Effective academic and clinical partnerships are essential for successful research and uninterrupted care. A perceived lack of time is a well-documented concern among clinicians (6) as are knowledge gaps surrounding research opportunities (1). No guidance exists for building these partnerships; rather, teams rely on group norms and the social skills of individual members to set/maintain the culture. This abstract highlights how our team applied the AACN Healthy Work Environment Standards during the successful launch of a new academic-clinical partnership consisting of researchers, scientists, nurses, doctors, other clinicians, and student trainees.
AACN Healthy Work Environment:
Effective Decision Making
Effective decision making and the involvement of stakeholders (outlined below) during the planning/launching of the study was critical.Key Investigators: Communication between the principal investigator (PI) and senior clinicians began prior to study conceptualization. These individuals also collaborated on key study details (e.g. inclusion/exclusion criteria) and logistics.
- Students: The PI reviewed hospital registry data with the students and related it to the study’s inclusion/exclusion criteria. Students were individually trained and evaluated by skilled screeners.
Skilled Communication
- Nurses: The research team followed up directly with the on-unit leadership (e.g. nurse manager; nurse educator) requesting requesting discussion of our study at weekly staff meetings to prepare staff for our presence.
- Other Clinicians: Our team met with unit leadership about the study goals/workflow. The blood draw form was streamlined to reduce superfluous information and clinician burden.Students: Communication of study goals and student responsibilities was accomplished using standard methods (e.g. emails, meetings) and technology (e.g. continuously updated Google Sites; a video with interactive questions to teach HIPAA requirements; task management apps).
True Collaboration
- Researchers/Academicians: The PI endeavours to embody true collaboration in all aspects of the study (e.g. screening, freezer de-icing).
- Nurses: A study of nurses in Australia found that many feel their assistance in research would be invaluable; however they perceived insufficiency of knowledge on involvement in research (1). Nurses should be encouraged to describe the study goals so they will understand how their contributions may help improve patient care through evidence-based practice (1, 2, 3). In launching the study, the PI shared with the unit the study goals and support of the nursing research department. The PI highlighted opportunities for mentorship from a PhD prepared nurse scientist (3, 4). In past studies, this increased nurse participation by allowing for education in terms understood by nurses and generating inspiration and respect for the nurse with a more advanced education level (3, 4).
- Students: Involvement of undergraduate students in research is challenging but offers practical advantages in addition to enhancing their training. As students engage in clinical and academic culture, they grow as future contributors (9). Faculty research sparks interest in mentees and sets an example for how to address challenging situations (9). In our study, students are encouraged to assume leadership positions leadership including: giving tours of research facilities, creating lab-specific HIPAA training, and role modeling inter-professional communication. This increases student self-efficacy, allows the PI to focus on tasks beyond the undergraduate scope, and reduces clinician burden (9). Including students from several disciplines enriches studies (9). Key to success is promotion of student independence whenever possible, including the conceptualization, writing, and editing of this abstract.
Appropriate Staffing
- Principal Investigator: The principal investigator is ultimately responsible for ensuring successful study execution. The PI and her mentor discussed strategies to maximize screening effectiveness; essentially, this requires the PI being on call 24/7 with support.
- Students: Screening the EHR for potential participants must occur 24/7. This is the responsibility of the PI, either by hiring clinical research coordinators and/or utilizing trained volunteers. The clinical research partnership described here was accomplished with the support of modest pilot funds, necessitating reliance on volunteers. Involvement of established team members in thoroughly orienting of new members facilitates exponential growth while minimizing PI burden.
- Nurses and Other Clinicians: Reliance on student volunteers for orientation minimizes the burden on clinical staff. When clinical staff involvement is required, the study team initially contacts the participant’s primary nurse and will reach out to the charge nurse if additional help is required.
Meaningful Recognition
- Clinicians: To express our gratitude, staff are acknowledged (2) using hand-written thank you letters. Students with a knack for baking were solicited to bring the unit treats to express gratitude. Additionally, clinical staff are updated frequently on study progress to maintain their enthusiasm and emphasize our appreciation for their help in making the study possible (7). In addition, the PI was inspired by a mentor to formally acknowledge the effort of unit nurses in the form of a letter to the hospital’s Director of Nursing.
- Students: The team formally recognizes students in several small ways to promote camaraderie. Each week, a student is chosen as mentee of the week (Monday) or rising star (Wednesday) and their accomplishments are highlighted. This validates their efforts and inspires other students to become leaders.Student leads on key study activities have been identified and provide reports at team meetings. When feasible, the PI treats her team tor happy hour or lunch to show appreciation for their efforts.
Authentic Leadership
- The most fundamental, yet challenging, component of launching a new academic-clinical partnership is consistently displaying authentic leadership. Essential skills include project management, delegation, and skilled communication between stakeholders. Self awareness/transparency about personal limitations and issues encountered, as well as effective communication of this information, has proven critical. Involving students facilitates development of their own authentic leadership skills. Public engagement efforts are critical, motivating the PI to present the study outside of professional conferences to increase awareness about nursing research. The PI presented at the Sigma Theta Tau International Epsilon Theta Research Dinner about nursing research and the various ways nurses can be involved. There are many misconceptions about nursing research, but these can be overcome with authentic leadership and public outreach.
Summary: In fast paced, acute settings, nurses and other clinicians have expressed concern that involvement in research will interfere with care (5). It is essential that clinicians are assured that patient care comes first and missing research enrollment is preferable to compromising patient care. The most common push back is the perceived lack of time to do research (6) leading us to strategically minimize clinician burden. Additionally, absence of incentive or reward for nurses to do research is a common complaint (6). Our under-funded study operationalized our gratitude with verbal appreciation, handwritten thank you cards, and treats. If additional funding is generated, IRB approval will be pursued to formally acknowledge nurses for their efforts (e.g. gift cards). Effective communication among team members, innovative use of technology, and demonstration of authentic leadership are critical to launching successful academic-clinical partnerships and training students to be the next generation of leaders.