Blog – Improving clinician-academic partnerships

Clinical research can be thought of as an umbrella term which encompasses any research studies with the aim of advancing knowledge or therapies for those who are affected by a particular illness, condition, or disease. Key to the success of clinical research is the involvement of clinicians, whether that’s as co-researchers or as key people enabling participant recruitment to a study, for example. However, there are significant challenges in clinical research, especially for projects lead by academics. In this blog, I will discuss how such barriers can be addressed through improving clinician-academic partnerships in dementia research.

I was first involved in clinical research as an undergraduate student 15 years ago when I worked as a research assistant carrying out a small-scale project with patients on an NHS inpatient ward under the supervision of a clinical psychologist. We were assessing an intervention to help patients with dementia at mealtimes, as this had historically been a challenging time for them as they could be unsure what mealtime in the day it was, what food was being served, and what happens at mealtimes on the ward. This confusion and uncertainty could be very stressful for patients, and they could often lose weight as a consequence, significantly impacting on their physical health. Therefore, we were hoping to improve on this experience for them.

Working on this project was the first time I experienced the challenge of trying to engage clinicians working on the ward to implement the interventions we were assessing. In any situation where you are asking people to take on additional tasks alongside an already full workload, there is going to be resistance, and it’s important to clearly communicate exactly what you need people to do and why it’s important, but also to work together on any mitigations. For example, is there any way the researcher can reduce the burden on the clinician to free up as much of their time as possible? Without working in unison, there is a real risk that clinical research can fail, not because of an inherent problem with the research question or study design, but due to poor implementation. The consequence of this can be that people with dementia are denied opportunities to be part of projects which could be beneficial to them and their family members.

Since then, I have worked on a number of different clinical research projects in secondary care, child and adolescent mental health services, and adult mental health services.

All have required the involvement of clinicians at some level, whether that be implementing an intervention as with the previous example or assisting with recruitment. Clinicians will often be the only people with access to patient information which is needed to determine who meets study criteria and who can be approached about participation. So in many ways, clinicians are the gatekeepers to the success of clinical research. Without requiring any specific research experience or project role, they can become the barrier or the facilitator to people participating in clinical research.

My experience of working in clinical research with clinicians at all levels of seniority has been mixed, and it got me thinking: why is this the case, and what can we do to improve partnerships between clinicians and academics to advance research? Nowhere is this more desperately needed than in dementia research where I strongly believe that we will only make significant progress towards disease-modifying treatments by taking researchers and clinicians out of their silos to gain a broader oversight of the field. For example, if you work in biomedical research on disease mechanisms and developing an effective drug treatment for Alzheimer’s disease, a lot can be gained from acquiring a general understanding of diagnostics, and vice versa, because in order for a treatment to work effectively, we must have the tools sensitive enough to diagnose the disease in its early stages.

I’ve already touched on some of the reasons why clinical research as a non-clinician can be challenging. You are adding to workloads, hanging around wards or clinics being a nuisance, and sometimes research and audits are conflated, creating a hostile environment where research is approached with caution and suspicion. So it’s important for the researcher to work with clinicians to identify potential challenges and concerns they may have, otherwise project timelines can be significantly delayed and outcomes compromised. Having key clinicians as co-principal investigators or co-investigators with a working knowledge of the service or clinic that you’ll be working in can be beneficial, as they will be a trusted person within the team and will be able to anticipate any challenges that may arise.

I’m confident there will be many academics who could benefit from working more closely with clinicians, and there will be many clinicians who want to be involved in research without formally doing a research-based qualification. Some efforts have been made to help build these partnerships, but I think more can be done to encourage matching of expertise, and provision of more specific funding streams to enable academics and clinicians to drive forward dementia research together.

Dr Kamar Ameen-Ali

Author

Dr Kamar Ameen-Ali is a Lecturer in Biomedical Science at Teesside University & Affiliate Researcher at Glasgow University. In addition to teaching, Kamar is exploring how neuroinflammation following traumatic brain injury contributes to the progression of neurodegenerative diseases that lead to dementia. Having first pursued a career as an NHS Psychologist, Kamar went back to University in Durham to look at rodent behavioural tasks to completed her PhD, and then worked as a regional Programme Manager for NC3Rs.

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