International Perspectives of Nurses, Midwives and Allied Health Professionals Clinical Academic Roles: Are We at Tipping Point?

  • Debbie Marie Carrick-Sen University of Birmingham https://orcid.org/0000-0002-2903-8649
  • Ann Moore University of Brighton, UK https://orcid.org/0000-0001-7627-3492
  • Patricia Davidson The Johns Hopkins University School of Nursing
  • Han Gendong Chinese Hospital Management Research Centre
  • Debra Jackson University of Technology Sydney
Keywords: clinical academic;, ; international, multi-professional, research capacity and capability building

Abstract

Healthcare research activity improves patient outcomes. Nurses, Midwives and Allied Health Professions (NMAHPs) make an important contribution to clinical research. Within the United Kingdom (UK), there is a 25-year history of increasing healthcare research capacity and capability through clinical academic roles. Medical colleagues were the first to introduce the role in 2005. In 2007, a national policy identified inequalities in access to and success of research training fellowships between medical and nursing healthcare professionals. This was followed by a number of national initiatives, which continue to evolve to the present day. There is evidence that the UK has reached the ‘tipping point’ to increase NMAHP research capacity and capability through clinical academic roles. Despite these initiatives substantial gaps remain. Outside, the UK, the term ‘clinical academic’ is not well understood. There is evidence of the presence of senior clinical academic roles, a clinical professor within Australia and the United States, for example, but there is a lack of opportunities and of a formulised research training pathway at a junior level. There is interest and appreciation of the NMAHP research-active clinical academic within the clinical setting in the Nordic countries and China, but the pace of change is slow due to co-existing priorities involving change and innovation. There is a need to develop and agree both national and international definitions that describes the NMAHP research-focused clinical academic role activity.

Author Biographies

Ann Moore, University of Brighton, UK

Professor Emerita Moore, A.P. CBE  PhD, MCSP, MACP, Cert.Ed., Dip.TP, FHEA, FCSP, FMACP, D.Sc (Honorary) Professor Emerita of Physiotherapy, University of Brighton, UK Email: a.p.moore@brighton.ac.uk

Patricia Davidson, The Johns Hopkins University School of Nursing
Professor Patricia Davidson. PhD, MED, RN, FAAN. Professor and Dean, School of Nursing, The Johns Hopkins University School of Nursing, Baltimore, Maryland, USA. Email: pdavidson@jhu.edu

 

Han Gendong, Chinese Hospital Management Research Centre

Dr Han Gendong, M.D., Director of Chinese Hospital Management Research Centre, Beijing, China. Email: beida99@126.com

Debra Jackson, University of Technology Sydney

Professor Debra Jackson. AO, RN, PhD, SFHEA, FACN. Professor of Nursing University of Technology Sydney, Australia. Email: Debra.Jackson@uts.edu.au

References

Adams, J., Kawchuk, G., Breen, A., De Carvalho, D., Eklund, A., Fernandez, M., Funabashi, M., Holmes, M. M., Johansson, M. S., de Luca, K., Moore, C., Pagé, I., Pohlman, K. A., Swain, M. S., Wong, A. Y. L., & Hartvigsen, J. (2018). Leadership and capacity building in international chiropractic research: Introducing the chiropractic academy for research leadership (CARL). Chiropractic & Manual Therapies, 26, 5. https://doi.org/10.1186/s12998-018-0173-3

Albert, N. M., Chipps, E., Falkenberg Olson, A. C., Hand, L. L., Harmon, M., Heitschmidt, M. G., Klein, C., Lefaiver, C., & Wood, T. (2019). Fostering academic-clinical research partnerships. Journal of Nursing Administration, 49(5), 234–241. https://doi.org/10.1097/NNA.0000000000000744

Becze, E. (2010). Defining the role of the clinical research nurse. ONS Connect, 25(5), 12–13.

British Medical Association. (2015) Walport 10th Anniversary Symposium Goodenough College. www.bma.org.uk/-/media/files/pdfs/developing%20your%20career/finaWALPORT-symposium-report.pdf

Bowman, C. C., & Gardner, D. (2001). Building health services research capacity in nursing: Views from members of nursing's leadership. Nursing Outlook, 49(4), 187–192. https://doi.org/10.1067/mno.2001.116334

Campbell, M., & Taylor, J. R. (2000). Academic and clinical collaboration. Contemporary Nurse, 9(3-4), 211–219. https://doi.org/10.5172/conu.2000.9.3-4.211

Cannaby, A. M., Gkantaras, I., Finn, A., Foreman, B., Butler, G., Topping, A., & Gray, R. (2017). Implementing a nursing systems framework in a developing country. International Nursing Review, 64(3), 345–352. https://doi.org/10.1111/inr.12380

Care Quality Commission. (2018). The state of health care and adult social care in England 2017/18. https://www.cqc.org.uk/sites/default/files/20171011_stateofcare1718_report.pdf

Carrick-Sen, D., Baillie, L., Deaton, C., Lowes, L., McCabe, C., Norton, C., Tod, A., & Robb, E. (2015). Improving nursing research activity: The importance of leadership. British Journal of Nursing, 24(14), 751. https://doi.org/10.12968/bjon.2015.24.14.751

Carrick-Sen, D., Richardson, A., Moore, A., & Dolan, S. (2016). Transforming healthcare through clinical academic roles in nursing, midwifery and allied health professions: A practical resource for healthcare provider organisations. https://councilofdeans.org.uk/wp-content/uploads/2019/02/AUKUH-Transforming-Healthcare.pdf

Cioffi, J., Leckie, C., & Tweedie, J. (2008). Practice development: a critique of the process to redesign an assessment. Australian Journal of Advanced Nursing, 25(2), 70–77.

Collins. (n.d.). Definition of practice development. In CollinsDictionary.com dictionary. Retrieved November 13, 2019, from https://www.collinsdictionary.com/dictionary/english/training

Condell, S. L., & Begley, C. (2007). Capacity building: A concept analysis of the term applied to research. International Journal of Nursing Practice, 13(5), 268–275. https://doi.org/10.1111/j.1440-172X.2007.00637.x

Considine, J., Martin, R., Smit, D., Jenkins, J., & Winter, C. (2006). Defining the scope of practice of the emergency nurse practitioner role in a metropolitan emergency department. International Journal of Nursing Practice, 12(4), 205–213. https://doi.org/10.1111/j.1440-172X.2006.00570.x

Coombs, M., Latter, S., & Richardson, A. (2012). Developing a clinical academic career pathway for nursing. British Journal of Nursing, 21(18), 1084–1090. https://doi.org/10.12968/bjon.2012.21.18.1084

Cregler, L. L., Clark, L. T., & Jackson, E. B., Jr. (1994). Careers in academic medicine and clinical practice for minorities: opportunities and barriers. Journal of the Association for Academic Minority Physicians, 5(2), 68–73.

Department of Health. (2012). Developing the role of the clinical academic researcher in the Nursing, Midwifery and Allied Health Professions. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_133094.pdf

Department of Health. (2015). The NHS Constitution: The NHS belongs to us all. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/480482/NHS_Constitution_WEB.pdf

Ditzenberger, G. R., Collins, S. D., & Banta-Wright, S. A. (1995). Combining the roles of clinical nurse specialist and neonatal nurse practitioner: The experience in one academic tertiary care setting. J Perinat Neonatal Nurs, 9(3), 45–52. https://doi.org/10.1097/00005237-199512000-00008

Edwards, N., Webber, J., Mill, J., Kahwa, E., & Roelofs, S. (2009). Building capacity for nurse-led research. International Nursing Review, 56(1), 88–94. https://doi.org/10.1111/j.1466-7657.2008.00683.x

Eisenberg, E. (1987). Academic/clinical career: The best of both worlds. Journal - Connecticut State Dental Association, 61(1), 17–18.

Eley, D. S. (2018). The clinician-scientist track: An approach addressing Australia's need for a pathway to train its future clinical academic workforce. BMC Medical Education, 18(1), 227. https://doi.org/10.1186/s12909-018-1337-5
Faivre-Finn, C. (2017). Breaking the glass ceiling for women in academic clinical oncology in the UK: A personal view. Clinical Oncology, 29(1), 1–2. https://doi.org/10.1016/j.clon.2016.09.022

Fatima, R., Yaqoob, A., Qadeer, E., Hinderaker, S. G., Heldal, E., Zachariah, R., Harriesm A. D., & Kumar, A. M. V. (2019). Building sustainable operational research capacity in Pakistan: Starting with tuberculosis and expanding to other public health problems. Global Health Action, 12(1), 1555215. https://doi.org/10.1080/16549716.2018.1555215

Finch, J. (2007). Developing the best research professionals. Qualified graduate nurses: Recommendations for preparing and supporting clinical academic nurses of the future. UKCRC. http://www.ukcrc.org/wp-content/uploads/2014/07/Nurses-report-August-07-Web.pdf

Foster, S. (2018). The need for clinical academic roles. British Journal of Nursing, 27(4), 229. https://doi.org/10.12968/bjon.2018.27.4.229

Friesen, E. L., Comino, E. J., Reath, J., Derrett, A., Johnson, M., Davies, G. P., Teng-Liaw, S., & Kemp, L. (2014). Building research capacity in south-west Sydney through a Primary and Community Health Research Unit. Australian Journal of Primary Health, 20(1), 4–8. https://doi.org/10.1071/PY12081

Goldacre, M. J., Lambert, T. W., Goldacre, R., & Hoang, U. (2011). Career plans and views of trainees in the Academic Clinical Fellowship Programme in England. Med Teach, 33(11), e637–643. https://doi.org/10.3109/0142159X.2011.610842

Gostin, L. O., & Nass, S. (2009). Reforming the HIPAA Privacy Rule: Safeguarding privacy and promoting research. Journal of the American Medical Association, 301(13), 1373–1375. https://doi.org/10.1001/jama.2009.424

Gullick, J. G., & West, S. H. (2016). Building research capacity and productivity among advanced practice nurses: An evaluation of the Community of Practice model. Journal of Advanced Nursing, 72(3), 605–619. https://doi.org/10.1111/jan.12850

Gunn, A. D. (1969). The nurse in general practice and the widening scope of her surgical role. Nursing Times, 65(41), 1291–1293.

Gureje, O., Seedat, S., Kola, L., Appiah-Poku, J., Othieno, C., Harris, B., Makanjuola, V., Price, L. N., Ayinde, O. O., & Esan, O. (2019). Partnership for mental health development in Sub-Saharan Africa (PaM-D): A collaborative initiative for research and capacity building. Epidemiology and Psychiatric Sciences, 28(4), 389–396. https://doi.org/10.1017/S2045796018000707

Havens, D. S., Stone, P., & Brewer, C. S. (2002). Nursing and health services research: building capacity and seizing opportunity. Applied Nursing Research, 15(4), 261–263. https://doi.org/10.1053/apnr.2002.37396

Health Education England (2018). Clinical academic careers framework: A framework for optimising clinical academic careers across healthcare professions. https://www.hee.nhs.uk/sites/default/files/documents/2018-02%20CAC%20Framework.pdf

Hicks, B. C., & Westphal, M. (1977). Integration of clinical and academic nursing at the hospital clinical unit level. The Journal of Nursing Education, 16(4), 6–9.

Hiley, J., Jerwood, J., Price, J., Thomas, S., & Kenkre, J. (2019). Combining a career in clinical practice and research: The benefits at junior career level. International Journal of Practice-based Learning in Health and Social Care, 7(2), 36–46. DOI 10.18552/ijpblhsc.v7i2.638

Hrynkow, S. H., Primack, A., & Bridbord, K. (2003). Paradigms and progress in building research capacity in international environmental health. International Journal of Hygiene and Environmental Health, 206(4–5), 413–422. https://doi.org/10.1078/1438-4639-00238

Hubbard, S. M. (1982). Cancer treatment research: the role of the nurse in clinical trials of cancer therapy. Nursing Clinics of North America, 17(4), 763–783.

Huenneke, L. F., Stearns, D. M., Martinez, J. D., & Laurila, K. (2017). Key strategies for building research capacity of university faculty members. Innovative Higher Education, 42(5–6), 421–435 https://doi.org/10.1007/s10755-017-9394-y

Jamerson, P. A., Fish, A. F., & Frandsen, G. (2011). Nursing Student Research Assistant Program: A strategy to enhance nursing research capacity building in a Magnet status pediatric hospital. Applied Nursing Research, 24(2), 110–113. https://doi.org/10.1016/j.apnr.2009.08.004

Jeffs, L., Smith, O., Beswick, S., Maoine, M., & Ferris, E. (2013). Investing in nursing research in practice settings: A blueprint for building capacity. Nursing Leadership, 26(4), 44–59. https://doi.org/10.12927/cjnl.2013.23630

Leao, E. R., Farah, O. G., Reis, E. A., Barros, C. G., & Mizoi, C. S. (2013). Perfil acadêmico, crenças e autoeficácia em pesquisa de enfermeiros clínicos: implicações para o Programa de Pesquisa de Enfermagem de um Hospital na Jornada Magnet® [Academic profile, beliefs, and self-efficacy in research of clinical nurses: implications for the Nursing Research Program in a Magnet Journey hospital]. Einstein (Sao Paulo), 11(4), 507–513. https://doi.org/10.1590/S1679-45082013000400018

Lionis, C., Dumitra, G., Kurpas, D., Tsiligianni, I., Papadakis, S., & Petrazzuoli, F. (on behalf of EURIPA). (2018). Building research capacity in rural health settings: Barriers, priorities and recommendations for practitioners. Australian Journal of Rural Health, 26(4). https://doi.org/10.1111/ajr.12422 doi:10.1111/ajr.12422

Liu, W., Zhang, H., Jing, M., Zhang, H., & Liu, G., (2018). The establishment and implementation of research nurse. Chinese Nursing Management, 2018(7), 937–939.

Macpherson, C. C. (2019). Research ethics guidelines and moral obligations to developing countries: Capacity-building and benefits. Bioethics, 33(3), 399–405. https://doi.org/10.1111/bioe.12577

Masood, M., Newton, T., Kharbanda, O. P., Masood, Y., Feine, J., Gussy, M., & Lahti, S. (2017). Building oral health research capacity in India: Identifying barriers and enablers using mixed methods. JDR Clinical & Translational Research, 2(2), 106–108. https://doi.org/10.1177/2380084417691722

Masterson, A., & Robb, L. (2016). Clinical academic careers: Embracing the art and science of nursing. Nursing Standard, 31(13), 40–42. https://doi.org/10.7748/ns.2016.e10553

Matus, J., Walker, A., & Mickan, S. (2018). Research capacity building frameworks for allied health professionals - A systematic review. BMC Health Services Research, 18(1), 716. https://doi.org/10.1186/s12913-018-3518-7

McCance, T. V., Fitzsimons, D., Keeney, S., Hasson, F., & McKenna, H. P. (2007). Capacity building in nursing and midwifery research and development: An old priority with a new perspective. Journal of Advanced Nursing, 59(1), 57–67. https://doi.org/10.1111/j.1365-2648.2007.04280.x

McConnell, D., Slevin, O. D., & McIlfatrick, S. J. (2013). Emergency nurse practitioners' perceptions of their role and scope of practice: Is it advanced practice? International Emergency Nursing, 21(2), 76–83. https://doi.org/10.1016/j.ienj.2012.03.004

Merriam-Webster. (n.d.). Definition of research. In Merriam-Webster.com dictionary. Retrieved November 13, 2019, from https://www.merriam-webster.com/dictionary/research

Minnesota State. (2019). Career pathways. careerwise.minnstate.edu/careers/pathways.html

Mohammadi, N. K., Zaree, F., de Leeuw, E., & Emamjomeh, M. (2011). Share of nations in 37 international public health journals: An equity and diversity perspective towards health research capacity building. Iran Journal of Public Health, 40(4), 129–137.

Mormina, M. (2019). Science, technology and innovation as social goods for development: Rethinking research capacity building from Sen's capabilities approach. Science and Engineering Ethics, 25(3), 671–692. https://doi.org/10.1007/s11948-018-0037-1

Nair, S., Tarey, S. D., Barathi, B., Mary, T. R., Mathew, L., & Daniel, S. P. (2016). Experience in strategic networking to promote palliative care in a clinical academic setting in India. Indian Journal of Palliative Care, 22(1), 3–8. https://doi.org/10.4103/0973-1075.173953

Nedd, N. (2006). Perceptions of empowerment and intent to stay. Nursing Economics, 24(1), 13–18, 13.

NHS England. (2019). The 14 allied health professions. https://www.england.nhs.uk/ahp/role/

Nielsen, O. L., Kongsted, A., & Christensen, H. W. (2015). The chiropractic profession in Denmark 2010-2014: A descriptive report. Chiropractic & Manual Therapies, 23, 27. https://doi.org/10.1186/s12998-015-0072-9

National Institute for Health Research. (2019a). NIHR strategic review of training 2017. https://www.nihr.ac.uk/documents/nihr-strategic-review-of-training-2017/21332

National Institute for Health Research. (2019b). The NIHR nursing and midwifery incubator. https://www.nihr.ac.uk/documents/the-nihr-nursing-and-midwifery-incubator/22559

Nursing & Midwifery Council. (2018). The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf

Nursing & Midwifery Council. (2019). Standards for competence for registered midwives. https://www.nmc.org.uk/standards/standards-for-midwives/standards-of-competence-for-registered-midwives/

Page, S. (2001). Demystifying practice development. Nursing Times, 97(22), 36–37.

Pager, S., Holden, L., & Golenko, X. (2012). Motivators, enablers, and barriers to building allied health research capacity. Journal of Multidisciplinary Healthcare, 5, 53–59. https://doi.org/10.2147/JMDH.S27638

Peloquin, S. M., & Abreu, B. C. (1996). The academic and clinical worlds: Shall we make meaningful connections? American Journal of Occupational Therapy, 50(7), 588–591. https://doi.org/10.5014/ajot.50.7.588

Pilowsky, D. J., Rojas, G., Price, L. N., Appiah-Poku, J., Razzaque, B., Sharma, M., Schneider, M., Seedat, S., Bonini, B. B., Gureje, O., Kola, L., Lund, C., Sorsdahl, K., Araya, R., & Menezes, P. R. (2016). Building research capacity across and within low- and middle-income countries: The collaborative hubs for international research on mental health. Academic Psychiatry, 40(4), 686–691. https://doi.org/10.1007/s40596-016-0493-3

Richardson, A., Avery, M., & Westwood, G. (2019). A cross-funder survey of enablers and barriers to progressing a research-related academic career in the non-medical health professions. https://cdn.southampton.ac.uk/assets/imported/transforms/content-block/UsefulDownloads_Download/954F8F73B2ED47C8BE68DC29D2359507/Cross%20Funder%20Survey%20Summary%20Document%20April%202019.pdf

Ryan, B. L., Thorpe, C., Zwarenstein, M., Wickett, J., Talukdar, N., Boisvert, L., & Wetmore, S. J. (2019). Building research culture and capacity in academic family medicine departments: Insights from a simulation workshop. Canadian Family Physician, 65(1), e38–e44.

Sabey, A., Bray, I., & Gray, S. (2019). Building capacity to use and undertake applied health research: Establishing a training programme for the health workforce in the West of England. Public Health, 167, 62–69. https://doi.org/10.1016/j.puhe.2018.11.001

Sculier, J. P. (2008). Comment faire survivre la recherche clinique académique (non commerciale)? [How can one insure the survival of clinical academic research?]. Revue Medicale de Bruxelles, 29(5), 497–499.

Shang, S., Wu, X., Gao, Y., Jin, J., Li, Y., Cheng, S., Wen, X., Wang, A., Li, Q., Li, M., Cao, J., & Wu, X. (2018). Investigation of nurses' scientific research competency and training demand in Chinese tertiary hospitals. Chinese Journal of Nursing, 53(3), 277–280.

Smith, M. C., & Rattray, J. (2009). 2020-Clinical Academic Careers: Implications for critical care nursing. Nursing in Critical Care, 14(1), 2–3. https://doi.org/10.1111/j.1478-5153.2008.00315.x

Sørensen, E. E., Kusk, K. H., Athlin, A. M., Lode, K., Rustøen, T., Salmela, S., & Hølge-Hazelton, B. (2019). The role of PhD-prepared, hospital-based nurses: An inter-Nordic study. Journal of Research in Nursing, 24(7), 470–485. https://doi.org/10.1177/1744987119877213

Squires, A. (2019). US nursing and midwifery research capacity building opportunities to achieve the United Nations sustainable development goals. Nursing Outlook, 67(6), 642–648.https://doi.org/10.1016/j.outlook.2019.06.016

Squires, A., Chitashvili, T., Djibuti, M., Ridge, L., & Chyun, D. (2017). Health research capacity building in Georgia: A case-based needs assessment. Public Health, 147, 1–7. https://doi.org/10.1016/j.puhe.2017.01.024

Strickland, K. (2017). Developing an infrastructure to support clinical academic careers. British Journal of Nursing, 26(22), 1249–1252. https://doi.org/10.12968/bjon.2017.26.22.1249

Thelen, M. H., & Ewing, D. R. (1970). Roles, functions, and training in clinical psychology: A survey of academic clinicians. American Psychologist, 25(6), 550–554. https://doi.org/10.1037/h0029483

Tiffin, C. (2012, March 28). Beyond the bedside: The changing role of today’s nurses. Huff Post. https://www.huffpost.com/entry/nursing-school_b_1384285

Tinker, L. [Newcastle Hospitals] (2019, May, 17). Make space for research campaign. [Video]. https://www.youtube.com/watch?v=6omlMJfDDdc&app=desktop

Turner, J., Smith, J., Bryant, K., Haynes, T., Stewart, M. K., Kuo, D. Z., Harris, K., McCoy, S., Lovelady, N., Sullivan, G., & Yeary, K. H. (2017). Community Building Community: The Distinct Benefits of Community Partners Building Other Communities' Capacity to Conduct Health Research. Prog Community Health Partnersh, 11(1), 81–86. https://doi.org/10.1353/cpr.2017.0010

Viney, K., Bissell, K., & Hill, P. C. (2019). Building operational research capacity in Papua New Guinea and the Pacific Islands. Public Health Action, 9(Suppl. 1), S3. https://doi.org/10.5588/pha.19.0039

Walport, M. (2005). Medically- and dentally-qualified academic staff: Recommendations for training the researchers and educators of the future. Report of the academic careers sub-committee of modernising medical careers and the UK clinical research collaboration. UK Clinical Research Collaboration. http://www.ukcrc.org/wp-content/uploads/2014/03/Medically_and_Dentally-qualified_Academic_Staff_Report.pdf

Wand, T., & White, K. (2007). Exploring the scope of the Emergency Department mental health nurse practitioner role. International Journal of Mental Health Nursing, 16(6), 403–412. https://doi.org/10.1111/j.1447-0349.2007.00495.x

World Health Organization. (2019). Nursing and midwifery: Key facts. https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery

Young, S. L., Gorny, D. A., & Ferrara, A. M. (1992). The clinical nurse specialist role in product research and development. Dimensions of Critical Care Nursing, 11(4), 202–209. https://doi.org/10.1097/00003465-199207000-00005
Published
2019-12-13
How to Cite
Carrick-Sen, D., Moore, A., Davidson, P., Gendong, H., & Jackson, D. (2019). International Perspectives of Nurses, Midwives and Allied Health Professionals Clinical Academic Roles: Are We at Tipping Point?. International Journal of Practice-Based Learning in Health and Social Care, 7(2), 1-15. https://doi.org/https://doi.org/10.18552/ijpblhsc.v7i2.639