So this goes back I think to what I was saying about having that pathway set up, there isn’t necessarily a clear pathway set up for you to integrate clinical work and research work. So, it’s interesting to think about why, you know how, everybody who I know is a researcher and a clinician has sort of cobbled together something and found their way and uses their skills and enjoys using their clinical skills, whether it be within delivering a clinical intervention, whether it be in supporting students to train, or informing research methods so that they’re appropriate for people with communication needs. Yeah, it’s, there’s no clear cut path and it, it can be a bit of a, a challenge to identify how you fit in it I suppose.

So meeting face-to-face is, is a really useful way of, of getting that process started.

Then when somebody has shown that they might be interested in hearing more I would go to visit them at home, and talk them, talk to them individually, away from the bustle and noise of the group, and talk to them individually about the specifics of the project. Exactly what it would entail, and I’d do that accompanying the consent form, so that they can read the consent form at the time, or they could follow it, but I’d read it aloud word for word so that they were getting the same written information as they were getting auditory information. And then I would pause and emphasise different bits as they go along. I would check and ask for questions. So, I’d use my kind of I’d monitor somebody’s facial expression or whatever, if they went, or you know where I’d check to say, You know, have you understood what that is? Do you, do you get that? And we’d talk about somebody’s specific situation.

And at that point I would say, Okay, so that’s the information, I’ve given them the opportunity to ask any questions, and so as I say I’d support any questions with a writing or reading or you know you can see I use gesticulation a lot, tone of voice changing re-wording things if they’re too complicated, using plain language, and then give them the time to think about it, and say when I’ll come back. If you’re happy for me to come back, so I would never do consent straightaway. There’s the time to think about it and you know be with others and if, if the person wants somebody else to be with them for that and to support them in that exercise then that’s great, we’re very happy for them to do that. But equally I feel very strongly that it’s important that it’s the person who’s taking part in the research, and critically it is the case that people with aphasia have capacity, to make these decisions but that the information needs to be delivered and presented to them in an accessible way.

Yeah.

So I think historically there might have been, it might have been easier to you know defer to a carer or a significant other, to explain things and to you know check that they’re alright with it, but my preference very much is to have the conversation directly with the person who’s got aphasia, and check that they understand it and then and then similarly with the consent form, I would, I wouldn’t just give it to them and let them read it, I’d say, Okay so what you’re agreeing to here, this says, are you happy with that? and then they can give a tick or whatever. And then even things like writing down their name at the end, on the bottom of the, on the consent form I would, if they’re not able to do it by themself I would write it down for them so that they could copy it, so there’s layers of different little support things. But that’s very much drawing on my clinical experience to do that.

And so, in terms of recruitment we I mentioned previously that there was a big cohort of people doing their PhD around the same time as me, all this actually sort of benefited us cos there were a number of aphasia projects going on and what happened was that we each project was looking for a slightly different profile of people with aphasia. So, for example my research was about people with very severe aphasia, so people almost unable to express themselves verbally, whereas other people were doing research for people who might have better spoken abilities but had difficulties with reading for example. And a number of others in between, a number of other kind of studies around aphasia in between.

So, at the time of recruitment we, we did a little roadshow, going out around visiting the different community stroke groups and we had like a little booklet, a little menu of different projects offering a variety of different research, and that might be suitable for different people. And that was a really lovely way to work actually because it meant that we could share the load of going out and speaking to people about the, the research, but also that we could present research that wouldn’t necessarily exclude people from the group when we approached them. So yeah, so we ended up with a big sort of collaborative co-operative research drive, and that’s that investment at that time I think has led to us having a very a very good community of research participants that are now connected to us at the university here, so the investment at that time and, and the subsequent involvement in research. And anybody who was happy to stay connected with us at the end of that research project, or who was interested in doing more could, would agree for us to contact them if future relevant research came up.

So oftentimes, the thing about research roles, which I’ve done for the most part is that they’re on fixed term contracts, so a certain amount of money comes out and you’re employed either part-time or full-time for X amount of months. And so there have been times when I’ve worked on a speech therapy bank and a speech therapy service as well, and so I’d be doing two or three days a week in clinical practice with children with speech and language therapy needs, and then two days a week on a research on a research role.

And it’s, yeah it was very hard, it was, it was difficult juggling the demands of that I think they’re slightly different mind sets, and I think regardless of whether it was two different roles I think having two different work places to, to juggle can, well it is, it’s a challenging thing cause everyone has their own set of rules and policies and familiarity and dynamic and systems that you need to be familiar with to just do the day-to-day things. And in the role, in the clinical role that I was doing I was a speech therapist visiting a number of schools, and so I, then within that role further I would need to develop relationships with each individual school and things. So, there was, there was quite a lot of settings and situations to get comfortable with and understand.

So now I’m on a sort of a three-year trajectory I suppose on, on three different research projects, one of which I’m a co- investigator on, so I was on the application for the funding, and we got the funding, so I’m a researcher and a co-investigator on it, which is really good. Obviously that’s a fixed term affair, so I’m going to be a researcher, a post-doc researcher, for well I’m a year in, so the next two years. And beyond that I don’t know. I don’t feel particularly inclined to be a lecturer, that might change, so, but that’s, that sort of the long term employed permanent position way to go, within academia. I don’t feel particularly inclined to be a permanent position, clinical speech therapist in a, an NHS setting for instance. But I don’t know where that leaves me, so I guess I’ve just been enthusiastic about everything I do up until now, and opportunities have presented themselves, and I’ve seized them. And I don’t necessarily always know quite what it’s going to be, but I’m quite open to the next interesting thing, so, watch this space, I suppose.

But it would be interesting, so I haven’t see the exact sort of criteria against which you have to provide evidence. But when you do your newly qualified practitioner competencies, so like when you’re a teacher and you spend your first year doing your newly qualified year, similarly when you’re a speech therapist you go from being a newly qualified practitioner and you sign off your competencies amongst a certain set of criteria, and then you’re able to, you know you’re a fully-fledged independent therapist, right? Certainly being able to fill those in for me in my research role, there are gaps that I couldn’t fill in, I’d had certainly loads of extra stuff to put in the blank space at the end that said, You might have additional things that you can add, but there were certain things about like maybe writing case reports, or different things, working in a multi-disciplinary team with different healthcare professionals, that I couldn’t fulfil with my research role. And I ended up filling those in when I was working clinically as a speech therapist, and in my other part-time role.
So this goes back I think to what I was saying about having that pathway set up, there isn’t necessarily a clear pathway set up for you to integrate clinical work and research work. So, it’s interesting to think about why, you know how, everybody who I know is a researcher and a clinician has sort of cobbled together something and found their way and uses their skills and enjoys using their clinical skills, whether it be within delivering a clinical intervention, whether it be in supporting students to train, or informing research methods so that they’re appropriate for people with communication needs. Yeah, it’s, there’s no clear cut path and it, it can be a bit of a challenge to identify how you fit in it I suppose.

And then in the, so the sort of challenges that come up in a research role are you, you need to often when you’re doing clinical research you need to adhere very strictly to a research protocol and that sometimes means you can’t use your clinical judgement to say, Oh I think that I might prefer to do things this way for this scenario. So you need to carry out x, y, z assessment, you need to carry out therapy according to this set of you know predefined things, so that it can then be testable and you can make clear assertions about how it works across a group of people if it’s applied consistently.

So that can sometimes feel, there’s, there’s an element of sort of sitting on your hands when you’re doing clinical research that you don’t have when you’re doing clinical practice in the same way. But that can also be, that can also be quite liberating because it, it frees you of the, the clinical judgement, the sort of clinical decision making where you might get it wrong or right, you can sort of relinquish that and say, Okay I’m following the protocol, and this is how it has to be, and I’m just going to see how it happens. And it means you don’t need to necessarily make any pre- you don’t need to necessarily have any preconceptions about how it’s gonna go, or who it’s going to be best for. Or if you do then you might be proven wrong and you can be proven wrong for instance about things.

So an example might be that my research is largely with older adults who’ve had a stroke. Which obviously contrasts to paediatric clinical work, but in my research I work with older adults who’ve had a stroke and I work on the effectiveness of computer based therapies, and they’re, certainly for me coming into it and a lot of people who I’ve explained my role to, they have preconceptions that older people won’t get on with computers, or wouldn’t be able to use or it wouldn’t be a suitable treatment to offer to somebody who’s older and maybe hasn’t been used to using a computer throughout their life in the way that some younger people might have. But actually when we have to meet everybody who takes part in the research and present them with the same opportunities and then do the therapy with them, it challenges that and has shown me that it isn’t the case, that actually lots of people can get on with computers if the if the scenario, if the intervention is appropriate for them and if it offers them something that they that they can benefit from.

I remember very early on when I was just about to go and qualify as a, when I was going to go and train as a speech therapist, I was working in a, I was working in a speech therapy setting as an administrator before I trained and one of the managers there said to me, Oh so somebody who had come and done their placement with us, was training to be a speech therapist, then went on and did research, and I thought oh what’s the point, we’ve completely, we’ve completely wasted all of our efforts doing clinical training with this person, cos she’s not going to be a clinician. And that really stuck with me. So ever since sort of I graduated and I’ve been doing research I’ve been thinking, you know, does everybody who works clinically think I’m a traitor for not using my clinical skills in research, in, in clinic, you know should I, should I be on the coal face in the NHS you know doing clinical work?

And I guess over time my feeling is that I feel that I can be more effective, that I can contribute more, I personally can contribute more to the profession by feeding into the research side than I might be able to were I entirely in the clinical setting. So Yeah, I think that’s evolved, but I, I do, I do have a, a big sort of what’s the word? A big sort of imposter syndrome sort of fear that I’m not a real speech therapist, at the bottom of it, even though I have my clinical competencies, even though I’m registered with the allied health professionals, even though, you know, I, every year when I sign the thing off that says you know I pay money to the HCPC, Health Care Professions Councils to say that I do use the skills that I trained clinically with, within my role. I still have that bit of me going, Yeah but I’m not doing it in the hospital ward, so maybe it’s not real, maybe it’s not genuine, That’s a bit weird, isn’t it?