In more than five years of research capacity building roles that have spanned academic, health service, and academic health science centre settings in rural and regional areas I’ve had several opportunities for professional reflection and growth. This article distils those into five key lessons for building research capacity in allied health:
Lesson 1: I’m building my own research capacity while building that of others
Allied health comprises more than 50 professional groups, including many smaller and lesser-known professions – please see A-Z of Allied Health if you’re not convinced! So, it’s not surprising that the research problems and ideas that arise in the allied health space are diverse and interesting. Some ideas are very “clinical” in nature (think: clinical trials, clinical effectiveness studies) and yet some relate more to service delivery issues, client experiences of services, and others to health profession-focused concepts and issues (e.g., exploring allied health identity, allied health education).
This diversity makes the research capacity building space exciting for allied health, but it’s also incredibly daunting. Allied health professionals commit to lifelong learning when they embark on their careers—working in the research capacity building space takes this to a whole new level. Even experienced allied health clinician researchers are considered novices in some areas because they simply haven’t had experience in and knowledge of all allied health research topics or research methods and approaches.
To work in the allied health research capacity building space, we as researchers must become very comfortable with never really feeling like we are across everything and always be open to learning. We need to develop a strong research network, made up of individuals with a range of research skills to both learn from and link AHPs we are supporting into, when we are out of our depth. I do this a lot.
As someone working in the research capacity building space, I am continuously learning and building my own research knowledge and skills, all the while helping to build those of the AHPs I work with.
Lesson 2: It’s a long game, and it’s hard to keep score
I was warned coming into the allied health research capacity building sphere that although it can be a very rewarding role, there is a lot of hard slog with some nebulous outcomes that take a long time to achieve. I have also become increasingly aware that measuring these outcomes and demonstrating value and impact to stakeholders is a real challenge.
Few would disagree that the ultimate aim of building research capacity in allied health is to decrease the gap between research evidence and clinical practice. We know this is far more likely to occur when research is close to practice and addresses real world clinical practice problems. There are so many small steps and hard-fought wins toward this aim—particularly if the organisation’s baseline research activity is low, or there is minimal research infrastructure—that it is difficult to demonstrate real impact.
Don’t get me wrong, we do see wins. With support and guidance, we see some novice AHP researchers publish first author papers, and we see novice researchers secure seed grants.
We see apprehensive AHPs submit abstracts that are accepted, and they go on to deliver smashing presentations!
We see partnerships between academic schools and allied health departments develop and flourish, after an off-the-cuff email introduction.
The most surprisingly rewarding outcome for me so far was receiving an out-of-the-blue email from a novice AHP researcher who was prompted by a colleague to reach out to me for research support. This was surprising because I barely remember the colleague who referred the novice AHP researcher to me; I had no idea of the impact I’d had on them. Hearing second-hand that I contributed to getting them started on their research journey, when to me, my input and guidance felt minimal, was validating. Then almost two years down the track, they encouraged one of their colleagues to take the leap into research. What a thrill! Albeit a long-awaited one.
It’s hard to capture those outcomes though, and too easy to question our value and impact when there are countless other interactions with AHPs that lead to very little research activity.
The literature on research capacity building highlights just how varied the reported outcome measures are and many research capacity building evaluations rely on self-reported data. Combine these factors with the different definitions of health research impact and then add staff turnover into the mix; demonstrating impact to stakeholders including health services managers and funding bodies, is extremely challenging.
I have taken to recording all the seemingly small wins along the way and to be creative about how I communicate the outcomes and impacts I have achieved. With consent, I have developed short (and more detailed) case studies and examples of outcomes and impact. For a host of reasons, we see very few of these types of impact reports in the peer-reviewed literature: ethical concerns, and the lack of appetite for these types of papers in academic journals, to name a couple. I have learned that patience, persistence, and innovative approaches, tailored to the organisation, are needed to measure and report impact.
Lesson 3: Multifaceted approaches are needed to build research capacity in allied health
We know from the literature that multifaceted strategies are needed to build research capacity. To achieve real improvements in research capacity, it is simply not enough to offer novice allied health researchers training without ongoing guidance and support. Nor is it enough to offer mentoring in the absence of fundamental knowledge of how to conduct research. Even then, research knowledge and guidance can only take allied health professionals so far if they don’t have managerial or organisational support to conduct research or the infrastructure to get it up and going (for example, ethics and governance pathways, survey platforms, etc.).
To work effectively in a research capacity building role, we require research knowledge, sure, but we also need mentoring capabilities, the ability to develop educational content (or knowledge of where and how to access appropriate content), the ability to network and problem-solve, and negotiate with executives to secure resources and funding for infrastructure (or know how to link into existing infrastructure where possible). Clearly, research capacity building is about far more than simply “doing research”.
Professor Nicholas Taylor and a team of allied health researchers evaluated the impacted of the introduction of an allied health clinical research office at a large metropolitan health service in Victoria, Australia. They demonstrated an increase in allied health professionals’ self-reported research interest and experience eight years after the research office was established, and an increase in research outputs over the same timeframe. Over the eight-year timeframe, there were numerous research capacity building initiatives implemented, including research training, regular communications about research, and research forums for allied health.
Many types of building blocks are needed to build research capacity in the form of people, roles, skills, strategies, and initiatives.
Lesson 4: Collaboration and responsiveness are key
This lesson is closely related to the one above. Research is a team sport; so too is research capacity building.
It is not uncommon for those in building research capacity roles to be employed in a fractional capacity and to be implemented in the absence of a supportive department or team. This can be isolating for the researcher and can also set unattainable expectations. Building research capacity simply cannot be done by one person, in the absence of supportive infrastructure or without a cultural shift within the organisation.
In our research capacity building roles, we play a key role in stimulating and adding momentum to the cultural shift, but the message that research is valued and important must come from multiple levels of influence within an organisation. What’s more, those in research capacity building roles must be part of a team working toward the same end goal.
In Victoria, 10 Allied Health Research Translation roles were implemented in 2018 and as part of this program, a research community of practice was established. This community of practice provides for an essential network for allied health researchers as they work to build research capacity and culture in their respective health services.
Dr Rachel Wenke led the evaluation of Queensland Health’s [Allied] Health Practitioner Research Fellow program in 2016, and found that one of the key challenges non-metropolitan-based Health Practitioner Research Fellows was a feeling of isolation. Recommendations to address this included developing a team with others in research-related roles where possible, and seeking support where possible from local university partners.
Research capacity building initiatives and strategies must respond to the unique needs and goals of the organisations concerned. It is crucial to take the temperature of the organisation initially, to understand what these needs and goals are, and to keep checking in with a range of stakeholders at different levels within the organisation to make sure the right initiatives are in place to meet these needs and goals.
Lesson 5: There is no defined career pathway for allied health clinician researchers, but that doesn’t mean there are no opportunities
Through their large qualitative study, Dr Caitlin Brandenburg and Professor Elizabeth Ward highlighted the lack of a career pathway for allied health clinician-researchers. This research evidence resonates with me and my own experiences. However, I have also witnessed many of my AHP researcher colleagues offered some amazing opportunities on their respective research journeys and many have new and exciting research roles established just for them. For example, as university-based research fellows positions, health service-based research management roles, and implementation scientist roles in large grant-funded projects.
AHPs start their research journal with different personal qualities and for different reasons. Some are keen to answer a burning question, others want to revolutionise clinical practice, some want to gain new skills or take on a new challenge to maintain their passion for their clinical career, and some seek to forge a career as a clinician researcher.
Working in a research capacity building role, I have become somewhat attuned to the different qualities, motivators, and goals of AHPs embarking on research and I try to tailor my support and strategies accordingly. It is particularly exciting working with those looking to forge a clinician research career as they are more likely to progress their research idea and see it through to the end.
I have learned to speak openly about the precarious clinician-researcher careers of AHPs, but also about the opportunities I have seen come up for colleagues and those I have had myself. We have a way to go in terms of establishing structured pathways for allied health. Still, there are some fabulous opportunities out there waiting to be taken—or created for talented allied health clinician-researchers.
The research capacity building space is challenging, fulfilling, and evolving. I hope these lessons have been helpful and resonate with others working in this space.
To share your thoughts and experiences of allied health research and capacity building, please leave a comment below.
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