scholarly journals A qualitative study exploring experiences and challenges of combining clinical academic training with family life

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Diane Trusson ◽  
Emma Rowley

Abstract Background Concerns are being expressed around the lack of diversity at higher levels of clinical academia. This study aimed to explore experiences and challenges associated with combining clinical academic careers with family life. Methods Qualitative data were gathered from participants from 4 NHS Trusts and 2 universities in the East Midlands of England using online surveys and semi-structured interviews. Results The survey was completed by 67 nurses, midwives and allied health professionals, and 73 medical clinical academic trainees. Interviews were conducted with 16 participants from each group including equal numbers of men and women. Caring responsibilities differed between the two study populations. Medical clinical academic trainees were younger and either had young children or were yet to start a family. In contrast, nurses, midwives and allied health professionals tended to be older when they embarked on a clinical academic career and often waited until their children were school-age or older. Similar concerns were raised regarding working part-time and childcare, and how their career prospects might be affected in terms of fulfilling promotion criteria and being able to relocate for work purposes. The occupation of their partners also featured in participants’ experiences; those who shared childcare with someone who worked ‘regular’ hours, appeared to be better supported to combine a clinical academic career with family life. Gender stereotyping was identified in some reported experiences highlighting a need for appropriate mentorship and for positive role models who were able to demonstrate that it is possible to survive and thrive as a clinical academic with family responsibilities. Conclusions Although people manage to find ways to successfully combine clinical academic roles with family life, findings highlight a need to identify ways of supporting and encouraging trainees with caring responsibilities to ensure that they remain on the clinical academic pathway.

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043270
Author(s):  
Diane Trusson ◽  
Emma Rowley ◽  
Jonathan Barratt

ObjectivesThis study aimed to compare experiences of medical clinical academics (MCAs) with those of nurses, midwives and allied health professionals (NMAHPs) pursuing a clinical academic career.DesignA multimethods approach was used to elicit qualitative data. Both sets of participants completed similar online surveys followed by in-depth interviews to explore emerging themes.SettingThe research was conducted in the East Midlands of England, encompassing two Higher Education Institutions and four National Health Service Trusts.ParticipantsSurveys were completed by 67 NMAHPs and 73 MCA trainees. Sixteen participants from each group were interviewed following a similar interview schedule.ResultsThe survey data revealed notable differences in demographics of the two study populations, reflecting their different career structures. MCAs were younger and they all combined clinical and academic training, lengthening the time before qualification. In contrast, most NMAHPs had been in their clinical post for some years before embarking on a clinical academic pathway. Both routes had financial and personal repercussions and participants faced similar obstacles. However, there was also evidence of wide-ranging benefits from combining clinical and academic roles.ConclusionsVariations in experiences between the two study populations highlight a need for a clear academic pathway for all health professionals, as well as sufficient opportunities post-PhD to enable clinical academics to fully use their dual skills.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Alison Cowley ◽  
Claire Diver ◽  
Alison Edgley ◽  
Joanne Cooper

Abstract Background A highly skilled workforce is required to deliver high quality evidence-based care. Clinical academic career training programmes have been developed to build capacity and capabilities of nurses, midwives and allied health professionals (NMAHPs) but it remains unclear how these skills and roles are operationalised in the healthcare context. The aim of this study was to explore the experiences of early career clinical academic NMAHPs who have undertaken, or are undertaking, clinical academic master’s and doctoral studies in the United Kingdom. Methods We conducted 17 in-depth semi-structured interviews with early career clinical academics which included; nurses, midwives and allied health professionals. The data were analysed using thematic analysis. Results Two themes emerged from the data; identity transformation and operationalising transformation. Both these highlighted the challenges and opportunities that early clinical academic training provided to the individual and organisation in which they practiced. This required the reconceptualization of this training from the pure acquisition of skills to one of personal and professional transformation. The findings suggest that individuals, funders, and organisations may need to relinquish the notion that training is purely or largely a transactional exchange in order to establish collaborative initiatives. Conclusion Stakeholders need to recognise that a cultural shift about the purposes of research training from a transactional to transformative approaches is required to facilitate the development of NMAHPS clinical academics, to enable them to contribute to innovative health and patient care.


BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e030595 ◽  
Author(s):  
Diane Trusson ◽  
Emma Rowley ◽  
Louise Bramley

ObjectivesThe clinical academic trajectory for doctors and dentists is well-established, with research embedded in their career development. Recent years have also seen a burgeoning interest and push for nurses, midwives and allied health professionals (NMAHPs) to pursue a clinical academic career. However, the National Institute for Health Research (NIHR) 10-year review suggested that there may be problems with progression post Master’s degree level for this group, with nurses and midwives receiving less NIHR funding than allied health professionals. This study responds to these concerns, tracking the progression and exploring experiences of NMAHPs in the East Midlands region of England.DesignAn online survey and in-depth interviews were used to capture a wide range of experiences.Participants67 NMAHPs who were pursuing a clinical academic career were surveyed, supplemented by 16 semi-structured in-depth interviews.ResultsThree themes emerged during data analysis: Embarking on a clinical academic career, overcoming barriers and benefits.ConclusionsNMAHPs are motivated to pursue a clinical academic career by a drive to improve services for the benefit of patients and the National Health Service more widely, as well as for personal development and career progression. People working in these roles have opportunities to explore possible solutions to issues that they encounter in their clinical role through academic study. Findings reveal benefits emanating from the individual level through to (inter)national levels, therefore academic study should be encouraged and supported. However, investment is needed to establish more clinical academic roles to enable NMAHPs to continue to use their experience and expertise post-PhD, otherwise the full extent of their value will not be recognised.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. Huglin ◽  
L. Whelan ◽  
S. McLean ◽  
K. Greer ◽  
D. Mitchell ◽  
...  

Abstract Background Allied health assistants (AHAs) support allied health professionals (AHPs) to meet workforce demands in modern healthcare systems. Previous studies have indicated that AHAs may be underutilised in some contexts. This study aims to identify factors contributing to the effective utilisation of AHAs across health, aged care and disability sectors and possible pathway elements that may optimise AHA careers in Victoria. Methods Using an interpretive description approach data collection included a workforce survey and semi structured interviews (individual and group). Data analysis included descriptive statistics, independent t-tests and thematic analysis. Participants included allied health assistants, allied health professionals and allied health leaders in the health, aged care or disability sectors; educators, managers or student of allied health assistance training; and consumers of Victorian health, disability or aged care services. Results The literature scan identified numerous potential barriers to and enablers of AHA workforce utilisation. A total of 727 participants completed the survey consisting of AHAs (n = 284), AHPs & allied health leaders (n = 443). Thirteen group and 25 individual interviews were conducted with a total of 119 participants. Thematic analysis of the interview data identified four interrelated factors (system, training, individual and workplace) in pre-employment training and workplace environments. These factors were reported to contribute to effective utilisation of the AHA workforce across health, aged care and disability sectors. Study findings were also used to create a conceptual diagram of potential AHA career pathway elements. Conclusion This study identified pre-employment and workplace factors which may contribute to the optimal utilisation of the AHA workforce across Victorian health, aged care and disability sectors. Further study is needed to investigate the transferability of these findings to national and global contexts, and testing of the conceptual model.


Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1024 ◽  
Author(s):  
Alexis Arasu ◽  
Lisa J Moran ◽  
Tracy Robinson ◽  
Jacqueline Boyle ◽  
Siew Lim

Background: Weight and lifestyle management is advocated as the first-line treatment for polycystic ovary syndrome (PCOS) by evidence-based guidelines. Current literature describes both systems- and individual-related challenges that general practitioners (GPs) face when attempting to implement guideline recommendations for lifestyle management into clinical practice for the general population. The GPs’ perspective in relation to weight and lifestyle advice for PCOS has not been captured. Methods: Fifteen GPs were recruited to take part in semi-structured interviews. NVIVO software was used for qualitative analysis. Results: We report that GPs unanimously acknowledge the importance of weight and lifestyle management in PCOS. Practice was influenced by both systems-related and individual-related facilitators and barriers. Individual-related barriers include perceived lack of patient motivation for weight loss, time pressures, lack of financial reimbursement, and weight management being professionally unrewarding. System-related barriers include costs of accessing allied health professionals and unavailability of allied health professionals in certain locations. Individual-related facilitators include motivated patient subgroups such as those trying to get pregnant and specific communication techniques such as motivational interviewing. System-related facilitators include the GP’s role in chronic disease management. Conclusions: This study contributes to the understanding of barriers and facilitators that could be addressed to optimize weight and lifestyle management in women with PCOS in primary care.


Author(s):  
Jemma Keeves ◽  
Sandra C. Braaf ◽  
Christina L. Ekegren ◽  
Ben Beck ◽  
Belinda J. Gabbe

Barriers to accessing healthcare exist following serious injury. These issues are not well understood and may have dire consequences for healthcare utilisation and patients’ long-term recovery. The aim of this qualitative study was to explore factors perceived by allied health professionals to affect access to healthcare beyond hospital discharge for people with serious injuries in urban and regional Victoria, Australia. Twenty-five semi-structured interviews were conducted with community-based allied health professionals involved in post-discharge care for people following serious injury across different urban and regional areas. Interview transcripts were analysed using thematic analysis. Many allied health professionals perceived that complex funding systems and health services restrict access in both urban and regional areas. Limited availability of necessary health professionals was consistently reported, which particularly restricted access to mental healthcare. Access to healthcare was also felt to be hindered by a reliance on others for transportation, costs, emotional stress and often lengthy time of travel. Across urban and regional areas, a number of factors limit access to healthcare. Better understanding of health service delivery models and areas for change, including the use of technology and telehealth, may improve equitable access to healthcare.


2018 ◽  
Vol 23 (4) ◽  
pp. 346-357 ◽  
Author(s):  
Greta Westwood ◽  
Alison Richardson ◽  
Sue Latter ◽  
Jill Macleod Clark ◽  
Mandy Fader

Background A national clinical academic training programme has been developed in England for nurses, midwives and allied health professionals but is insufficient to build a critical mass to have a significant impact on improved patient care. Aim We describe a partnership model led by the University of Southampton and its neighbouring National Health Service partners that has the potential to address this capacity gap. In combination with the Health Education England/National Institute of Health Research Integrated Clinical Academic programme, we are currently supporting nurses, midwives and allied health professionals at Master’s ( n = 28), Doctoral ( n = 36), Clinical Lecturer ( n = 5) and Senior Clinical Lecturer ( n = 2) levels working across seven National Health Service organisations, and three nurses hold jointly funded Clinical Professor posts. Results Key to the success of our partnership model is the strength of the strategic relationship developed at all levels across and within the clinical organisations involved, from board to ward. We are supporting nurses, midwives and allied health professionals to climb, in parallel, both clinical and academic career ladders. We are creating clinical academic leaders who are driving their disciplines forward, impacting on improved health outcomes and patient benefit. Conclusions We have demonstrated that our partnership model is sustainable and could enable doctoral capacity to be built at scale.


2020 ◽  
Vol 18 (1) ◽  
Author(s):  
J. Nightingale ◽  
S. Fowler-Davis ◽  
K. Grafton ◽  
S. Kelly ◽  
C. Langham ◽  
...  

Abstract Background Developing 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. Methods A 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. Results Important 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. Conclusions 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 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.


2021 ◽  
Vol 4 ◽  
pp. 8
Author(s):  
Emma Carr ◽  
Arlene McCurtin ◽  
Audrey Tierney ◽  
Carol-Anne Murphy ◽  
Kevin Johnson ◽  
...  

Background: The COVID-19 outbreak was declared a pandemic by the World Health Organization on March 11th, 2020. An ongoing challenge in healthcare is ensuring that up-to-date and high-quality research evidence is implemented in practice. In the context of a global pandemic it is assumed, given the increased pressures on healthcare professionals that this problem has the potential to be exacerbated. Furthermore, the COVID-19 pandemic resulted in many health professionals being reassigned to areas outside their usual scope, returning to practice following absence or commencing their career as new entrants in the midst of a major crisis. These professionals are likely to require additional support to assist their confidence and competence. Aims: This project has two broad aims: to design and deliver an online educational platform to support nursing and allied health professionals in their clinical practice throughout the pandemic and to evaluate that platform and its implementation. Methods: The research protocol for this study consists of two work streams: the development and delivery of the online platform; and the project evaluation. This research will have a mixed methods approach including website data analytics, quantitative surveys and qualitative data analysis of semi-structured interviews. Conclusion: Through knowledge brokering and adherence to principles of effective technology-enhanced-learning this project will provide an accessible, individualised online educational resource to effectively meet the needs of individual nurses and allied health professionals in this unprecedented time. The evaluation of the platform and its implementation will provide key learning for future initiatives and may act as proof-of-concept for other organisations and countries seeking to support healthcare professionals’ knowledge needs during similar future pandemics.


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