Building research capacity in speech and language therapy – Part 2

Research Facilitators to make the research process a little less daunting and overwhelmingSo as a Research Facilitator for SLT my remit was to increase research capacity in local NHS SLT services.The ultimate aim of this was to improve SLT services’ potential of taking part and leading large research projects which would be eligible for inclusion on the National Institute of Health Research’s Research Portfolio. This portfolio being a list of ‘high-quality’ clinical research within the UK which is funded directly through NHS funding streams or through streams that are open on a nationally competitive basis (i.e. where the researchers have applied for funding and where these applications have been judged alongside other competing bids). The long and short of this being that the more involvement in Portfolio research a particular NHS Trust has, the more money they will subsequently be alloted for research purposes in future cycles – so NHS Research and Development (R & D) offices are very keen on this!

However, not all SLTs have the personal desire to do such ‘high-quality research’ (which is fair enough) or the time allowed within their job description to do so even if it is an appealing proposition.Therefore, I saw my role as two-fold:1) to identify and support those who have the desire and committment to engage actively in research; and 2) to help develop core research skills with those, who while not considering research (at this stage), were still interested in developing their ability to conduct evidence based practice.

Those SLTs who were interested in being active in research were also at varying stages of experience both as researchers and also as SLTs in general and therefore my work with them also varied quite a bit but included:

  • linking SLTs up to appropriate academic partners and support
  • Support in developing seedling ideas into more substantial research questions and project ideas
  • guidance in developing project protocols and completing various application forms (e.g. funding applications, NHS Ethics, NHS Caldicott)
  • support in project management (e.g. working together to set timeframes, etc)
  • support with obtaining appropriate referrals to projects (e.g. by ‘gently reminding’ SLTs about particular projects and participant inclusion criteria)
  • support in finding ‘difficult to obtain’ research literature and resources
  • support in managing project data (e.g. storing data logically in Excel etc) and some basic statistical advice

Work with the second group of SLTs, i.e. those wanting to improve their basic research skills to support their EBP was perhaps a bit less clearly defined but some examples of this type of work included:

  • Delivering a short workshop on critical appraisal at a paediatric dysphagia SIG
  • Establishing a small-scale literature/journal searching and review network within one particular NHS SLT team
  • Facilitating one session with a different NHS adult staff group to come up with a plan to coordinate individuals’ CPD activities within a staff group around a particular theme that would ultimately lead to some kind of service improvement outcome
  • Attending regular NHS team meetings to update on research activities in the local vicinity to attempt to enthuse people (!)

One of the key things that I (and my job share partner) hopefully achieved was to work to change the working philosophy of some SLT departments who we worked closely with.We strongly encouraged departments to keep a visible record of questions and thoughts that individuals had with regard to things that arose from their clinical practice.For example, questions relating to the evidence base for assessment and therapy approaches, questions relating to the effectiveness or challenges that had come about through multidisciplinary team working, questions that generally related to service delivery issues and patient satisfaction.SLTs were encouraged to do this no matter how trivial the issue seemed to be as if there was already an answer to the question, it would encourage inter-departmental sharing of knowledge and ideas, or alternatively, if colleagues were also unsure over whether there was an answer to a particular issues, this may indicate a need to devote some CPD time to investigating the issues further.

Issues around ‘questions arising out of clinical practice’ were also followed up in a small workshop event that gathered together SLTs working across the North East across all caseloads.This aimed to give some brief background into the research environment and workings in the North East NHS Trusts.More importantly it gave clinicians with similar interests time to get together and share experiences and get some seedling ideas of things they’d be interested in taking further.This was especially beneficial for those SLTs working in relatively small teams (or even in isolation) and in specialist caseloads where inter-team discussion is often restricted or non-existent.Such events therefore looked to bridge the divide between the two groups of SLTs I previously identified by:i) raising awareness of issues affecting particular clinicians, or ideally groups of clinicians; ii) getting them to talk about these issues to allow workable ideas and action plans to develop; and iii) then for myself and my jobshare partner to follow these specific ideas up in follow-up meetings.

So rather than having SLTs turn up to this event and log it as 3 hours towards their CPD and ‘move on’, the idea was that with myself and my jobshare partner in place as Research Facilitators, we had the capacity and the skills to follow-up any ideas that came out of the event in the hope that some ideas would come to fruition.  And, this did happen with three separate SLTs whose ideas were taken forward and fleshed out in a bit more detail and these clinicians got to a stage where they could be in a position to act on these ideas (e.g. apply for funding), if and when they are ready to seriously embark on this from a personal perspective and also when they have the flexibility to do so within their particular service (i.e. if their caseload demands allow it).

Finally, one of the other things that came out of the work of the Research Facilitators was the development of a website which served to promote the research activities in the North East of England and also served as a signpost for SLTs to access which could point the way to useful resources for all aspects of research.This website is located at http://research.ncl.ac.uk/slt/ and while it does need some updating should provide a bit more of a detailed overview of some of the things I have talked about previously.

Hopefully, you are now thinking, “hmm Research Facilitators that are specific to SLT sound really useful and I wish there were more of them around“. Well unfortunately, in my case at least, the funding for role was initially only guaranteed for a 12 month period and when it came to reapplying for further funding this was denied by local NHS R&D through their Flexibility and Sustainability funding allocation . My interpretation on why this was denied is to do with the competition for this money. On balance, SLT is a relatively small profession in comparison to the medical profession, so if for example 5% of each profession are research active, the sheer number of medics who have the capacity to take part and attract ‘high quality’ research simply dwarfs the numbers from SLT. This is in spite of their being evidence to suggest SLT as being a more research engaged profession than other healthcare professions, at least in terms of percentage proportions (Metcalfe et al, 2001). So from R&D’s perspective, I can appreciate the decision although it was frustrating given what was achieved within what is, in research terms, a relatively short space of time. For example, during the 12 months that I was in position, I worked with one SLT to develop a research protocol, apply for and obtain a small amount of funding to ‘buy out’ some time from clinical duties, get the project off the ground through to the data analysis stage to the point where some findings could be presented at a local Allied Health Professionals research showcasing event (not bad for 12 months work if you ask me).

So once again this has been a bit of a lengthy posting but as Part 1 generated quite a bit of a response in comments in this blog and via my Twitter I’ll be interested to see how this ‘Research Facilitator’ position does compare to existing services that are out there in other parts of the UK and the world. And generally – do we as a profession need more people doing these kind of things to support development of research capacity in clinical SLT contexts? One of the major issues that we were faced with is justifying our existence as a profession specific service as opposed to a more general allied health service. This is an interesting debate in itself and one which probably doesn’t have a straightforward answer. Maybe it is something to do with the North East though as Newcastle University have been the first to develop a specific Masters degree programme focusing on Evidence Based Practice in Communication Disorders as opposed to a general EBP in Healthcare programmes.

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About chrissp1980
Currently a lecturer in speech pathology in North Queensland, Australia. I'm lecturing in acquired disorders of speech and language and also attempting to enthuse students in conducting clinically-relevant projects using principles of Evidence-Based Practice. Wish me luck!

2 Responses to Building research capacity in speech and language therapy – Part 2

  1. Anthony Caldwell says:

    I was really interested to read this blog. I am currently doing an MSc at City Uni, London, while working full-time for the NHS in Kent. Now that funding is being more closely linked to outcome measures, it would seem absolutely essential for the future of the profession that research capacity becomes a fundamental part of speech and language therapy service structure.
    We could really use a Research Facilitator in our service.

    • chrissp1980 says:

      With regard to the need for someone to facilitate research I do think there is some onus on the clinician, or ideally a team of clinicians to show interest in doing research. In the NHS Trust that I did most of my work with, the line manager was aware that there were several project ideas just bubbling under the surface so she was instrumental in establishing the Research Facilitator post (although I did not work solely with one particular Trust). It probably varies depending on the particular line manager but if there is a demonstrated interest coming from the clinicians working within a particular team, then the line manager may/should have contacts in R&D offices who may be able to identify any existing support that may be available (e.g. through their own staff, or possibly through NIHR Clinical Research Networks) or alternatiuvely it may provide impetus for something to happen around this area.

      I think you (or any SLT) would be in a strong position to request support if you have a clear propsotion of what you need and why.

      In Kent for example there is the Kent and Medway Comprehensive Local Research Network which may have some services you can access (http://www.crncc.nihr.ac.uk/about_us/ccrn/kent_medway), although again, this is primarily targetted at researchers who are likely to be conducting research eligible for the NIHR Research portfolio.

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