Karen

Age at interview: 55
Brief Outline: Karen has combined research with clinical practice throughout her career as a physiotherapist. She is now a clinical director in a large teaching hospital and she oversees a number of staff undertaking research.
Background: Karen is a professor of physiotherapy. She is married and has children. Her ethnic background is White British.
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Throughout her career as a physiotherapist, Karen has combined research with clinical practice. Initially, before she was contracted to do research, she found time to follow her interests in research “on the side” by working long hours. Karen’s managers were generally supportive of her research, “as long as you were doing the job you were paid to do they were quite happy to tolerate you doing this on the side”. She also found guidance through more senior researchers in the field by attending a monthly research group, and support from a professor and a practitioner she worked with. Acting as mentors, they offered advice and comments on research ideas through to the writing-up of findings. Some of the early research that Karen undertook included a randomised controlled trial looking at outcomes of a TENS treatment on patients with unexplained abdominal pain. Karen’s first “formal post” involving research was a trial on spine stabilisation, where she was asked to recruit and follow-up patients.
Over the years, Karen’s involvement in research has shifted from aiding with recruitment and data collection, to developing and initiating research. In her current post, Karen is a clinical director in a hospital where she employs 65 staff, eight of whom do research. Karen supervises several researchers, encouraging them to gain experience in clinical practice as well as research, with the aim that they will eventually work in a “hybrid role”. She says that continuing to develop clinical skills is also important “so that they are not unemployable in the wider NHS”. Karen feels a sense of “duty” to promote career opportunities for her staff. Nonetheless, she acknowledges that maintaining a career in both clinical practice and research has its challenges. Karen describes there being a number of changes since she initially conducted research. For example, the amount of paperwork and emphasis on information governance has increased drastically. This can be time-consuming and Karen feels it should be “more proportionate to the level of risk of what the trial is”.
Karen thinks research is “absolutely complementary and symbiotic with” clinical practice, and that this is necessary to ensure that the two inform one another. This includes to “generate clinically relevant questions”, but also for research to improve the care that patients receive: “the whole point for me of doing research is that it improves clinical practice and clinical pathways”. However, she feels it is important that patients understand the differences between the two when they are offered various treatments and interventions. Karen describes the need for research physiotherapists to make sure patients understand what participating in a study involves and what it means, “you’ve got to be careful you’re not coercing them because, particularly in this sort of setting, patients tend to be so grateful that you are helping with their clinical problem that they feel an element of obligation to help with the research”.
Karen encourages physiotherapists interested in taking on a research role to try it. She highlights that physiotherapists have important skills and knowledge to bring to studies. Karen suggests that an ideal career for a research physiotherapist would combine both research and clinical practice, to explore research questions that can make a difference. She feels there is a need for a “much clearer clinical academic pathway” for research physiotherapists.
Over the years, Karen’s involvement in research has shifted from aiding with recruitment and data collection, to developing and initiating research. In her current post, Karen is a clinical director in a hospital where she employs 65 staff, eight of whom do research. Karen supervises several researchers, encouraging them to gain experience in clinical practice as well as research, with the aim that they will eventually work in a “hybrid role”. She says that continuing to develop clinical skills is also important “so that they are not unemployable in the wider NHS”. Karen feels a sense of “duty” to promote career opportunities for her staff. Nonetheless, she acknowledges that maintaining a career in both clinical practice and research has its challenges. Karen describes there being a number of changes since she initially conducted research. For example, the amount of paperwork and emphasis on information governance has increased drastically. This can be time-consuming and Karen feels it should be “more proportionate to the level of risk of what the trial is”.
Karen thinks research is “absolutely complementary and symbiotic with” clinical practice, and that this is necessary to ensure that the two inform one another. This includes to “generate clinically relevant questions”, but also for research to improve the care that patients receive: “the whole point for me of doing research is that it improves clinical practice and clinical pathways”. However, she feels it is important that patients understand the differences between the two when they are offered various treatments and interventions. Karen describes the need for research physiotherapists to make sure patients understand what participating in a study involves and what it means, “you’ve got to be careful you’re not coercing them because, particularly in this sort of setting, patients tend to be so grateful that you are helping with their clinical problem that they feel an element of obligation to help with the research”.
Karen encourages physiotherapists interested in taking on a research role to try it. She highlights that physiotherapists have important skills and knowledge to bring to studies. Karen suggests that an ideal career for a research physiotherapist would combine both research and clinical practice, to explore research questions that can make a difference. She feels there is a need for a “much clearer clinical academic pathway” for research physiotherapists.
Across her thirty year career as a physiotherapist, Karen found ways to carry out research within her clinical job.
Across her thirty year career as a physiotherapist, Karen found ways to carry out research within her clinical job.
I’ve had people who’ve been supportive just in that almost they’ve turned a blind eye and let me do it, and haven’t interfered, and that is great support, cos the worst thing you need is somebody who’s going to be constantly trying to put you back in your box. So, I’ve been, I had, you know, my early career, several physiotherapy managers who, they knew I was doing this sort of thing, but they didn’t do anything to stop you. I wouldn’t say they did anything particularly to encourage me, but they let you get on and do it, as long as you were doing the rest of your job as well.
Karen described there being different power dynamics with patients/participants in research.
Karen described there being different power dynamics with patients/participants in research.
In the physiotherapy research that Karen leads, there can be Adverse Events (AEs) which need to be reported as per the study documentation.
In the physiotherapy research that Karen leads, there can be Adverse Events (AEs) which need to be reported as per the study documentation.
Karen highlighted that, in very research-active environments, it was important to stagger studies.
Karen highlighted that, in very research-active environments, it was important to stagger studies.
Karen had seen increases and changes in the research governance structures across her career. Going through ethics processes could be “paralysingly slow” and “bureaucratic”.
Karen had seen increases and changes in the research governance structures across her career. Going through ethics processes could be “paralysingly slow” and “bureaucratic”.
You know it is, it is paralysingly slow sometimes, and ethics, well actually if you get, if you ever get to an ethics committee it’s fine, it’s getting it through R&D [Research & Development], checking it, changing it, changing it, and it’s very much sometimes about one person’s slant on things versus another. I mean it drives me demented when you have to put things to R&D, and they’ve changed the wording of your letter. You know, you know, for god’s sake, you know, I’ve been doing this for 30 years, I know how to write a letter to a patient. You may have phrased it differently, but what I did was not unintelligible. But, but yeah, it’s just one of the irritants of doing research.
It is quite, quite bureaucratic.