Introduction
Research should underpin professional activities whether these are clinical or educational, forming part of most job descriptions and central to a radiation therapists’ good practice.1 Traditionally therapists have played important roles within major clinical trials but there is real momentum for therapist driven research into areas outside the major national or international trials that concern both therapists and users. The number of radiation therapists with higher degrees is increasing and the requirement for research activity within radiotherapy undergraduate and postgraduate qualifications means interest in research and research skills within the therapist community is generally more prevalent.
This article is aimed at those with limited or no previous experience of research or those wanting to develop their research capabilities. The article initially will discuss the importance of research, what skills are needed to participate in research, followed by a brief discussion of the research process, the importance of getting the people with the relevant skills for your proposed study on your project teamReference Nokes, Major, Greenwood, Allen and Goodman2 and some key points to consider when applying for research funding.
Getting Started: Why Research?
Practitioners undertake research for a number of reasons (see Box 1). Research enables therapists to improve patient care as it provides insights into practice and affords the opportunity to test the effectiveness of the care provided.Reference Crow3
Utilising research to underpin practice is the ultimate aim of therapists undertaking research, acting as a catalyst for innovative work. Research should be encouraged so that those with an interest or affinity in certain projects can become involved and have ownership of the changes that occur as a result, aiding professional development and job satisfaction.
The therapist's role also requires co-operation and intercommunication with other health professionals so that multidisciplinary research work can be undertaken, thus recognising the overall well being of the patient from a holistic approach via the constructive sharing and mutual exchange of information.Reference Dilly4 This provides an environment for strong and effectively performing teams, rather than professions working in isolation, or even against each other.
Collaboration enables staff groups to work effectively and efficiently together and to educate each other about their roles and professions, enabling a mutual working environment rather than professional territoriality and ensuring seamless patient care.5
Many members of the health professions fail to see or do not wish to see the importance and relevance of research in a clinical setting and it is only by persevering and demonstrating why it is important that their views may be expected to change. Lack of enthusiasm by others can also be the fault of the researcher who must communicate appropriately with others.
Research in a work area requires commitment by everyone and must be encouraged and valued by the whole team, otherwise barriers can exist which may block research findings being utilised and implemented. Research work needs to be valued and must not be just a token gesture in a department if it is to co-exist with radiotherapy procedures on a daily basis.Reference Harris6 It needs to become a culture, the norm. Research is about sharing work and all therapists need to feel included and have ownership of the work.
Of course research can be flawed; it does not answer all the problems. Good research can only provide insights into the problem being investigated and the original question that was asked. Hence good research training is necessary and should be encouraged as part of the continuous professional development (CPD) of all radiographers.
It is important that radiographers are involved with projects at their centre. ‘In-house’ research adds to the professional body of knowledge and is excellent for personal portfolios. When trying to get started with research it is worth trying to get involved with clinical trials and commercial studies. These provide confidence to do it alone and may be used to sponsor in-house work and to fund education and courses for staff. Opportunities for research training are likely to increase and as time progresses research involvement is being recognised as a legitimate part of professional activity.
Getting Started: What Skills do you need?
A good researcher needs to acquire a range of basic (see Box 2) and specialist (see Box 3) skills to produce high-quality outputs. For those thinking about getting involved in research a review of the skills listed in Box 2 may identify some gaps in current expertise that may need attention prior to initiating any project.
There are a number of educational establishments that offer short courses on a variety of basic research skills as well as more specialist courses on research methods (see the web links in the resources section at the end of this article), some even offer e-learning alternatives to reduce the need for time away from the workplace. In addition, it is important for researchers to have good communication skills in order to
network
put together strong research teams
consult with relevant stakeholders to gain access to potential research participants
engage interested parties in collaborating on the proposed work (see the article in this edition on patient and public involvement).
It is also important to be willing to invite feedback (however critical) about your work in order to improve the quality of the subsequent study.
Getting Started: The Research Process
When undertaking research it is important to follow the research process, Figure 1 shows the standard cycle of events that most novice researchers should follow. Primarily there are two main stages: conceptualisation and operationalisation. Good measurement starts with good conceptualisation.Reference Ruane7 This means being clear about the concept you intend to research and clarifying relevant terms. In addition, the conceptualisation stage includes considering each of the following:
Topic analysis
Aims and objectives
Scope of the study
Research questions (hypothesis or proposition)
Review of the current literature
Methodological tradition or standpoint
Sample
Variables to be studied and variables to be controlled
Reliability and validity
Timetable of activities and key milestones.
Figure 1. The research process.
Within the conceptualisation stage it is necessary to consider the research topic or the questions to be answered. For those new to research it is important to consider the resource implications (both the cost of undertaking the project as well as the time commitment from participants) that will be involved. Research for postgraduate qualifications is often seen as ‘a means to an end’ and the researcher must consider the societal benefit of undertaking the study as well as any potential harm to participants when formulating the questions to be answered. Box 4 indicates where potential new research ideas may develop from.
Following clarification of the research topic a meticulous review of the current literature on the topic is usually required to ensure the answer to the proposed question is not already available from previous research, as well as using previous research to augment the design of the proposed study (by incorporating design approaches that have been used in successful studies). Furthermore, previous research can provide data to inform sample size calculations where appropriate. Specialist research methods (such as Grounded Theory) may require that a thorough review of the literature be reserved until a theory has started to emerge from the data.Reference Glaser8 Box 5 lists some databases that novice researchers may find useful when investigating the current available published evidence.
A detailed proposal should also be prepared during the early design stage serving a number of functions:
Helps ensure important details about operationalisation of the study have been considered.
Can be submitted to relevant ethics and governance approval panels as well as funding bodies.
Can be used as a template for the study and used to develop a protocol for individuals involved in data collection providing guidance on when data need to be obtained and in what format.
Can be referred to during data analysis to ensure the results’ focus on the initial questions posed.
During conceptualisation of the study it is important to consider the research method that will allow you to answer the research questions posed. It is beyond the scope of this article to discuss all the methods and their applications; Figure 2 presents an example of the spectrum of research designs and some radiotherapy examples.
Figure 2. The spectrum of research methodologies, methods and tools.
The second stage of the research process is the operationalisation of the project design and involves doing the research and disseminating the results. This stage involves a range of activities including
Undertaking a pilot study
Data collection
Data analysis
Synthesis of the results
Placing the results in context of published literature
Testing the results against the research questions
Disseminating the results through journal articles, presentations, and reports to key stakeholders.
Getting Started: The Project Team and Project Management
Putting together the project team needs as much thought as the project design. Ensuring that the team has the requisite skills to complete the proposed work is important if funding bodies are to feel confident that the project has a high chance of success. There are no hard fast rules to apply when selecting your project team but some thoughts to consider are provided in Box 6.Reference Nokes, Major, Greenwood, Allen and Goodman2
As well as considering with care members for the project team, consideration also needs to be given to who will be the project manager. The project manager should be someone with relevant managerial experience as they will be expected to manage the team and the resources to ensure that the project produces the outcomes expected on time and on budget. Many senior therapists already have the requisite skills to be project managers and will have relevant experience in managing teams, and budgets (see Box 6). It is worth thinking about the approach to project management; the critical chain method is one approach. In this method high risk activities are identified in the timeline, and where possible multi-tasking is avoided to ensure maximum chance of success of each of the activities.Reference Nokes, Major, Greenwood, Allen and Goodman2 A buffer is added to the end of non-critical activities in the timeline to protect the start of other critical activities (see Figure 3 for an example timeline utilising the critical chain method). The buffer times can be used as diagnostic tools to alert the team to any circumstances where a recovery plan should be implementated to keep the project on target.
Figure 3. Example timeline using the critical chain method of project management for 1 year of a research study.
Getting Started: Funding the project
One of the main challenges for novice researchers when getting started in research is being able to secure funds to buy out your time from normal clinical or educational duties. Even where research is a part of an individual's core duties, funding is usually necessary to provide appropriate resources for completion of the study. Applying for and securing project funding is not easy even for experienced researchers. Competition is often high and funding bodies have limited budgets so proposals need to have high quality and value for money. Therefore, it is recommended that those new to research join established research teams on other research projects to gain experience and develop a research reputation before attempting to do it alone. It may also be worth looking for funding bodies that target novice researchers or those who are in the early stages of a research career. These funding bodies often have a remit to broaden research activity and in order to build capacity they may look positively on less experienced researchers offering support in order to nurture a research environment. For example, in the UK the Society and College of Radiographers has a funding stream that will support doctoral projects or support individuals to undertake research training as a way of enhancing research capacity. Funding opportunities for UK based therapists can be found on the research and development website, www.RDinfo.org.uk. When identifying possible funders remember to ensure your project reflects the priorities of the funding bodyReference Madden and Wiles9 as well as priorities of professional bodies, or government agencies. When completing funding applications it is important to follow guidelines stipulated by the funding body; failure to do so may jeopardise the success of the application.
Funding bodies generally use some form of peer review so it is important to find out how the application will be assessed. Box 8 lists the criteria used by the UK College of Radiographers to assess funding applications.
Getting Started: Research training
You may feel that you need some training before you embark on a research project of your own or may be you are thinking about a research career. Research training may be provided in undergraduate and postgraduate courses in the form of single modules covering a broad perspective of research designs. These single modules are usually viewed as an introduction to research methods and further research training may be needed to develop specialist skills. Universities usually offer a range of taught modules or single day events for CPD purposes. In the UK the RDInfo website lists formally taught research courses as well as short courses on a range of research topics. In addition, practitioners should look out for local workshops or study days run by Research and Development Support Units (see http://www.national-rdsu.org.uk/).
Those wanting more formal training may want to consider Masters courses in research methodology or a Master of Science degree by thesis, Master of Philosophy (MPhil) or a Doctorate. The Doctor of Philosophy (PhD) qualification usually requires a period of study of a range of research methodologies relevant to the chosen thesis topic. In addition, the newer Professional Doctorate qualifications include a formal programme of research training; both options allow individuals subsequently to give greater intellectual input to research studiesReference Gambling, Brown and Hogg10 rather than remaining simply as data collectors, interviewers or recruiters of research participants.
Conclusion
Getting started in research can seem a daunting prospect. However, all that is needed initially is an enquiring mind, lots of enthusiasm and motivation to get involved. It is important to develop the necessary skills required to complete a project to a high standard; so for practitioners with little or no previous experience a good place to start is a research methods training course. Getting involved in local projects with experienced researchers is an excellent way to gain research experience and understanding of the research process. As experience, knowledge and confidence develop practitioners may want to consider further specialist research training before leading their own projects and applying for research funding as a principal researcher. Through this progression practitioners should develop from users of research to data collectors and finally to research leaders. Developing relationships with experienced researchers to mentor early research activity can lead on to the development and fostering of research collaborations and a network of likeminded researchers as research experience becomes consolidated.
This discussion article on how to get started should help identify the skills needed to start, where to go for help and some principles that may guide the early stages of the novice researcher's research experience. It is important to have good support either through project supervision or mentorship from experienced researchers initially and this can be provided locally within the hospital or workplace, through local educational establishments (Universities) or from professional bodies. In the UK the College of Radiographers Research Group will help direct novice researchers to suitable mentors or supervisors.
Resources
R&D info for funding opportunities: http://rdfunding.org.uk/
R&D info for research training courses: http://www.rdlearning.org.uk/
