Most academics would like their research to have a bigger impact on practice. Most practitioners acknowledge that their day-to-day decision-making could be improved by making better use of research evidence. Nevertheless, the gap between what we know from research evidence and what happens in practice persists and is proving remarkably difficult to address.
The Researcher-in-Residence model is being developed to address this challenge by increasing the practical relevance of improvement science and health services research. The model underpins much of our work in Improvement Science London and a growing number of people working in university departments, CLAHRCs and Academic Health Science Networks from across the country are working with health service partners on the design, delivery and evaluation of the model.
The following section provides a brief summary of the in-residence approach and some links to relevant projects, publications and presentations.
- A bit of background
The Researcher-in-Residence model aims to narrow the gap between academia and practice by both mobilising established research evidence into practice and, through service evaluation, by creating new research evidence that is more relevant and more actionable for decision makers in the health service.
The model is based on the principles of participatory research - collaboration across the full range of stakeholders (including those who use services); a desire to solve practical problems; a focus on initiating change through reflection, greater understanding and shared learning; a willingness to find common ground through competing interests; and a focus on agency and addressing imbalances in power.
The 'in-residence' term is familiar to many people. Barnsley football club has a poet-in-residence, Wimbledon tennis club has an artist-in-residence, and the British Library has an innovator-in-residence. The first researcher-in-residence programme that we are aware of was established by the Department for Education in the early 1990s, when university academics were placed in schools to engage children in science. The model was developed as a way of democratising expertise, moving that expertise from the rarefied environment of learned institutions to where people live and work.
- Key features
At this early stage in its development the model is purposefully being kept flexible. This ensures that it can be adapted to meet local needs and also gives us an opportunity to explore and evaluate different approaches.
So, across the country we are seeing different academic disciplines working on many kinds of projects at different levels in a range of health and local government environments. We are seeing varying degrees of embeddedness, both in terms of the proportion of time spent being embedded and the duration of the project, and different styles of interaction between the research and practitioner partners.
Most in-residence researchers are working in isolation on a particular project, though a growing number of support networks are being established at a local level and some embedded researchers are working in teams on the same project. The structures and governance arrangements supporting the research and the service partners vary, as does the source of funding for the work.
Underpinning this diversity are three common features which help to define the model and to differentiate it from other approaches to knowledge creation and mobilisation:
- Rather than working solely in an academic institution, the researcher spends a high proportion of their time as a member of a service-based operational team, working on and solving practical problems
- The researcher is explicit about the expertise that they bring to the operational team. As well-trained academics they bring an expert understanding of the established research evidence in whatever field they are working, an understanding of the theoretical and conceptual basis of that field, practical skills in evaluation and teaching others when and how to evaluate, and an ability to utilise complex data.
- The researchers are willing and able to negotiate their expert knowledge, rather than to 'inform' or 'impose' it on their service partners
The third feature is the most important and most complex element of the model. It highlights the epistemological challenges of an embedded approach to research because it requires the researcher to see evidence derived from empirical research as just one of many ways of knowing. It also requires the researcher to enter discussions about the relative merits of different ways of acquiring and using knowledge and pragmatically to find common ground between these ways of knowing.
A growing number of participatory research initiatives around the country are using the term 'Researcher-in-Residence' to describe their work. There are probably many more examples of researchers who meet the three defining features of the model but use other terms to describe what they do.
The following is a far-from-complete and as yet unsorted list of examples of the in-residence model that we are aware of from across the country:
- Linguistic social scientist-in-Residence working on a large scale pioneer integrated care programme in East London - WELC
- Knowledge mobilisation Researcher-in-Residence supporting health and social care practitioners to share knowledge with one another in Leeds
- Dr Ceri Jones, a NIHR Knowledge Mobilisation Fellow and Patient Safety Improvement Specialist at University Hospitals Leicester (UHL) and Senior Research Fellow at the University of Leicester is leading a project to build internal capacity for quality improvement (QI) and human factors (HF) in UHL. She is working with clinicians carrying out quality improvement projects to develop their knowledge of quality improvement and human factors methodology and evaluation and build internal knowledge and capability through the development of an internal faculty of quality associates and QI and HF Fellows. The project also aims to build closer links with academics at the University of Leicester through Leicestershire Improvement and Innovation in Patient Safety Unit - LIIPS
- North West Coast Academic Health Science Network, in partnership with Lancaster University have advertised a Researcher in Residence post to be an integral part of its evaluation of vanguard sites in Lancashire and South Cumbria. It is anticipated that the post will commence in April 16 with the researcher being embedded in the two projects and reporting to/ involving a range of key stakeholders who can support success of the vanguard sites.
- Multi-disciplinary embedded research team at University College London Hospitals, comprising researchers from the fields of medical anthropology, operational research and health economics. The team assists clinicians and hospital management in developing, implementing and evaluating research to address the challenging problems they face. It is aligned to NIHR CLAHRC North Thames
- Dr Mandy Cheetham is working 3 days per week co-located with, and funded by, the public health team in Gateshead Council to evaluate the 'Live Well Gateshead' programme, supervised by Prof Rosemary Rushmer. Mandy examines the LWG quantitative routine data and then using her qualitative skills collects primary data to understand what the trends mean and why they occur. Her findings are fed back, iteratively, to the public health team and to providers in order to make sense of them and discuss their implications together. Part of Mandy's role is to build research capacity in the public health team, which involves answering questions and brokering new links between council and academic colleagues. The remainder of her week is spent at Teesside University and as a member of Fuse (the centre for translational research in public health) where she is the Post-Doctoral Research Associate for the translational research programme.
- Further readings and presentations
- Article by Researcher-in-Residence Dr Laura Eyre - Laura describes how she is embedding research expertise into a large scale integrated care programme and suggests ways in which this model can make current evidence more accessible and collaboratively generate new knowledge.
- Blog by Martin Marshall (Feb 2013) - Researchers in Residence
- Eyre L, George B, Marshall M. Protocol for a process-oriented qualitative evaluation of the Waltham Forest and East London Collaborative (WELC) integrated care pioneer programme using the Researcher-in-Residence model. BMJ Open 2015;5: e009567. doi:10.1136/ bmjopen-2015-009567.
- Marshall M, Pagel C, French C, Utley M, Allwood D, Fulop N, Pope C, Banks V, Goldmann A. Moving improvement research closer to practice: the Researcher-in-Residence model. BMJ Quality and Safety 2014; doi:10.1136/bmjqs-2013-002779
- ISQUA Webinar, Martin Marshall - How to make improvement research useful to improvement practitioners; an introduction to the Researcher-in-Residence model
- The Health Foundation Webinar, Martin Marshall - Tips and challenges for making the most of the researcher-in-residence model
- Next steps
We have been learning a lot about the potential of the in-residence model to contribute to narrowing the so-called 'know-do' gap, and also about its challenges and weaknesses. We want to continue to encourage people from around the UK to establish and test different models and to capture learning from their work. Over coming months we hope to establish a national learning set to share these experiences. In addition, a small group are currently designing a large scale evaluation of models of knowledge mobilisation which emphasise participatory co-design and the negotiation of knowledge.
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