Advancing primary care through education and research: from translational research to translational scholarship
We need to "Think differently" about healthcare as "a necesary prerequisite for doing differently" (NHS Institute for Innovation). Knowledge translation–mobilising knowledge across the different settings of research and practice–is identified as one means to support innovation and change. Promoting and strengthenting translational research is a priority for research funders. What we still lack is an adequate framework for understanding, evaluating and so supporting translational research.
We use our NIHR funded Innovation project - bounce back - as a case study to explore these issues. Led by Advocacy in Wirral (AiW), a mental health charity, in partnership with Liverpool University (UoL), the project aims to tackle three barriers to accessing mental health care identified from previous research. And so to integrate the AiW model of practice into the general practice setting. the researchers' role is to support the evolution of both the process of integration and the outcomes of the intervention. Recognising the AiW approach as a complex intervention (CI), we are using Normalisation Process Theory (NPT) as a framework to support evaluation. Our presentation derives from a critical reflection on the process of developing, delivering and evaluating the project framed by the existing literature on evaluating translational research.
Three themes emerge.
- Both partners have had to modify their expectations about the outputs of the project. AiW sought data on their service impact to support future bids for contracts. UoL sought understanding of the process of integrating a CI. With a sharing of expertise to achieve both goals. In practice, our output has been creating a new understanding of the complex intervention.
- Actions for both sides have changed. AiW staff have had to develop new scholarship roles - in the critical practice of curiosity and creativity. UoL staff have taken on new roles in service development and delivery.
- Much of our time has been taken up with developing a shared vision. Within the team, in order to support capacity to manage change. And with wider stakeholders, in order to support meaningful engagement and a shift in focus from transacting (contracting) to transforming services.
Our observations resonate with Evans’ (2014) description of translational research as moving from ‘bridging’ between practices to ‘blurring’ traditional boundaries. Like Evans, we note implications for the “depth of research done”. Although for us, we believe we have achieved greater depth of learning but at a ‘cost’ of time. Leaving us with a new question of how to evaluate this alternative approach to translational research. Drawing on Pozen, we will discuss how our experience and findings are supporting the development of a new framework of translational scholarship.