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Training in research competencies: a strategy for neonatology
  1. Gopi Menon1,
  2. Mark A Turner2,
  3. Amanda L Ogilvy-Stuart3,
  4. Anne Greenough4
  1. 1Department of Neonatology, Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, Edinburgh, UK
  2. 2Division of Perinatal Reproductive Medicine, Neonatal Medical Unit, Liverpool Women's Hospital, University of Liverpool, Liverpool, UK
  3. 3Addenbrookes NHS Trust, Neonatal Unit, Neonatal Unit, Rosie Hospital, Cambridge, UK
  4. 4Division of Asthma, Allergy and Lung Biology, Kings College Hospital, Kings College London, London, UK
  1. Correspondence to Dr Gopi Menon, Department of Neonatology, Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK; gopi.menon{at}nhslothian.scot.nhs.uk

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The report ‘Turning the tide’ highlighted the need to increase the capacity for clinical research in child health.1 The increase in training posts funded by the National Institute for Health Research (NIHR) will slow the fall in academic consultant positions.2 The rapid growth in clinical trials in neonatology (figure 1), however, means that all neonatal professionals need to have the necessary awareness and skills. Research involvement within a clinical service should be considered a sign of healthcare quality.3

Figure 1

Time trend in published clinical trials in neonatology.

With the separation of academic and clinical specialist training, most trainees have little involvement in research4 and proposed changes could make this worse.5 The paediatric curriculum does include research skills that are currently being refined and linked to assessment of competencies by the Royal College of Paediatrics and Child Health (RCPCH). There is, however, no easily accessible training, and it is thus not surprising that trainees lack confidence in this area.1

Nurses are the primary source of information for parents of babies in neonatal units6 and are thus potentially important advocates for research. Nurse training curricula include no research competencies, although the specific roles of the clinical research nurse and nurse researcher have recently been defined.7

The British Association of Perinatal Medicine (BAPM) is developing Basic Research Skills Training for all neonatal professionals with input from the NIHR Neonatal Clinical Studies Group and the RCPCH with a curriculum mapped to competencies in the paediatric curriculum (see online supplementary appendix). A training day was developed for research-naive professionals and piloted with three learning objectives: (a) develop awareness of the importance of clinical research, (b) understand the important features of engaging parents in research and (c) gain practical ideas for increasing the profile of research in neonatal units. The day began with talks by a clinician researcher and by parents of a baby entered into a trial. There were interactive sessions on (a) communication of research to parents (simulated using professional actors) and (b) increasing the profile of research within a unit (and barriers to this). Delegates were signposted to relevant existing online resources.810 Attendance was by invitation and was free for nurses (acknowledging their limited access to educational funding). The delegates were 6 nurses, 15 trainees and 1 consultant, with a significant collective research experience (4 research nurses, 10 postgraduate degrees, several with grant applications and experience of being chief or principal investigator). The faculty comprised 14 professional and 3 parent facilitators, 2 administrative staff and 4 professional actors. The costs of the day (£2230) were part funded by commercial organisations, which had no influence on content or delivery. Costs included two planning meetings, the venue, expenses of faculty and nursing delegates, and actors' fees.

Delegates mainly gave the training day a high rating (of those who gave a rating (18/22), excellent 1, very good 12 (67%), good and poor 2 (11%) each, average 1) and felt that it had increased knowledge relating to delivering research. Comments from those who gave a low rating suggested that the training was too basic for their needs, probably reflecting the research experience of the Pilot Day delegates. Self-assessed knowledge level showed a statistically significant increase post training for ‘creating a research culture’ (figure 2), but not for the other two learning objectives.

Figure 2

Delegates’ self-assessed pre-training and post-training knowledge levels on ‘creating a research culture’.

The training is being further developed, informed by the rich feedback from research-experienced delegates (table 1), and it is planned to hold an annual training day. Delegates will have access to further online resources, including (a) a description of research structures (eg, the Research Ethics Committee, the National Health Service (NHS) R&D Department, the Medicines and Healthcare Products Regulatory Agency and the NIHR) and the requirements for trial involvement, included in the recently developed RCPCH CYP Research Charter;11 (b) documents mapping how trainees can gain research competencies during training and from the training day (including the RCPCH guide for trainees12); (c) videos illustrating communication of research to parents; (d) a list of active research trials and relevant contacts and (e) the RCPCH database of funders of child health research. It is hoped in future to assess the impact of such training both at individual delegate and national levels by looking at changes in trial recruitment of eligible babies.

Table 1

Feedback themes and proposed changes to training day

During the communication simulations, an embryonic research communication assessment was tested, and this will be refined based on feedback. Further assessments are needed for use during journal clubs, clinical presentations and ward rounds. They will help build a culture in which research and evidence-based medicine are considered integral to clinical practice.

While there are existing examples of courses aimed at those undertaking their own research, we are not aware of any training for a multidisciplinary research-naive audience. The RCPCH has brought together the Clinical Specialty Groups and the NIHR Clinical Study Groups (CSGs) with the aim of making this novel training accessible to all paediatric trainees.

Involvement in research improves the delivery and scrutiny of care3 and may improve health outcomes even with placebo treatment.13 Parents are generally positive about being asked to enter their child in a trial.14 Thus, our ambition should be to give the family of every baby receiving neonatal care the option of research involvement, as pledged in the NHS England Constitution.15 A strategy for training all health professionals in basic research skills will be an important step towards this end.

Acknowledgments

The following were part of the Steering Group that developed the training and played important roles in the development and delivery of the training: Jon Dorling (CSG): sourced parent communication materials and was faculty member for training day. Mehali Patel (Bliss): identified and supported parent facilitators and was faculty member for training day. David Summers (BAPM): provided nursing perspective. Christopher Gale (CSG): provided trainee perspective and was faculty member for training day. Mark Johnson (CSG): provided trainee perspective and was faculty member for training day. Katie Farmer (BAPM): provided trainee perspective and was faculty member for training day. Dan Lumsden (RCPCH and APA): representing academic paediatric trainees. Tyabba Siddiqui (BAPM): provided administrative support, producing written materials and organising meetings and the training day. Danielle Wilson Marlow and Michelle Evans (Clinical Research Facility, Edinburgh): provided valuable advice in the early stages of planning the training. The authors are grateful to the parent facilitators who provided an important parent perspective on the training day and to actors from Ben Hur Productions for help with the role play. The Royal College of Paediatrics and Child Health provided accommodation for the pilot meeting.

References

Footnotes

  • Twitter Follow Gopi Menon at @gopi_menon

  • Contributors GM wrote the article. All authors were involved as part of the Steering Group that developed and delivered the Research Skills Training and contributed to the editing of the article.

  • Funding The Neonatal Society and the Academic Paediatrics Association helped with funding for the training day. The following commercial organisations also contributed funding: SLE, Alexion, Chiesi, Fisher & Paykel and Draeger.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data sharing statement Further details of the training materials and the programme for the Training Day can be obtained from GM.

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