Objective Combining research with clinical practice has benefits for health services and practitioners. There is limited information available on strategies used by health professionals to balance research with high clinical service demands. The aims of the present study were to examine how research is initiated and to identify the factors that influence the successful integration of research into a clinical work role. Methods Semistructured recursive-style interviews were conducted with 15 research-active allied health professionals at regional health services using a combination of criterion and purposive sampling. Interviews were recorded, transcribed and analysed using constant comparative techniques to identify dominant themes, which were integrated to create a conceptual model. Results Becoming a clinician researcher involved four phases: (1) a research debut; (2) building momentum; (3) developing a track record; and (4) becoming an established clinician researcher. A research debut was enabled by pre-entry exposure to research or through quality activities, predisposing personal characteristics and research opportunities at work. Quarantined time for research, a research-friendly workplace culture and supportive research relationships enabled a clinician to thrive as a researcher despite the challenges. Conclusion The clinician researcher career trajectory contributes to a better understanding of how a research career commences and develops in clinical settings. It may assist to develop strategies to support research capacity building. What is known about the topic? There are potential benefits for clinicians and health services that flow from incorporating research into clinical roles. Factors that motivate, enable and constrain allied health research in clinical settings have been identified, but little is known about how a research career is initiated and progresses over time. What does this paper add? The present study contributes an important career path understanding to the successful development of research capacity from a clinician perspective. The clinician researcher career trajectory delineates four phases and identifies enabling and constraining factors. The study highlights the combination of factors that can initiate a research debut and lead clinicians to thrive as researchers. What are the implications for practitioners? Conducting research can provide an opportunity for a professional challenge and increased job satisfaction. A research-friendly environment, supportive research relationships and quarantined time for research contribute to research output in clinical settings.

SummaryBreast cancer-related lymphoedema (BCRL) is a debilitating, distressing condition affecting approximately one in five breast cancer survivors (Clark B, Sitzia J, Harlow W. Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study. QJM 2005;98:343-8). The evidence-base for breast cancer-related lymphoedema risk reduction advice is scant and contradictory, with most studies in the area limited by small numbers, retrospective design and other methodological inadequacies. Current advice has the capacity to profoundly alter quality of life following treatment for breast cancer. Health professionals should review the risk reduction advice they provide to reflect the current understanding of aetiology and risk factors. Further research is required to provide more evidence for the content, to identify optimal methods of precautionary education delivery and to determine the effect of the advice on the patient's quality of life and perception of recovery.

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Objective: To evaluate the development and implementation of the Allied Health Rural Generalist Program, a two-level online post-graduate education program, which includes Level 1, an entry-level non-award pathway program, and Level 2, a Graduate Diploma in Rural Generalist Practice. Design: A convergent mixed methodology evaluation in two overlapping stages: a process evaluation on quality and reach, together with a mixed method case study evaluation on benefits, of the program. Setting: Rural and remote Australia across ten sites and seven allied health professions: dietetics; occupational therapy; pharmacy; physiotherapy; podiatry; radiography; speech pathology. Participants: Process evaluation included 91 participants enrolled in all or part of the Rural Generalist Program. Case study evaluation included 50 managers, supervisors and Rural Generalist Program participants from the ten study sites. Interventions: The Allied Health Rural Generalist Program. Main outcome measures: Process evaluation data were derived from enrolment data and education evaluation online surveys. Case study data were gathered via online surveys and semi-structured interviews. Quantitative and qualitative data were collected concurrently, analysed separately and then integrated to identify consistency, expansion or discordance across the data. Results: The Rural Generalist Program was viewed as an effective education program that provided benefits for Rural Generalist Program participants, employing organisations and consumers. Key improvements recommended included increasing profession-specific and context-specific content, ensuring Rural Generalist Program alignment with clinical and project requirements, strengthening support mechanisms within employing organisations and ensuring benefits can be sustained in the long term. Conclusion:The Rural Generalist Program offers a promising strategy for building a fit-for-purpose rural and remote allied health workforce.

Objective. Delegation and skill sharing are emerging service strategies for allied health (AH) professionals working in Queensland regional cancer care services. The aim of the present study was to describe the consistency between two services for the types and frequency of tasks provided and the agreement between teams in the decision to delegate or skill share clinical tasks, thereby determining the potential applicability to other services.Methods. Datasets provided by two similar services were collated. Descriptive statistical analyses were used to assess the extent of agreement.Results. In all, 214 tasks were identified as being undertaken by the services (92% agreement). Across the services, 70 tasks were identified as high frequency (equal to or more frequently than weekly) and 29 as not high frequency (46% agreement). Of the 68 tasks that were risk assessed, agreement was 66% for delegation and 60% for skill sharing, with high-frequency and intervention tasks more likely to be delegated.Conclusions. Strong consistency was apparent for the clinical tasks undertaken by the two cancer care AH teams, with moderate agreement for the frequency of tasks performed. The proportion of tasks considered appropriate for skill sharing and/or delegation was similar, although variation at the task level was apparent. Further research is warranted to examine the range of factors that affect the decision to skill share or delegate.What is known about the topic? There is limited research evidence regarding the use of skill sharing and delegation service models for AH in cancer care services. In particular, the extent to which decisions about task safety and appropriateness for delegation or skill sharing can be generalised across services has not been investigated. What does this paper add? This study investigated the level of clinical task consistency between two similar AH cancer care teams in regional centres. It also examined the level of agreement with regard to delegation and skill sharing to provide an indication of the level of local service influence on workforce and service model decisions. What are the implications for practitioners? Local factors have a modest influence on delegation and skill sharing decisions of AH teams. Practitioners need to be actively engaged in decision making at the local level to ensure the clinical service model meets local needs. However, teams should also capitalise on commonalities between settings to limit duplication of training and resource development through collaborative networks.