So, who am I?
I’m Rhianna and I’m a paediatric ST5 trainee based in the Northwest Deanery, and despite being 6ft tall - I will forever be a big kid - relishing in any opportunity to talk about superheroes, decorate anything with stickers and glitter and I love any chance to use the play specialist bubble machine!
What is my research experience?
The simple answer is none. I’ve never been an academic trainee and my only experience of research prior to this year, was as a medical student (more than 10 years ago…) doing a literature review on different methods for embryo transfer in IVF (which as you can imagine as a 3rd year medical student…was very heavily supported by a research savy consultant!).
How did I get involved in research this year?
Throughout my paediatric training I tried to involve myself in audits and quality improvement but struggled to find ways to be involved in what I considered ‘research’. I didn’t feel like I had enough time to be able to do research and didn’t know who to ask for advice/support. My husband is an orthopaedic trainee, and their training has a significant focus on research – with protected research time in their weekly rota as it is a heavy part of their ARCP requirement. I often saw the differences between the approaches to research in paediatrics and orthopaedics - especially collaborative work across hospitals/deaneries which is frequently done in orthopaedics.
I have always been interested in paediatric safeguarding and often thought about how I would like to be involved with research within it, however I never knew where to start - not knowing who would be able to support me or who to turn to for advice. When I was on my community placement during the COVID pandemic, I had a bit more admin time and was able to start thinking around research. I had only recently learnt about Adverse Childhood Experiences (ACEs) and felt this was a huge part of paediatrics that I felt I wasn’t made aware (in either paediatric training, foundation training or at medical school) and I wondered if my colleagues felt the same. After a quick ask around of my paediatric trainee friends it led me to realise that it wasn’t just me who didn’t know about ACEs and I felt that this was something that needed to be addressed.
I actually didn’t even really think that I was in the realm of ‘research’ initially as I always perceived research as clinical trials or things that required extensive ethical approval and funding. However, after talking to one of my friends and colleagues Chris (who just so happened was in the process of co-creating PRIME - the North West Paediatric Research Network) he made me realise that in fact I was thinking about research and it had the potential for a bigger project.
So what happened next?
Through PRIME we set up a meeting to discuss my idea - essentially a basic hypothesis that paediatric trainees don’t know enough about ACEs. PRIME helped me realise that getting into research was really as easy as just trying to prove or disprove what was currently an anecdotal theory!
From there I was able to produce a survey assessing trainee knowledge of ACEs and trauma informed care (TIC) and PRIME helped me tweak the survey to get the best outcome. This initially was sent around to trainees in our region (via the facebook, whatsapp, PRIME and other email networks) and we had 50 responses (including seven consultants) within two months. The results showed that only 46% knew about ACEs, with 96% feeling they didn’t know enough and 98% wanting more training. I was so surprised by the results - firstly, because I couldn’t believe people completed the survey in the first place and secondly, because the results were even more stark than I thought they would be!
Again, I was able to go back to PRIME and show them my results and explain that I was interested in seeing if these results were replicated in other regions - which seemed like the logical next step. PRIME were able to support with the national dissemination of the survey - sharing it through the other research networks in the UK (which resulted in 32 responses from just 3 deaneries vs the 78 responses from the remaining 18 deaneries) and I pestered the TPD’s of every deanery asking if they would be happy to share the survey link to their trainees. This collaborative approach to research was so beneficial and made me realise how little we utilise the connections across deaneries for research.
These results made it fairly easy to put a case together for the need for delivering training, and this research has led me to be able to gain regional funding for the Northwest region to train all paediatric (and hopefully other specialities) in ACEs and TIC.
The results of this national survey (153 trainee responses) found that 67.9% reported that they were aware of ACEs, with 88.9% highlighting that they didn’t know enough about the topic, with 95.4% stating they wanted to have more training on ACEs and TIC. These results made it fairly easy to put a case together for the need for delivering training, and this research has led me to be able to gain regional funding for the Northwest region to train all paediatric (and hopefully other specialities) in ACEs and TIC.
Never when I started reading about ACEs and realising how little I knew did I think it would lead to a national research survey and instigation of a new regional teaching programme! I believe that is because I had a preconceived notion of what ‘research’ and that I wasn’t cut out for ‘lab work’, but my experience has made me realise that there are so many ways to ‘undertake’ research and they don’t all require research fellow jobs, academic posts or funded PhD’s.
I would not have got as many national responses if not for the research networks either so will definitely try and incorporate the use of collaborative work into future projects.
I absolutely would not have been half as successful with my project without the support of a regional research network - even just for someone to bounce ideas off on who maybe has a slightly more ‘research focussed mind’ or help point you in the direction of a consultant who might be helpful/research orientated. Also, I would not have got as many national responses if not for the research networks either so will definitely try and incorporate the use of collaborative work into future projects.
How did I manage to do these projects with working full time?
These projects cumulatively took just over six months to complete and I had no assigned ‘time’ to do them - so initially was doing it in my own time, but then with the introduction of the compulsory CPD time I was able to use some of that time to work on the projects. This made ‘doing research’ a little easier as it put less pressure on my work life balance - so I think this has been a positive move by the college to include compulsory CPD time in our training. However, it would be great in the future if we could get dedicated research time in our week (like some other specialities) as unfortunately with clinic admin / management / teaching requirements it is not always possible to do research in this CPD time which might still deter some trainees.
What next?
This project - albeit just a survey, has been able to guide me towards focusing more on research and I’ve been fortunate enough to be appointed a paediatric clinical research fellow based at Lancashire Teaching hospital for the next year. The ACEs research I had done being a big talking point in my interview! I hope that now I’ll be able to develop more research skills and be able to support other paediatric trainees hoping to get into research.
So, what is my advice for trainees wanting to be involved in research?
I think the best starting point is to find someone that is interested in research - whether that be a fellow trainee, consultant or research network (if you have one in your deanery) and have an open conversation about what you’re interested in. You’ll be surprised how easy it is to stumble across a hypothesis that you can then tease out into a research project. In my case I had an incredibly research enthusiastic friend who gently, and not so subtly, pushed me in the research direction - and now look where I am - apparently it is infectious!
If you wanted to contact me to ask any other questions - please feel free - I’m happy to help in anyway I can: rhianna.netherton@nhs.net.