The nurses, midwives and allied health professionals (NMAHPs) employed in research delivery roles* that we spoke to had many different experiences of induction, training and mentorship. Some had a grounding in research activities before starting in their first post, like Tabitha who had completed a research internship and was in the process of finishing a Master’s degree. Others felt they arrived into their first post with little knowledge or practical experience of carrying out research. Many described the process of adjusting to their first research post as a ‘big’ learning curve.
NMAHPs employed in research delivery posts had learnt about their role and the skills, knowledge and activities it would involve in various ways. These included: training courses (online and face-to-face, sometimes with role-playing exercises), shadowing colleagues (on the same or a different study, within their own team or another), orientation (visiting other units, potentially other Trusts) and being mentored/supervised. Lots of studies ran their own training specific to the tasks entailed, which supplemented core skills and knowledge such as taking consent and Good Clinical Practice (GCP) for research.
The terminology and abbreviations used in research were often baffling at first. For Sian, it was ‘a whole new language’. Melanie downloaded a glossary of research ‘jargon’ which she stuck to her wall. Whilst moving into research might involve learning new and unfamiliar things, many people also emphasised that it could involve transferrable skills they already had developed (e.g. in their previous clinical roles*) – although, as Alice highlighted, these might require adapting somewhat.
Ginny highlighted that all nurses and midwives take consent from patients as part of their role, and that this is not only in research.
The use of abbreviations and their meanings was unfamiliar to Sugrah when she started in research.
Although not covered in this section, those pursuing research via qualifications (such as Master’s or PhDs) often saw the endeavour as a form of training in itself and often attended additional courses on particular methods and research tools. They also spoke about their supervisors and mentors. For those who had first worked in research delivery roles, senior members of the research team sometimes went on to become their PhD supervisors.
Graham didn’t have any official training when he started as a research paramedic, but he had good mentors who also supported him in pursuing a doctorate.
The changing provision of training and support
Many people felt that the induction, training and mentorships provided to new research NMAHPs had become more extensive in recent years – including through the National Institute for Health Research (NIHR) Clinical Research Network (CRN). Those who had started many years ago had often found training lacking or inconsistent. Simona had worked in research for seven years and recalled that, at the start, ‘I had to find things out for myself’. Helen felt she was ‘just thrown into it’. As a lead research nurse, Claire had worked on various packages of training to support new research NMAHPs; she had also designed a package for research nurses who had worked in their role for some time but who hadn’t initially received formal training. She described a recent Tweetchat where research nurses across the UK relatively new to the role ‘were amazed to hear there was little support only a few years ago as they were reporting all sorts of supervision, teaching, training and buddy systems’.
Simona didn’t have much training or support when she started in her first research nurse post. Now that she leads a team of her own, she provides new staff with more support.
Sandra described some of the training, checklists and approaches used by the Clinical Research Network for research nurses.
Vicky joined a university unit as the first research nurse they had employed. It required her to think carefully about her role and training needs.
Inductions and orientations
Inductions and orientations varied widely. Libby had three: one induction for the Trust, one for the department and one for working in research. Some people had moved to a new clinical environment to take up a research post (a different hospital, department/specialty, or another setting such as primary care). A Trust and/or department induction could help them learn more broadly about the processes and practices, both clinical and research-based, in that setting.
Another type of induction, sometimes called an ‘orientation’, was into research activities and the research team. These often included observing others carry out research activities and visiting other teams/locations. Osi felt this helped her to ‘find out what a research midwife looks like. what do they do? What’s their day-to-day?’ She was also given examples of some blank paperwork, ‘as a skeleton’, to help her understand the paperwork for studies at her own hospital.Training courses
Many people had undertaken training on a range of topics, including:
- Good Clinical Practice (GCP);
- taking informed consent for research (from adults and/or children);
- communication skills; and
- site file management.
GCP is an internationally-recognised ethical and scientific standard for clinical trials, and GCP training is intended to ensure that these studies are designed, carried out and reported in a way which meets the quality standard. Several people had undertaken both an online version and a face-to-face GCP training course. Many felt the latter was more helpful; for example, Nicky liked the opportunity to discuss issues with other attendees and felt it helped to ‘put the theory into practice’. Paul thought it was good that he could do some types of training online. It meant he could do it from home or fit it into days which were quieter in terms of research study activities.
Julie and research staff in her team had undertaken a course specifically focusing on doing research in intensive care, in recognition that this involves ‘families in very sensitive and tricky situations’. Layla felt there was a lot of extra/optional training available to her when she started in a post as a research midwife. She soon realised she would have to ‘narrow it down a bit’ so she could keep up with the research activities too, and has taken up training to help build her expertise in areas she is particularly interested in. Some people highlighted that undertaking training was useful as evidence of Continued Professional Development and for professional revalidation/re-registration.
The timing of training varied. Some people were required to take courses (online or in person) as soon as they started in the post, others found there was a delay. Most felt that undergoing training sooner rather than later was good for someone new to research. Laura X wasn’t trained to use the computer systems at her hospital for research purposes until she had been in post for a month, by which time she had already worked out for herself how to use them.
Some people had been on ‘refresher’ courses. James and Dawn both repeated GCP after a few months, as they felt it helped consolidate their learning. Julie felt it was important that research NMAHPs should ‘always be constantly reviewing our practice’, even if they have been doing an activity (like taking consent for research studies) for a long time.
Study-specific training included learning about technologies/devices that research NMAHPs would have to demonstrate to participants and various lab skills, such as centrifuging/spinning bloods. Some people had also attended study days or professional conferences, where they learnt (from talks or informal networking) about skills or picked up ‘tips’ to use in their roles.
Supervision, mentorship and peer support
Some research NMAHPs had mentors who guided them in learning activities when they were first in the role or had changed to a new team and/or specialty. Osi had support from someone who was a research champion (a role appointed to raise awareness of the importance of clinical research in a particular area or profession, e.g. midwifery); she found this ‘really helpful’ in terms of learning processes like maintaining site files as well as for reassurance: ‘it was nice just to have a pat on the back to start off with’.
Many people described learning ‘on the job’ through colleagues. For some, this worked well. Being able to ask questions was a great way to cement their learning. Sarah and Helen both found it helpful to shadow colleagues taking consent, and thought it was interesting to see the different styles between people and professions. Michael was able ‘to see how they organised a clinical trial, to learn their little tricks as to how to get a scan quickly’. Ella liked that she had people to learn from, until ‘you felt ready to do it on your own’. Rachel X started at the same time as another new research midwife, and they ‘figured it out together as we’ve gone on’.
Others found the coverage of information from colleagues patchy and, on occasion, even incorrect. Nicky had attended some training and been under the instruction of a colleague when she first started in a research nurse post eight years ago. However, the instructions she got could be quite ad hoc and unclear: ‘I found the whole thing very confusing I always felt like there were bits of the jigsaw missing’. Some people had little or no contact with other research NMAHP colleagues. Simona was the only research nurse when she first started, so ‘attached myself in a way to other research groups where they were a bit bigger and had some experience’.
In turn, once they were comfortable and familiar in their role and the research activities involved, some people helped teach and/or mentor new research NMAHPs. They often found it rewarding being able to share their knowledge and it could also affirm their expertise. As Sian said, ‘it becomes second nature’. Those in leadership/managerial roles had sometimes designed induction and training resources. Imogen had developed an induction pack, drawing on national resources but ‘bespoke to our team’ based in the emergency department.
*The people interviewed for this website were mostly research NMAHPs (i.e. those employed in a research delivery role). However, we also interviewed some NMAHP researchers (i.e. those leading research as independent researchers). The latter group included people who were undertaking or had completed academic research qualifications, such as PhDs, and many had previously been in (or continued to also be in) research delivery roles. For more information about the distinctions between these roles and the sample of NMAHPs interviewed for this project, please see the Introduction section.
*Many research NMAHPs and NMAHP researchers felt strongly that they continued to be clinical within their research roles. As such, the wording of ‘research’ NMAHPs/staff and ‘clinical’ NMAHPs/staff can be problematic for implying that research is not also clinical activity. Where the wording ‘clinical staff’ is used on the website, we mean for this refer to non-research clinical staff (i.e. those who are not currently employed to carry out research or enrolled to pursue research through an academic qualification).