The benefits for health care staff of involvement in applied health research: a scoping review

The benefits for health care staff of involvement in applied health research: a scoping review

Abstract

Background Initiatives are increasingly encouraging health and social care staff involvement in research, with evidence for patient and organisational level benefits. There is less evidence of the benefits for staff and whether this varies by type of involvement. This scoping review aimed to identify the different ways staff are involved in applied health research, the benefits experienced, and whether this varies by type of involvement. This will help to inform leaders in service organisations, funders, and researchers about how to maximise such benefits.

Methods The scoping review followed the JBI methodology. Four databases were searched: CINAHL, MEDLINE, PsycINFO and Scopus. Grey literature was identified via Google, Google Scholar and relevant websites. Records had to be UK-based, published in English between two thousand three and twenty twenty-three and cover applied health and care research, health care staff involvement and report on benefits. Text was extracted from records, coded afterwards, and quality checked. The benefits were distilled by four research active health care staff. Descriptive statistics and narrative synthesis were used to report the results.

Findings In total, forty-nine records were reviewed, forty-two records were from the database search and seven from the grey literature search. Records were most commonly journal articles, covering multiple care settings and mixed professional groups, used qualitative methods and focussed on clinical academic roles. Six benefits of involvement in research were distilled: personal fulfilment, general competencies and skills, connections and networks, opportunities for learning, opportunities for leading improvements in practice, and using evidence more effectively. Records that focussed on the more intensive clinical academic roles reported more examples of opportunities for leading improvements in practice, and the building of connections and social support. Non-clinical academic records more frequently reported that involvement in research provided opportunities for learning.

Conclusions These findings support efforts to involve staff in research, with a range of benefits associated with enhanced job satisfaction, even when research involvement is in a less intense form, such as participation in a study. These findings can be used to encourage involvement, with recommendations for future research to review the benefits for social care staff, and to examine more directly the effect on staff wellbeing and retention. Keyword Health care staff, Research involvement, Benefits

Introduction

Positive associations are reported between clinicians' and health care organisations' engagement in research and improved processes of care, such as treatment access, adherence to best practice, and patient health outcomes, with a potential 'dose effect' of research engagement also suggested. Similar positive associations have been reported for research active English general practices, including their scoring higher on measures of clinical quality of care and reduced accident and emergency attendances. Many of these advantages are realised through the positive influence research involvement can exercise on translation of research evidence into day-to-day care, as well as the organisation and delivery of services more broadly, as well as through the value of research networks which have a remit to reach out to and engage clinicians. Perhaps unsurprisingly then, there is a growing onus on supporting health and social care staff involvement in research. For example, in England, the National Institute for Health and Care Research announced an additional thirty million pounds a year of funding to expand and strengthen existing opportunities for health and social care professionals to develop research careers. Examples include fellowship schemes at pre- and post-doctoral levels, and the NIHR INSIGHT programme, providing funding to inspire students into research. In the UK, as well as the USA and Australia there are also advanced clinical practice roles, with research in the job specification, and research is specified in competency frameworks of the Nursing and Midwifery Council.

Underpinned by a rich and expanding body of literature on co-production, including works from the social sciences and humanities, political science, public management, and academic entrepreneurship, scholars have been equally enthusiastic in creating a variety of conceptual frameworks, guidelines, and principles for co-production. Recent systematic reviews of co-production have summarised the different co-production approaches in use and collated the outcomes and effects of co-production. Despite the proliferation of conceptual thought, empirical studies on co-production are less frequent. Many co-production models and frameworks are not supported by robust evidence and do not describe in practical terms what co-production of research on the ground looks like.

Similarly, whilst the benefits of research involvement for organisations and patients are well reported, less is known about the benefits for staff themselves, although the challenges to involvement are better reported. Where benefits are reported,

as found by Marjanovic et al., the tendency is towards commentary on the potential benefits, rather than actual benefits identified for example, through interviews or surveys with staff. Importantly, there may also be 'hidden benefits' for health and social care staff. Hidden benefits for patients involved in research include their having improved knowledge of their health condition, a sense of pride from taking part, an increased desire to help others, and appreciating the opportunity to talk to someone.

For health professionals, hidden benefits may be linked to the process of being involved, such as satisfaction and a sense of achievement. There is potential for such hidden benefits for staff to contribute to job satisfaction and hence improved workforce retention. Indeed, in the NHS Long Term Workforce plan, the word 'research' appears twenty-nine times, including reference to enabling more flexible and autonomous career development through portfolio careers encompassing research roles for medics. Workforce retention is a pressing issue, with the current NHS vacancy rate of six point nine percent across all roles, which is even higher for nurses and midwives at seven point five percent. Thus, given this backdrop of stretched resources, it is vital to be able to demonstrate the full plethora of benefits if staff are to be supported to spend time on activities other than direct patient care. It is also vital to help identify novel approaches to upskill, retain and attract new staff.

This scoping review was undertaken to identify the different types of involvement in research, what the benefits are, including hidden benefits, and whether they vary depending on the type or intensity of involvement. We specifically explored the benefits because barriers to involvement in research are already well reported, and we focused on involvement in applied health and social care research, rather than on clinical research, as this is less well explored. The findings will be of value to researchers seeking to encourage and optimise health care staff involvement, to the NHS, and to funders and policy makers seeking to attract health care staff into research and to understand and maximize the benefits for them.