Building Research Capacity in Allied Health: New Decade, New Challenges and New Opportunities
It is well recognised that research can play an integral role in the delivery of safe, effective, efficient, patient-centred, accessible and timely health care. Evidence Based Practice, for instance, recognises the importance of research to health care and argues the need for clinical practice to be informed by the best available research evidence (along with clinical expertise and patient values). While the importance of, and the need to develop, research in health care, especially in the medical and nursing fields has been well document, what about allied health professions? The drivers for building research capacity in allied health are no different to that of other health professions. Research in allied health can assist in minimising overuse, underuse and misuse of precious health care services. It can help grow the body of evidence for allied health professions, many of which have a limited evidence base. Research can help test and evaluate new and innovative approaches in areas where there is an emerging need for allied health professions to play a key role (such as chronic disease management). Research in allied health can also provide an avenue for career progression and development for allied health professionals as they embark on new models of service delivery (such as advanced and extended scope of practice). Research can help to develop professional esteem and credibility and ensure allied health professionals are at the same levels as their fellow health care practitioners. Last but not least, research within allied health professions may also be part of the professional requirements of individual professional groups as a component of ongoing registration requirements.
While the drivers for research in allied health are well established, there continues to be key challenges in expanding this concept further in allied health. Some of these challenges include the definition of allied health, the diverse roles and responsibilities of allied health professionals, the mix of research training and skills among allied health professions (Pickstone et al 2008), just to name a few. While acknowledging these inherent challenges in allied health, it is important to explore opportunities for building research capacity in allied health professions. Not surprisingly, the literature evidence for research capacity building is limited to medical and nursing literature. Generalising this body of evidence to allied health should be undertaken with caution due to allied health centric issues highlighted before. So, how can allied health move forward with regards to building research capacity?
Before we discuss how to build research capacity in allied health, it is important to reflect on the definition of research capacity building. While there is no agreed definition (we have come across seven different definitions), the one which is routinely cited is by Trostle (1992). According to Trostle, research capacity building is the process of individual and institutional development which leads to higher levels of skills and greater ability to perform useful research (pg 1321). Cooke et al (2005) expand on this definition further and highlight that research capacity building should be underpinned by six key principles. They are developing skills and confidence, supporting linkages and partnerships, ensuring the research is 'close to practice', developing appropriate dissemination, investing in infrastructure, and building elements of sustainability and continuity. Based on these principles, it is clear that research capacity building is much more than just focussing on individuals. Rather, it is a complex process which should target the individual, team, organisation and networks.
When operationalising research capacity building in practice, it must be recognised that it is unrealistic to expect all allied health professionals to be active researchers. What is realistic is the expectation that all allied health professionals, irrespective of their position, are cognisant of emerging research (evidence) from their respective fields, are regularly updated and incorporate it into their routine clinical practice. McPhee and colleagues (2005) term these allied health professionals as research consumers. The next level of allied health professionals might be a smaller group who are actively involved in research initiatives. These research active allied health professionals might collaborate with a university-based research team or may undertake higher education in the form of postgraduate or doctoral research. The next level of allied health professionals are research leaders who spearhead research activities in a clinical setting and may also have an active clinical role. These research leaders have the knowledge, skills and understanding of research processes and can lead groups of allied health professionals as part of a research team. Therefore, the science of research capacity building can be considered as three distinct domains; research for practice: where research is conducted by academic researchers to inform clinical practice; research through practice: where research is conducted in collaboration between academics and practitioners; research by practice: where research is conducted by practitioners.
Literature evidence is scant on the effectiveness of models, strategies and outcomes for research capacity building in allied health. However, what is clear from the literature is that there is no one size which fits all and there are a number of factors which need to be taken into account when building research capacity. These include dedicated time and resources, mentoring, clarity and clear goal setting, involvement of users, collaboration and linkages, dissemination and outputs, continuity and sustainability and organisational support. These critical success factors, along with recognising and addressing local contexts, are likely to play a key role in the success of any research capacity building initiatives in allied health. Therefore, in allied health, as we move forward with research capacity building initiatives, it is imperative to consider a broad range of strategies, over a long term, to achieve sustainable and wide ranging outcomes. It is also important that processes and outcomes from these initiatives are widely disseminated as they can contribute to the evidence base for research capacity building in allied health and act as learnings for allied health communities.
Cooke, J. 2005, A framework to evaluate research capacity building in health care, BMC Family Practice, vol.6, no.44. doi:10.1186/1471-2296-6-44.
McPhee, K., Nancarrow, S., Cooke, J., Hammersley, V. Building research capacity in the allied health professions: approaches, benefits and barriers, http://www.sapmea.asn.au/conventions/alliedhealth/presentations/Nancarrow,%20Susan%20ah146.ppt Accessed 5th April 2010.
Pickstone, C., Nancarrow, S., Cooke, J., Vernon, W., Mountain, G., Boyce, R., Campbell, J. 2008, Building research capacity in the allied health professions, The Policy Press, vol. 4, no.1, pp. 53-68.
Trostle, J. 1992, Research capacity building and international health: definitions, evaluations and strategies for success, Social Science and Medicine, vol.35, no.11, pp. 1321-4.
Kumar S. Building Research Capacity in Allied Health: New Decade, New Challenges and New Opportunities. The Internet Journal of Allied Health Sciences and Practice. 2010 Apr 01;8(2), Article 3.