EPIC model: promoting research

Screen Shot 2015-11-24 at 13.03.40Today we are moving around the EPIC model from Explore to Promote. The start of a new foray into activities which can be undertaken within a clinical setting by emergent health researchers to increase engagement with research and contribute to the health research community.

To get you into ‘promoting’ mode here is something to ponder …

In 2012 a poll commissioned by NIHR showed that 82% of the public think  it important for the NHS to offer opportunities to take part in healthcare research. If this is the case

  • When was the last time you gave someone information about the research going on in your clinical specialty that they might be interested in participating in?
  • How well informed are you about the range of research being undertaken by colleagues in your extended clinical team?

If I’m honest the need to promote other peoples’ research didn’t really enter my consciousness until I became a researcher myself. Then it became REALLY important.

I prepared a stack of patient information packs and put them in nicely coloured folders in the hope that they would stand out and set off to talk with colleagues about who I would love them to pass the packs on to. I  explained the importance of my research to future practice, was as upbeat and encouraging as possible and offered to return with more packs once the initial pile had been given out. And then I waited.

Participants did eventually come forward but it seemed to take forever and I knew, from the numbers of packs given out and the number of patients being seen, that in spite of my colourful folders a lot of potential participants weren’t receiving the information.

In my head I knew how challenging it was to remember about someone else’s research in the midst of a clinical session but in my heart a voice was saying, ‘Oh come of guys please just remember’

At this point you may be thinking, OK, but is this my problem? Well yes it is and here are some reasons why: it’s in the NHS constitution; it matters to patients; it’s important to the growth of the economy.

The benefits to patients of participating in clinical research have been described by the NIHR Clinical Research Network as

  • providing patients with additional treatment options
  • supporting them in developing a better understanding of the management of their condition
  • providing additional contact and a partnership relationship with their health professionals
  • enabling them to give something back to the NHS, and contribute to better treatment

Every year on International Clinical Trials day there is a national campaign focused on the public called ‘It’s OK to ask’. The focus is on encouraging people, when they come into contact with healthcare professionals, to ask about any research that they might be able to take part in. If someone asked you would you be able to answer the question?

In 2012 NIHR commissioned a Mystery Shopper exercise in 40 acute Trusts to determine the extent to which research was being promoted through notice boards, Trust websites and by asking at reception.

91% of sites didn’t have any information in their reception area, on notice boards, on electronic screens or leaflets displays.

A common experience was described as follows:

… a mystery shopper approached a greeter, who directed the shopper to the receptionist, who sent the shopper to the information desk where no information was available, after which they were sent to the Trusts website.

Lets think a little about the economy as well. The government is committed to making the UK the best place in the world to undertaken health research, not only does it benefit patients but it benefits the economy as well. Putting this into context

  • 73,000 people are employed directly by the pharmaceutical industry in the UK
  • The industry generates a trade surplus of £3bn per annum
  • And 25% of all expenditure on R&D in UK businesses is by the pharmaceutical industry

Association of British Pharmaceutical Industry

The pharmaceutical industry is functioning in a competitive market and needs to conduct its business in countries with the ability to provide the relevant infrastructure to support its work. It can take over 12 years to bring a new medicine to market and typically costs over one billion pounds. With this level of investment the industry needs to be confident that clinical trials can be conducted efficiently and this includes recruiting participants which in turn requires all of us to promote research to patients.

What would it mean if the industry withdraws business from the UK? Well, it’s not just about the economic impact, imagine an NHS without access to trials of the latest medicines or interventions. If you or a member of your family were ill wouldn’t you want to be given the chance to take part in a clinical trial of a cutting edge  intervention? How would you feel if you knew that a new treatment was being trialed and no one gave you the opportunity to take part?

This post has provided an introduction to why the promotion of research is a key activity within the research community and I will develop this a little further in the next post. But for now the take home message is that being a part of the research community requires us all to see the promotion of research as part of our role in improving patient care.

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The EPIC model: Explore

 

Screen Shot 2015-11-24 at 12.48.05The focus of todays post is on the first component of the EPIC model for emergent health researchers:

Explore to develop and increase your understanding of the health research community.

What does this mean? The Oxford English Dictionary defines explore as, to travel through an unfamiliar area to learn about it which is an apt definition for exploring the world of health research. For most healthcare professionals this world presents an unfamiliar landscape. One which may have been encountered briefly during undergraduate study but even that brief sojourn was more likely to have been into the world of academic research, an important part of the landscape but not the whole picture.

The world of health research is rich and multifaceted and it is appropriate that entry into this world starts with a process of exploration, a time to venture into different areas, have a look around, get lost and find yourself. This kind of purposeful wandering will help to increase your knowledge and understanding of all of the different parts of the community, how they interface and connect. You will start to identify specific aspects and communities which are of more interest to you, those which resonate and are aligned to your values and it will require you to start wearing the mantle of someone interested in research.

If you are wondering if this is necessary here are some questions to ponder. At an organisation level:

  • How much do you know about the research community within your organisation?
  • Who is your Director of Research and your Research and Development manager and what do they do?
  • What are the research strengths of your organisation
  • What funding is available within your organisation to support research capability building?
  • What is in your organisations research strategy, does it have one?

Looking at the wider community

  • What are the research strengths of your local Universities?
  • Do you have a CLAHRC in your area and if so what are the opportunities for linking in with its work
  • Do you have an Academic Health Science Network what does it do?
  • What seminars are being held over the coming 6 months that you could attend?
  • What do you know about the work of the medical research charities relevant to your area of practice?
  • What does your professional body do to support research

I could go on but hopefully you get the gist.

Why is exploration important to emergent health researchers? To answer this question I’m going to draw upon the Researcher Development Framework (RDF), which, as I mentioned in the previous post, identifies the knowledge, attributes and behaviours of successful researchers. Whilst the RDF is aimed at researchers at doctoral level and beyond it is possible to map the process of exploration onto the framework to give you some idea of the knowledge, attributes and behaviours you will start to develop and acquire through the process of exploration.

The reason I’m doing this is to enable you to see their alignment with that of developing as a researcher, it is not just about methods, study design and data analysis. To remind you the framework is divided into 4 domains and each domain has 3 sub-domains, (the titles at the top of each column).

1.Knowledge and intellectual abilities

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2.Personal effectiveness

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3.Research Governance and organisation

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4.Engagement influence and impact

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So as you can see from the above you can start developing relevant skills and expertise at a very early stage in your research journey by getting to understand the workings of the community you are wanting to join, asking questions about how it works, what drives it and finding out about opportunities to engage with it.

How will it help you? Increasing your knowledge and understanding of the research community, its stakeholders and the things which drive it will become your launchpad for greater engagement. It will support you in championing research within your team and it will place you in a stronger position when applying for competitive bursaries and fellowships. For example you may consider applying for a Health Education England Internship, an NIHR funded place on a Masters in Clinical Research or funding from a medical research charity to support academic fees. What will make your application stand out?

In the section which asks why you are making the application you will be able to write it with reference to your organisations research strategy and explain how the skills you will develop will support delivery of the strategy. You might be able to say that you are actively involved in a research special interest group you have joined or that you have attended Trust research events.

If you are shortlisted for interview you will be able to demonstrates your enthusiasm for research. As an emergent researcher you may not be able to provide evidence of presentations or publications on your CV but what if you were able to demonstrate a knowledge and understanding of your research community, evidence of attending seminars, webinars or workshops? You suddenly have something to talk about in the interview.

So there we go, an introduction to Explore. In the next post I will expand upon this by looking at some of the specific things you can do as an explorer in this area of your research development.

Explore: moving forward into action

 

Screen Shot 2015-11-24 at 12.48.05By the time you read this post I hope that you have bought into the idea of what it means, within the context of the EPIC model, to Explore and how this will contribute to your development as an emergent researcher.

Exploration in this context is not an onerous process but does require you to set out with a sense of adventure and an open and inquiring mind. It is a brilliant activity for emergent researchers to engage in because as you develop on your research journey the time available for exploration will become more limited.

 

Think of this as a funneling exercise – start exploring broadly and over time you will understand the connections and networks within the community and identify those of greater interest and relevance enabling you to become more focused.

Your equipment requirements are minimal, access to a smart phone, tablet or computer. The time requirement is flexible. It can be as little as 10-15 minutes on your chosen technology over a cup of coffee or up to an hour to have a conversation. It also doesn’t need to be a solitary activity. If you colleagues are interested in research share the journey and knowledge you glean.

Be courageous. Exploring on the internet, for most of us, presents minimal challenge but when you are required to have conversations with people about research this can be more challenging especially when you are starting out. All kinds of self-doubt can creep in such as, ‘will I say something stupid’ or ‘who am I to ask to meet this leading researcher’. But you know what, people will love your enthusiasm and commitment and generally researchers love talking about research. If you are truly aspirational about becoming more involved in research at some point you will need to step into this space.

Get organised. Develop an approach to organising the information you discover. Talk to any researcher and they will recount stories about finding the most amazing article only to be unable to locate it when it was needed. It may be a paper based portfolio or one of the many online tools. A while ago I was introduced to Pocket and Evernote both of which I now use to keep track of information I discover online, organise and share it.

Use social media. Social media is a great way of not only exploring but also, once you have identified key organisations, or individuals, keeping your finger on the pulse of what is happening.

So where do you start?

Start close to home. How much do you know about the research community within your organisation? Who are the key people driving the research agenda, what are the roles of different members of the R&D team and how can they support you and vica versa. What research seminars or workshops are held? Are there funds you could apply for to support your development? Does your organisation have a research strategy and if so what is in it?

How long is it since you have been into your organisations’ library if it has one? A wealth of knowledge and expertise resides in clinical librarians which, from my experience, is under utilised by healthcare professionals.

How much do you know about the research being undertaken within your clinical team? Have you ever talked with the people involved in research, whether it is someone conducting a clinical trial or a colleague completing a project as part of a masters programme, about what they are doing, how and why they are doing it and what they are finding out?

Academic communities. Who is researching in your area of interest in your local Universities? Explore their websites and look beyond faculties of health and into areas such as design and technology, IT, management, and arts based faculties.

Professional communities. My professional body, the College of Occupational Therapists, offer a range of resources to support OTs with an interest in research including a fortnightly research and development bulletin, funding opportunities via the UK Occupational Therapy Research Foundation, access to an ever-expanding range of ebooks and journals. What does your offer?

The wider research community. All of the major medical research charities outline the scope of their funding, their research strategies and priorities and information for researchers on their websites. Funding opportunities for individuals will range from small travel bursaries and academic fees to awards for doctoral and post-doctoral level study. Get to know the relevant medical research charities for your area of interest. These are invaluable links to develop.

All of the above are just suggestions and I’m sure you will have many of your own.

Exploration will enable you to develop a sense of the research community and how it functions, different parts of its infrastructure and their key agendas and priorities. I guarantee that you will be surprised by what you find and the opportunities and resources which are open to you if you make the effort to venture out. There is no such thing as a closet researcher so time to step out and start exploring.

Introducing the EPIC model for emergent health researchers.

IMG_1205In my last post I said that over the coming weeks I would introduce a model I have been working on outlining activities which can be undertaken by healthcare professionals working in clinical practice who want to develop their understanding of, engagement with and entry into the health research community. Well, today is the start of this journey.

I want to preface what follows with an acknowledgement of the fundamental importance of formal academic study to the development of research skills and expertise and the  centrality of clinical academic pathways to the leadership of health research and improvement of patient care. On a personal level I have obtained a PhD and supervised healthcare professionals working towards Masters and Doctoral level qualifications.

However as a clinician, and in my many meetings with clinicians, I know that so much can be done outside of academia to engage with research especially for those who see themselves as emergent health researchers, i.e. those starting to explore the world of research. This is one of my main motivations for developing this model. I want to encourage you to think beyond a sole focus on ‘doing’ research, to explore different aspects of what it means to be a researcher and to consider the range of activities which can be developed and built upon within your everyday clinical practice.

I have written before about the need to develop a composite story for research within the NHS which broadens our thinking about what it means to be involved in health research and creates a more inclusive view of how healthcare professionals with differing levels of skills, expertise and interest can engage with research. I hope this model contributes to this discussion.

If you travel this journey with me  over the next few weeks I will really encourage you think about your role in delivering the NHS constitutional commitment to the promotion, conduct and use of research, to explore the breadth of the research community and to increase your understanding of the wide range of resources available outside of academia to support the development of research expertise. For example, last week WeAHPs hosted a twitter chat on research the storify of the chat can be found here and a free MOOC is currently taking place on Future Learn on Improving Health Care Through Clinical Research.

All of the activities outlined in the model are central to being a part of the health research community and so with that in mind here is an overview of the emergent EPIC model.

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The EPIC model for emergent health researchers

Structure: The model comprises two concentric circles. The outer circle can be seen as fundamental activities which can, and in the case of promoting and implementing research, should be engaged with by all healthcare professionals working within the NHS. The inner circle represents activities which can be engaged with by those wishing to build and develop their engagement with research.

Individual components: There are seven components to the model which comprise

Explore to develop and increase your understanding of the health research community

Promote opportunities to engage with research to service users at every opportunity

Implement evidence informed practice and consolidate and extend your expertise in critical appraisal and evidence synthesis

Communicate your interest in research to your line manager, colleagues involved in research and your wider clinical team

Advance your skills and expertise in research through formal and informal personal development

Champion research within your clinical team and profession

Engage strategically to develop relationships and potential collaborations in the area of research you are interested in.

Over the next seven posts I will focus on the individual components of the model and explore them in detail. I will expand on what they mean, why they are important and the skills and expertise you will develop by engaging with them.

I see this as a process of working out loud and so if, as the model unfolds, you have any comments or observations I would love to hear from you.

Where do I fit in the world of health research?

Crop of pumpkins from The Lost Garden of HeliganI have been pondering the best way to answer this question for quite a while now as it seems to crop up in one form or another on a regular basis. The more I talk with healthcare professionals who want to become involved in research the more I realise how many people are in search of an answer.

The question is posed in a number of different ways including:

  • ‘How/where do I get started with research’
  • ‘Who do I talk to about doing research’
  • ‘How do I turn my ideas into research questions’

But all are underpinned by the same aspiration to ‘do’ research. But here in lies a challenge. Whilst, as healthcare professionals, we are familiar with the differing stages in the development of a clinical career we tend to be less familiar with the career progression of a health researcher.

There is often confusion about the kinds of activities which are appropriate for differing levels of a research career, what is required to progress from one level to the next and the point at which it is realistic to be in a position to apply for funding as an independent researcher. In fact the starting point may not even be to ‘do’ research, but more on this in the future.

This lack of understanding can lead to incredibly high expectations about what is possible and achievable, quite a lot of frustration and, in some cases, a fair amount of misplaced time and effort. So in the next few posts I am going to do a bit of #workoutloud and start to describe a framework I have been working on recently aimed specifically at the very early stages of getting involved in health research. I started to explore this several months ago in a previous post but as time has moved on my thinking has developed.

Why focus here? Well for a couple of reasons really: I think this is where the trickiest challenge for healthcare professionals lies – knowing how to get started; this is where the greatest community of aspiring health researchers reside; my experience suggests that this is the point at which expectations have a tendency to exceed the reality of what is possible.

But before ending this post I didn’t want to neglect anyone who may already be on a research pathway and is thinking about their development. So I want to flag up the Researcher Development Framework (RDF) as a resource worth investigating. The RDF was developed in the UK by Vitae and endorsed by organisations including Research Councils UK and Universities UK. It identifies the knowledge, behaviours and attributes of effective and skilled researchers at different stages of their research career and is a tool that can be used for planning and supporting personal, professional and career development by researchers and those responsible for their development. The RDF comprises four domains:

  • Domain A: Knowledge and intellectual abilities
  • Domain B: Personal effectiveness
  • Domain C: Research governance and organisation
  • Domain D: Engagement, influence and impact

You can explore it via the Vitae website but to access it fully you need to part of a membership organisation. If you are studying at any University in the UK you can check to see if your University is a member and if it is you can access not only the RDF but a wide range of excellent resources. If you are unfamiliar with Vitae I would highly recommend you to explore the site.

So, if you are interested in this topic please drop by for the next few posts when I’ll start to focus on how healthcare professionals new to research can start to build their research profile and expertise.  It would be great to work on something together so I would really welcome you chipping in with comments and reflections. It would be fun.