Professor Sheree Smith, Western Sydney University, Sydney Australia
Across the globe, clinical academic careers for nurses and midwives have been discussed in both academic and clinical forums for over a decade. These discussions often have great passion and commitment and yet we still are addressing many of the same issues discussed a decade ago. Not all nurses and midwives will want to have a clinical academic career and those nurse clinicians and midwives who choose to deliver evidenced based care without an aspect of conducting research also need to be celebrated for the quality of care they deliver. Equally there are many nurse and midwifery academics whose careers are solely focused on teaching and learning expertise and educational research within the university sector.
The Council of Deans of Health’s report is a welcome addition to these clinical research career discussions by documenting tangible achievements being made in the domain of clinical academic NMAHP careers. This UK report highlights an important issue of conducting large scale studies. Nurses and midwives may find it difficult to develop large scale studies when there are very few clinical research leaders in their particular specialism. Nationally and internationally, this situation differs to that of our medical colleagues. Whilst there are a small number of clinically embedded named university funded professoriate chairs, for example, in cancer nursing across the UK, there are even fewer or none at all in other specialisms such as musculoskeletal, neuroscience, surgical nursing, ophthalmic, renal and respiratory. More often than not, we see titles such as ‘Professor of Nursing’ that convey a perception of being ‘research to all nurses on all topics’. This generalist approach essentially impacts on the track record of all researchers, from post-doctoral to chair positions. A research track record that lacks focus diminishes opportunities to gain competitive funding to support future studies to answer important clinical questions. This occurs when there is a disparate body of research being conducted by an investigator. A specific programme of research demonstrates depth of knowledge and experience in conducting research related to a particular area and cohesion across their research studies over a significant period of time. A disparate research track record is a significant departure to other disciplines such as medicine and science.
Unfortunately, a lack of embedded university funded chair appointments in clinical specialisms is also evident in other nations outside of the UK such as Australia where there are very few fully university funded named professorial chair positions. In some states of Australia, there are conjoint nursing appointments which are partly funded by a university and a hospital. Clinical academics in these conjoint appointments often face tensions and challenges in trying to meet the needs of two separate organisations with differing expectations and rather than building a programme of clinical research, the local health service priority may be education (1). Nurses and midwives (as our Australian allied health professionals seem to have progressed further in this area than nurses and midwives) compete for funded personal awards such as fellowships (these pay the investigators salary) and project funds (to pay the research assistants salary) to conduct high quality studies. Proportionally nurses and midwives are poorly represented in these schemes and there are many reasons for this less than satisfactory outcome. Recently an Australian perspective was published in two discussion papers (2; 3) associated with clinical research careers, clinical researcher and non-investigator roles. The discussion paper outlining a potential clinical researcher career trajectory with embedded outcomes and expectations for each level of the clinical researcher career trajectory seeks to be one step in helping to redress this imbalance in success rates of nurse and midwifery research funding applications. These outcomes and expectations were based on published characteristics of successful applicants who were awarded National Health and Medical Research Council early career fellowships. Being informed at a granular level of expected outcomes, and the associated aspects of research careers such as chairing sessions at international conferences, would potentially place nurses and midwives on a more even footing with researchers from other disciplines when they apply for competitive funding and fellowships. Also by understanding the characteristics of successful applicants, nurses and midwives can plan their research careers through understanding and addressing these expectations in a proactive way.
In conclusion, the NMAHP UK report forms part of the international dialogue associated with clinical academic researcher careers. The report adds to our understanding of clinical academic careers in the UK and it is important to celebrate the progress being made to date.
About the author
Professor Sheree Smith is an internationally recognised researcher in respiratory care and leads a program of acute care and primary health services research. She led the working group that developed the clinical research career trajectories for nurse researchers and non-investigators and is an author on the subsequent publications referenced in this blog.
(1) Daryshire, P. (2010). Joint or clinical chairs in nursing: From cup of plenty to poisoned chalise? Journal of Advanced Nursing, 66(11), 2592–2599 https://doi.org/10.1111/j.1365‐2640.2010
(2) Smith, SM., Gullick, J., Ballard, J., Perry, L. (2018) Proposed Clinical Research Support Career Pathway for Non-investigators, International Journal of Nursing Practice published: 08 March 2018 https://doi.org/10.1111/ijn.12641
(3) Smith, S.M., Gullick, J., Ballard, J., Perry L. (2018) Clinician Researcher Career Pathway for Registered Nurses and Midwives, International Journal of Nursing Practice published: 25 March 2018 https://doi.org/10.1111/ijn.12640