Multiprofessional perceptions of clinical research delivery and Clinical Research Nursing: Exploring the interface between clinical service delivery and clinical research delivery in the NHS

Introduction & Background
Clinical research activity generates multiple health benefits. Resistance/avoidance at the interface between research delivery and clinical service delivery may affect the success of research. Little is known about how those practicing alongside, yet outwith clinical research teams, view research delivery and the Clinical Research Nurse role.

Methods
A realist review was undertaken to first generate theories about the interface between research delivery and clinical service delivery. A group concept mapping (GCM) phase then tested one such theory by asking Nurses, Midwives and AHPs outwith research teams about their role in relation to the delivery of research. Participants sorted views thematically before considering their likelihood of generating resistance/avoidance behaviours and importance to address.

Results
The realist review generated 13 programme theories, one of which was tested in the GCM phase. Participants responded to an open-ended statement, then sorted and rated the dataset. Analysis produced a set of visual maps. The final concept map contained 99 unique statements sorted into 6 conceptual clusters 1. “We value & understand the importance of research”, 2. “How it should be & how we could work together”, 3. “Behaviours, beliefs & missed opportunities”, 4. “Dissonance & disengagement”, 5. “Time & capacity affects our ability to engage” and 6. “I keep thinking of ways to facilitate research as everyone’s business but it is hard”.
Rating revealed three clusters most likely to generate resistance/avoidance behaviours (three, four and five), and two as most important to address (two and five).

Conclusion
A range of contextual factors are likely to generate resistance/avoidance behaviours. Eliciting the views of participants practicing outwith research delivery structures provided an opportunity for new perspectives to be heard. Participants expressed a desire for time to engage with research and increased opportunities for those outside of clinical research delivery to be involved with supporting studies. Improved communication between clinical research delivery teams and clinical service delivery was considered pivotal to the success of research.