Development, implementation and evaluation of a clinical research engagement and leadership capacity building program in a large Australian health care service

Pushing the Boundaries for Evidenced-Based Practice: Can Online Training Enhance Andrology Research Capacity Worldwide? An Exploration of the Barriers and Enablers - The Global Andrology Forum

PURPOSE

This is the first study to design and assess a research capacity building (RCB) specifically tailored for clinical and non-clinical andrology practitioners worldwide. We appraised: 1) the barriers and enablers to research among these practitioners; 2) attendees' satisfaction with the webinar; and 3) research knowledge acquisition as a result of the webinar (before/after quiz).

MATERIALS AND METHODS

A online RCB webinar was designed, comprising two presentations in research design and systematic review/meta-analysis (SR/MA). An online survey using validated published questionnaires assessed the three above-stated objectives. Paired t-test compared the means of the pre- and post-webinar scores. Subgroup analysis was performed on the participants' professional background, sex, and number of years in practice.

RESULTS

A total of 237 participants attended the webinar, of which 184 completed the survey and are included in the current analysis. Male participants were about double the females and 60.9% were from Asian countries. The most common research enablers were to publish scientific papers (14.8%) and to develop research (14.7%) or new skills (12.7%). The most common barriers were the lack of training in research (12.4%), training in research software (11.8%), and time for research (11.8%). Satisfaction with the webinar was considerably high (86.3%-88.4%) for the different features of the webinar. Compared to the pre-webinar knowledge level, there were significant improvements in participants' research knowledge acquisition after the webinar in terms of the total score for the quiz (13.7±4.31 vs. 21.5±4.7), as well as the scores for the study design (7.12±2.37 vs. 11.5±2.69) and SR/MA sessions (6.63±2.63 vs. 9.93±2.49) (p<0.001 for each).

CONCLUSIONS

Clinical and non-clinical andrology webinar attendees recognized the importance of research and exhibited a range of research skills, knowledge and experience. There were significant improvements in the participants' knowledge and understanding of the components of scientific research. We propose an RCB model that can be implemented and further modeled by organizations with similar academic research goals.

Inter-hospital variation in data collection, radiotherapy treatment, and survival in patients with head and neck cancer: A multisite study

BACKGROUND AND PURPOSE

Inter-hospital inequalities in head and neck cancer (HNC) survival may exist due to variation in radiotherapy treatment-related factors. This study investigated inter-hospital variation in data collection, primary radiotherapy treatment, and survival in HNC patients from an Australian setting.

MATERIALS AND METHODS

Data collected in oncology information systems (OIS) from seven Australian hospitals was extracted for 3,182 adults treated with curative radiotherapy, with or without surgery or chemotherapy, for primary, non-metastatic squamous cell carcinoma of the head and neck (2000-2017). Death data was sourced from the National Death Index using record linkage. Multivariable Cox regression was used to assess the association between survival and hospital.

RESULTS

Inter-hospital variation in data collection, primary radiotherapy dose, and five-year HNC-related death was detected. Completion of eleven fields ranged from 66%-98%. Primary radiotherapy treated Tis-T1N0 glottic and any stage oral cavity and oropharynx cancers received significantly different time-corrected biologically equivalent dose in two gray fractions (EQD2T) by hospital, with observed deviation from Australian radiotherapy guidelines. Increased EQD2T dose was associated with a reduced risk of five-year HNC-related death in all patients and those treated with primary radiotherapy. Hospital, tumour site, and T and N classification were also identified as independent prognostic factors for five-year HNC-related death in all patients treated with radiotherapy.

CONCLUSION

Unexplained variation exists in HNC-related death in patients treated at Australian hospitals. Available routinely collected data in OIS are insufficient to explain variation in survival. Innovative data collection, extraction, and classification practices are needed to inform clinical practice.

Describing the evidence-base for research engagement by health care providers and health care organisations: a scoping review

BACKGROUND

Having a research-engaged health and medical workforce is associated with improvements in clinical outcomes for patients. As such, there has been significant government investment internationally to support health care organisations and services to increase staff engagement with research.

OBJECTIVES

This scoping review sought to provide an overview of the literature describing strategies employed to increase research engagement by health care providers and organisations, and to undertake a qualitative analysis to generate a list of research engagement strategies.

METHODS

A scoping review using systematic search strategies was undertaken to locate peer-review publications and grey literature related to research engagement by health care providers and organisations. Research engagement was defined as a 'deliberate set of intellectual and practical activities undertaken by health care staff and organisations to conduct research'. A database search of electronic records was performed with no limit on publication date. Publications were included regardless of study type (excluding systematic reviews) and categorised as either databased (presenting data or new analysis of existing data) and non-databased (no new data or analyses). Databased publications were further classified according to study type, study design and setting. A qualitative synthesis using a Framework Approach was undertaken with all studies that described a strategy to improve research engagement.

RESULTS

A total of 152 publications were included in this study with 54% categorised as non-databased. Of the databased articles, the majority (72%) were descriptive studies describing prevalence of correlates of research engagement, 17 (25%) described intervention studies where only two were controlled studies. The following research engagement strategies were identified: i) dual skilled team/staff, ii) resources or physical infrastructure, iii) incentives, iv) leadership support of research, v) education/training, vi) networks, vii) forming partnerships or collaborations and viii) overall leadership structure of entity.

CONCLUSIONS

The literature on research engagement is primarily opinion-based and descriptive in nature. To provide the evidence needed to inform strategies, this needs to progress beyond descriptive to more rigorous well-designed intervention research.

A capability framework to inform the fundamental requirements for clinical trial unit development, growth and long term success in outer metropolitan and rural areas

Background

Participation in clinical trials is linked to improved patient outcomes. Despite this, most trial participants either reside in, or are treated in metropolitan areas. TrialHub developed hub-and-spoke models to support and grow clinical trial units in outer metropolitan and regional/rural centres in order to boost clinical trial engagement and reduce demands of trial participation on patients from outer metropolitan and regional/rural areas. The aim of this project was to establish a capability framework for clinical trial unit growth and development.

Methods

An integrative methods study design was used to inform the co-design and development of the capability framework based on data collected in Victoria during 2020-21. This included reviews of the literature and of existing local resources, infrastructure, and staffing; as well as education, mentoring and support, and a needs assessment through multidisciplinary working groups.

Results

We developed a capability framework based on the level of support required for outer metropolitan and regional/rural centres with diverse existing capabilities across Victoria. The framework applies a maturity model to assess resources, processes and practices which impact the capacity and capability of centres to conduct trials safely and sustainably. Each level of the model uses a consistent set of factors to describe the core elements required for safe clinical trial delivery. This benchmarking allows targeted investment to ensure safe and high-quality delivery of trials at newly establishing trial units.

Conclusion

The capability framework developed by TrialHub provides a basis for staged, planned and successful trial unit development and trial implementation. Further validation of the framework is required.

Research Ready Grant Program (RRGP) protocol: a model for collaborative multidisciplinary practice-research partnerships

Background

Little attention has been given to the process of implementing or evaluating a structured academic–clinician (university–health service) research capacity-building (RCB) model within healthcare settings. We have developed a model for collaborative multidisciplinary practice–research partnerships called the Research Ready Grant Program (RRGP). The RRGP is informed by Cooke’s (BMC Fam Pract 6:44, 2005) RCB framework and principles. The aim of the study outlined in this protocol is to conduct a process and outcome evaluation of the programme. We will explore how the RRGP's structured mentor model contributes to RCB of clinician-led multidisciplinary research teams. We will identify key factors at the organization, team and individual levels that affect research capacity of health professionals working in one regional health service district. This protocol describes the RRGP design and outlines the methods we will employ to evaluate an RCB programme, the RRGP, delivered in a regional health service in Australia.

Methods

The study will adopt an exploratory concurrent mixed-methods approach designed to evaluate the process of implementing an RCB model across one regional hospital and health service. Both quantitative and qualitative data collection methods over a 12-month period will be implemented. Data triangulation will be applied to capture the complex issues associated with implementing collaborative multidisciplinary practice–research partnerships.

Discussion

The RRGP is an innovative RCB model for clinicians in their workplace. It is expected that the programme will facilitate a culture of collaborative multidisciplinary research and strengthen hospital–university partnerships.

An impact review of a Western Australian research translation program

The translation gap between knowledge production and implementation into clinical practice and policy is an ongoing challenge facing researchers, funders, clinicians and policy makers globally. Research generated close to practice and in collaboration with end users is an approach that is recognised as an effective strategy to facilitate an improvement in the relevance and use of health research as well as building research capacity amongst end users. The Research Translation Projects (RTP) program funded by the Western Australian (WA) Department of Health facilitates clinical and academic collaboration through competitive funding of short-term research projects. Its aim is to improve healthcare practice while also finding efficiencies that can be delivered to the WA health system. A mixed methods approach was adopted to evaluate the research impact of the RTP program, at completion of the two-year funding period, across a range of impact domains through the adaptation and application of the Canadian Academy of Health Sciences’ (CAHS) framework for research impact. In addition, further analysis was undertaken to address specific objectives of the RTP program more closely, in particular research capacity building and collaboration and health system Inefficiencies targeted by the program. Social network analysis was applied to assess the extent and growth of collaboration across WA health organisations over time. Results indicated that the ‘bottom up’ approach to research translation has triggered modest, yet positive outcomes across impact domains including advancing knowledge, collaboration and capacity building as well as contributing to changes in policy and practice. Additionally, the projects identified opportunities by which inefficiencies in the health system can be addressed. Further work is required to better understand the pathways by which short-term outcomes can be translated into more long-term impacts and the mechanisms that trigger this process.

Evaluation of Research Capacity and Culture of Health Professionals Working with Women, Children and Families at an Australian Public Hospital: A Cross Sectional Observational Study

Background

There is limited evidence for use of the Research Capacity and Culture tool across multidisciplinary health professionals. We explored using the Research Capacity and Culture tool among multidisciplinary health professionals at an Australian secondary hospital.

Methods

A cross-sectional observational study where online and paper-based surveys of the Research Capacity and Culture tool were disseminated between November 2020 and January 2021. Descriptive analyses of demographic variables and Likert scale items were summarized using median and inter-quartile ranges. Differences between organization, team and individual domains were checked using a Friedman test. Post-hoc Wilcoxon signed rank tests determined specific differences between domains.

Results

Seventy-six multidisciplinary health professionals (female, 89.3%) reported overall perceptions of research success/skills highest in the organization (median 6), followed by the team (median 5) and individual domains (median 3.5). Only 21.3% agreed that research activities were a part of their role description. Mean scores across professions were highest for Medicine (5.47), Midwifery (4.52), Nursing (4.47) and Allied Health (3.56), respectively, for the team domain. Individual domain scores across all professions were below 50%. Commonly reported barriers to research were “lack of time for research,” “other work roles taking priority” and “a lack of skill.” “Developing skills” was the most common personal motivator.

Conclusion

Multidisciplinary health professionals reported the highest overall perception of research success/skills in the organization domain. Medical health professionals perceived research success/skills highest compared to nursing, midwifery and allied health professionals.

Embedded researchers in Australia: Survey of profile and experience across medical, nursing and midwifery and allied health disciplines

AIMS AND OBJECTIVES

This study explores embedded researcher's age, qualifications, research environment and experience in healthcare and academic organisations in Australia and makes comparisons across three core professional disciplines of nursing and midwifery, medicine and allied health.

BACKGROUND

The embedded researcher model, where a researcher is embedded as a core member of the clinical team, offers promise to support the implementation of research evidence into practice. Currently, there is a lack of clarity about how the model has been adopted across the three largest professional disciplines in Australian health care.

DESIGN

A cross-sectional survey was designed and reported, using the STROBE Statement.

METHODS

A purposive sample of embedded researchers was invited to participate in an exploratory online survey. Embedded researchers worked, or had worked, for a minimum of 30% of their time, in a healthcare organisation doing research or building research capacity. Participant responses were extracted from the survey and imported into SPSS for analysis.

RESULTS

Perspectives of 100 Australian embedded researchers were compared across nursing and midwifery (36%, n = 37), allied health (35%, n = 36) and medicine (26%, n = 27). Professional differences are reported in respondents' qualifications and experience, employment conditions and their research cultures and environments. Comparatively, most nursing and midwifery embedded researchers were older, more clinically experienced than allied health respondents, who were more research qualified. Medical-embedded researchers are typically older, more clinically experienced and focussed on producing personally relevant clinical research. Nursing and midwifery embedded researchers reported doing clinical research within their teams, as well as research capacity building, management and clinical practice roles.

CONCLUSIONS

Embedded researchers describe different career trajectories across the three largest professional disciplines in Australian health care.

RELEVANCE TO CLINICAL PRACTICE

Embedded researchers from different professional disciplines enact their work differently. It appears that when they engage in research capacity building via a range of management and networking roles, embedded researchers contribute to their organisation's research culture and receive greater recognition for their achievements.

Guidelines for Evaluating Clinical Research Training using Competency Assessments

This article was migrated. The article was marked as recommended. Effective training programs in clinical and translational research (CTR) are critical to the development of the research workforce. The evolution of global CTR competencies frameworks motivates many CTR institutions to align their training offerings with these professional standards. Guidelines for integrating competency-based frameworks and assessments into rigorous program evaluations are needed in order to promote the quality and impact of these training programs. These guidelines provide practical suggestions for how to ensure that subjective and objective assessments of CTR knowledge and skill can be effectively integrated in the evaluations used to improve these essential training programs. The approach presented here necessarily involves the systematic and deliberate incorporation of these particular types of assessments into comprehensive evaluation plans. While these guidelines are broadly applicable to the work of those charged with developing, administering and evaluating CTR training programs, they have been specifically designed for use by program directors.

Pressure injury data in Australian acute care settings: A comparison of three data sets

Hospital-acquired pressure injuries (HAPIs) represent a serious clinical and economic problem. The cost of treating HAPIs in Australian public hospitals was recently reported at AUS$983 million per annum. There are three main sources of data for documenting pressure injury (PI) occurrence in Australian hospitals: incident reporting, medical record coded data, and real-time surveys of pressure injury. PI data reported at hospital level and to external agencies using these three different sources are variable. This reporting issue leads to inaccurate data interpretation and hinders improvement in accuracy of PI identification and PI prevention. This study involved a comparison of the three different data sources in selected Australian hospitals, to improve the accuracy and comparability of data. Findings from this study provide benchmark areas for improvement in PI documenting and reporting. Better understanding the agreement between the three data sets could lead to a more efficient and effective sharing of data sources.

Assessment of Health Research Capacity in Western Sydney Local Health District (WSLHD): A Study on Medical, Nursing and Allied Health Professionals

Background

Research should inform clinical decision-making and evidence-based practice for all health professionals. To build research capacity among all health professionals, there is a need to measure the levels of research capacity and identify the gaps and needs of health-care professionals. The aim of the study was to better understand the research culture and capacity of health professionals (medical, nursing and allied health) in Western Sydney Local Health District, Sydney, Australia.

Methods

A research capacity and culture tool (RCCT) survey was electronically distributed to all health staff in WSLHD. Data were collected between November 2016 and January 2017. Participants were surveyed through a 10-point Likert scale that measured research capacity at the individual, team and organisational levels.

Results

A total of 393 health staff responded to the study: allied health practitioners (46.3%), nursing staff (35.4%) and medical practitioners (18.3%). Females made 76% of the sample, and 54% were aged between 35 and 54 years. Individual responses were different across professions, with an average median score for medical 6.3 (95% CI 5.8-6.9), allied health 5.3 (95% CI 4.9-5.7) and nursing 4.5 (95% CI 4.1-5.0) after adjustment for age and gender. Team responses for medical staff (average median score 5.9 95% CI 5.3-6.4) were higher than allied health (4.1 95% CI 3.7-4.6) and nursing (4.3 95% CI 3.8-4.8), after adjusting for age and gender. However, there were no differences between the three professions for the organisational responses. Allied health and nursing staff were less confident in obtaining research funding, submitting ethics applications, writing for publication and mentoring colleagues about research.

Conclusion

This study demonstrates the individual research capacity for medical, allied health and nursing professionals are different. Research capacity building needs to be individually tailored to the specific needs of each profession. This research will inform future capacity building activities and training for health professionals in a large public health organisation of Sydney, Australia.

Assessing research capacity in Victoria's south-west health service providers

OBJECTIVE

To investigate the research interest, capacity and culture in individuals, teams and health organisations across south-western Victoria.

DESIGN

Cross-sectional survey.

SETTING

Eight public health services in the south-western region of Victoria.

PARTICIPANTS

All staff were invited to participate.

INTERVENTION

Hospital staff survey.

MAIN OUTCOME MEASURE

The Research Capacity and Culture tool.

RESULTS

The survey was completed by 776 staff including nurses, allied health staff and doctors. Half of the respondents were currently involved in research, while most wanted to be more involved. Respondents reported having moderate research skills and success at individual, team and organisation levels. Women and nurses reported having lower skills than comparable groups. Motivators for undertaking research were skill development (increased job satisfaction and brain stimulation) while the most commonly selected barriers were lack of time, other work taking priority and lack of funding.

CONCLUSION

Health organisations in regional and rural Victoria could harness opportunities to enable staff participation in research by supporting identified strengths, addressing barriers and providing "permission" for staff to get involved in research. Efforts to improve research capacity among women and nurses could lead to the greatest overall improvement in organisations' research capacity and output-and translation of evidence into practice.

Supporting Resident Research Learning in the Workplace: A Rapid Realist Review

PURPOSE

Residents are increasingly expected to engage in practice-based research; however, engagement in research whilst also fulfilling clinical duties is often challenging. Evidence suggests that residents require specific developmental experiences, along with clinical practice, to become effective researchers. The authors therefore conducted a rapid realist review to explore strategies and key mechanisms supporting effective resident research activities in clinical settings. They examined relationships amongst different clinical contexts, learning mechanisms, and research engagement outcomes to provide evidence-based, theory-informed recommendations for improving resident research engagement and extending understandings of workplace learning in health care settings.

METHOD

In 2015-2016, the authors used a rapid realist methodology informed by workplace learning theory to review international literature published between January 2005 and December 2015. The review drew upon sources from OVID Medline, ERIC, Embase, and AustHealth. The authors screened articles for eligibility using inclusion criteria and appraised articles using realist review quality criteria.

RESULTS

The authors included 51 articles in the review. The review process identified three key mechanisms for effective integration and support of resident research engagement, as informed by workplace learning theory: (1) opportunities to engage in practice-informed research supported by longitudinal curricula, (2) guidance by clinician-researchers, and (3) assessing residents' research readiness and promoting their intentionality for engagement.

CONCLUSIONS

This review extends existing literature and informs workplace-based research engagement strategies for residents whilst demonstrating the applicability of workplace learning theory to improving residents' research engagement. The authors propose a learning model to support effective resident research engagement through clinical practice.

Research capacity building frameworks for allied health professionals - a systematic review

Background

Building the capacity of allied health professionals to engage in research has been recognised as a priority due to the many benefits it brings for patients, healthcare professionals, healthcare organisations and society more broadly. There is increasing recognition of the need for a coordinated multi-strategy approach to building research capacity. The aim of this systematic review was to identify existing integrated models and frameworks which guide research capacity building for allied health professionals working in publicly funded secondary and tertiary healthcare organisations.

Methods

A systematic review was undertaken searching five databases (Medline, CINAHL, Embase, AustHealth and Web of Science) using English language restrictions. Two authors independently screened and reviewed studies, extracted data and performed quality assessments using the Mixed Methods Appraisal Tool. Content and thematic analysis methods were used to code and categorise the data.

Results

A total of 8492 unique records were screened by title and abstract, of which 20 were reviewed in full-text. One quantitative study and five qualitative studies were included, each of which describing a research capacity building framework. Three interconnected and interdependent themes were identified as being essential for research capacity building, including ‘supporting clinicians in research’, ‘working together’ and ‘valuing research for excellence’.

Conclusions

The findings of this systematic review have been synthesised to develop a succinct and integrated framework for research capacity building which is relevant for allied health professionals working in publicly funded secondary and tertiary healthcare organisations. This framework provides further evidence to suggest that research capacity building strategies are interlinked and interdependent and should be implemented as part of an integrated ‘whole of system’ approach, with commitment and support from all levels of leadership and management. Future directions for research include using behaviour change and knowledge translation theories to guide the implementation and evaluation of this new framework.

Trial registration

The protocol for this systematic review has been registered with PROSPERO. The registration number is CRD42018087476.

Electronic supplementary material

The online version of this article (10.1186/s12913-018-3518-7) contains supplementary material, which is available to authorized users.

Frameworks for embedding a research culture in allied health practice: a rapid review

BACKGROUND

Although allied health clinicians play a key role in the provision of healthcare, embedding a culture of research within public and private health systems remains a challenge. In this rapid review we critically evaluate frameworks for embedding research into routine allied health practice, as the basis for high quality, safe, efficient and consumer-focused care.

METHODS

A rapid review (PROSPERO: CRD42017075699) was conducted to evaluate frameworks designed to create and embed research in the health sector. Included were full-text, English-language, peer-reviewed publications or Government reports of frameworks that could inform the implementation of an allied health research framework. Eight electronic databases and four government websites were searched, using search terms such as models, frameworks and research capacity-building. Two independent researchers conducted all review stages and used content and thematic analysis to interpret the results.

RESULTS

Sixteen framework papers were finally included. Content analysis identified 44 system and regulatory level items that informed the research frameworks, 125 healthcare organisation items and 76 items relating to individual clinicians. Thematic analysis identified four major themes. Firstly, sustainable change requires allied health research policies, regulation, governance and organisational structures that support and value evidence-based practice. Secondly, research capability, receptivity, advocacy and literacy of healthcare leaders and managers are key to successful research implementation. Third, organisational factors that facilitate a research culture include dedicated staff research positions, time allocated to research, mentoring, professional education and research infrastructure. When healthcare agencies had strong partnerships with universities and co-located research leaders, research implementation was strengthened. Finally, individual attributes of clinicians, such as their research skills and capabilities, motivation, and participation in research teams, are essential to embedding research into practice.

CONCLUSION

Theoretical frameworks were identified that informed processes to embed a culture of allied health research into healthcare services. Research-led and evidence-informed allied health practice enables optimisation of workforce capability and high-quality care.

Ground-up-top down: a mixed method action research study aimed at normalising research in practice for nurses and midwives

Background

Improving health, patient and system outcomes through a practice-based research agenda requires infrastructural supports, leadership and capacity building approaches, at both the individual and organisational levels. Embedding research as normal nursing and midwifery practice requires a flexible approach that is responsive to the diverse clinical contexts within which care is delivered and the variable research skills and interest of clinicians. This paper reports the study protocol for research being undertaken in a Local Health District (LHD) in New South Wales (NSW) Australia. The study aims to evaluate existing nursing and midwifery research activity, culture, capacity and capability across the LHD. This information, in addition to input from key stakeholders will be used to develop a responsive, productive and sustainable research capacity building framework aimed at enculturating practice-based research activities within and across diverse clinical settings of the LHD.

Methods

A three-phased, sequential mixed-methods action research design underpinned by Normalization Process Theory (NPT).

Participants will be nursing and midwifery clinicians and managers across rural and metropolitan services. A combination of survey, focus group, individual interviews and peer supported action-learning groups will be used to gather data. Quantitative data will be analysed using descriptive statistics, correlation and regression, together with thematic analysis of qualitative data to produce an integrated report.

Discussion

Understanding the current research activity and capacity of nurses and midwives, together with organisational supports and culture is essential to developing a productive and sustainable research environment. However, knowledge alone will not bring about change. This study will move beyond description of barriers to research participation for nurses and midwives and the promulgation of various capacity building frameworks to employ a theory driven action-oriented approach to normalisation of nursing and midwifery research practice. In doing so, our aim is to make possible the utilisation, generation and translation of practice based research that informs improved patient and service delivery outcomes.

Electronic supplementary material

The online version of this article (10.1186/s12912-017-0249-8) contains supplementary material, which is available to authorized users.

Strategies for research engagement of clinicians in allied health (STRETCH): a mixed methods research protocol

INTRODUCTION

Allied health professionals (AHPs) report positive attitudes to using research evidence in clinical practice, yet often lack time, confidence and skills to use, participate in and conduct research. A range of multifaceted strategies including education, mentoring and guidance have been implemented to increase AHPs' use of and participation in research. Emerging evidence suggests that knowledge brokering activities have the potential to support research engagement, but it is not clear which knowledge brokering strategies are most effective and in what contexts they work best to support and maintain clinicians' research engagement.

METHODS AND ANALYSIS

This protocol describes an exploratory concurrent mixed methods study that is designed to understand how allied health research fellows use knowledge brokering strategies within tailored evidence-based interventions, to facilitate research engagement by allied health clinicians. Simultaneously, a realist approach will guide a systematic process evaluation of the research fellows' pattern of use of knowledge brokering strategies within each case study to build a programme theory explaining which knowledge brokering strategies work best, in what contexts and why. Learning and behavioural theories will inform this critical explanation.

ETHICS AND DISSEMINATION

An explanation of how locally tailored evidence-based interventions improve AHPs use of, participation in and leadership of research projects will be summarised and shared with all participating clinicians and within each case study. It is expected that local recommendations will be developed and shared with medical and nursing professionals in and beyond the health service, to facilitate building research capacity in a systematic and effective way.