Assessing research capacity and capability (RECAP) in HCPs: A collaborative pilot study in Leeds Children’s Hospital

Description

Aims

• To convert the Research and Development (R&D) Culture Index into an electronic format (the e-R&D Culture Index) that can be administered via email and which respondents can complete online
• To assess the feasibility of administering the e-R&D Culture Index to all health-care professional staff in Leeds Children’s Hospital (LCH), part of the wider to assess its potential for research capability and capacity building
• To assess the feasibility of extending the research to other settings.

Method study design

An anonymous electronic questionnaire was created using the Bristol Online Survey in summary, the questionnaire comprises: Section 1: Demographic details; Section 2: the 16 item index scored on a 4-point Likert scale from strongly disagree to strongly agree (0-3) comprising 16 items, respondents also be asked to identify and rank the five items they perceive to most strongly contribute to R&D culture and explain their reasons using open-ended text-based comments. Section 3: Seven open ended questions, free-text qualitative answers to determine respondents’ research training needs and experience.

After obtaining approval from SHREC and LCH Research Strategy Group, the researcher appointed (CS) attended staff meetings to briefly introduce the survey, explain its purpose, reassure staff of anonymity if they prefer, and answer any queries. All registered health-care professionals in LCH then received a link to the survey in an email via an existing distribution list. The email also contained an invitation to participate in the survey, a Participant Information Sheet, researcher contact details for any queries, and the survey closing date. After 3 weeks a second email /link to the survey was sent thanking those who already participated and inviting non-respondents to complete the questionnaire within 1 week.

Response rates to the first and second emails and the overall response rate were estimated with 95% CIs.  All items on the questionnaire were  examined for completeness of response.  Respondents’ characteristics were summarised descriptively using numbers and percentages or means and standard deviations as appropriate, and compared between key groups such as doctors, nurses, physiotherapists and by grade using unpaired t-tests and one-way ANOVA for continuous variables and Chi-square and related tests for categorical variables. The primary aim of the analysis was to model the dependence of the R&D Culture Index Score on the explanatory variables obtained from the questionnaire using multiple linear regression and to further explore the dependence using decision tree analysis. Descriptive data were analysed using IBM SPSS Statistics 22.  Free text, qualitative data were analysed using Framework Analysis which is flexible, systematic, and rigorous, offering clarity, transparency, an audit trail, an option for theme-based and case-based analysis and for readily retrievable data.

The results will guide strategy in promoting and supporting professionals’ engagement with research in LCH. Lessons learned from the pilot will inform the development of a full grant application to an external funder for a national survey in all UK children’s hospitals. This study has the potential to generate results to inform ongoing national capacity / capability building in the child health workforce, and could also pave the way for a similar survey in the wider LTHT.

Summary

The proposed study will enable us to: create an innovative e-R&D Culture Index, assess R&D culture amongst health professionals in LCH, test out the procedures for administering the index and analyzing data, and gauge its potential for research capability/capacity building, and of extending our design and methodology to LTHT and other UK Children’s Hospitals.

Background

There is a growing emphasis in the NHS on clinical decision-making that builds on rigorous evidence. The NHS Executive and DoH research strategies seek to maximise research outcomes and develop the evidence base to improve quality and outcomes. Research is, therefore, ‘everybody’s business’, it is central to the NHS and to clinical decision-making [2, 3]. In UK Children’s hospitals the particular challenge is: …” how to harness this evidence and momentum and turn it into improved outcomes for our current and future generations of children and young people” [1:1] when research engagement by health-care professionals is poor [4-6]. There is little consensus in the literature to explain this limited research engagement, and efforts to promote R&D cultures in different contexts have been thwarted by a prevailing perception of research as an activity that is remote from the ‘real world’ of practice, and a lack of supportive infrastructures [7]. In order to promote research engagement amongst professionals we first need to assess current levels of research capacity and capability and examine the factors affecting staff aptitude for using or undertaking research. This knowledge can guide strategies to promote a culture where research activity and evidence-based, clinical decision-making are truly central.

The R&D Culture Index (the index) was developed by a team including the lead applicant of this current proposal [8] and is a valid and reliable tool to provide evidence on which to build research capacity and capability. The index was developed in a large acute hospital NHS Trust to identify personal and organisational development needs and to guide strategy in promoting and supporting nurses’ engagement with research. The pilot instrument was later distributed to nurses in three different types of Trust. Factor analysis of the combined data sets found the index provided an efficient means of assessing the strength of an organisation’s R&D culture in a way that captures the role of individuals and the organisational environment.  Three factors were identified: R&D Support (Cronbach’s alpha 0.86); Personal R&D Skills and Aptitude (Cronbach’s alpha 0.80) and Personal R&D Intention (Cronbach’s alpha 0.75). Each factor and the overall index had good internal reliability.
The index was subsequently used in other types of Trusts, in other countries and with other disciplines e.g.  [9, 10]. However, to our knowledge, R&D culture has not been assessed using such a rigorously developed tool as the R&D Culture Index with multidisciplinary teams in a UK Children’s hospital or in a Teaching Hospital NHS Trust. Therefore, the proposed pilot will assess the current level of research activity and culture of all registered healthcare professionals in LCH using the index. This will serve as a precursor to a national survey in all UK Children’s Hospitals and the wider Leeds NHS Trust. The study will provide LCH with evidence on which to build future research capacity and capability, and will test out mechanisms and assess response rates to inform a future application for a LTHT-wide survey and in all 25 UK children’s hospitals.

People

Prof Veronica Swallow (PI), Dr Linda Milnes, Dr Heather Iles-Smith, Cilla Sanders, Prof Steve Ersser, Hollis,  Munyombwe, Stanton

Funding body: School of Healthcare Research Pump Priming Fund  £800

Contact: Veronica Swallow