Statistics from Altmetric.com
- hospital pharmacy education
- hospital pharmacy competencies
- health policy
- organisational development
- health services administration and management
- pharmacy management (personnel)
- research and teaching
- lifelong learning
Introduction: pharmacists as researchers
The Common Training Framework project for hospital pharmacists—developed to enhance the safety, quality and equity of access to patient care across Europe—recommends that hospital pharmacists should be able to ‘describe, explain and discuss commonly used research methodologies in order to be able to participate in pharmacy practice research and clinical research’.1 It also recommends that hospital pharmacists should be able to ‘plan, lead on, and conduct research/practice development projects to promote safe and rational use of medicines’ and be able to ‘collaborate with other healthcare professionals’.1 In 2010, research strategy coordinators for the Royal Pharmaceutical Society published a series of articles expressing the relevance of research to all areas of pharmacy—highlighting patient benefits.2 3 Numerous studies have shown that pharmacists, and indeed pharmacy students, have an interest in research.4–7 Yet in 2017, the European Association of Hospital Pharmacists found that only 30% of hospital pharmacists routinely publish research.8 There is a current drive for NHS trusts to develop consultant pharmacist posts that provide patients with a high level of expertise from practitioners leading the profession. Part of this role includes a need to be ‘conducting and supervising research’, as well as ‘contributing to the development of research questions and methodologies’.9 In November 2019, Williams queried why more hospital pharmacists are not getting involved in research or publishing their work.10 These questions resonated with my own experience as a hospital pharmacist interested in developing my research skills.
My journey as a novice researcher
I have been working as a clinical pharmacist for more than a decade, and over the past few years, the role of the pharmacist in the field of clinical research has been an area of intrigue to me. I undertook a degree in biochemistry with immunology before studying pharmacy, and the scientist in me is always asking, ‘Are we sure this is the best way we could be doing this? Where is the evidence?’ Each year, my list of personal professional development goals begins with ‘Get more involved in research’. Clinical work, however, is prioritised. Clinical academics are not commonplace in pharmacy, and so just finding allies who are also clinical academic researchers is challenging.
My turning point arrived when my line manager advised me to consider applying for an internship with Health Education England and the National Institute for Health Research. The Department of Health and Social Care began this initiative with the view to encouraging more clinical professionals to develop their skills and knowledge in order to become clinical academics.11 Places on the internship are awarded to applicants who submit a short application form and are successful at the ensuing interview. The internship provides funding to back-fill 30 days of clinical work across a 9-month period to facilitate full immersion in a research environment. While this opportunity is open to all healthcare professionals working in the NHS in England, the uptake from hospital pharmacists has been relatively low, in keeping with Williams observations of low research engagement among pharmacists. Of the last two cohorts, only 5% of successful applicants from the North East of England have been pharmacists (J Nightingale, personal communication, 2020).
Obstacles facing novice researchers
Williams describes how, for a pharmacist, ‘research is a journey’10 and that has certainly proved to be the case for me. After finally finding a means to overcome the challenge of needing time to immerse myself in research, I discovered an even greater obstacle; a lack of confidence in my own abilities as a researcher. I began the internship with the giddy enthusiasm of a child going ice-skating for the very first time—coat zipped up and skates in hand—ready to explore the world around me from a new perspective as a pharmacy researcher. The reality, however, was not quite so bright. While there were many high points—I loved the experience of tackling a systematic literature review, of having a supervisor to learn from, of getting to meet other researchers in person—deep down I was having doubts. The feeling was certainly not unlike the first time I tried ice-skating. I approached the rink with boundless excitement, keen to join the dizzying exhibition of style and grace. But as soon as I arrived, I found my confidence quickly ebbing away. Even before I skittered out onto the ice, I was struggling just to get my skates on. I feel this is partly due to the fact that as clinical pharmacists, we are not quite as well prepared to enter the world of research as other disciplines. While some of us are lucky enough to have taken modules on research skills during our studies, the reality is that the structured nature of pharmacy, and the focus on clinical practice, means that it is not a seamless transition. To be suddenly tasked with self-directed learning, academic writing, professional networking and grant writing, as well as reading and understanding countless papers depicting new research methodologies, frameworks, techniques and approaches, is a new challenge. At times I felt isolated. I even wondered if becoming involved in research had been the right decision, but thankfully, communicating my fears ultimately redeemed me. Thanks to the advice and feedback from mentors, I began to find my way. With some guidance, I was able to see that everyone needs to take those clumsy first steps before they start to resemble a confident researcher.
To stretch my ice-skating metaphor even further, I realised that the world of research I craved to join only seemed—from a distance—like a perfect harmony of skaters; elegantly and effortlessly gliding across the ice. When I finally got close enough to be part of the spectacle, I could see how many others were just like me. Many are novice researchers, uncertain of their paths, cautiously making slow progress while needing constant support and encouragement to stay on their feet, lest they end up stumbling and landing embarrassed on their behinds while everyone else whizzes relentlessly around them. Acknowledging this fear of failure is probably the first step all of us need to take before we can succeed as researchers. The more time I have spent in research, the more my eyes are open to the truth that it is not just novice researchers who stumble and fall. One of my mentors once broke the silence of our writing group to exclaim that she wanted to ‘go have a scream in the park’ to relieve stress. The research environment can be slippery and unpredictable, and even the most experienced researchers may wobble at times.
Conclusion: opportunities for hospital pharmacists
As Eriksson noted, one of the ways hospital pharmacists might gain new competencies is by sharing knowledge through knowledge networks.12 In addition, Eriksson asks us to consider questions that are pertinent to the future of hospital pharmacists.In particular, he seeks to understand how hospital pharmacists should be encouraged to undertake research and publish their results in EJHP. Given my experience of being a novice researcher, I believe there are more pharmacists like me who would relish the opportunity to undertake research if adequate support is in place. Protected time for research—through internal workplace arrangements or external funding schemes—would help overcome time constraints; likely the main barrier to getting to grips with the demands of research. The second critical constraint—the lack of confidence—could be remedied through mentorship. Professional advice and encouragement are invaluable, and EJHP’s policy of offering mentoring to first-time authors is an example of an initiative that could really help hospital pharmacists to fulfil their potential as valuable contributors to the field of clinical research. In addition, I believe multidisciplinary research—which has been outside my current experience to date—plays an important role in this field and is an area I wish to pursue in the future. Research is challenging. Sometimes it is as frustrating as it is compelling, and it requires almost single-minded determination. However, if being a clinical academic appeals to you, then it is worth seeking out the people who can help you explore your options.
This work would not be possible without the help of Health Education England and the National Institute for Health Research. The author would like to thank Andrew Gennery, Niina Kolehmainen, Joseph Roche and Nicola Vasey.
Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; internally peer reviewed.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.