There were a range of research colleagues that research nurses, midwives and allied health professionals (NMAHPs)* spoke about. These included Principal Investigators (PIs), Chief Investigators (CIs), staff at study centres, and fellow research NMAHPs. Whilst these individuals sometimes overlapped as clinical colleagues* (including Principal Investigators who were often clinicians), this section describes their working relationships in the context of research.
Principal Investigators (PIs), Chief Investigators (CIs) and study centres
The UK Health Research Authority (HRA) make a distinction between PIs and CIs, although in practice the terms were sometimes used interchangeably by the NMAHPS we spoke to. The HRA defines PIs as individuals with responsibility for the study being run at a particular site. Often the PIs were clinicians but some were NMAHPs by background. Indeed, Claire, Karen, Gavin and Nicky had all been PIs (or co-PIs) themselves. CIs have ultimate responsibility for the study being run across all study sites. Some research NMAHPs we interviewed, such as Nikki, worked in departments or units where the CIs were based. Many research NMAHPs had worked with study centres – this usually meant a team of people, including CIs and trial managers, with overarching responsibility for coordinating the study.
Some research NMAHPs worked very closely with PIs/CIs and study centres, whereas others had less contact and felt more distant. This situation often depended on the scope and scale of the research, including whether it was an academic or commercial study. For example, whether a study was being run locally at one or two sites by a small team, versus many sites (regionally, nationally, internationally) with a large research team located elsewhere.
Sometimes it was the PIs who first introduced studies to patients and took consent; other times, this was done by research NMAHPs. This depended on the type of study and context (e.g. if eligibility depended on consultants making a diagnosis). Often though PIs had delivered some form of training on recruitment and other data collection activities to research NMAHPs. Helen felt it was important to hear them talk about studies to get tips on explaining the information to patients before starting recruitment. At times, clinical workload pressures made it difficult for PIs/CIs to also stay on top of research activity, so some research NMAHPs saw part of their role being to make this as seamless as possible.
There were inevitably occasional disagreements between PIs/CIs and research NMAHPs. In some situations, research NMAHPs felt under a lot of pressure to follow PI instructions. Some people felt able to stand their ground and that their views on important matters would be taken into consideration. Ellen described having worked with some ‘keen’ PIs who ‘just don’t always get the little grey areas’ of balancing recruitment numbers with advocating for patient choice. Ginny found some PIs/CIs were remote and quite uninvolved. When she was first in post, Osi struggled to rally enthusiasm from some PIs whose research had fizzled out a bit and become ‘out of sight, out of mind’.
Contact with study centres included activities like Site Initiation Visits (SIVs) and monitoring; both Ellen and Osi learnt a lot from these processes when they were new to research. Michael felt strongly about the importance of SIVs: ‘it’s a great opportunity and they go through everything in detail’.
In some cases, there was frequent communication from data managers at study centres/within research teams. They might contact research NMAHPs to ask for updates on participant recruitment and retention or with queries or requests about missing data and updates. Rachel X emphasised that it was important to respond in a timely manner. However, this communication was sometimes felt to be too much. Louise felt there was quite a lot of pressure on her when she first started in a research midwife role. At the other end of the research lifespan, some people felt that the findings of studies were not forthcoming or given promptly enough to research NMAHPs (and/or to patients).
For those research NMAHPs jointly employed as study coordinators, fostering good relationships with study sites was important. This sometimes reflected a recognition that they wanted to be a support rather than burden. Carole clarified to a study site she was due to visit that ‘I wasn’t a threat, I wasn’t there to shadow them, I wasn’t there to be heavy-handed, I’m there to help’.
Other research NMAHPs
Some people worked with other research NMAHP colleagues – either on the same project(s), in shared offices, or in the same team/department. A few people also had colleagues without health professional backgrounds who were in research delivery roles (e.g. often titled Clinical Trials Officers/CTOs). However, a number of people did not have any research NMAHP (or CTO) colleagues when they first started in their post; this could be quite isolating, and it could make the adjustment into their role more difficult.
There were several advantages to having research NMAHP colleagues. For example, if a research NMAHP was on (annual, sick) leave or otherwise overwhelmed with work, their colleagues could sometimes help out. Having fellow research NMAHPs was often a valuable source of information and advice on a range of topics, including overcoming recruitment barriers. Meeting research NMAHPs from other contexts and sites was appreciated, whether this was through a networking event, study meeting or as a research champion (a role appointed to raise awareness of the importance of clinical research in a particular area or profession, e.g. midwifery).
Although not generally viewed as part of the research team, many research NMAHPs liaised with research support services in the course of their jobs. This included ‘Research and Development/Innovation’ teams, ethics committees and sometimes IT services.
*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).