Engaging with research as a clinician

Engaging with research as a clinician
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Dr Eleanor Chatburn’s advice for psychologists applies to other non-medical clinical professionals too. She considers the challenges and opportunities of engaging with research as an early career psychologist. This article was first published in The Psychologist magazine on 3 January 2023.

Are you an early career practitioner clinician with a keen interest in research? Want to know how to become more research active but unsure where to start? Then this article is for you!

In this short guide, I share some top tips and resources that you can use to make your next steps into research. I have drawn on my own experiences of starting out on a clinical academic career pathway since I qualified as a clinical psychologist one year ago as well as the reflections of several research active practitioner psychologists who kindly shared their advice with me.

Why become more research active?

Becoming more research active in your role as a practitioner psychologist can have multiple benefits. For the individual practitioner, “being research active helps you to be the most effective therapist you can, and it also helps retain curiosity and enthusiasm in the work”, Professor Barney Dunn, a research clinical psychologist at the University of Exeter, told me. “But equally importantly, practitioners bring a fresh, clinically grounded perspective”, he added”, “which helps ensure that the research that is being done in the field genuinely reflects the needs of the clients we serve and the services that are delivering care, closing the research practice gap.”

Did you know that the value of clinical research is actually written into The NHS Constitution? It emphasises that one aspect of providing high quality care is “through the promotion, conduct and use of research to improve the current and future health and care of the population” (Department of Health, 2015). So far, so good. A big problem until fairly recently has been a scarcity of funding opportunities for allied health professionals or psychological practitioners to engage in research activity; many funding schemes prioritised medics which effectively shut out other practitioners from research (Newington et al., 2021).

But there is good news for practitioner psychologists. “There has been a real shift in the last few years”, one research active Cognitive Behaviour Therapy (CBT) therapist* told me. “Both the academic side and the clinical lead side now recognise that there is a pool of talented, willing and interested clinicians in the field who could make a meaningful and patient-focussed contribution to research.”

We now have a greater range of resources and funding streams available to practitioners who want to become research active such as the National Institute for Health and Care Research (NIHR) Integrated Clinical and Practitioner Academic (ICA) scheme.

What are the challenges?

Although we have made some great progress in supporting practitioners to become more research active, there is still space for improvement. The literature documents that the common barriers to becoming more research active include funding issues, interference with work/life balance, a lack of clarity for the career path, and insufficient support for clinical academics (Deane & Clunie, 2021; Newington et al., 2021).

Some specific barriers to research activity that practitioners described include:

  • Lack of protected time or resources for research activity within a clinical role. Newly qualified practitioners in particular can be under considerable pressure to focus on clinical appointments, leaving no time (or headspace) within the working day to shift gear and work on any kind of research.
  • Research not prioritised by senior leaders or service managers. One CBT therapist* told me that “the service just want me to get through the waiting list”. Another therapist described a “lack of support by management structures with some research topics being discouraged”.
  • Limited specific clinical-academic roles and career structures within the NHS. Once a fixed-term research fellowship or trial therapist job ends, it can be a real challenge to maintain both your research and your practice unless you can get more funding.
  • Isolation and difficulty making contacts. It can feel lonely trying to pursue research on your own in a service that is not supportive of this activity. Practitioners are also unlikely to have an extensive network of research contacts and may not know of a suitable supervisor within their chosen topic. “I had difficulties making links with academic research departments who did not respond to emails”, one CBT therapist explained, and another told me that the researchers they contacted “were not willing to engage” with practitioners.
  • Personal impact. Several practitioners reported they ended up having to work on their research passions in their evenings/weekends as realistically they were otherwise unable to make any progress. Some people even chose to drop some of their contracted hours to collaborate on research projects in an unpaid capacity which they described as not financially sustainable.

It seems clear that there are some structural barriers to research activity for practitioner psychologists that are outside the control of individual practitioners, which require more action from our senior leaders and funders. I am keen to emphasise though that if you are passionate about research, there are some great resources and like-minded people out there who want to help you to navigate this challenging but hopefully rewarding journey. In the next sections, I have collated all the best advice that I could find for practical, doable ways that you can take that next step into research.

Write up a case study. Prof. Dunn’s top tip is to start by writing up some routine clinical work. “Add a little more methodological rigour to the routine outcome monitoring we typically do in therapy for example, by using a single case experimental design that tracks symptom change over time from a baseline to a treatment phase. This kind of paper can make a useful contribution to the literature in helping us to “characterise the individuals who present to routine services and how well their needs are met”. You could submit your case study to a publication like The Cognitive Behaviour Therapist which also runs an excellent mentoring scheme for new authors.

Create opportunities within your current role. Looking for some “quick wins” can be a great starting point, advises Dr Tim Clarke, Principal Research Clinical Psychologist at Norfolk and Suffolk Foundation Trust. You could take a lead on an audit or service development project and disseminate the results for example, as a poster at a professional conference, or in a professional magazine or peer-reviewed publication.

Publish any existing work. If you completed a Masters or Professional Doctorate thesis, then now is a great time to revisit your previous work and turn it into a publishable paper or present your findings as a poster or short talk at a conference. Your previous supervisor should be able to help you. Demonstrating output from prior research is important for some fellowship applications.

Work with a trainee. Supervise or co-supervise a trainee’s case study, service development or main research project. This can be a great way to learn new research methods and to link with staff at the trainee’s academic institution. You could then collaborate with the trainee on any dissemination activities and outputs.

Get a mentor. Clinical psychologist Dr Maria Loades is an NIHR Development & Skills Enhancement Award Holder at the University of Bath. Her best advice? “Get mentorship from and link into a university department who are interested in a similar topic and/or method to you”. In my experience, getting the right mentor makes all the difference and it is worth spending time speaking to a range of people to get the right ‘fit’ for you. If you end up working with an academic/research supervisor from a different professional background to you, I highly recommend also finding a research active practitioner mentor (even if they work on a different topic or population) who can help you to negotiate the dual role of researcher and practitioner.

Contact your R&D team. Most NHS Trusts have an internal Research and Development team who are a great source of information about current research projects that the Trust is supporting such as opportunities to get involved in recruitment for large multi-site studies.

Train as a P.I. The NIHR runs an Associate Principal Investigator (PI) Scheme where you can shadow a PI to learn about the role. You may want to then become a site PI on a study, which is a great way to develop skills with clinical recruitment and research governance. Some regional NIHR Clinical Research Networks (CRNs) also run a “Greenshoots” scheme that offers extra funding for clinicians who are involved in recruitment for a study. Ask your R&D team for more information.

Network. “Linking with colleagues and like-minded individuals” is essential, as one CBT therapist told me. Dr Loades also advised, “look out for special interest groups of relevance to your topic area and conferences that will help you link up with others with similar interests.” Clinical research is not done in isolation, and in my experience you need a team of collaborators and supervisors around you to make progress. Do reach out to others to learn about their research, explain why you are passionate about their topic, and explore any opportunities to collaborate.

Collaborate on an existing project. Getting your own new project idea off the ground can be challenging without buy-in from more established researchers. You may choose to build your research skills and ideas first by joining an existing project and research team. You could ask the lead researcher if they have any existing projects where you could make a defined contribution (e.g., screening studies for a systematic review). Working as part of a team on a larger project can be a great way to learn different research methods. Once you have these links, you may decide you want to apply for a fellowship to develop your own spin-off project (perhaps using the same data set or drawing on their methodology) so you can continue working with your new collaborators.

Work on a trial. One newly qualified clinical psychologist* told me about their experience of working as a trial therapist. “As an early career psychologist this was a brilliant opportunity to continue to build on my developing therapeutic skills after training”, they explained, and added “and it also gave me an insight into some of the ‘behind the scenes’ work on a trial”. You may be able to take on some additional sessions within your current role or to apply for full-time trial therapist jobs when you see these advertised.

Join a higher education institution (HEI). If you are passionate about teaching and supervising trainees, there are Teaching Fellow or teaching-track Lectureship roles on practitioner training programmes at many HEIs which often do not require much evidence of prior research activity. Once in post, you could then look for opportunities to supervise trainee research or to run small-scale projects. A good and supportive HEI should offer you career development support to apply for fellowships or to move across to a research-track position.

Apply for your own funding. There are dedicated funding streams for clinicians and practitioners who want dedicated time for research (see Box). Be aware that completing an application for a fellowship is a time-consuming process! A full NIHR doctoral research fellowship could take up to one year to develop. Many fellowships schemes are also highly competitive, and you should be prepared to receive rejections or requests for extensive revisions. Funders have recognised some of these difficulties, and there are now predoctoral schemes that will give you funding to spend time with a supervisor to work up your initial project idea into a fully costed, detailed fellowship application.

I hope that this article has given you some ideas for practical ways in which you can take your interest in research to the next level. Good luck with your research endeavours!






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