Gavin

Age at interview: 42
Brief Outline:

Gavin is a podiatry researcher. He carefully splits his time between clinical work and undertaking a PhD. He sees his PhD as a process of developing research skills which he can then utilise in his own profession, thus building podiatry’s research capacity.

Background:

Gavin is a podiatry researcher. He is married and has three children. His ethnic background is White Scottish.

More about me...

Gavin is a podiatry researcher. He currently splits his time two days a week clinically in the NHS and three days a week completing a PhD. For Gavin, the move into research was about contributing to a research culture, knowledge generation and career development. He has been interested in research since qualifying 20 years ago, stemming from a sense that much of the podiatry curriculum lacked an evidence base. He completed a Master’s and, over time, developed an interest in podiatry practices around fall prevention for older people. He came across research conducted in Australia, and was keen to explore the relevance for the Scottish context. The funding was awarded and allowed Gavin to conduct a small pilot randomised controlled trial (RCT) for two days a week out of his clinical post over two years. This experience was challenging but rewarding, and Gavin went on to be a successful applicant for a PhD fellowship.

Gavin’s experiences span various aspects of research activities. After securing funding and ethics approval for the pilot RCT, he: consented participants; delivered the intervention; collected and analysed data (including tests and validated questionnaires); and conducted qualitative interviews with participants to evaluate acceptability of the trial after first shadowing a qualitative researcher. Gavin has had access to a lot of training through his PhD fellowship but, before this, it was a case of “learning by doing”. He networked widely and found that, on the whole, the academics he approached were very generous in sharing their experiences. Working with a clinical trials unit gave him a “little flavour of all the little bits of things you have to do on a randomised controlled trial”. Gavin thinks he has been fortunate with good mentorship and support from academic colleagues. 

The pilot RCT involved care homes and elderly participants, and Gavin faced a number of challenges. For example, he re-consented participants with every study visit and some could no longer participate in the study when their cognition declined. Although Gavin had clinical experiences of elderly populations, he highlighted that consent for research is quite different. He had completed Good Clinical Practice training but felt strongly that “nothing really prepares you for sitting down in front of cognitively impaired older person [and] a) assessing their capacity to consent, and then b) running through the actual patient information sheet with them”. Gavin felt more comfortable over time and looked back on the experience as teaching him that “research is messy, and you spend a lot of time dealing with uncertainty and solving problems”.

As encouraged by the funders, Gavin has used his PhD as a “vehicle” to learn many different research skills and develop “a set of skills that [are] going to be incredibly useful to building up the evidence base for my own profession”. His PhD supervisors have different health professional backgrounds to his own. He highlights that having clinical podiatry experience “allows you to develop clinically relevant questions”.

Gavin tries to “compartmentalise” and “essentially treat the PhD like a job” – he occasionally works on evenings and weekends but it’s challenging with a young family. He tries to keep clear boundaries between his clinical and research split. When Gavin previously tried to combine them within the same days and location, he found that ““you end up doing neither of them very well”. Gavin strongly recommends that “where you do your research is not where you do your clinic”. When he was carrying out the pilot RCT, Gavin would sometimes do a half day clinical and half day research; being in uniform and doing computer work in the clinic office meant that colleagues and patients sometimes didn’t realise he was busy. Although Gavin mostly keeps his clinical and PhD jobs separate, there is sometimes a bit of crossover and his colleagues come to him for advice about how to use research.

Gavin recommends that other podiatrists thinking of pursuing a research career complete a Master’s degree, network with others (within and beyond podiatry, and geographically local), and identify funding sources to adequately support research.

Ever since he started training, Gavin felt there needs to be more evidence underpinning podiatry practices. He hopes to contribute to this through carrying out research.

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Ever since he started training, Gavin felt there needs to be more evidence underpinning podiatry practices. He hopes to contribute to this through carrying out research.

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Well I qualified, back in 1998, so and I was, I was interested in doing research then and at that point, and I was quite interested in doing a PhD but the, the landscape wasn’t as well developed and there wasn’t really any fellowships around about at that time. So, I just went and started working clinically, but I think what kind of drove me to do it was that I wasn’t-, when you’re, when I was taught at undergraduate, the stuff I was taught seemed-, podiatry is very much like it’s almost like a craft. So it’s very kind of hands on, and it was clear to me from an early stage there wasn’t an awful lot of evidence [laugh] underpinning what we did.
 
Okay.
 
It was just, a lot of it was like folklore, almost just like kind of handed down from generation-to-generation. And there was no clear evidence base or at least as-, we had a sort of a smattering of research methods that went into an undergraduate course, we did sort of basic statistics and sort of critical appraisal. But it was very much a kind of an add-on type thing. And so I was interested in ‘what is the evidence for any of the interventions that we tend to do?’ from quite an early stage.

Gavin felt that his research skills could benefit his profession of podiatry, such as using them to address clinically relevant questions and supporting colleagues to use research findings in service development.

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Gavin felt that his research skills could benefit his profession of podiatry, such as using them to address clinically relevant questions and supporting colleagues to use research findings in service development.

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But I hope once I’ve kind of come to the conclusion of my PhD, ‘cos I’ve learnt lots of skills, I’m doing ethnography, I’m doing quantitative methods as well, so it’s a mixed methods PhD. I’m really hopeful that I’ll have a set of skills that is going to be incredibly useful to building up the evidence base for my own profession as well.
 
Mm. Yeah.
 
So, it’s, whilst I’m interested in the topic it’s also, a vehicle for learning skills.
 
From a departmental point of view, they have never had anyone that is interested in research. So I’ve kind of, in a, on a, in a-, within my clinical capacity there’s a, anyone within the clinical department. So there’s a recognition that I know about this stuff, and no-one’s expecting anyone in the NHS-, everyone, no-one’s expecting everyone to be research active like as I am, you don’t need that, but what the NHS does require- and I think something that I’ve contributed to over the past, you know, informally over the past ten years when I’ve been involved in this type of work is almost- teaching is probably the wrong word, but showing clinicians how to be consumers and users of research, and that has been a very definite outcome and in terms of management. So my, our line manager, they like that because in these days of limited resources there’s a constant need for clinicians to be justifying their existence. And research feeds into that readily, and with me being in that role, I can-, you know, simple stuff that you and I would take for granted, things like doing a proper search within multiple electronic databases, using key words for relevant literature, that kind of thing, you know. I, that’s stuff that no-one else has the experience to do reliably and successfully, so I can do that. I can locate stuff, information for them – whilst it’s not relevant to my PhD I can bring out evidence, so if they ask me about, so say, podiatry as a profession is in terms of patients hugely oversubscribed and there’s quite, an increased level of interest in developing self-management strategies for podiatry patients. So, for instance I’ve been, pull out some literature that was relevant to that, give that to our line managers who can then put, pass that onto the board and it gives them a sort of like justification for the way that they’re developing the service. So, it, whilst me myself I’m not that interested in being a service manager, I think research skills that you bring to the party can massively feed into service development, and I’m quite happy to do it and that. So, it kind of straddles that. So, they see the value in having someone with those skills.

Gavin’s expertise was helpful in his department and used by his colleagues, as he could show them “how to be consumers and users of research”.

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Gavin’s expertise was helpful in his department and used by his colleagues, as he could show them “how to be consumers and users of research”.

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With me being in that role, I can-, you know, simple stuff that you and I would take for granted, things like doing a, a proper search within multiple electronic databases, using key words for relevant literature, that kind of thing, you know. I, that’s stuff that no-one else has the experience to do reliably and successfully, so I can do that. I can locate stuff, information for them – whilst it’s not relevant to my PhD I can bring out evidence, so if they ask me about, so say, podiatry as a profession is in terms of patients hugely oversubscribed and there’s quite, an increased level of interest in developing self-management strategies for podiatry patients. So, for instance I’ve been, pull out some literature that was relevant to that, give that to our line managers who can then put, pass that onto the board and it gives them a sort of like justification for the way that they’re developing the service. So, it, whilst me myself I’m not that interested in being a service manager, I think research skills that you bring to the party can massively feed into service development, and I’m quite happy to do it and that. So, it kind of straddles that. So, they, they see the value in having someone with those skills.
 
Yeah.
 
Which they’ve never really had before. So it’s quite nice.

Gavin recommended that those with both research and clinical roles separate the activities, both in terms of days and work spaces.

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Gavin recommended that those with both research and clinical roles separate the activities, both in terms of days and work spaces.

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Monday and Friday, I’m in clinic and then so the Tuesday, Wednesday, Thursday I essentially treat the PhD like a job. So I’m at my desk by half past eight and I leave at five o’clock, and that’s how I, I compartmentalise. I mean there’s been days when I’ve tried to do both things and what I’ve learnt that you end up doing neither of them very well.
 
Okay.
 
So for me it has to be very definite blocks of time allotted to a particular task. And that’s how it works, that’s how it works for me.
 
What I think made it helpful, and I would recommend this to anyone, would be to make sure that where you do your research is not where you do your clinic.
 
Okay.
 
So I started out by doing research work within my clinic office. People, if people see you at a computer, they think you’re not necessarily that busy and you often get pummelled with clinical problems or if patients come in, you have to then, you feel compelled ‘cos you’re, it’s what you do. So, you, you go and see them. So what then worked for me was to absolutely physically as well as organisationally, but physically separate out my research space from my clinic space.
 
And that was very successful. So the days that I’m on research work, I’m nowhere near my clinical environment and that for me works very well.