Katherine

Age at interview: 38

Brief Outline:

Katherine is a speech and language therapy researcher. She is undertaking a PhD part-time and has a role developing the research culture in her Trust. She would like there to be more opportunities and support available for clinical academic careers.

Background:

Katherine is a speech and language therapy researcher. She is married and has three children aged 9, 6 and 2 years. Her ethnic background is White British.

More about me...

Katherine is a speech and language therapy/therapist (SLT) researcher. Before working in research, she worked in rehabilitation and, during this time, was invited as a consultant on a research project. She went on to complete a Master’s degree which “spurred my interest” further. Katherine thought “about redirecting my career pathway” towards research when she relocated, in part to “broaden opportunities and horizons going forward for my career”. She applied for a job at a research unit; although she was not offered the job, she received some “nice feedback” and advice on next steps – including the suggestion to consider NIHR clinical-academic pathway support. Katherine secured a new clinical job and started to develop more specialist interests in augmentative and alternative communication and communication aids (AAC). She became involved in various research networks and went on to secure an internship. This involved Katherine taking five months out of her clinical post to work at a research unit and gain experience, “as a springboard” to successfully gaining doctoral funding. She is now in the process of undertaking a PhD part-time (over five years). 

Katherine’s PhD is about the use of communication aids by patients. Her background as a SLT has been useful, giving her “an awareness of barriers to communication and how important it would be to make the research accessible”. To guide her PhD research, Katherine set up a Public and Patient Involvement (PPI) group and this has been “a massive part of my learning”. At times, this has meant questioning or adjusting standard practices used in research because they “don’t necessarily fit with the needs of certain populations” and end up excluding them. For example, although Katherine had initially devised easy-read participant leaflets, she found they were still inaccessible for some people and so she has been exploring the use of picture and video-based resources. 

With regards to her clinical environment, Katherine has tried to “use the fellowship to the best effect”. The research culture in her organisation is “at the embryonic phase” so she is working on developing it within her Trust. Although there is support for this, she feels that research is “still very much seen as something that’s slightly separate from day-to-day practice” and an individual-based undertaking rather than core business. Katherine’s Trust is in the process merging with a Mental Health Trust and she thinks this is providing good opportunities “to take on roles and opportunities that will help embed a change in culture and embed opportunities to develop research practice within clinical practice”. Amongst Katherine’s clinical colleagues, there has been “a real mix” of responses to her fellowship and role in the department. She has found that, on the whole, more recently qualified SLTs are “much more enthusiastic and interested in the pathway that I’ve taken”. Katherine has connections with another nearby Trust who have a specialist service related to her research interests and she has been able to support them in developing their research culture too.

Compared to working in a “reactive” way in clinical practice, Katherine feels research offers “a really nice antidote […] I like the way it develops your thinking skills”. She has enjoyed discovering new networks and individuals engaged in research activity. Online social media has been a good source of information and she has then channelled information back to her local contacts/networks. As a result of a blog post she wrote and a resulting Twitter discussion, Katherine is now involved in developing a special interest group to support clinical academic careers for SLTs. Finding out about the SLT research activity happening across the UK has been “quite eye-opening” for Katherine and it wasn’t something she was aware of when a practising clinician or even during her internship. Networking online has been important for Katherine; her PhD is registered at a university some distance away and, although she visits quite regularly, she feels that she lacks an in-person peer support network. She finds it is difficult to attend events where she might meet her peers as these are often arranged at relatively short notice, whereas she has to plan her visits well in advance. 

Katherine feels that research offers more progression career-wise than is available practising clinically; however, it remains a matter of waiting to see whether opportunities “actually manifest or not”. She feels more progress needs to be made in developing and sustaining a supportive environment for clinical academic roles within the NHS, including consideration around banding/salaries. Katherine says her “ideal job [after completing the PhD] doesn’t exist currently” but she hopes that some of the activities she’s currently involved in will create new opportunities. At the moment, there are three main directions she would consider: if she were to stay in her Trust then, “maybe an AHP research lead role”; a clinical lectureship; and/or involvement in implementing strategy at a national level. Katherine’s advice to other SLTs interested in research is to “find a mentor, look for opportunities, take them when they arise, and try to get research as part of your professional role”.

After being a consultant on a research grant, Katherine started thinking about doing a Master’s degree.

I guess the opportunity that I mentioned at the start of the video, to be a consultant on a, research grant, was the only research opportunity that came my way in, you know, during my clinical practice to that point, and by then I’d probably been practicing I guess six or seven years. So yeah that’s the only opportunity that I’d really thought about. And I guess it was from that, I think you know once something is put on your radar you start noticing more opportunities I suppose.
 
So from that point I suppose that’s when I thought, started thinking about doing the Master’s, and from the Master’s I sat thinking about where that might take me going forward, and I guess I’d enjoyed doing the learning, that sort of like I said deep thinking based learning, that the Master’s gave me an opportunity to look up and outside of my profession, and learn from more broadly sort of healthcare policy and strategy, and how that might inform my practice and my service development.
 
So, I really liked the idea of looking more broadly across a range of different disciplines, I suppose. And developing and informing my practice from that. And then, like I said, I kind of sought out research opportunities going forward. I still didn’t really ever contemplate a PhD. I didn’t really think that would be part of my career trajectory until sort of much later on.

Katherine was very positive about her supervisor and mentors.

My supervisor, so my doctoral supervisor was also the supervisor for my internship, and she’s a speech therapist by training, and is now a professor. And she’s been really supportive of me throughout. So, she’s sort of been my supervisor and my mentor. She’s really helped me think about opportunities that the research might present to me. She’s been, she’s really good at networking, so she’s great at sort of putting me in touch with different people, as and when I visit university. And we have quite a good relationship in that she seems to really understand where my strengths and areas for development lie, and she’s quite sensitive to my reactions to things. She knows when I’m going to be overwhelmed by something and will tend to sort of take that off the agenda. So I’ve got a good relationship with her, and she’s helped me put together a really good supervisory team for the project.
 
And I’ve got clinical supervisor within that team whose got lots of research experience and he’s really great at seeing things through a sort of pragmatic clinical lens. And I’ve also got a sort of very experienced researcher, or a couple of researchers on the team who bring me specific research skills. And again, are really good at looking at things from an academic lens, and through the processes that I’m going to need to engage in, in order for the research to be of value I suppose and rigorous and robust, so I’ve got kind of a really nice balance within that supervisory team, and I consider myself really fortunate to have that, to have a nice sort of balance of skills. And have positive relationships thus far with everyone within my supervisory team.

Katherine had learnt about the best ways to engage her PPI contributors, including “pictures-based resources”, and she planned to use these approaches in her recruitment resources too.

So when I first started the PPI group I followed all the guidance, I had lots of easy read documents for them, and an agenda which I sent out in advance so that people could plan and prepare for the meeting. And I felt the first meeting was kind of okay, but that the group members weren’t as involved as I’d hoped, they hadn’t maybe prepared as much as I had thought they might. And they really didn’t engage with any of the paper-based resources that I provided, so the sort of easy-read, I had shown them participant recruitment information for example, and the easy-read leaflets. So, I had given them like the ones you had shown me, I had sent them round by email in advance, I’d brought paper copies to the meetings, and they barely looked at them.
 
And the feedback from that group was largely, “We, we can’t engage with this sort of media, this material isn’t suitable for our needs.”
 
So, I used loads of pictures-based resources, annotated all the minutes, I came up with an audio-visual tool which I put on YouTube, and posted people the link beforehand so they could see what the agenda was for the minutes and again used pictures and head shots for that. And within the meeting itself I had some sort of practical activities that the group could engage in, and the following group went much better, people were much more engaged, there was a bit more of a dynamic. People were kind of talking much more with their communication partner, or with their facilitator within the group, and we got much, we got some really nice outcomes from that. And generally the feedback on the resources that I showed them this time round for participant recruitment was much more positive. People really liked the videos, they really liked the pictures on the sheets, the fact that it was colourful, the words were simple, all that sort of thing.

Katherine had discussed clinical-academic careers for speech and language therapists on Twitter. Building on this, she was hoping to gather examples to create a resource for others seeking these careers.

So yeah, the but the blog post that I wrote, particularly about clinical academic careers obviously really resonated with a lot of people who had read it within Twitter, and I got lots of comments and retweets, and I think that led onto other people reading it and commenting and retweeting, and the essence of the blog was that there aren’t really clear clinical academic careers for speech and language therapists. There aren’t that many examples where people can do both research and clinical practice within one role. I can understand why they aren’t skills that necessarily sit well together, as I said earlier, you know, clinical practice is maybe much more reactive, academic practice is maybe much more reflective, you need slightly different thinking skills, and you-, a clinical academic career for me would definitely require protected research time and protected clinical time, rather than something that embodied doing both at the same time.
 
But yeah there are obviously lots of other people felt very similarly – they were interested in doing research, they were interested in being involved in research activity and in developing a research career but were kind of reluctant to step away from clinical practice. And that’s in essence, where this idea of developing a sort of support network came from. The idea of well if we can capture examples of good practice, if we can learn from each other’s experience, if people are developing clinical academic careers in different parts of the country or developing networks then, you know, maybe we can use the momentum behind that blog post and this Twitter conversation to really start to influence strategy, and to build some really practical sort of, some real practical framework and infrastructure stuff that will help people going forward, then that would be great.

Katherine felt the support for clinical-academic roles needed to be translated into posts, and not only in large teaching hospital Trust settings.

One of the conversations which keeps on happening, or coming up again and again when we think about this idea of clinical academics is sort of aligning sort of the, the national strategy with the motivations and, and of an operational management I suppose of NHS organisations. And what I’ve found is that within the NIHR, within government policy, within, you know, the research projects, there’s an awareness of the impact that having clinical academics can have and that research active organisations have on the ultimate  and the benefit’s it has on patients, you know, the impact it has on outcomes for patients, is well recognised. And yet we still don’t have a culture within NHS organisations that really sort of supports the idea of clinical academic roles. And particularly thinking about the kind of I guess recognition and banding that maybe clinical academics should have.
 
And I suppose what would be really nice would be to know that at some point conversations were happening between leaders and health organisations and leaders and higher educational institutes, and leaders with health strategy organisations such as NHS England, and the NIHR where really, we’re thinking about sort of how to fund and evaluate clinical academic roles, in order that they can become practical reality. And not just for teaching hospital Trusts, which I know is where lots of money goes, because they get the research funding. But also, for community Trusts who are really looking to develop their research capacity.