Options for Meaningful Engagement in Clinical Research for Busy Frontline Clinicians

Abstract

In order for health care innovations to be effective and actionable, they must align with the needs and practice patterns of those delivering care at the bedside. While research has started to incorporate the patient voice, it has yet to fully invest in the expertise of frontline clinicians. Frontline clinicians carry a wealth of clinical knowledge and the lived experience of providing realworld medical care that the research community seeks to improve. We consider options for clinicians as research stakeholders along a continuum of engagement as outlined by the UCSF Clinical and Translational Science Institute from minimal to supportive to participatory. In order to make an effective value proposition to support reallocation of clinician time to research engagement, we advocate evaluating the impact of clinicians as stakeholders at both the process level (e.g., clinician satisfaction, study recruitment rates) and endpoint level (e.g., clinical outcomes). Investing in clinicians as research stakeholders can offer benefits for the individual, health system, and population by increasing the generalizability, adoption, and sustainability of effective interventions.

Optimizing team science in an academic medical center: A qualitative examination of investigator perspectives

“…There is little evidence to suggest that physicians are increasingly gravitating to research careers, despite widespread recognition that physician engagement in research is critical to advance clinical care [28]. Given that frontline physicians have the knowledge and lived experience of providing medical care that researchers seek to improve, it is critical to ensure their involvement in research geared toward translating healthcare innovations to improve patient care and clinical outcomes [29,30]. This study noted that the engagement of early-career physicians in multidisciplinary teams had positive impact on interest in pursuing further research and that efforts to facilitate transdisciplinary team science by involving physicians within an academic medical center through the provision of dedicated funding resources was effective in increasing physician engagement, suggesting that barrierremoving engagement from clinical, research, and organizational leadership [31] may be essential to continued progress.…”

Context-specific adaptation of an eHealth-facilitated, integrated care model and tailoring its implementation strategies—A mixed-methods study as a part of the SMILe implementation science project

“…While stakeholder inclusion is an adaptation process that helps ensure that the approach is appropriate, feasible, and acceptable (104), it is also time-, resource-and effort-intensive (31,105). For interventions in chaotic, resource-competitive clinical settingsparticularly compared to the controlled environment of a research setting-including stakeholders is especially difficult (99, 106): numerous environmental factors (especially limited time and funding) can act as barriers to participation in clinical research projects (107,108). For example, for many stakeholders, involvement requires skills and competences both to present their own opinions and interests and to argue for or against those of others (31, 105).…”

Frontline Clinician Appraisement of Research Engagement: “I feel out of touch with research”

“…Clinician engagement in research endeavors stands to positively impact the generalizability of study findings and adoption into clinical practice thus improving patient care. 7 We undertook a quality improvement study within one Veteran Affairs (VA) Healthcare System to determine the barriers, facilitators, and solutions to optimal clinician engagement in the research enterprise. The purpose of this QI initiative was to form the foundation of our frontline clinician engagement efforts at our research center.…”

“…Desired Degree of Engagement As full-time clinicians, participants discussed their desired level of engagement with research as not generally a part of their job role. Given the following definitions, adapted from Goldstein et al, 7 participants discussed where they were willing to engage: supportive, recognizing that research is important to the VA mission and you allow access to your patients; informant, recognizing potential research topics in your service and report on them; Involved, acting on information generated by a study; collaborator, actively involved in the research process and share your thoughts and ideas with leaders; and leader, leading a research investigation. Supportive, informant, involved, and collaborator were endorsed widely across the sample while only two (both social workers) chose Leader.…”