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

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Health services research can benefit from frontline clinician input across all stages of research, yet their key perspectives are often not meaningfully engaged.

          Objective

          How can we improve clinician engagement in research?

          Design

          Convenience sampling and semi-structured interviews followed by descriptive content analysis with an inductive approach, followed by group participatory listening sessions with interviewees to further contextualize findings.

          Participants

          Twenty-one multidisciplinary clinicians from one healthcare system.

          Key Results

          We identified two major themes: perceptions of research (how research fits within job role) and characterizing effective engagement (what works and what does not work in frontline clinician engagement). “ Perceptions of Research” encompassed three subthemes: prior research experience; desired degree of engagement; and benefits to clinicians engaging in research. “ Characterizing Effective Engagement” had these subthemes: engagement barriers; engagement facilitators; and impact of clinician’s racial identity.

          Conclusions

          Investing in frontline clinicians as research collaborators is beneficial to clinicians themselves, the health systems that employ them, and those for which they care. Yet, there are multiple barriers to meaningful engagement.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s11606-023-08200-9.

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          A Tong, P SAINSBURY, J. Craig (2007)
          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

            Laura Damschroder, David Aron, Rosalind E Keith … (2009)
            Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. Conclusion The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings.
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              Saturation in qualitative research: exploring its conceptualization and operationalization

              Benjamin Saunders, Julius Sim, Tom Kingstone … (2017)
              Saturation has attained widespread acceptance as a methodological principle in qualitative research. It is commonly taken to indicate that, on the basis of the data that have been collected or analysed hitherto, further data collection and/or analysis are unnecessary. However, there appears to be uncertainty as to how saturation should be conceptualized, and inconsistencies in its use. In this paper, we look to clarify the nature, purposes and uses of saturation, and in doing so add to theoretical debate on the role of saturation across different methodologies. We identify four distinct approaches to saturation, which differ in terms of the extent to which an inductive or a deductive logic is adopted, and the relative emphasis on data collection, data analysis, and theorizing. We explore the purposes saturation might serve in relation to these different approaches, and the implications for how and when saturation will be sought. In examining these issues, we highlight the uncertain logic underlying saturation—as essentially a predictive statement about the unobserved based on the observed, a judgement that, we argue, results in equivocation, and may in part explain the confusion surrounding its use. We conclude that saturation should be operationalized in a way that is consistent with the research question(s), and the theoretical position and analytic framework adopted, but also that there should be some limit to its scope, so as not to risk saturation losing its coherence and potency if its conceptualization and uses are stretched too widely.
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                Author and article information

                Contributors
                Nathan A. Boucher:
                ORCID: http://orcid.org/0000-0002-5732-1927
                Nathan.boucher@va.gov
                Journal
                Journal ID (nlm-ta): J Gen Intern Med
                Journal ID (iso-abbrev): J Gen Intern Med
                Title: Journal of General Internal Medicine
                Publisher: Springer International Publishing (Cham )
                ISSN (Print): 0884-8734
                ISSN (Electronic): 1525-1497
                Publication date (Electronic): 18 April 2023
                Pages: 1-7
                Affiliations
                [1 ]GRID grid.512153.1, Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), , Durham VA Health Care System HSR&D, ; Durham, NC USA
                [2 ]GRID grid.26009.3d, ISNI 0000 0004 1936 7961, Sanford School of Public Policy, , Duke University, ; Durham, NC USA
                [3 ]GRID grid.26009.3d, ISNI 0000 0004 1936 7961, Department of Population Health Sciences, School of Medicine, , Duke University, ; Durham, NC USA
                [4 ]GRID grid.26009.3d, ISNI 0000 0004 1936 7961, Department of Medicine (Geriatrics), School of Medicine, , Duke University, ; Durham, NC USA
                [5 ]Duke-Margolis Center for Health Policy, Durham, NC USA
                [6 ]Cooperative Studies Program Epidemiology Center – Durham, Durham, NC USA
                [7 ]GRID grid.26009.3d, ISNI 0000 0004 1936 7961, Division of General Internal Medicine, School of Medicine, , Duke University, ; Durham, NC USA
                Author information
                http://orcid.org/0000-0002-5732-1927
                Article
                Publisher ID: 8200
                DOI: 10.1007/s11606-023-08200-9
                PMC ID: 10112825
                PubMed ID: 37072534
                SO-VID: f4a99a48-5019-453e-a6bc-5b07058e72a9
                Copyright © © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2023
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date received : 4 October 2022
                Date accepted : 5 April 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100018131, Durham Center of Innovation to ADAPT;
                Funded by: VA Health Services Research and Development CDA
                Award ID: #1IK2HX002407-01A2
                Award Recipient :
                Categories
                Subject: Original Research: Qualitative Research

                ScienceOpen disciplines: Internal medicine
                Keywords: clinicians,clinical research,health services research,quality improvement
                Data availability:
                ScienceOpen disciplines: Internal medicine
                Keywords: clinicians, clinical research, health services research, quality improvement

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