Commentary on Cecil R, Thompson K & Parahoo K (2006) The research assessment exercise in nursing: learning from the past, looking to the future. Journal of Clinical Nursing, 15, 395–402
Marie Carney, Lecturer and Head, UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland. E-mail: Marie.Carney@ucd.ie
This paper is timely and helpful for those nursing research units who must now commence planning to make their submissions for the 2008 Research Assessment Exercise (RAE). The findings distinguish those units deemed to be successful or rated highly in the 2001 RAE; the highest rated units were those engaged in primary research that was multidisciplinary in nature and focussed on patient care and clinical issues. Success in the RAE was also related to collaboration with external agencies and publication of findings in journals rated as excellent in nursing, or in journals outside nursing. In pointing the way forward for nursing research activity, Cecil et al. (2006) have set out future pathways for nursing researchers and ultimately for the development of evidence for clinical practice. Although the authors contend that there is an inward-focus bias that is centred on the profession, there is little doubt that this is changing due in part to the emphasis by funding bodies on multidisciplinary and interdisciplinary research in the awarding of research grants. This introspective bias may be because of the evolutionary stage of nursing research that has tended to focus on the profession rather than on clinical service.
As clinicians have demonstrated their commitment to interdisciplinary collaboration to enhance care delivery (Carney 2002), there is no reason to doubt that, in the same way, commitment to interdisciplinary collaboration in research will not enhance the quality of research and the success of funding procurement. This is achieved through commitment to the principle that working together and researching together ultimately serves the best interests of society. This commitment will ultimately benefit the professions through recognition by health-service providers and by society of the visible benefits of such research. It is known that the values and beliefs that clinicians bring to healthcare delivery serve to enhance patient-care delivery that ultimately permits the cultural changes required for involvement in multidisciplinary clinical research (Carney 2004). What is not known is why nurses are not seen as innovative in research that is pertinent to clinical practice. Perhaps one of the reasons for this perception is that nurses are not procuring substantial grants to undertake large-scale clinical research.
Establishing a research centre
Cecil et al. have pointed the way forward for future success in funding procurement through collaborative research and I now wish to comment on one of those areas that the authors have demonstrated as contributing to success in the RAE: establishing a research centre. Without a research centre that is accessible to nursing researchers in universities or institutes of higher education, those engaged in the RAE are unlikely to be successful or to reach their full potential.
In establishing a research centre, the first task is to persuade the college authorities and particularly the key corporate strategists, such as the college vice-president for research, that a nursing research centre is both warranted and is capable of ‘swimming in the funding stream’. That is, the authorities must be convinced at the outset that the centre is both viable and sustainable in the long term through a high output of research and publications. The centre should be established with a director who is skilled in generating interest in the centre among the relevant college authorities, by articulating the mission, aims and objectives of the centre and by quickly establishing a strategic direction with a focus on specific research areas and expertise. The centre should be established with personnel who will be actively engaged in the core activities of the centre and should include a designated director at the level of professor, senior research fellows, research fellows, research assistants, a business manager and administrative staff and its overall governance should be based on a board of management.
The first and most important strategic task of a centre so established is to identify and target funding sources, with the aim of developing a research programme that will give rise to multiple but focussed research projects that are built on the principles of interdisciplinary, interinstitutional and international collaboration and with the focus on health and social gain. This implies that the centre must be capable of attracting not just funding but other researchers from outside nursing and outside agencies. Indeed, as already observed, collaboration is key to the success of funding procurement and it is the extent of this that may ultimately contribute to the viability of the centre. While the type of projects that are undertaken must ‘fit’ with the strategic mission of the centre, importantly they must be of sufficient magnitude to sustain the centre and its research output. Cecil et al. have noted that nursing research output during the latter part of the 20th century has been focussed on nursing. In the new millennium, this output will clearly have to relate to client experiences and outcomes and from a much broader perspective.
Part of the process of establishing a research centre is establishing a brand that is commensurate with both the corporate identity of the parent institution and the mission of the centre itself. This will involve naming the centre, with its name clearly demonstrating its primary function and marketing it at institutional, national and international levels and will necessitate the establishment of a website and publicity materials. Branding and marketing will function primarily to generate awareness and interest among potential funding agencies, but will also serve other subsidiary but no less strategically important functions of declaring intent and staking a claim to topics of research, both in the parent institution and beyond. Marketing will identify the centre's focus in relation to populations, geographical areas, specific health systems, specific technologies, specific research methods and specific theoretical and disciplinary perspectives. It will also serve to place the centre in its relevant research funding stream(s). The strategic use of popular media such as newspaper, radio and television should be considered, including how best to achieve media appeal and elicit media attention for the research programme and the individual projects.
The appointment of a director of research with the experience, knowledge and expertise to lead other academics is critical to the success of the centre. The role of the director will include recruiting and selecting the right personnel with expertise in a range of qualitative and quantitative research methods and further developing their research capability. A priority in recruiting is to ensure that a statistician and/or methodologist is part of the centre or is available as a resource to the centre. Additionally, the recruitment of a team of researchers from many disciplines is important in that it will be more likely to generate multidimensional research projects that will be attractive to funding agencies. As Cecil et al. have demonstrated, having an expert in the topic of research for which an application is being made, increases the likelihood of success.
The director and the team should set out to form strong alliances with like-minded agencies and individuals, including psychologists, sociologists, epidemiologists, health economists, biochemists and so forth, to maximize the potential for funding procurement. Virtual collaboration can flourish through the judicious use of communication technologies, such as teleconferencing and the Internet. Collaboration may be entered into for a number of reasons, including grant-proposal writing, multidisciplinary research, publications, enhancing PhD student recruitment, funding for senior research fellows and sharing of expertise in such areas as business management, administrative support and statistics. Collaborating with other disciplines and agencies requires prior agreement through formally agreed protocols for research collaboration, including memoranda of agreement for individual research projects. This will involve agreement in relation to roles, responsibilities and tasks, the distribution of grants and costs and authorship and publications. In this latter regard, the tracking of research output by the centre will be a key function of the centre director.
Pursuing research grant funding inevitably involves competing with other disciplines and other researchers within the parent institution and also with national and international researchers. A legitimate pretext for finding strategic international partners is to build on established links, such as those that exist in and through international mobility programmes, such as Socrates-Erasmus, Leonardo and Tempus and the Thematic European Nursing Network group.
In the pursuit of research grants, a strategic activity of the centre's core personnel is to establish a reliable system for identifying funding opportunities as they are presented and to target them accordingly. This requires a degree of research savvy in anticipating funding announcements and also anticipating future research topics that are likely to become important to policy makers in the near to medium term. Thus publications from official bodies like the WHO, the European Commission, the Council of Europe and national governments in the areas of healthcare and related social policy will give rise to many of the research questions that will need to be addressed.
The establishment of performance standards is critical to the success of a research centre. This involves setting minimum standards in relation to funding procurement from the principal streams, for the number of grants to be procured, the number of postgraduates and research fellows who will be actively engaged with research in the centre and targets for the minimum number of refereed publications that the centre will generate. Performance standards should be set for the medium and the long term.
As Cecil et al. have indicated, nursing must become increasingly research active in the areas of primary research, which is multidisciplinary in nature and clinically focussed. The success of nursing as a research-active discipline will more likely be attained if its research activities are anchored to a firm structure within the academy and a research centre can provide such an anchor.