Pre-implementation context and implementation approach for a nursing and midwifery clinician researcher career pathway: A qualitative study.

AIM: To describe the pre-implementation context and implementation approach, for a clinician researcher career pathway. BACKGROUND: Clinician researchers across all health disciplines are emerging to radically influence practice change and improve patient outcomes. Yet, to date, there are limited clinician researcher career pathways embedded in clinical practice for nurses and midwives. METHODS: A qualitative descriptive design was used. DATA SOURCES: Data were collected from four online focus groups and four interviews of health consumers, nursing and midwifery clinicians, and nursing unit managers (N = 20) between July 2022 and September 2023. RESULTS: Thematic and content analysis identified themes/categories relating to: Research in health professionals' roles and nursing and midwifery, and Research activity and culture (context); with implementation approaches within coherence, cognitive participation, collective action and reflexive monitoring (Normalization Process Theory). CONCLUSIONS: The Pathway was perceived to meet organizational objectives with the potential to create significant cultural change in nursing and midwifery. Backfilling of protected research time was essential. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The Pathway was seen as an instrument to empower staff, foster staff retention and extend research opportunities to every nurse and midwife, while improving patient experiences and outcomes. IMPACT: Clinicians, consumers and managers fully supported the implementation of clinician researchers with this Pathway. The Pathway could engage all clinicians in evidence-based practice with a clinician researcher leader, effect practice change with colleagues and enhance patient outcomes. REPORTING METHOD: This study adheres to relevant EQUATOR guidelines using the COREG checklist. PATIENT OR PUBLIC CONTRIBUTION: Health consumers involved in this research as participants, did not contribute to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript.

Research translation mentoring for emerging clinician researchers in rural and regional health settings: a qualitative study.

BACKGROUND: Building clinician and organisation-level research translation capacity and capability is fundamental for increasing the implementation of research into health practice and policy and improving health outcomes. Research translation capacity and capability building is particularly crucial in rural and regional settings to address complex problems impacting these socially and economically disadvantaged communities. Programs to build clinicians' research translation capability typically involve training and mentoring. Little is known about the features of and influences on mentorships in the context of training for emerging clinician-researchers working in rural and regional healthcare settings. Research translation mentorships were established as part of the Supporting Translation Research in Rural and Regional settings (STaRR) program developed and delivered in Victoria, Australia from 2020 to 2021. The study sought to address the following research questions: 1) What context-specific types of support do research translation mentors provide to emerging researchers?. 2) How does the mentoring element of a rural research translational training program influence research translation capacity and capability development in rural emerging researchers and mentors, if at all?. 3) How does the mentoring element of the program influence translation capacity and capability at the organisational and regional level, if at all? METHODS: We conducted a qualitative descriptive study. Interviews with individuals involved in the STaRR program took place approximately 12 months after the program and explored participants' experiences of the mentored training. Interviews were undertaken via telephone, audio-recorded, and transcribed. Data were analysed using a team-based five-stage framework approach. RESULTS: Participants included emerging researchers (n = 9), mentors (n = 5), and managers (n = 4), from five health services and two universities. We identified four themes in the interview data: (1) Mentors play an educative role; (2) Mentoring enhanced by a collaborative environment; (3) Organisational challenges can influence mentorships, and (4) Mentorships help develop research networks and collective research and translation capacity. CONCLUSIONS: Mentorships contributed to the development of research translation capabilities. The capabilities were developed through mentors' deepened understanding of the rural and regional healthcare contexts in which their emerging researchers worked, the broadening and strengthening of rural and regional research networks, and building and sharing research translation knowledge and skills.

Research capacity-building for clinicians: understanding how the research facilitator role fosters clinicians' engagement in the research process.

BACKGROUND: There is evidence reporting more positive outcomes from research capacity-building (RCB) programmes that include a research facilitator role. Further, it has been suggested that research facilitator roles can be a useful strategy in building the research capacity of healthcare clinicians. However, until now, little attention has been applied to identifying the characteristics of the research facilitator role and how this role contributes to clinicians' engagement with the research process. The aim of this present study is to explore the characteristics required of the research facilitator role in the educational workshop phase of an RCB programme. METHODS: This qualitative study employed an inductive approach and utilized face-to-face interviews to gather data from a purposely selected cohort. Professionally transcribed responses were thematically analysed. RESULTS: The role of the research facilitator emerged as comprising two main themes: (1) facilitating the research process and (2) engaging expert clinicians as novice researchers. Pragmatically, analysis of data led to the development of a table outlining the responsibilities, skills and attributes related to each theme. Conceptually, theme 1 encapsulates the research facilitators' skills and experience and their role as knowledge brokers and cocreators of knowledge. Theme 2 provides insight into the clinician-centric approach the research facilitators utilized to build and foster relationships and support the clinicians through their research journey. CONCLUSION: This study reports on the characteristics of the research facilitator role in one phase of an RCB programme in one regional health service district in Australia and explains how the role fosters clinicians' engagement with the research process. Findings from this study will inform the development of future RCB programmes, which is important considering that clinicians' increased engagement with the research process is vital for developing a sound evidence base to support decision-making in practice and leads to higher levels of skills and greater ability to perform useful research.

A cross-sectional study of United States Academic-clinical research collaborations: Characteristics, resources, benefits and outcomes.

AIMS: The aims of the study were to compare characteristics, resources, benefits and outcomes of academic-clinical collaborations of nursing researcher leaders from academic, clinical and joint-employer sites. BACKGROUND: Few research-based publications addressed academic-clinical research collaborations. New knowledge could increase nursing and multidisciplinary research productivity, including implementation science. DESIGN: An anonymous survey using a 40-item questionnaire. METHODS: Information letters with a link to the questionnaire were emailed to United States nursing research leaders. Data were grouped by institution type: academic, clinical or joint-employer. Analyses included Kruskal-Wallis tests for ordered responses, Pearson's chi-square test or Fisher's exact test for categorical responses and Cohen's Kappa agreement statistic for expected and actual time devoted to research. STROBE guidelines were followed. RESULTS: Of 120 respondents from academic (n = 60; 50.0%), clinical (n = 53; 41.2%) and joint-employer (n = 7; 5.8%) sites, 78.3%, 92.3% and 100%, respectively, were from metropolitan areas. Mean (SD) priority for active collaborations was higher at joint-employer sites; p = .002. Clinical sites were more likely to have directors of evidence-based practice (p = .031) and informatics (p = .008) and librarians (p = .029). Sites with collaborations were more likely to have access to research subjects (p = .008) and post-award research account management (p = .045). By collaboration status, there were no differences in the number of ethics board-approved studies. Collaborating site benefits were perceived to be executive leadership support (p = .003), greater research engagement by clinical nurses (p = .048), more co-authored publications (p = .048) and more abstracts accepted at national meetings (p = .044). Despite more resources and perceived benefits, outcomes did not differ by collaboration status. CONCLUSIONS: Sites with and without academic-clinical research collaborations differed; however, outcomes were similar. Future efforts should focus on nurse scientist collaboration to address important clinical questions aimed at improving clinical outcomes. RELEVANCE TO CLINICAL PRACTICE: Despite some successful outcomes, potential benefits of academic-clinical research collaborations have not been fully actualised.

Embedding post-doctoral clinical academic careers in practice: The St Bartholomew's Hospital model.

AIMS AND OBJECTIVES: In order to retain and develop pre-doctoral and doctoral staff, we sought to establish and implement a model for supporting postdoctoral clinical academic careers at our hospital. BACKGROUND: Doctorally-prepared nurses can raise clinical practice standards, but there is a deficit of career opportunities and post-doctoral positions. This will inevitably impact delivering the evidence for improving patient outcomes and service delivery. It is therefore imperative that post-doctoral nursing and allied professional post-doctoral clinical academic career opportunities are developed and embedded in practice. DESIGN: We describe the development and implementation of a model to provide and embed post-doctoral clinical academic roles at our hospital. METHODS: A multidisciplinary group devised the model which was approved by the Hospital Executive Board. RESULTS: The model includes having a bespoke plan for each individual, planning the post-doctoral role at time of PhD planning, providing 1 day a week protected research time for a minimum of 12 months after PhD completion, having an appropriate honorary academic contract at a partner University, and providing integrated clinical and academic supervision throughout. Other key components include senior clinical and Executive Board support and an existing vibrant research culture at our organisation. CONCLUSIONS: The St Bartholomew's Hospital model, focusing on individualised posts integrating clinical and academic roles to address service needs, offers a novel approach to supporting post-doctoral clinical academic careers in a clinical setting. RELEVANCE TO CLINICAL PRACTICE: Since doctorally-prepared nurses can raise clinical practice standards we developed a sustainable infrastructure to increase our postdoctoral nursing and allied professional workforce. This model could provide a framework for other hospitals to embed postdoctoral clinical academic careers in practice.

Promoting cardiovascular nursing practice and research: A model for a university joint appointment.

BACKGROUND: University joint appointments promote continuity of academic leadership and the acceleration of nurses' impact on improved outcomes and health service delivery. The role of university-appointed and hospital-located nurse scientists is of growing interest in the academic and clinical settings, and within the nursing profession. There is a pressing need to describe and study models of appointments, responsibilities and contributions to strengthen the integration of this boundary-crossing role across the continuum of the nursing profession. AIMS AND OBJECTIVES: We report on the implementation of the inaugural St. Paul's Hospital and Heart & Stroke Professorship in Cardiovascular Nursing at the University of British Columbia, Vancouver Canada. DISCUSSION: This model was based on recommendations provided by nursing to provincial government policy-makers, co-created and co-funded by academic and practice partners. Appointed by the university, the role is primarily located in the hospital, with the target of contributing 75% of time and focus on clinical research and leadership. The position is facilitated by its academic affiliation and the provision of university research and teaching infrastructure. In clinical practice, the role benefits from integration and visibility in the cardiac programme and leadership team, collaboration with advanced practice and multidisciplinary research groups, and access to office and human resources located on the clinical unit. Deliverables centre on achieving adjusted indicators of university performance to support academic promotion, and delivery of a practice-close research programme that prioritises improved patient outcomes, multidisciplinary practice and improved outcomes. RELEVANCE TO CLINICAL PRACTICE: The dual appointment aims to provide tangible benefits to both the university and the hospital that match each organisation's needs; this requires sustained senior leadership engagement and support, and modification of conventional indicators of impact and success. Its ongoing evaluation will elucidate required modifications and future strategies required to strengthen nurses' academic and clinical leadership.

Approaches for establishing and sustaining clinical academic partnerships: A discursive review.

AIMS AND OBJECTIVES: To discuss the need for a formalised structure that bridges the clinical and academic realms with concrete recommendations for programme development. BACKGROUND: In the rapidly changing landscape of health care, nurses are challenged with the responsibility to engage in evidence-based practice, quality improvement and research projects. Clinical and academic partnerships play a vital role in fostering collaboration, mentorship and resources. DESIGN: Discursive paper. METHOD: Searching international literature published between 2010-2020 in PubMed, CINAHL and Google Scholar, we explored the benefits, barriers and facilitators of clinical academic partnerships from the available evidence and professional perspectives from both sides of a clinical/academic collaboration. DISCUSSION: Evidence-based literature supports the establishment of partnerships schools of nursing and clinical institutions to improve patient outcomes and experiences and provide additional resources for improved research and practice capacity between both entities. Barriers to establishing clinical academic partnerships included lack of time, lack of formal collaborations and knowledge deficits. Facilitators included visible leadership endorsement, mentoring and modelling a culture of inquiry. CONCLUSIONS: The establishment of formalised clinical academic partnerships can be used to develop continuing education programmes, promote engagement in nursing inquiry, fill in knowledge gaps in practice and improve available resources and patient outcomes. There is a great need for capacity building in hospitals, superficially, those with a mission to address the research-practice gap, promote nursing excellence and improve patient outcomes. RELEVANCE TO CLINICAL PRACTICE: Nurse leaders play an instrumental role in establishing sustainable clinical academic partnerships that create shared resources, resulting in mutual benefit, and influences a much-needed shift in organisational culture and infrastructure.

A clinical-academic partnership to develop a family management intervention for parents of preterm infants.

AIMS: To examine the critical role that an academic clinical partnership played in the development and refinement of a family management intervention in the Neonatal Intensive Care Unit (NICU). BACKGROUND: Clinical-academic partnerships enable earlier infusion of implementation science principles into development of evidence-based interventions, yet partners often report difficulty leveraging resources, personnel and expertise to create beneficial outcomes for all. DESIGN: Longitudinal qualitative descriptive design. METHODS: To develop and refine the intervention, designated time was taken during meetings of the NICU's Parent Partnership Council (PPC), a committee comprised of nursing, physician and allied health leadership and former NICU parents. Partnership was also achieved by having bedside clinical nurses, in addition to medical and nursing students, participate as research team members. Qualitative data were collected via email, research team and Council meetings, and informal individual chats with key stakeholders (N = 25) and NICU mothers (N = 22). Qualitative data were analysed deductively using thematic analysis based on MacPhee's partnership logic model and the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) model. The consolidated criteria for reporting qualitative research checklist guided our work. RESULTS: During Council meetings, the clinical-academic nurse, Director of Family-Integrated Care and Council members identified the need for a family management intervention, and worked together to develop and refine PREEMIE PROGRESS. Mothers found the intervention had numerous strengths and perceived a benefit knowing they helped future parents. CONCLUSIONS: This work was only possible by leveraging both the university's technology/research resources and the clinical expertise of the NICU staff and PPC. Co-authored presentations, publications and grant funding continued this NICU's legacy in family-centred care and helped shape the clinical-academic nurse's career. RELEVANCE TO CLINICAL PRACTICE: Clinical-academic partnerships can promote excellence in nursing practice, research and education through swifter knowledge translation and earlier infusion of implementation science principles into the development of evidence-based nursing interventions.

Describing the implementation of an innovative intervention and evaluating its effectiveness in increasing research capacity of advanced clinical nurses: using the consolidated framework for implementation research.

BACKGROUND: Despite advanced nursing roles having a research competency, participation in research is low. There are many barriers to participation in research and few interventions have been developed to address these. This paper aims to describe the implementation of an intervention to increase research participation in advanced clinical nursing roles and evaluate its effectiveness. METHODS: The implementation of the intervention was carried out within one hospital site. The evaluation utilised a mixed methods design and a implementation science framework. All staff in advanced nursing roles were invited to take part, all those who were interested and had a project in mind could volunteer to participate in the intervention. The intervention consisted of the development of small research groups working on projects developed by the nurse participant/s and supported by an academic and a research fellow. The main evaluation was through focus groups. Output was analysed using thematic analysis. In addition, a survey questionnaire was circulated to all participants to ascertain their self-reported research skills before and after the intervention. The results of the survey were analysed using descriptive statistics. Finally an inventory of research outputs was collated. RESULTS: In the first year, twelve new clinical nurse-led research projects were conducted and reported in six peer reviewed papers, two non-peer reviewed papers and 20 conference presentations. The main strengths of the intervention were its promptness to complete research, to publish and to showcase clinical innovations. Main barriers identified were time, appropriate support from academics and from peers. The majority of participants had increased experience at scientific writing and data analysis. CONCLUSION: This study shows that an intervention, with minor financial resources; a top down approach; support of a hands on research fellow; peer collaboration with academics; strong clinical ownership by the clinical nurse researcher; experiential learning opportunities; focused and with needs based educational sessions, is an intervention that can both increase research outputs and capacity of clinically based nurses. Interventions to further enhance nursing research and their evaluation are crucial if we are to address the deficit of nurse-led patient-centred research in the literature.

Once a clinician, always a clinician: a systematic review to develop a typology of clinician-researcher dual-role experiences in health research with patient-participants.

BACKGROUND: Many health researchers are clinicians. Dual-role experiences are common for clinician-researchers in research involving patient-participants, even if not their own patients. To extend the existing body of literature on why dual-role is experienced, we aimed to develop a typology of common catalysts for dual-role experiences to help clinician-researchers plan and implement methodologically and ethically sound research. METHODS: Systematic searching of Medline, CINAHL, PsycINFO, Embase and Scopus (inception to 28.07.2014) for primary studies or first-person reflexive reports of clinician-researchers' dual-role experiences, supplemented by reference list checking and Google Scholar scoping searches. Included articles were loaded in NVivo for analysis. The coding was focused on how dual-role was evidenced for the clinician-researchers in research involving patients. Procedures were completed by one researcher (MB) and independently cross-checked by another (JHS). All authors contributed to extensive discussions to resolve all disagreements about initial coding and verify the final themes. RESULTS: Database searching located 7135 records, resulting in 29 included studies, with the addition of 7 studies through reference checks and scoping searches. Two overarching themes described the most common catalysts for dual-role experiences - ways a research role can involve patterns of behaviour typical of a clinical role, and the developing connection that starts to resemble a clinician-patient relationship. Five subthemes encapsulated the clinical patterns commonly repeated in research settings (clinical queries, perceived agenda, helping hands, uninvited clinical expert, and research or therapy) and five subthemes described concerns about the researcher-participant relationship (clinical assumptions, suspicion and holding back, revelations, over-identification, and manipulation). Clinician-researchers use their clinical skills in health research in ways that set up a relationship resembling that of clinician-patient. Clinicians' ingrained orientation to patients' needs can be in tension with their research role, and can set up ethical and methodological challenges. CONCLUSION: The typology we developed outlines the common ways dual-role is experienced in research involving clinician-researchers and patient-participants, and perhaps the inevitability of the experience given the primacy accorded to patient well-being. The typology offers clinician-researchers a framework for grappling with the ethical and methodological implications of dual-role throughout the research process, including planning, implementation, monitoring and reporting.

Career Interests of Canadian Psychiatry Residents: What Makes Residents Choose a Research Career?

OBJECTIVES: Training future clinician-researchers remains a challenge faced by Canadian psychiatry departments. Our objectives were to determine the prevalence of residents interested in pursuing research and other career options as part of their practice, and to identify the factors associated with interest in research. METHOD: Data from a national online survey of 207 Canadian psychiatry residents from a total of 853 (24.3% response rate) were examined. The main outcome was interest in research as part of residents' future psychiatrist practice. Bivariate and multivariate analyses were performed to identify demographic and vocational variables associated with research interest. RESULTS: Interest in research decreases by 76% between the first and fifth year of psychiatry residency (OR 0.76 per year, 95% CI 0.60 to 0.97). Training in a department with a residency research track did not correlate with increased research interest (χ2 = 0.007, df = 1, P = 0.93). CONCLUSIONS: Exposing and engaging psychiatry residents in research as early as possible in residency training appears key to promoting future research interest. Psychiatry residency programs and research tracks could consider emphasizing research training initiatives and protected research time early in residency.

Emergency medicine residency pathways for MD/PhD trainees: A national cross-sectional study of physician-scientist training programs.

Background: Combined clinical and research training is common in residency programs outside emergency medicine (EM), and these pathways are particularly valuable for combined MD/PhD graduates planning to pursue a career as a physician-scientist. However, EM departments may not know what resources to provide these trainees during residency to create research-focused, productive, future faculty, and trainees may not know which programs support their goal of becoming a physician-scientist in EM. The objective of this study was to describe research training and resources available to MD/PhD graduates in EM residency training with a focus on dedicated research pathways. Methods: This study was a cross-sectional inventory conducted through an electronic survey of EM residency program directors. We sought to identify dedicated MD/PhD research training pathways, with a focus on both resources and training priorities. Descriptive statistics were used to summarize survey responses. Results: We collected 192 survey responses (69.6% response rate). Among respondents, 41 programs (21.4%) offered a research pathway/track, 52 (27.4%) offered a research fellowship, 22 (11.5%) offered both a residency research pathway/track and a research fellowship, and two (1.0%) offered a dedicated EM physician-scientist training pathway. Most programs considered research a priority and were enthusiastic about interviewing applicants planning a research career, but recruitment of physician-scientist applicants was not generally prioritized. Conclusions: Some EM residency programs offer combined clinical and mentored research training for prospective physician-scientists, and nearly all residency programs considered research important. Future work will focus on improving the EM physician-scientist pipeline by optimizing pathways available to trainees during residency and fellowship.

Clinical research nursing pathways: The development and evaluation of a nursing research internship program using the RE-AIM framework.

Background: In 2018 a Nursing Research Internship program was started within a major referral and tertiary teaching centre in Australia. Aim: We aimed to evaluate the first 12 months of the program using an implementation science framework. Methods: This was a qualitative study. Following ethical approval n = 20 semi -structured interviews were recorded and transcribed verbatim. Participants included nurses with clinical, research and management roles who had engaged in or supported a Nursing Research Internship program. The Framework Method was conducted to analyse the findings. Results: Key themes identified included 'What is the impact of a Nursing Research Internship program?'; 'Why do a Nursing Research Internship program?'; 'How do we do a Nursing Research Internship program?'; 'How do we sustain a Nursing Research Internship program?'. Positive impacts were identified for clinical nurses and their teams, for the hospital and health service, and for patients and families. Identified key components included protected research time, specialist support (including library, statistics, health economist, implementation scientist), regulatory support (ethics and governance procedures) and access to a computer and IT resources. The Nursing Research Internship program required support from nurse clinicians, nurse managers and nurse academics. Conclusion: A structured Nursing Research Internship program supports clinical nurses to answer research questions identified directly from clinical practice.

Clinical and Research Perspectives on the Therapeutic Conversation: The Case of MS. M.

This paper presents a collaboration between a clinician (C.M.J.) and a research team (W.B., B.M., and S.M.) to address the question: At an operational level, what happens in the special form of conversation that is psychotherapy? How can we study, beyond a priori lenses of psychoanalytic models, what we are actually doing when we engage in this process? How can we capture from the linear flow of conversation, the simultaneous, complex, active, interwoven, dimensional emotion schemas that words can only point toward? To address the question, we first present the need for new approaches in the current climate within the clinical and research communities. Next, we address the challenges for clinicians and researchers by using multiple code theory and derived linguistic measures that offer an objective view of the processes of subjectivity. We then apply the research methods to the clinical data to illustrate the yield of the collaborative effort-a yield that captures the connection between the linear flow of words and the arousal, verbal expression, and reflection/integration of emotion schemas without the usual filters of psychoanalytic models of process and change. The project illustrates the critical value of clinicians' perspectives to guide researchers and encourages clinicians to participate in research to advance our field. For researchers, this project represents a "fourth generation" of process research that includes the criteria of video-recorded, transcribed data; the clinician's report of their experience; a theory of how emotion-laden meaning and motivations (emotion schemas) are expressed in the therapeutic conversation; and reliable, valid measures to capture and represent those processes; and that encourages researchers to access the rich contributions of clinicians' understanding. The implication for clinical practice is a new way to look beyond the lens of psychoanalytic models into what is actually unfolding in real time.

Power Dynamics in Discussions of Contemporary Jungian Theory and Practice.

Groups of Jungian analysts, which included the present authors, met to discuss four key theoretical concepts, each of which was felt to have problematic aspects if used unquestioningly in contemporary practice. The concepts were: The Primitive, Inner and Outer Worlds, Contrasexuality and Participation Mystique. The discussions were informed by clinical material and specific papers chosen for their critical evaluation of the topic. Four recorded transcripts were made, with permission, for further consideration of the relationship between contemporary Jungian theory and practice using the research method of thematic analysis. Three main themes were identified: Work of Analysis, Frames of Reference and Power Dynamics. The authors discuss the themes in relation to the overarching theme of power, understood as operating at conscious and unconscious levels. The artwork "Cold Dark Matter: An Exploded View" by Cornelia Parker is used as a metaphor in discussing the dynamic of challenging foundational concepts. The authors suggest that power dynamics are intrinsic in both the difficulty and the benefits of critically evaluating key concepts, binding together the theoretical (what informs us) with the clinical (what we do in the consulting room) as well as blowing apart pre-conceived notions of what underpins the analyst's work.

Les auteurs de cet article ont fait partie de groupes d'analystes jungiens qui se sont rencontrés pour débattre de quatre concepts théoriques fondamentaux, chacun de ces concepts étant perçu comme problématique si on l'utilise dans la pratique contemporaine sans se poser de questions. Ces concepts sont : primitif, mondes intérieur et extérieur, contra­sexualité et participation mystique. Les discussions ont été nourries par du matériel clinique et par des articles spécialement choisis pour leur évaluation critique du sujet traité. Quatre transcriptions enregistrées furent faites, avec l'accord des personnes concernées, pour une étude plus approfondie de la relation entre la théorie et la pratique jungienne contemporaine, en s'appuyant sur la méthode de recherche de l'analyse thématique. Trois thèmes furent identifiés : le travail d'analyse, les cadres de référence, et les dynamiques de pouvoir. Les auteurs débattent de ces thèmes en les reliant avec le thème fondamental du pouvoir, perçu comme fonctionnant aux niveaux conscient et inconscient. L'œuvre de l'artiste Cornelia Parker « Cold Dark Matter: An Exploded View ¼ est utilisée comme métaphore lorsqu'il est question de la dynamique de questionner des concepts fondamentaux. Les auteurs suggèrent que les dynamiques de pouvoir sont propres à la difficulté mais aussi aux bénéfices de cette remise en question, en reliant le théorique (ce qui nous informe) avec la clinique (ce que l'on fait dans la salle de consultation) et en faisant sauter les notions qui n'ont pas été questionnées, en ce qui concerne ce qui étaye le travail analytique.

Grupos de analistas Junguianos, los cuales incluyen a las presentes autoras, se reunieron para discutir cuatro conceptos teóricos fundamentales, cada uno de los cuales se consideraba que tenía aspectos problemáticos si se utilizaba sin cuestionamientos en la práctica contemporánea. Los conceptos eran: Primitivo, Mundos Interior y Exterior, Contrasexualidad y Participation Mystique. Los debates se basaron en material clínico y en artículos específicos elegidos para una evaluación crítica del tema. Se transcribieron con permiso cuatro grabaciones para un examen más detenido de la relación entre la teoría y la práctica junguiana contemporánea utilizando el método de investigación del análisis temático. Se identificaron tres temas: Trabajo Analítico, Marcos de Referencia y Dinámicas de Poder. Las autoras analizaron los temas en relación con el tema más amplio del poder, entendido como algo que opera a nivel consciente e inconsciente. La obra de arte "Cold Dark Matter: An Exploded View", de Cornelia Parker, fue utilizada como metáfora para discutir acerca de la dinámica de cuestionar los conceptos fundamentales. Se sugiere que las dinámicas de poder son intrínsecas tanto a la dificultad como a los beneficios de hacer esta tarea, ligando lo teórico (lo que nos informa) con lo clínico (lo que hacemos en la consulta), así como a desarmar nociones incuestionadas de aquello que sustenta el trabajo analítico.

Embedded Research: Possibilities for Learning Health Systems Comment on "'We're Not Providing the Best Care if We are Not on the Cutting Edge of Research': A Research Impact Evaluation at a Regional Australian Hospital and Health Service".

Brown et al show that research investments in an organization with a research and translation mandate can make important gains for research impact across domains, including quality of care and patient outcomes. Their multi-stage mixed methods evaluation provides insight into research capacity development in rural health systems in Australia and draws attention towards persistent geographic inequities. In extension of this important contribution, here, a focus on the "what and the why" of embedded research is offered. Specific attention is paid to the sustainability potentials of systematized data capture systems, funding-operational mandate alignments, researcher-scientist career pathways, and networked approaches to mentorship.

Reproductive Scientist Development Program: Bridging the Gap to the Physician Scientist Career.

Career development awards are a successful strategy to facilitate the advancement of physician-scientists trained in obstetrics and gynecology (OBGYN) toward a path of investigative independence. While these funding mechanisms can be effective approaches to developing the career of future OBGYN scientists, optimizing the probability of obtaining these awards requires determining the appropriate career development award for the applicant. There are many details and opportunities that need to be considered when deciding on the appropriate award. Some of the most sought-after awards are those that integrate career development and applied research, such as the K-series awards supported by the National Institutes of Health (NIH). A quintessential example of an NIH-funded mentor-based career development award to support the scientific training of an OBGYN physician-scientist is the Reproductive Scientist Development Program (RSDP). In this study, we provide data on the academic achievements of past and present RSDP scholars and discuss the structure, impact, and future of the RSDP, a federally funded K12 program dedicated to women's health for OBGYN scientific investigators. As healthcare is changing and physician-scientists comprise a unique and valuable part of the biomedical workforce, programs such as the RSDP are critical to maintaining a well-trained pipeline of OBGYN scientists to maintain and challenge the leading edge of medicine, science, and biology.

Encouraging Cross-Disciplinary Collaboration and Innovation in Epidemiology in Japan.

Background: Scientific innovation is often achieved through the intersection of ideas from different fields. However, barriers prevent non-epidemiologists from cultivating interests in epidemiology or undertaking epidemiologic work. In this study, we evaluated changes in the diversity of research topics in an epidemiologic journal over time. We aimed to understand how epidemiologists and non-epidemiologists communicate about epidemiologic data and how this impacts innovation in the field. Methods: We categorized the topics of articles published in the Journal of Epidemiology during the early and late 2010s based on their titles. We calculated the Shannon-Weaver diversity index (H') to measure changes in the diversity of topics addressed by published articles. Results: Comparing 2011-2013 with 2017-2019, there was no significant change in the diversity of article topics (H' = 4.25 and 4.21, respectively) published in the Journal of Epidemiology. Conclusion: To encourage healthcare providers and public administrators to conduct or comment on epidemiologic studies, epidemiologists should present their findings in easily understood language with appropriate and relevant statistical indicators and useful illustrations. Bringing experience from other specialties into epidemiology may yield new findings from epidemiologic data because of the exposure of non-epidemiologists to different values, workplaces, and occupations. Collaboration among professionals from varied backgrounds and with varied occupational experiences may help to promote scientific innovation by broadening perspectives. In addition, a range of professional experiences may enable individuals to solve difficult research questions more easily by themselves.

Characteristics and Drivers of the Registered Dietitian Nutritionist's Sustained Involvement in Clinical Research Activities: A Mixed Methods Study.

BACKGROUND: Research contributions by registered dietitian nutritionists (RDNs) are important for enhancing the use of nutrition-related evidence-based guidelines in dietetics practice. Involvement of RDNs in research activities has been studied previously, but little is known about the drivers (motivators) of sustaining research involvement by RDNs who work in clinical practice. OBJECTIVE: To identify key characteristics of established RDN clinician researchers and drivers that contributed to their sustained research involvement. DESIGN: We used a convergent parallel mixed methods study design utilizing the clinician career research trajectory as a framework. Research involvement was examined using the Practice-Based Dietitian Research Involvement Survey (PBDRIS). Workplace support was assessed using the Research Capacity and Culture (RCC) survey. Semistructured interviews were used to investigate key themes in established RDN clinician researchers. PARTICIPANTS/SETTING: We identified 450 RDNs involved with research activities in the United States through hand-searching clinically relevant nutrition journals and contacted them to participate in an online survey. A total of 29 RDNs met criteria and completed (6.4%) the quantitative survey, then a subsample (n=10) participated in semistructured interviews to explore drivers for continued research involvement. RESULTS: Research involvement scores (n=29) from the PBDRIS ranged from 60.0% to 97.5%, indicating involvement in higher-level research-related tasks by our sample participants. RCC results revealed the importance of workplace support and mentorship. Interviews with established RDN clinician researchers identified exposure, curiosity, and dedication as three overarching themes with eight subthemes driving continued research involvement. CONCLUSION: Based on the experiences of select RDN clinician researchers who have demonstrated success in sustaining their research involvement, we found that having an available mentor, support from their workplace environment, and personal drive were integral to their success.

An Introduction to Research Work, Scholarship, and Paving a Way to a Career in Academic Medicine.

Introduction: Despite high faculty attrition and challenges to expanding the number of clinician-researchers, career development to heighten trainees' pursuit of an academic research career remains a relatively understudied topic. Completing peer-reviewed publications during medical school increases a trainee's likelihood of becoming a future faculty member. There is a lack of educational content to guide trainees in selecting research activities, publishing, and gaining self-efficacy to pave a path towards a clinician-researcher track. Methods: The Kern model was applied to create a multimodal workshop that would heighten trainee awareness of various research opportunities, skills for conducting research, best practices in publishing, and also help them develop a personal plan to pursue research. The workshop included a presentation, reflection exercises, and a case scenario. The workshop was implemented among trainees attending professional development conferences at nine medical schools. A questionnaire assessed participants' change in self-efficacy in completing research scholarship and pursuing an academic research career. Results: Sixty medical students and seven residents participated in the workshops. Paired-sample t tests indicated a statistically significant increase in participants' perception that academic medicine would allow them to engage in research work, and in their self-efficacy to publish and succeed along a clinician-researcher track. Discussion: The workshop not only exposed participants to a variety of research activities but also provided a sense that all research types are valid, aiding some participants to identify new research opportunities. In addition, participants gained clarity on how to publish and develop a research path, which may help maintain interest in a clinician-researcher track.