Clinician-Researcher Collaborations: Strengthening Clinical Outcomes Through Science
Patricia M. Chute, EdD, CCC-A
Dean School of Health Professions
Health Policy Fellow
New York Institute of Technology
As the medical field and health professions embrace evidence-based practice, it becomes essential for present and future clinicians to develop an understanding of research protocols and their impact on patient care. Clinicians and scientists need to forge collaborative relationships to support the direction and outgrowth of research. At no time in the history of providing health care has the clinician-scientist research collaboration been more important. It behooves both groups to become familiar with the role each plays and the potential for collaboration to change the face of health services. Colleges and universities must train future clinicians and scientists to provide the foundation for research-based initiatives that attempt to answer important basic and applied questions. Answers to these questions will result in evidence-based practices for clients who are seen in health care or educational settings.
Collaborative Relationships in the Changing Health Care Landscape
The Affordable Care Act (ACA) will restructure all of medicine both from an administrative perspective as well as an outcomes perspective. The reliance upon evidence to support more efficient patient care is the foundation of ACOs (Accountable Care Organizations) and PMHs (Patient Medical Homes). Evidence-based practice is centered on identifying a diagnosis or treatment and determining the efficacy of the protocols used to determine their relative utility. The short-term and long-term goals of efficiency-related outcomes are the driving forces behind collaborative relationships between clinicians and scientists. In some cases, the clinician is also the scientist; in most cases there is a clinician-scientist team. Regardless of the model used, the overall objective is to provide the highest-quality patient care and enhance health professional-patient interaction, thereby improving health outcomes.
As changes in health care delivery become part of the American health care landscape, the governmental charge is to support initiatives that produce quality, affordable care to the clients/patients. The United States presently spends 18% of its GDP (gross domestic product) on health care, with health outcomes that compare poorly to other high income countries. The new systems in the ACA are designed to provide care, monitor results, and improve outcomes. A great deal of this initiative will be in the form of collaborative teaming in which researchers and clinicians work together as ACOs and PMHs to collect data as part of diagnostic and treatment plans. These data will drive efficiencies in the system to help inform future decisions with the long-term goal of improved services at decreased costs. The integration of these systems with electronic health records, coupled with the burgeoning field of health informatics technology (HIT), will support these initiatives over time. HIT’s use of data from health records will inform decisions regarding patient care. As programs in communication sciences and disorders (CSD) evolve, curricula will include aspects of HIT, so that students are armed with technology that may become essential in the delivery of patient-centered services. The clinician-scientist bond will become stronger as data collection becomes seamless in its effects on outcomes.
Challenges and Rewards of Collaborative Research
On the surface, the challenges of collaborative study might appear to be overwhelming, as these professionals often work in different facilities or laboratories. Issues of funding, resources, and time commitment also may create barriers that hamper smooth, joint intellectual endeavors. However, with some organizational strategies and a combined sense of purpose, solutions to these challenges can result in successful, cooperative ventures. Along the way, relationships between the clinician and researcher can evolve so that long-term collaborations become part of each professional's role.
As a researcher in the field of cochlear implantation from the early days, I witnessed numerous research collaborations as they evolved over time, resulting in enormous growth in this area of study. Over many decades of research, the basic science has continually advanced, permitting development of devices that produce better outcomes for large numbers of cochlear implant (CI) recipients. The clinician, as a direct service professional, works on the front line of assessing the utility of CI devices. Basic scientists, engineers, software designers, and product developers rely on information provided by clinicians to make improvements in CI devices. This interplay among team members is what supports growth in the field.
Historically, as information expands, more questions arise that require increasing expertise of clinical practitioners; pursuing answers to these questions often results in greater efficiencies as the knowledge base of those involved in the research grows. Every clinician-patient/client interaction in speech-language pathology, audiology, swallowing, and balance assessment or treatment supports these types of research initiatives. Clinicians must view themselves as integral to the process of scientific research by contributing important clinical questions that require answers, as well as participating in the assessment and treatment protocols.
Preparing Future Clinician-Researchers
Graduate and undergraduate education programs in CSD have embraced a research paradigm by integrating research findings and research opportunities into academic and clinical curricula throughout students’ courses of study. In general, research indicates that undergraduate research experience is perceived as highly beneficial and a value-added aspect of undergraduate education and that such experience instills a respect and enduring appreciation for the research process (Bauer & Bennet, 2003). By engaging clinicians of the future in research activities, institutions of higher learning lay the groundwork for tomorrow's advances in science, medicine, and clinical practices. Students learn early on about assessing outcomes to inform decision making in diagnosis and treatment. The long-term result is a better understanding of the research process and its effect on patient quality of care and health outcomes.
In short, the question “Will this work?” must be answered. Clinicians must be prepared with answers; if none are available, then they must be prepared to study the issue. It is important to remember that answers evolve from not only large research-based institutions, but also from clinics, colleges, and schools that are on the front line of client/patient care. Research initiatives tailored to individuals rather than to large populations will support the newer medical/clinical treatments. Such work can only be accomplished through the collaborative efforts of clinicians and scientists.
The future of medicine and its health-related professions, especially those in CSD, is becoming increasingly reliant upon better diagnostic and treatment paradigms involving collaboration among professionals. The evolution of these patterns of care also will, in turn, support increased reliance on interprofessional education and practice whose purpose will be to improve health care overall. The days of diagnostic and treatment silos will come to an end, resulting in a healthier population receiving care that is based on evidence. Although it may appear to be a confusing time, it remains a very exciting one in health care, research, and personnel preparation.
Bauer, K. W., & Bennet, J. S. (2003). Alumni perceptions used to assess undergraduate research experience. The Journal of Higher Education, 74(2), 210–230.
ASHA Related Resource
Don't Most Researchers Who Participate in Research Collaborations "just do it?"