encouraged and supported to do so. It is possible to craft clinical academic careers that take account of existing funding and, with some additional resources and careful investment, create attractive opportunities for those wishing to teach and undertake research. If changes and investments are not made soon, we will face critical shortages of these essential staff.