Clinician-led research helps to ensure close links between practice and research, builds research capacity and optimises translation opportunities in rehabilitation.
Clinical Fellowships are an integral part of The Hopkins Centre’s approach to embedded models of research that promote continuous, positive relationships and interactions between clinicians, researchers and other key endusers of research. The aim is for clinicians and collaborators to develop a research project that addresses current challenges in clinical practice and build a translation strategy to ensure that the findings benefit rehabilitation services and the people who utilise these services.
The impact of the introduction of the HabITec Lab at the PAH.
Soo Oh, Snr. Occupational Therapist, Spinal Injuries Unit, DoR, PAH, MSH Long-term Clinical Researcher Fellowship.
Project Synopsis: Soo’s project aimed to respond to the current need and demand for technologies in rehabilitation by both clients and clinicians. It aimed to understand the impact of the HabITec Lab on patients and clinicians working in this field. Over 12 months, the HabITec clinic provided technology consultation and bespoke solutions for 25 individuals in inpatient rehabilitation (90% SCI). The Fellowship also facilitated multidisciplinary research projects, placements, demonstration sessions and Citizen Challenges with consumers, engineers, designers and allied health clinicians.
Outcomes and Impacts: The project highlighted the feasibility and need for a socio-technical space embedded within a hospital setting. There was a strong interest in and demand for personalised technology solutions. Attendance at the clinic was associated with improved goal attainment for patients and increased their independence, knowledge and confidence in technology use. Through its user-centred citizen-led approach, HabITec enables people with acquired neurological conditions to develop the knowledge, skills and confidence to use technology they want and need early in their rehabilitation, which can enhance their independence and quality of life after discharge.
Adapting TBI Express communication partner training for leaders of a community peer support group for adults with acquired brain injury (ABI).
Clare Morgan, Speech Pathologist, ABIOS, MSH Long-term Clinical Researcher Fellowship.
Project Synopsis: Clare’s project examined the effectiveness of delivering an evidence-based communication partner training program (TBI Express) in the context of a statewide community support group for adults with brain injury in Queensland, called STEPS (Skills To Enable People and Communities). STEPS leaders have brain injury or are family members and often struggle with managing communication in these groups. This project was conducted in collaboration with Professor Leanne Togher and Dr. Emma Power, University of Sydney and Dr. Emma Finch, UQ.
Outcomes and Impacts: The program has been found to improve communication skills within the workplace, between staff and participants and across stakeholder groups. The program is currently running as part of STEPS Leadership program at MSH. It is an affordable and effective program and can be easily adapted to other services and industry contexts. Findings have contributed to practice guidelines for ABI, and the program is now embedded into STEPS Leaders training programs (benefiting 300 participants over 2 years). It is being translated into clinical practice by Speech Pathology teams within the DoR, PAH, MSH.
Singing Cords - Therapeutic group singing for people with spinal cord injury.
Brooke Wadsworth, Physiotherapist, Spinal Injuries Unit, PAH Short-term Intensive Clinical Fellowship.
Project Synopsis: Brooke’s Fellowship was centred around Singing Cords which developed in partnership with Tim McCallum (THC Ambassador), a professional performer and singer who experienced a SCI 20 years ago. The project responded to the high rate of respiratory problems in people with SCI and the need for preventive intervention. A feasibility study of a 24-session peer group singing program for respiratory health and wellness was conducted at the Spinal Injuries Unit at PAH. Watch the Singing Cords film.
Outcomes and Impacts: This project determined that group based, peer-led singing programs was feasible within existing models of rehabilitation care and demonstrated positive effects on breathing and voice measures and improved wellbeing for participants. The Singing Cords peer group program is now part of routine leisure therapies for NIISQ and CTP participants at PAH, supported by Spinal Life Australia. A larger study is planned to support the scaling up of this program beyond the pilot site at the PAH. The program has received nation-wide publicity and has been featured in several rehabilitation conferences.
Identifying the research capacity needs of medical officers in rehabilitation and related services to inform strategies to enhance participation in research.
Dr Letitia Burridge, Nurse researcher in the DoR, PAH, MSH Long-term Clinical Researcher Fellowship.
Project Synopsis: This fellowship built on our successful Masterclass and mentorship program for rehabilitation nursing in DoR. The masterclass was delivered to nurses to build research capacity. In this project, Letty identified the research skills, engagement, experience, priorities and training needs of medical officers in rehabilitation. She sought to develop training strategies to build capacity for research across MSH, enabling physicians to apply for grants and fellowships.
Outcomes and Impacts: A set of practical training modules were developed for busy medical officers to build their research skills in small steps in a self-paced form that can fit around clinical work. They can also complete modules when a need stimulates their engagement with skills-training. The modules were pilot-tested and interactive worksheets were established on the PAH Intranet, DoR, MSH. A focus group and survey of medical officers’ research goals and training needs has resulted in a 2 hour interactive workshop on research capacity building in rehabilitation medicine
Integrity Check of Citizen Engagement in Research.
Delena Amsters, Senior Researcher and Physiotherapist, Spinal Injuries Outreach Team, PAH Short-term Intensive Clinical Fellowship.
Project Synopsis: This project was conducted to inform processes of citizen engagement (CE) across Griffith University and MSH. It responded to the need for methods that could easily support citizen engagement and for consistency in our commitment to this way of working. Through surveys and communication with key stakeholders, the project aimed to develop a shared understanding of the concept of consumer engagement and best practice for undertaking CE in the rehabilitation and disability service contexts.
Outcomes and Impacts: The project identified a good ethos of citizen engagement in THC, with The Dignity Project serving as an exemplar. Recommendations were made for improving citizen engagement included the use of consistent and plain language, use of citizen panels, providing perspectives on different disabilities, improving researcher knowledge and communication and disseminating the Centre’s successful approaches and learnings. The findings have informed elements of the Aus-InSCI Translation project (i.e., use of visual and easy read material, use of design principles for communicating messages).
Assessing cognitive-communication skills in the Acquired Brain Injury return to work population.
Katherine Cameron, Senior Speech Pathologist, Acquired Brain Injury Translational Rehabilitation Service Long-term Clinical Fellowship.
Project Synopsis: Changes in the ability to communicate is a common consequence of brain injury. A growing body of evidence points to assessment and treatment processes that may better support people with communication disability to return to work. However, clinicians lack the clinical tools to translate this evidence into practice. Using the Knowledge-to-Action (KTA) Process Framework, this project aimed to develop tools and resources for assessing workplace communication needs to support return to work after brain injury.
Outcomes and Impacts: Informed by a review, national and international clinical benchmarking survey and expert opinion focus group, a suite of clinical tools for assessing cognitivecommunication skills in the return-towork process have been identified. These resources are being integrated into existing vocational rehabilitation practices within ABI-TRS and are expected to inform other vocational rehabilitation services. Requests for resources have been received from other States, the UK and the USA. Kate has enrolled in a Masters degree and will upgrade to a PhD to continue this project.
Optimising the processes of care for the management of people with a Spinal Cord Injury on the Orthopaedics Ward at the PAH: Solutions Design.
Glenn Verner-Wren, Physiotherapist, Spinal Injuries Unit, MSH Short-term Intensive Clinical Fellowship.
Project Synopsis: This project was a clinical redesign project aiming to improve the care provided to people with a newly acquired SCI on the Orthopaedics ward waiting to be admitted to the spinal injuries unit (SIU). It aimed to improve seamless clinical processes and expertise across acute and rehabilitation for the benefit of quality care for patients with a SCI where there are known transition delays. This was achieved through clinician-led practice improvement and stakeholder engagement to enable interface and system efficiencies across the continuum of care.
Outcomes and Impacts: The findings have led to direct improvements in the way care is delivered to people with SCI including:
- Introduction of a joint ward round (orthopaedics and SIU)
- New equipment for the orthopaedics team to care for SCI
- Formal education program for nursing staff
- Care pathway report for the management of people with SCI
Feedback from staff and patients highlights that these initiatives have led to better clinical care for people with an acute SCI, improved education for orthopaedic clinicians managing acute SCI and more effective communication and collaboration between acute and rehabilitation work areas.
Getting research closer to practice: Using a research capacity building framework to develop and evaluate a clinician-researcher position in occupational therapy.
Rebecca Seeney and Kylie Bower, Occupational Therapists, BIRU, DoR, PAH, MSH Shared Clinician-Researcher Fellowship.
Project Synopsis: This project sought to address the lack of research skills, resources and confidence of allied health clinicians in rehabilitation. It aimed to establish and evaluate a clinical researcher role with a focus on research capacity building. A model of research capacity building was developed around two patient-centred research programs focused on yoga and fatigue management in people with brain injury. This project responded to the need for models that could deliver capacity in the busy clinical setting.
Outcomes and Impacts: A clinician-researcher role was established, enabling evaluation of a yoga program for patients of a sub-acute brain injury rehabilitation service which is now sustained in practice. Similarly, a clinicianresearcher worked on a fatigue study developed and implemented through seed grant funding. The fellowship worked with these two projects to explore capacity building. The result was a model that highlights the need to keep research ‘close to practice’ and has been the springboard for a series of allied health projects that champion research into clinical service delivery. Every project should leave a legacy of increased capacity in clinicians.