Expanding postgraduate clinical research capacity: an exploration of key resistances

ABSTRACT

There have been increasing calls in healthcare for the development of a more robust evidence base. Facilitating research activity amongst clinicians is the primary means of achieving this, although engagement is often undermined by a number of barriers and resistors. This article identifies and explores the forms of resistance that graduates from three postgraduate healthcare education programmes have encountered on their return to practice. This study employed a collective case study approach and gathered data from 29 semi-structured interviews. Thematic analysis revealed a range of challenges, both anticipated and unexpected, which related to research engagement. Four forms of resistance were subsequently identified: managerial, medical, organisational and interprofessional. In exploring these forms of resistance, it became apparent that barriers to research engagement are not only contextually determined but also rooted in enduring social perceptions, role insecurity and professional protectionism. The study also found that, whilst research engagement was rhetorically supported, organisations offer very little tangible assistance to potential clinical researchers. A particular type of education has proved manifestly disruptive in this instance, and this disruption will need to be recognised as curricula are adjusted and developed. Further exploring the identified miscommunication between education and practice will also be of particular value to both fields.

KEYWORDS:

• postgraduate education
• clinical research
• resistance
• professional disruption

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London (NIHR CLAHRC South London) at King’s College Hospital NHS Foundation Trust. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

Notes on contributors

Simon Fletcher

Dr Simon Fletcher has a background in sociology. Building on his PhD, which explored the cultural dynamics surrounding intergenerational touch between PE teachers and pupils, his work in the Faculty of Health, Social Care and Education has focused on interprofessional interaction and its associated socio-cultural implications for healthcare.

Cheryl Whiting

Dr Cheryl Whiting has a professional background in radiography and is an Associate Professor within the Faculty of Health, Social Care and Education. Her professional roles and responsibilities have been substantive, particularly in relation to enhancing the student experience and progressing educational policy and practice.

Annette Boaz

Professor Annette Boaz is a social scientist evaluating the impact of research on policy and practice. In addition, she has expertise in service improvement research and patient involvement in and experience of research.

Scott Reeves

Professor Scott Reeves is a social scientist who has been undertaking the education of health professionals and health service research for over 20 years. His main interests are focused on developing conceptual, empirical and theoretical knowledge to inform the design and implementation of interprofessional education and practice activities.