Rethinking Health Professionals’ Motivation to Do Research: A Systematic Review

Figures & data

Figure 1 Flow chart of the study selection protocol. PRISMA figure adapted from Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 6(7):e1000097. Creative Commons⁴⁵.

Table 1 Quality Assessment of the Included Studies

QATSDD Criteria	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	Total Score	% of Total Score	Grade
Akerjordet, Lode, and Severinsson 2012^Citation83	0	3	2	1	3	1	0	3	3	2	N/A	3	0	N/A	0	3	24/42	57	Good
Albert et al 2016^Citation67	0	3	3	3	3	3	3	2	3	3	N/A	3	1	N/A	0	3	33/42	79	Good
Alison, Zafiropoulos, and Heard 2017^Citation64	0	3	3	3	3	3	3	3	3	3	N/A	3	3	N/A	0	3	36/42	86	Excellent
Bench, Dowie-Baker, and Fish 2019^Citation74	0	3	3	1	2	3	0	3	1	3	3	3	0	3	2	2	32/48	67	Good
Berthelsen and Holge-Hazelton 2015^Citation84	0	3	3	2	2	3	2	3	3	3	N/A	2	1	N/A	0	2	29/42	69	Good
Borkowski, McKinstry, and Cotchett 2017^Citation52	0	3	2	1	3	2	3	2	1	3	N/A	3	2	N/A	0	2	27/42	64	Good
Chan et al 2011^Citation68	0	3	2	2	3	2	3	3	3	3	N/A	2	0	N/A	0	0	26/42	62	Good
Choo, Muninathan, Pung, and Ramanathan 2017^Citation89	0	3	3	3	3	2	3	3	1	3	N/A	3	1	N/A	2	2	32/42	76	Good
Cianciolo et al 2020^Citation69	3	3	3	1	1	3	2	2	N/A	N/A	3	3	2	3	2	3	34/42	81	Excellent
Connolly, Allum, Shaw, Pattison, and Dark 2018^Citation75	3	3	3	2	3	3	3	2	1	3	3	2	3	3	2	3	42/48	86	Excellent
Conradie, Duys, Forget, and Biccard 2018^Citation16	0	3	3	3	2	3	1	3	0	3	2	3	1	3	0	3	33/48	69	Good
Dannapfel, Peolsson, and Nilsen 2013^Citation85	0	3	3	2	3	3	1	2	N/A	N/A	1	3	3	3	1	0	28/42	67	Good
Dannapfel, Peolsson, Stahl, Oberg, and Nilsen 2014^Citation86	3	3	3	2	3	3	1	2	N/A	N/A	2	3	3	3	1	3	35/42	83	Excellent
Elphinston and Pager 2015^Citation53	0	3	3	2	1	3	1	2	3	3	N/A	3	0	N/A	0	3	27/42	64	Good
Finch, Cornwell, Nalder, and Ward 2015^Citation54	0	3	3	3	3	3	2	2	N/A	N/A	3	3	1	3	0	3	32/42	76	Good
Harvey, Plummer, Nielsen, Adams, and Pain 2016^Citation55	0	3	3	3	3	2	0	2	N/A	N/A	1	3	2	3	0	3	28/42	67	Good
Hiscock et al 2014^Citation56	0	3	2	2	3	3	0	1	0	3	N/A	3	1	N/A	2	3	26/42	62	Good
Ito-Ihara et al 2013^Citation91	0	3	3	2	3	2	2	3	0	3	2	3	1	3	0	3	33/48	69	Good
Janssen, Hale, Mirfin-Veitch, and Harland 2016^Citation93	0	3	3	1	3	3	3	2	3	3	3	3	3	3	0	3	39/48	81	Excellent
Jones, Griffith, Ubel, Stewart, and Jagsi 2016^Citation32	0	3	2	2	3	3	1	2	0	3	3	3	2	0	0	3	30/48	63	Good
Lowrie et al 2015^Citation76	0	3	2	3	3	3	1	3	N/A	N/A	3	3	3	3	2	3	35/42	83	Excellent
Luckson, Duncan, Rajai, and Haigh 2018^Citation79	0	3	3	1	2	2	3	3	1	3	3	3	1	0	3	3	34/48	71	Good
Mahmoud et al 2011^Citation87	0	3	3	2	2	2	0	2	0	3	N/A	3	1	N/A	2	2	25/42	60	Good
Mansi, Karam, and Chaaban 2019^Citation70	0	3	3	2	2	2	0	2	0	2	N/A	3	0	N/A	0	3	22/42	52	Good
Marshall et al 2016^Citation65	0	3	3	3	1	3	3	3	3	3	3	3	3	3	3	3	43/48	90	Excellent
McDonald 2020^Citation92	0	3	3	2	2	3	0	3	1	3	N/A	3	0	N/A	2	3	28/42	67	Good
McMaster, Jammali-Blasi, Andersson-Noorgard, Cooper, and McInnes 2013^Citation57	0	3	3	2	3	2	1	3	1	3	N/A	3	0	N/A	1	1	26/42	62	Good
McNab, Berry, and Skapetis 2019^Citation58	0	3	3	3	2	2	0	3	1	2	N/A	3	3	N/A	2	3	30/42	71	Good
Mills et al 2019^Citation3	0	3	3	3	3	3	0	2	0	3	N/A	3	0	N/A	0	3	26/42	62	Good
Oliver-Baxter, Brown, and McIntyre 2017^Citation59	0	3	3	2	3	3	0	3	1	3	N/A	2	0	N/A	0	3	26/42	62	Good
Pager, Holden, and Golenko 2012^Citation60	0	3	3	2	2	3	2	2	1	2	2	1	0	1	0	3	27/48	56	Good
Paget, Lilischkis, Morrow, and Caldwell 2014^Citation66	0	3	2	3	1	3	2	3	0	3	N/A	2	0	N/A	3	0	25/42	60	Good
Pain, Petersen, and Fernando 2018^Citation61	0	3	3	2	2	2	0	3	0	3	N/A	2	1	N/A	0	2	23/42	55	Good
Sarwar et al 2018^Citation80	0	3	3	3	3	2	0	3	3	3	N/A	3	0	N/A	2	2	30/42	71	Good
Scala, Patterson, Stavarski, and Mackay 2019^Citation71	2	3	3	3	3	3	0	2	N/A	N/A	3	3	0	3	0	2	30/42	71	Good
Siedlecki and Albert 2016^Citation72	3	3	3	2	2	2	0	3	N/A	N/A	2	2	1	3	0	2	28/42	67	Good
Silberman et al 2012^Citation73	0	3	3	2	3	2	0	3	0	3	N/A	3	0	N/A	0	3	25/42	60	Good
Snelgrove and James 2011^Citation77	0	3	3	1	1	2	0	3	0	3	3	2	1	3	0	1	26/42	62	Good
Stewart et al 2015^Citation81	0	3	3	2	2	3	1	2	3	3	N/A	3	3	N/A	2	2	32/42	76	Good
Stewart et al 2019^Citation78	3	3	3	1	3	3	2	2	3	3	N/A	3	2	N/A	0	3	34/42	81	Excellent
Sultana, Al Jeraisy, Al Ammari, Patel, and Zaidi 2016^Citation82	1	3	3	2	3	3	1	3	3	3	N/A	3	1	N/A	2	3	34/42	81	Excellent
Torres et al 2017^Citation90	0	3	3	2	2	3	1	3	3	3	N/A	3	1	N/A	2	2	31/42	74	Good
van Hoving and Brysiewicz 2017^Citation88	0	3	3	1	3	3	1	3	0	3	N/A	3	1	N/A	0	3	27/42	64	Good
Wenke, Mickan, and Bisset 2017^Citation62	0	3	3	1	2	3	3	3	0	3	N/A	3	2	N/A	0	3	29/42	69	Good
Wenke, Noble, Weir, and Mickan 2020^Citation63	3	3	3	3	2	3	2	3	N/A	N/A	3	3	3	3	0	2	36/42	86	Excellent
White 2013^Citation51	1	3	2	1	1	0	1	2	1	2	N/A	1	1	N/A	0	0	16/48	33	Low

Notes: The QATSDD criteria included: (1) theoretical framework; (2) aims/objectives; (3) description of research setting; (4) sample size; (5) representative sample of target group; (6) procedure for data collection; (7) rationale for choice of data collection tool(s); (8) detailed recruitment data; (9) assessment of reliability and validity of measurement tool(s) (quantitative only); (10) fit between research question and method of data collection (quantitative only); (11) fit between research question and data collection method (qualitative only); (12) fit between research question and method of analysis; (13) good justification for analytical method selected; (14) reliability of analytical process (qualitative only); (15) evidence of user involvement in design; (16) strengths and limitations.

Table 2 Study Characteristics and Participant Demographics for Reviewed Articles

Author and Year	Title	Country	Setting	Study Design	Type of Participants	Participants (No., Gender, Mean Age [Yrs.]) Response Rate
Akerjordet, Lode, and Severinsson 2012^Citation83	Clinical nurses’ attitudes towards research, management and organisational resources in a university hospital: part 1	Norway	Not stated	Quantitative	Nurses	N = 364; Females (95%, n =347); Age: (41.2 ± 11.52) RR 61%
Albert et al 2016^Citation67	Clinical nurse specialist roles in conducting research: Changes over 3 years	USA	Urban	Quantitative	Nurses	N = 2052; Females (95.9%, n =1782); Age: (50.3 ± 9.3) RR 25%
Alison, Zafiropoulos, and Heard 2017^Citation64	Key factors influencing allied health research capacity in a large Australian metropolitan health district	Australia	Urban	Quantitative	Allied Health	N = 278; Females**; Age: <25->60yrs: RR 54%
Bench, Dowie-Baker, and Fish 2019^Citation74	Orthopaedic nurses’ engagement in clinical research; an exploration of ideas, facilitators, and challenges	UK	Not stated	Mixed methods	Nurses	N = 75; Females (75%, n =56); Age: (>40 = 56%) RR 20%
Berthelsen and Holge-Hazelton 2015^Citation84	Orthopaedic nurses’ attitudes towards clinical nursing research - A cross-sectional survey	Denmark	Regional	Quantitative	Nurses	N = 43; Females (97.8%, n =42); Age: (>40 =62.7%) RR 49.4%
Borkowski, McKinstry, and Cotchett 2017^Citation52	Research culture in a regional allied health setting	Australia	Regional	Quantitative	Allied Health	N = 136; Females**; Age**: RR 46%
Chan et al 2011^Citation68	Barriers and perceived needs for understanding and using research among emergency nurses	USA	Not stated	Quantitative	Nurses	N = 978; Females**; Age**: RR 3.6%
Choo, Muninathan, Pung, and Ramanathan 2017^Citation89	Attitudes, barriers, and facilitators to the conduct of research in government hospitals: a cross-sectional study among specialists in government hospitals, northern states of Malaysia	Malaysia	Not stated	Quantitative	Physicians	N = 467; Females (49.9%, n =233); Age: 30–44yrs n=340 (72.8%) RR 63.7%
Cianciolo et al 2020^Citation69	Physician-scientist or basic scientist? Exploring the nature of clinicians’ research engagement	USA and Pakistan	Urban and rural	Qualitative	Physicians	N = 36; Females (39%, n =14); Age: (34.5+9.5)
Connolly, Allum, Shaw, Pattison, and Dark 2018^Citation75	Characterising the research profile of the critical care physiotherapy workforce and engagement with critical care research: a UK national survey	UK	Not stated	Quantitative	Physiotherapists	N = 268; Females** Age**RR**
Conradie, Duys, Forget, and Biccard 2018^Citation16	Barriers to clinical research in Africa: a quantitative and qualitative survey of clinical researchers in 27 African countries	Africa	Not stated	Mixed methods	Physicians	N = 134; Females**; Age**: RR=32%
Dannapfel, Peolsson, and Nilsen 2013^Citation85	What supports physiotherapists’ use of research in clinical practice? A qualitative study in Sweden	Sweden	Urban and rural	Qualitative	Physiotherapists	N = 45; Females (75%, n =33); Age: (41+11) RR**
Dannapfel, Peolsson, Stahl, Oberg, and Nilsen 2014^Citation86	Applying self-determination theory for improved understanding of physiotherapists’ rationale for using research in clinical practice: a qualitative study in Sweden	Sweden	Urban and rural	Qualitative	Physiotherapists	N = 45; Females (75%, n =33); Age: (41.11+5) RR= RR**
Elphinston and Pager 2015^Citation53	Untapped potential: Psychologists leading research in clinical practice	Australia	Urban	Quantitative	Psychologists	N = 60; Females (77%, n =46); Age**: RR mean 26.1 across 3 time points
Finch, Cornwell, Nalder, and Ward 2015^Citation54	Uncovering motivators and stumbling blocks: Exploring the clinical research experiences of speech-language pathologists	Australia	Urban and rural	Qualitative	Speech language pathologists	N = 21; Females (100%, n =21); Age**: RR**
Harvey, Plummer, Nielsen, Adams, and Pain 2016^Citation55	Becoming a clinician researcher in allied health	Australia	Regional	Qualitative	Allied Health	N = 15; Females (87%, n =13); Age**: RR**
Hiscock et al 2014^Citation56	Clinical research potential in Victorian hospitals: the Victorian clinician researcher needs analysis survey	Australia	Urban and rural and remote	Quantitative	Allied Health Nurses Physicians	N = 1027; Females (67%, n =688); Age**: RR**
Ito-Ihara et al 2013^Citation91	An international survey of physicians regarding clinical trials: a comparison between Kyoto University Hospital (KUPH) and Seoul National University Hospital (SNUH)	Japan and South Korea	Urban	Quantitative	Physicians	KUPH N = 301; Females (17%, n = 50); Age ≤29 -≥50: RR 64% SNUH N = 398; Females 37% n = 147: Age ≤29->50: RR 45%
Janssen, Hale, Mirfin-Veitch, and Harland 2016^Citation93	Perceptions of physiotherapists towards research: a mixed methods study	New Zealand	Not stated	Mixed methods	Physiotherapists	N = 25; Females (84%, n =21); Age: (38.11); RR**
Jones, Griffith, Ubel, Stewart, and Jagsi 2016^Citation32	A mixed-methods investigation of the motivations, goals, and aspirations of male and female academic medical faculty	USA	Not stated	Mixed methods	Physicians	N = 1275; Females (45.6%, n =582); Age** RR=74.6%
Lowrie et al 2015^Citation76	Research is ‘a step into the unknown’: an exploration of pharmacists’ perceptions of factors impacting on research participation in the NHS	UK	Urban and rural	Qualitative	Pharmacists	N = 54; Females (68%, n =37); Age** RR**
Luckson, Duncan, Rajai, and Haigh 2018^Citation79	Exploring the research culture of nurses and allied health professionals (AHPs) in a research-focused and a non-research-focused healthcare organisation in the UK	UK	Urban	Mixed methods	Allied Health Nurses	N = 224: Females (87%, n =194); Age** RR=24%
Mahmoud et al 2011^Citation87	Survey of medical specialists on their attitudes to and resources for health research in Nigeria	Nigeria	Not stated	Quantitative	Physicians	N = 51; Females (22%, n =11); Age**: (45.3+7.23) RR=63.3%
Mansi, Karam, and Chaaban 2019^Citation70	Attitudes of residents and program directors towards research in otolaryngology residency	USA	Not stated	Quantitative	Physicians	N = 209 Residents n =178 Program directors n= 31 Females**; Age**: RR**
Marshall et al 2016^Citation65	Survey of research activity among multidisciplinary health professionals	Australia	Urban	Mixed Methods	Allied Health Nurses Physicians	N = 151; Females (56.2%, n = 82); Age** RR=2.5%
McDonald 2020^Citation92	Motivators and stressors for Canadian research coordinators in critical care: The motivate survey	Canada	Not stated	Quantitative	Allied Health Nurses Physicians	N = 66; Females**: Age**: RR=78%
McMaster, Jammali-Blasi, Andersson-Noorgard, Cooper, and McInnes 2013^Citation57	Research involvement, support needs, and factors affecting research participation: A survey of Mental Health Consultation Liaison Nurses	Australia	Not stated	Quantitative	Nurses	N = 31; Females (44%, n =14); Age: (50–59 yrs. =50%) RR=94%
McNab, Berry, and Skapetis 2019^Citation58	The potential of a lecture series in changing intent and experience among health professionals to conduct research in a large hospital: a retrospective pre-post design	Australia	Urban	Quantitative	Allied Health Nurses	N = 49; Females (89.8%, n =44); Age: (50–65years =47.9%) RR=38.9%
Mills et al 2019^Citation3	Attractions and barriers to Australian physician-researcher careers: Physician-researcher influences	Australia	Not stated	Quantitative	Physicians	N = 427; Females (44%, n =31); Age: (38+13): RR**
Oliver-Baxter, Brown, and McIntyre 2017^Citation59	Surviving or thriving in the primary health care research workforce: the Australian experience	Australia	Urban and rural and remote	Quantitative	Allied Health, Nurses, Physicians	N = 37; Females (75.7%, n =28); Age: (47.9+10.2): RR**
Pager, Holden, and Golenko 2012^Citation60	Motivators, enablers, and barriers to building allied health research capacity	Australia	Not stated	Quantitative	Allied Health	N = 85; Females**; Age**: RR**
Paget, Lilischkis, Morrow, and Caldwell 2014^Citation66	Embedding research in clinical practice: differences in attitudes to research participation among clinicians in a tertiary teaching hospital	Australia	Urban	Quantitative	Allied Health, Nurses, Physicians	N = 208; Females (76%, n =158); Age: <30 years =20%, 30–50 years =66%, >50 years =14%: RR=17%
Pain, Petersen, and Fernando 2018^Citation61	Building allied health research capacity at a regional Australian hospital: A follow-up study	Australia	Regional	Quantitative	Allied Health	2011: N = 248; Females (76%, n =188); Age**: RR43% 2015: N = 234; Females (76%, n =178); Age**: RR37%
Sarwar et al 2018^Citation80	Attitude, perception, willingness, motivation and barriers to practice-based research: A cross-sectional survey of hospital pharmacists in Lahore, Punjab, Pakistan	Pakistan	Urban	Quantitative	Pharmacists	N = 130; Females (42.3%, n =55); Age: <30yrs (82.3%) RR=92%
Scala, Patterson, Stavarski, and Mackay 2019^Citation71	Engagement in research: A clinical nurse profile and motivating factors	USA	Not stated.	Qualitative	Nurses	N = 34; Females (91.2%, n =31); Age**: RR**
Siedlecki and Albert 2016^Citation72	Research-active clinical nurses: against all odds	USA	Not stated	Qualitative	Nurses	N = 26; Females**; Age: (50+7.7): RR**
Silberman et al 2012^Citation73	Recruiting researchers in psychiatry: The influence of residency vs early motivation	USA	Urban	Quantitative	Physicians	N = 127; Females (51.6%, n =65.5); Age**: RR=67%
Snelgrove and James 2011^Citation77	Graduate nurses’ and midwives’ perceptions of research	UK	Not stated	Qualitative	Nurses	N = 58; Females** Age**: RR=29%
Stewart et al 2015^Citation81	Building hospital pharmacy practice research capacity in Qatar: a cross-sectional survey of hospital pharmacists	Qatar	Urban	Quantitative	Pharmacists	N = 213; Females (47.9%, n =102); Age**: RR= 53.1%
Stewart et al 2019^Citation78	A theoretically informed survey of the views and experiences of practicing pharmacists on research conduct, dissemination and translation	UK	Rural and remote	Quantitative	Pharmacists	N = 136; Females (76.5%, n =104); Age: (>45 30.9%) RR= 19.4%
Sultana, Al Jeraisy, Al Ammari, Patel, and Zaidi 2016^Citation82	Attitude, barriers and facilitators to practice-based research: cross-sectional survey of hospital pharmacists in Saudi Arabia	Saudi Arabia	Urban	Quantitative	Pharmacists	N = 182; Females (51.1%, n =93); Age**: RR=84%.
Torres et al 2017^Citation90	Assessment of research capacity among nursing faculty in a clinical intensive university in the Philippines	Philippines	Urban	Quantitative	Nurses	N = 66; Females (77%, n =51); Age**: RR 80.49%
van Hoving and Brysiewicz 2017^Citation88	African emergency care providers’ attitudes and practices towards research	Africa	Not stated	Quantitative	Physicians, Nurses	N = 188; Females (27.4%, n =46); Age: (36.3+9.1) RR= 34.8%,
Wenke, Mickan, and Bisset 2017^Citation62	A cross sectional observational study of research activity of allied health teams: is there a link with self-reported success, motivators and barriers to undertaking research?	Australia	Regional	Quantitative	Allied Health	N = 95; Females**; Age**: RR**
Wenke, Noble, Weir, and Mickan 2020^Citation63	What influences allied health clinician participation in research in the public hospital setting: a qualitative theory-informed approach	Australia	Regional	Qualitative	Allied Health	N = 21; Females**; Age**: RR 2.9%

Note: **Values/categories not specified.

Table 3 Theoretical Framework Summary of Study Outcomes

Author and Year/Reference #	Type of Participants	Theoretical Framework	Research Capacity	Attitude	Barriers
Akerjordet, Lode, and Severinsson 2012^Citation83	Nurses	NIL	Lacks confidence requires support >20% wanted to improve research skills as did 56% of the 8% engaged in research	Positive – utility value Positive attitude to research by 40% all respondents	Lack of designated time for research Lack of organisational support Lack of knowledge Lack of support including acceptance by colleagues, reward, and acknowledgement Lack of interest in research
Albert et al 2016^Citation67	Nurses	NIL	Competent < 42% conducted research	Positive – utility value Mid-range scores for value and confidence in conducting research	Lack of knowledge Lack of support including acceptance by colleagues, reward, and acknowledgement Access to literature
Alison, Zafiropoulos, and Heard 2017^Citation64	Allied Health	NIL	Lacks confidence requires support Ten of the 19 items at the individual level had a median score of ≤5	Positive – utility value Main motivators to performing research reported by participants included: to develop skills (84%, n=210)	Lack of designated time for research Lack of funding including incentives and failed grants Lack of training/resources/dedicated research team Lack of confidence, competence, skills, or experience Lack of organisational support Lack of interest in research Access to literature
Bench, Dowie-Baker, and Fish 2019^Citation74	Nurses	NIL	Lacks confidence requires support 27% respondents had desire to be involved in research. 87% reported never having published 61% never having presented at a conference	Negative – no connection to researchers Research not part of the role - Unpleasant and scary	Lack of designated time for research Lack of confidence, competence, skills, or experience Lack of training/resources/dedicated research team Lack of knowledge
Berthelsen and Holge-Hazelton 2015^Citation84	Nurses	NIL	Lacks confidence requires support Interested in improving research skills	Very positive – attainment, intrinsic and utility value. Low theoretical knowledge and practical research competencies	Lack of designated time for research Lack of confidence, competence, skills, or experience Lack of training/resources/dedicated research team Lack of support including acceptance by colleagues, reward, and acknowledgement Lack of interest in research
Borkowski, McKinstry, and Cotchett 2017^Citation52	Allied Health	NIL	Lacks confidence requires support Low research capacity and culture with other work roles taking priority and lack of time and skills	Positive – utility value Focus on developing skills but unable to overcome numerous barriers	Lack of designated time for research Lack of confidence, competence, skills, or experience
Chan et al 2011^Citation68	Nurses	NIL	Lacks confidence requires support Overwhelming lack of research experience but highly interested	Very positive – attainment, intrinsic and utility value	Lack of confidence, competence, skills, or experience Lack of knowledge Lack of support including acceptance by colleagues, reward, and acknowledgement
Choo, Muninathan, Pung, and Ramanathan 2017^Citation89	Physicians	NIL	Competent 34.8% unlikely to participate in research under present working conditions	Negative – no connection to researchers Identified research benefits for patients and society (98.9%) and professional development (93.3%). However, less than half perceive research to be one of their job functions (49.7%)	Lack of designated time for research Lack of funding including incentives and failed grants Lack of training/resources/dedicated research team Lack of support including acceptance by colleagues, reward, and acknowledgement
Cianciolo et al 2020^Citation69	Physicians	SCCT and Professional Identity Formation	Competent Pakistan better alignment between clinicians’ research success and national priorities than U. S	Very positive – attainment, intrinsic and utility value Clinicians and scientists resilient in pursuing research	Lack of funding including incentives and failed grants
Connolly, Allum, Shaw, Pattison, and Dark 2018^Citation75	Physiotherapists	COM-B model. capability, opportunity, motivation, and behaviour	Competent 84.7% indicated existing research experience. 60.8% had postgraduate qualifications at master’s level or above	Very positive – attainment, intrinsic and utility value. 24.2% of respondents currently involved in research. 10.4% not interested in any research training.	Lack of designated time for research Lack of funding including incentives and failed grants Lack of confidence, competence, skills, or experience
Conradie, Duys, Forget, and Biccard 2018^Citation16	Physicians	NIL	Lacks confidence requires support Potential for research once barriers are addressed.	Very positive – attainment, intrinsic and utility value	Lack of training/resources/dedicated research team Lack of support including acceptance by colleagues, reward, and acknowledgement. Barriers to successful participation in ASOS related to resource limitations and not motivation of the clinician investigators.
Dannapfel, Peolsson, and Nilsen 2013^Citation85	Physiotherapists	NIL	Lacks confidence requires support Research use Changes in practice based on research findings, which reflects changes in thinking rather than actual behaviour	Very positive – attainment, intrinsic and utility value Positive attitudes to research and a strong motivation to use research in clinical practice	Lack of designated time for research Lack of knowledge Lack of confidence, competence, skills, or experience Lack of support including acceptance by colleagues, reward, and acknowledgement Access to literature
Dannapfel, Peolsson, Stahl, Oberg, and Nilsen 2014^Citation86	Physiotherapists	Self-determination Theory SDT	Lacks confidence requires support Motivation measured along continuum of autonomy from intrinsic – extrinsic-amotivated	Very positive – attainment, intrinsic and utility value Autonomous forms of motivation were most common	Lack of interest in research
Elphinston and Pager 2015^Citation53	Psychologists	NIL	Competent Greater research capacity of psychologists compared with other allied health professions	Negative – no connection to researchers Majority of psychologists in study perceived that research not part of their work role	Lack of designated time for research Lack of funding including incentives and failed grants Lack of organisational support
Finch, Cornwell, Nalder, and Ward 2015^Citation54	Speech language pathologists	NIL	Lacks confidence requires support Time constraints from their clinical caseload greatly limited their research engagement	Fear of research Lack of research training was viewed as a key obstacle preventing participants who were not engaged in research from partaking in research related activities	Lack of designated time for research Lack of organisational support Lack of support including acceptance by colleagues, reward, and acknowledgement Lack of training/resources/dedicated research team
Harvey, Plummer, Nielsen, Adams, and Pain 2016^Citation55	Allied Health	NIL	Lacks confidence requires support Clinician researcher career trajectory	Very positive – attainment, intrinsic and utility value Predisposing personal qualities and exposure to research facilitated a research debut by priming participants to take advantage of workplace opportunities for research.	Lack of designated time for research Lack of funding including incentives and failed grants Lack of organisational support Lack of support including acceptance by colleagues, reward, and acknowledgement
Hiscock et al 2014^Citation56	Allied Health, Nurses, Physicians	NIL	Competent Gender, age, occupation, and postgraduate qualification – were significantly associated with research activity	Very positive – attainment, intrinsic and utility value Research-inactive clinicians identified protected research time as the key enabler of future research.	Lack of designated time for research Lack of organisational support Lack of training/resources/dedicated research team Lack of support including acceptance by colleagues, reward, and acknowledgement
Ito-Ihara et al 2013^Citation91	Physicians	NIL	Competent Physicians with experience in clinical trials	Positive – utility value Showed interest in conducting clinical trials	Lack of designated time for research Lack of funding including incentives and failed grants Lack of organisational support Lack of training/resources/dedicated research team Lack of support including acceptance by colleagues, reward, and acknowledgement Unrealistic workload and tedious research process
Janssen, Hale, Mirfin-Veitch, and Harland 2016^Citation93	Physiotherapists	NIL	Lacks confidence requires support 56% of subjects had not attended a research course and 60% Confidence in conducting research ranged from 0 to 100 [mean 38 (SD 27)]	Positive – utility value Physiotherapists were generally positive towards research but struggled with the concept of research. use of research vs participation in research.	Lack of confidence, competence, skills, or experience
Jones, Griffith, Ubel, Stewart, and Jagsi 2016^Citation32	Physicians	NIL	Competent Attrition from academic medicine may be more so due to a combination of conflicting values	Very positive – attainment, intrinsic and utility value. Elite sample of highly apt and research-motivated clinician– investigators	Lack of designated time for research Lack of funding including incentives and failed grants Lack of support including acceptance by colleagues, reward, and acknowledgement
Lowrie et al 2015^Citation76	Pharmacists	NIL	Lacks confidence requires support. Active engagement in research is set out as a part of the role however, saw research as an activity that involved substantial personal cost for limited personal gain.	Negative – no connection to researchers HSR for most pharmacists, for multiple reasons, was viewed as an exceptional activity rather than a core role.	Lack of designated time for research Lack of confidence, competence, skills, or experience Lack of organisational support Lack of interest in research
Luckson, Duncan, Rajai, and Haigh 2018^Citation79	Allied Health, Nurses	NIL	Lacks confidence requires support Individuals lacking adequate skills to undertake most aspects of research.	Positive – utility value Partner with external links such as universities to do research.	Lack of confidence, competence, skills, or experience Lack of organisational support Lack of knowledge Lack of support including acceptance by colleagues, reward, and acknowledgement
Mahmoud et al 2011^Citation87	Physicians	NIL	Lacks confidence requires support Internet always source of literature search for 96.1% library 28%.	Very positive – attainment, intrinsic and utility value. Advancement of knowledge strongest motivator for research 78.4%	Lack of designated time for research Lack of confidence, competence, skills, or experience Access to literature Lack of research opportunities
Mansi, Karam, and Chaaban 2019^Citation70	Physicians	NIL	Competent 90% of the residents reported previous research experience during medical school, and 71.6% reported research during their undergraduate education	Very positive – attainment, intrinsic and utility value. More than half (56%) of the residents surveyed agreed that resident research is a positive experience overall.	Lack of designated time for research Lack of knowledge Lack of interest in research
Marshall et al 2016^Citation65	Allied Health, Nurses, Physicians	NIL	Competent (n = 113; 75.3%) reported they had actively participated in ethics-approved research.	Very positive – attainment, intrinsic and utility value. Embedding research in clinical practice was critical and should be seen as core business	Lack of designated time for research Lack of research opportunities
McDonald 2020^Citation92	Allied Health, Nurses, Physicians	NIL	Lacks confidence requires support. Mainly involved in applying for research ethics board approvals, entering data, attending study start-up and update meetings, and screening patients for study eligibility.	Positive – utility value Overall, 26% were “very satisfied” and 53% were “satisfied” with their jobs.	Lack of designated time for research Lack of support including acceptance by colleagues, reward, and acknowledgement Unrealistic workload and tedious research process Felt undervalued
McMaster, Jammali-Blasi, Andersson-Noorgard, Cooper, and McInnes 2013^Citation57	Nurses	NIL	Lacks confidence requires support Majority of respondents reported no current involvement in research	Positive – utility value Over half of participants in our study reported having research goals for the following 12 months	Lack of designated time for research Lack of confidence, competence, skills, or experience Lack of organisational support Lack of training/resources/dedicated research team Lack of interest in research
McNab, Berry, and Skapetis 2019^Citation58	Allied Health, Nurses	NIL	Competent Six one-hour face to face research lectures improvement in self-reported levels of intention to become involved in research as well as research experience.	Positive – utility value Significant change in the self-assessed level of experience was seen in a wide range of research areas.	NIL
Mills et al 2019^Citation3	Physicians	NIL	Competent 49% agreed that medical research is a lifestyle-friendly career	Positive – utility value Improve human health, intellectual stimulation, and career diversity	Lack of designated time for research Lack of funding including incentives and failed grants Lack of training/resources/dedicated research team Unrealistic workload and tedious research process
Oliver-Baxter, Brown, and McIntyre 2017^Citation59	Allied Health, Nurses, Physicians	NIL	Competent Higher research degree graduates completed their RHD in the last 5 years	Positive – utility value Importance of connection/relatedness. Stayers are more affiliated with professional organisation than leavers.	Lack of designated time for research Lack of funding including incentives and failed grants
Pager, Holden, and Golenko 2012^Citation60	Allied Health	NIL	Competent 43.9% of all participants had postgraduate qualifications. About half were required to do research as part of their role description.	Very positive – attainment, intrinsic and utility value Desire to develop skills, increase job satisfaction, and address identified problems	Lack of designated time for research Lack of funding including incentives and failed grants Lack of organisational support Lack of training/resources/dedicated research team Lack of knowledge Lack of support including acceptance by colleagues, reward, and acknowledgement
Paget, Lilischkis, Morrow, and Caldwell 2014^Citation66	Allied Health, Nurses, Physicians	NIL	Competent Most participants identified themselves as having research skills or experience (63%) or formal research training (66%)	Very positive – attainment, intrinsic and utility value. Enjoy participating in research (68%) and the departments value research (66%)	Lack of designated time for research Lack of funding including incentives and failed grants Lack of organisational support Lack of training/resources/dedicated research team Lack of support including acceptance by colleagues, reward, and acknowledgement
Pain, Petersen, and Fernando 2018^Citation61	Allied Health	NIL	Lacks confidence requires support. Research experience increased from 2011 to 2015 as did the need for support. Conducting research was part of role description.	Positive – utility value Make a difference in clinical care (56.8%) and evaluate their service (52.6%).	Lack of designated time for research
Sarwar et al 2018^Citation80	Pharmacists	NIL	Competent Majority of the respondents (n = 112, 86.2%) agreed with the statement “I have the required abilities to participate in research”.	Positive – utility value Uplifting of the profession, opportunity to gain knowledge, provide better services and increased patient care.	Lack of designated time for research Lack of funding including incentives and failed grants Lack of knowledge Lack of research opportunities
Scala, Patterson, Stavarski, and Mackay 2019^Citation71	Nurses	Vroom’s expectancy theory framework:	Competent 7 (20.6%) Master’s degree	Positive – utility value Feeling empowered to make a difference and legitimize the profession	Lack of organisational support
Siedlecki and Albert 2016^Citation72	Nurses	Research-Active Nurse Model	Competent 65% Master’s Degree	Very positive – attainment, intrinsic and utility value. Passion for enquiry; they enjoyed the process, despite the work and personal time involved.	Lack of designated time for research Lack of funding including incentives and failed grants Lack of knowledge
Silberman et al 2012^Citation73	Physicians	NIL	Competent 30.7% had master’s or doctoral degrees in addition to medical degrees.	Very positive – attainment, intrinsic and utility value. Had a consistent pattern of interest and involvement in research, starting well before residency.	Lack of funding including incentives and failed grants Barriers specific to women
Snelgrove and James 2011^Citation77	Nurses	NIL	Competent Most participants had completed or were completing a master’s level degree	Research frightening/Lack of connection and institutional support. Despite positive attitudes and some research education, many of the participants described research as ‘frightening’, with a lack of skills cited as a determinant of this fear	Lack of organisational support Lack of training/resources/dedicated research team
Stewart et al 2015^Citation81	Pharmacists	NIL	Competent One third (32.9%, n = 70) had completed a postgraduate course, one third (30.0%, n = 64) were currently studying for a postgraduate qualification.	Positive – utility value Generally held positive attitudes, with a median overall score of 13 (IQR 8–18), range possible 8–40, with 8 representing best positive attitudinal score	Lack of organisational support Lack of training/resources/dedicated research team
Stewart et al 2019^Citation78	Pharmacists	Theoretical Domains Framework TDF	Competent Postgraduate qualifications 58.1% (79) 14.7% (n=20) had been involved in research in the past and had plans to be involved in the future, and 12.5% (n=17) were currently involved in research.	Positive – utility value Attainment value – 94% benefit to profession. Utility value – benefit to patients 90.45 benefit to self-72.6%.	Lack of designated time for research Lack of organisational support Lack of support including acceptance by colleagues, reward, and acknowledgement
Sultana, Al Jeraisy, Al Ammari, Patel, and Zaidi 2016^Citation82	Pharmacists	Social cognitive theory	Competent Prior research experience was reported by 59% of participants. More than 40% of participants hold Masters degree in pharmacy.	Positive – utility value 70% of the participants were interested in doing practice-based research with nearly half willing to make time for it.	Lack of designated time for research Lack of organisational support Lack of research opportunities
Torres et al 2017^Citation90	Nurses	NIL	Competent Perceived knowledge and skills of the research process were above 3 on a 5-point scale (means ranged between 3.14 and 4.06).	Positive – utility value Professional advancement, tenure and promotion, research record	Lack of confidence, competence, skills, or experience Lack of knowledge Unrealistic workload and tedious research process
van Hoving and Brysiewicz 2017^Citation88	Physicians, Nurses	NIL	Competent Honours or Masters degree - 44 (26.2%). Doctoral degree - 35 (20.8%)	Positive – utility value Improvement of research skills (70.2%) and having research published (69.6%)	Lack of designated time for research Lack of funding including incentives and failed grants Lack of training/resources/dedicated research team Access to literature
Wenke, Mickan, and Bisset 2017^Citation62	Allied Health	NIL	Lacks confidence requires support. 80% of interviews was a lack of belief or confidence in their capability to undertake aspects of research	Positive – utility value Better patient outcomes	Lack of designated time for research Lack of funding including incentives and failed grants Lack of confidence, competence, skills, or experience Lack of training/resources/dedicated research team Lack of support including acceptance by colleagues, reward, and acknowledgement
Wenke, Noble, Weir, and Mickan 2020^Citation63	Allied Health	Theoretical Domains Framework YES – TDF & COM- B system	Lacks confidence requires support All ‘novice’ researchers and had no formal postgraduate research qualifications	Fear of failure or feeling intimidated Clinicians described feeling overwhelmed or intimidated at the thought of undertaking research	Lack of designated time for research Lack of funding including incentives and failed grants Lack of confidence, competence, skills, or experience

Table 4 Major Types of Barriers by Participant Groups

Participants	Number of studies and #	Major Barriers
Physicians	6^Citation3,Citation32,Citation69,Citation73,Citation89,Citation91	Lack of funding including incentives and failed grants
AH, Nurses, Physicians	2^Citation59,Citation66
Physicians, Nurses	1^Citation88
AH	8^Citation53,Citation55,Citation60,Citation62^–^Citation64,Citation75,Citation80
Nurses	1^Citation72
Total	18
AH	8^Citation62^–^Citation64,Citation75,Citation76,Citation85,Citation93,Citation94	Lack of confidence, competence, skills, or experience
Nurses	5^Citation57,Citation68,Citation74,Citation84,Citation90
AH, Nurses	1^Citation79
Physicians	1^Citation87
Total	15
AH	9^Citation53^–^Citation55,Citation60,Citation64,Citation76,Citation78,Citation81,Citation82	Lack of organisational support
Nurses	4^Citation57,Citation71,Citation77,Citation83
AH, Nurses, Physicians	2^Citation56,Citation66
AH, Nurses	1^Citation79
Physicians	1^Citation91
Total	17
AH	4^Citation60,Citation62,Citation64,Citation81	Lack of training/resources/dedicated research team
Nurses	4^Citation57,Citation74,Citation77,Citation84
Physicians	4^Citation3,Citation16,Citation89,Citation91
AH, Nurses, Physicians	2^Citation56,Citation66
Physicians, Nurses	1^Citation88
Total	15
Nurses	6^Citation67,Citation68,Citation72,Citation74,Citation83,Citation90	Lack of knowledge
AH	3^Citation80,Citation85,Citation95
AH, Nurses	1^Citation79
Physician	1^Citation70
Total	11
AH	5^Citation55,Citation60,Citation62,Citation78,Citation85	Lack of support (including acceptance by colleagues, reward, and acknowledgement)
Physicians	3^Citation16,Citation32,Citation91
Nurses	2^Citation68,Citation84
AH, Nurses, Physicians	2^Citation66,Citation92
AH, Nurses	1^Citation79
Total	13
AH	2^Citation54,Citation60	Lack of supervisors/mentors
Nurses	2^Citation67,Citation83
AH, Nurses, Physicians	2^Citation56,Citation66
Physicians	2^Citation89,Citation91
Total	8
AH	3^Citation64,Citation76,Citation86	Lack of interest in research
Nurses	3^Citation57,Citation83,Citation84
Physicians	1^Citation70
Total	7
AH	1^Citation64	Unrealistic workload and tedious research process
Nurses	1^Citation90 1 ^Citation88
AH, Nurses, Physicians	2^Citation3,Citation91
Physicians
Total	5
AH	2^Citation64,Citation85	Access to literature
Nurses	1^Citation67
Physicians, Nurses	1^Citation88
Physicians	1^Citation87
Total	5
AH	2^Citation80,Citation82	Lack of research opportunities
AH, Nurses, Physicians	1^Citation65
Physicians	1^Citation87
Total	4
AH, Nurses, Physicians	1^Citation92	Felt undervalued
Total	1
Physicians	1^Citation73	Barriers specific to women
Total	1

Table 5 Integration of Theoretical Framework Elements by Participant Groups

Research Capacity	Attitude	Participants	Numbers	Major Barriers	Summary
Competent	Very positive – attainment, intrinsic and utility value	AH	1^Citation60	Multiple barriers	Demonstrated all three types of value, felt connected to other research colleagues and despite multiple barriers, they had genuine interest which fostered their capacity for on-going, long-term research. Viewed research as highly beneficial in advancing clinical knowledge, improving patient health outcome (utility value), producing new knowledge, gaining recognition (attainment value) as well as broadening personal scope of professional career and building sustainable problem-solving systems to identify solutions to key clinical problems (intrinsic value).
		AH Physiotherapists	1^Citation75
		AH, Nurses, Physicians	3^Citation56,Citation65,Citation66
		Physicians	4^Citation32,Citation69,Citation70,Citation73
		Nurses	1^Citation72
		Total	10
Competent	Positive – utility value	AH Pharmacists	4^Citation78,Citation80^–^Citation82	Multiple barriers	Competent and positive in their attitude, but they exhibited only utility value because connection with professional organisation was lacking
		AH, Nurses	1^Citation58
		AH, Nurses, Physicians	1^Citation59
		Physicians	2^Citation3,Citation91
		Physicians, Nurses	1^Citation88
		Nurses	3^Citation67,Citation71,Citation90
		Total	12
Competent	Negative – no connection to researchers	AH Psychologists	1^Citation53	Lack of organisational support	High confidence/competence levels, but they were negative and feared research Perception that research was not part of their job roles and there was no organisational support, so they did not see the connection with the research community
		Physicians	1^Citation89
		Total	2
Competent	Fear of Research	Nurses	1^Citation77	Lack of organisational support Lack of training/resources/dedicated research team	As above
		Total	1
		Total Competent	25
Lacks confidence requires support	Very positive – attainment, intrinsic and utility value	AH	1^Citation55	Lack of organisational support Lack of training/resources/dedicated research team	Lacked confidence but because of their predisposing personal qualities and exposure to research, which was facilitated by workplace research opportunities, they had very positive attitude towards research
		AH Physiotherapists	2^Citation85,Citation86
		Physicians	2^Citation16,Citation87
		Nurses	2^Citation68,Citation84
		Total	7
Lacks confidence requires support	Positive – utility value	AH	4^Citation52,Citation61,Citation62,Citation64	Lack of organisational support Lack of training/resources/dedicated research team Lack of support including acceptance by colleagues, reward, and acknowledgement	Perceived only the utility value
		AH Physiotherapists	1^Citation93
		AH, Nurses	1^Citation79
		AH, Nurses, Physicians	1^Citation92
		Nurses	2^Citation57,Citation83
		Total	9
Lacks confidence requires support	Negative – no connection to researchers	AH Pharmacists	1^Citation76	Lack of organisational support Lack of training/resources/dedicated research team Lack of knowledge	Perceived that it had no value and involved a lot of personal cost for limited personal gain
		Nurses	1^Citation74
		Total	2
Lacks confidence requires support	Fear of Research	AH	1^Citation63	Lack of organisational support Lack of training/resources/dedicated research team	Perceived that it had no value and involved a lot of personal cost for limited personal gain
		AH Speech language pathologists	1^Citation54
		Total	2
		Total Lacks confidence requires support	20

Abbreviations: EVC, expectancy-value theory; SDT, self-determination theory; HMR, translational health and medical research; HPs, health professionals; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; EVC, expectancy-value-cost model of motivation; QATSDD, Quality Assessment Tool for Studies with Diverse Designs.

Figure 2 Process of motivation to do research.

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