As with previous posts linked to components of the EPIC model an exploration of the research skills which can be developed through implementation are located within the domains of the Vitae researcher development framework. Whilst the framework is aimed at supporting personal development for people undertaking doctoral level study and beyond it also has utility in demonstrating how engaging in activities within a clinical setting can start to develop transferable skills for anyone seeking to develop research expertise at earlier stages of their research journey.
Domain C, focused on research governance and organisation, is less pertinent to this component and is omitted.
The skills outlined within Domain A are especially relevant if you are required to undertake a critical appraisal and synthesis of evidence to inform an aspect of practice development. The skills should be familiar to all from undergraduate study and continue to be key skills to maintain and develop.
It takes confidence to question our practice and, inherently, the practice of our colleagues, and requires resilience to lead an implementation project. As highlighted previously implementation is a complex process with many confounding variables. Therefore the implementation of research within a practice context draws heavily on personal effectiveness, influence and engagement as it is usually focused on driving change within a team, system or organisation calling for teamwork, collaboration and effective communication.
Implementation: moving forward into action.
To complete this section of the EPIC model here are some suggestions to support you in moving forward with implementation.
The Critical Appraisal Skills Programme. CASP has developed workshops and tools, including interactive and e-learning resources to support critical appraisal. CASP provides links to Health Knowledge whose focus is on public health however one of the resources they support is a video course taking you through the process of finding and assessing the quality of evidence. The resource is free and comprises a number of learning units including finding the evidence, RCTs, systematic reviews, economic evaluations, making sense of results. This is a tool you could work through with colleagues or on your own.
The Cochrane Library. The Cochrane Library now contains over 9,000 high quality systematic reviews and is a key resource from which to explore the current state of evidence base for your practice. There are many ways of getting involved with the work of the Cochrane Collaboration which will develop your skills including suggesting ideas for reviews via the topic specific Review Groups, being part of a review group and helping to screen health research records with the EMBASE project. This project provides an opportunity for new and potential contributors to get involved with Cochrane work by screening records for potential inclusion in Cochrane’s trials register, CENTRAL. Important point to note here: No prior experience is necessary and novice screeners are welcome.
Your clinical librarian. In the first component of the EPIC model Explore I described the importance of getting to know different aspects of the research community within your organisation flagging up clinical librarians as a key resource, if you are in a Trust, or subject librarians if you are linked with a University. The role of clinical librarians is changing rapidly to support the focus on evidence informed practice. If you are unfamiliar with the range of services your library provides make it a priority to find out how they can support you in developing evidence informed practice.
Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) have also been flagged up previously as organisations to link with. If you are not sure if you have a CLAHRC in your area you can find out here. As an example of the work they are undertaking the North West Coast CLAHRC is offering currently for its member organisations a workshop on Finding evidence: informing practice which aims to provide participants with: an understanding of how evidence can inform practice; an opportunity to refine and develop a search question; an overview of search strategies and processes; an opportunity to design and implement an evidence search with the support of an expert; access to IT within the workshop to commence your evidence search. The range of support offered by CLAHRCs varies but a key area of their expertise resides in the implementation of applied research.
The School for Health Care Radicals. If you are in the position of leading a change in practice the 2016 School for Health and Care radicals, led by Helen Bevan and her team at the NHS Horizons Group, has just started. It is a free online learning programme comprising webinars, handbook, study guide and guided social learning. The reason I’m flagging this up is that it is a high quality programme focused on leading radical change within the NHS. It is well worth exploring as it is not only highly informative but also highly motivating and designed to develop your expertise as an agent for change.
Implementation Research. If you are at the point of exploring potential topics for a Masters or Doctoral dissertation this new and growing area of research may be of interest. As noted in the first post about implementation it is a focus for some medical research charities and NIHR have a specific fellowship programme aimed at knowledge mobilisation. Significant contributions to providing high quality evidence informed care can be made by understanding how to facilitate more effectively the mobilisation of knowledge from research into practice contexts.