Registered nurses need to be prepared to understand and engage with research as part of core NHS business. This article – the first in a series of two – explores how this can be achieved through student nurse placements with clinical research teams. These placements offer excellent learning opportunities for students and can address placement-capacity issues in NHS trusts. They require planning but can be very successful, engaging student nurses with the research agenda as well as promoting research in the nursing profession in the longer term.
Citation: Brand S et al (2022) Engaging student nurses in research 1: research-delivery placements. Nursing Times [online]; 118: 9.
Authors: Sarah Brand is assistant divisional nurse, Nottingham University Hospitals NHS Trust; Julie Menzies is nurse researcher, Birmingham Women’s and Children’s NHS Foundation Trust; Niveeta Vijayakumaran and Cherelle Bijou-Rowe are undergraduate nurses; both at University of Nottingham.
- This article has been double-blind peer reviewed
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Research is increasingly important for the nursing profession. This was reflected by the chief nursing officer (CNO) for England in the NHS’s (2021) strategic plan for research, which outlined an ambition to “create a people-centred research environment that empowers nurses to lead, participate in and deliver research” and for research to be “fully embedded in practice and professional decision-making, for public benefit”. The Nursing and Midwifery Council (NMC) has also expresed a hope that future student nurses will be exposed to, and engaged, in research (NMC, 2018a).
This article is the first in a two-part series that explores potential approaches to raising the profile of research in undergraduate nursing programmes through practice placements. The series discusses how placements can provide an opportunity for student nurses to engage with, and experience, research practice in its various forms. This article focuses on clinical research practice placements, and the second will describe a model for a clinical academic placement to show how it can incorporate the breadth of research.
Benefits of research placements
Clinical research delivery is crucial to embedding research into nursing for the long-term benefit of patients. The CNO for England’s strategic plan is supported by the director for nursing and midwifery at the National Institute for Health and Care Research, which supports clinical research delivery throughout the UK (NHS, 2021). It also reflects ambitions set out in both the Department of Health & Social Care et al’s (2021) implementation plan and the NHS’s (2021) strategic plan, which aims to “release nurses’ research potential”.
To achieve this, the importance and potential of research in all its forms needs to be highlighted and promoted at the earliest stages of nurses’ careers. The most common way of integrating research into undergraduate teaching for nurses, midwives and allied health professionals is through research-informed teaching around evidence-based practice, research methods and skills (Council of Deans of Health, 2021). We observe that clinical research delivery is often neither considered, nor highlighted as a viable or exciting career option, to student nurses. Succession planning is equally important in research delivery as in any other area of nursing, and the most committed and passionate nurses should be encouraged to consider this career pathway whenever possible.
Undergraduate placements offer student nurses the opportunity to gain skills and knowledge to complement their academic learning. Undertaking a placement with a research team gives undergraduate nurses research skills and teaches them how clinical research is being carried out across the wider NHS. As research has been identified as part of the NHS’s core business (NHS, 2021; NMC, 2018a), learning about all aspects of research is vital for student nurses and midwives.
Both universities and students began recognising that placements with research teams offer valuable learning opportunities for student nurses (Naylor et al, 2014). Clinical research nurses have specific and specialised research-delivery expertise, as well as skills that translate to general nursing care; student nurses can, therefore, gain diverse experience from such placements (Box 1).
Box 1. Research placements: experiential learning areas
- Clinical practice and consent processes
- Laboratory work
- Data entry and query resolution
- Delegation of duties log
- Insight visits in clinical areas
- Screening for potential participants
- Site initiation and close-down visits
- Central research and innovation functions, such as study set-up and regulatory approvals
- Teamwork with the wider multidisciplinary team and with specialist teams
- National Institute for Health and Care Research bitesize research
There are two models of service provision in clinical research:
- Generic teams that cover a wide breadth of clinical specialities;
- Teams embedded in a speciality.
Both models offer students a range of opportunities to develop their skills and knowledge, and to help them meet their pre-registration proficiencies (NMC, 2018a). They also allow students to learn about widely recognised research standards; this includes the Guideline for Good Clinical Practice, which is the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use’s (2016) international ethical, scientific and practical standard.
Nationally, there are practice placement capacity issues, due to the expansion of pre-registration nursing places (NHS, 2019). In many trusts, research teams are an underused resource for student placements (Council of Deans of Health, 2021) and can help expand practice placement capacity in organisations. They also broaden the range of placements available for undergraduate nurses, increasing the options open to higher education institutes and enabling a better matching of students to suitable placements.
Clinical research teams can also provide elective placements for students, supporting their emerging interests in various aspects of nursing practice. The current nursing recruitment and retention issues facing many trusts mean organisations need to use all strategies available to attract high-calibre individuals. Offering valuable placements with research teams can form part of a wider workforce recruitment and retention strategy: in our experience, newly registered nurses often begin their careers in teams where they have completed successful, enjoyable and fulfilling placements.
In the past, clinical research nurses have been unable to use their mentoring and supervisory skills due to a lack of student nurses in their teams, and many welcome the opportunity to demonstrate their skills and knowledge to undergraduate nurses (Lafleur and White, 2010). Having learners in a team:
- Motivates staff;
- Enhances job satisfaction;
- Challenges practice;
- Encourages staff to question and justify their ways of working, thereby enhancing quality and safety (Lafleur and White, 2010).
There are also benefits of students who do not go on to choose a career in clinical research undertaking placements with these teams. It increases their knowledge in this essential element of healthcare, and supports and promotes the field of clinical research.
Box 2 gives two case studies of students who have undertaken placements with research teams and found them beneficial.
Box 2. Case studies of research placements
Niveeta, undergraduate nurse
“During the final year of my undergraduate nursing course, I had a four-week placement with the children’s clinical research team. The placement gave me the opportunity to develop knowledge and practise many clinical and research skills [that would be] unavailable in a [ward-based] placement.
“Initially, I completed Guideline for Good Clinical Practice and informed-consent training, which [are] required to assist with the trials. I assisted with screening and recruitment of patients, preparing for studies by making lab kits, preparing training documentation, training student and staff nurses on study procedures, entering data into case report forms, attending outpatient clinics to follow up trial patients, and processing and packaging biological samples for analysis.
“The importance of the multidisciplinary team was obvious during this placement. I was able to work with various health professionals, including research assistants, research nurses, specialist nurses, consultants and biomedical scientists. I also spent time with the patient and public involvement lead, who works with seldom-heard communities to raise awareness about the importance of clinical research and strategies to increase participation in clinical research. There is a lack of representation in research from the Black, Asian and minority ethnic communities, both as research participants and staff, and this has inspired me to drive this agenda forward. Working on Covid-19 trials also gave me the opportunity to work with research professionals from the adult teams and gain an insight into adult nursing.
“The placement helped me understand how new drugs and treatments come into practice, and it was rewarding to see the direct impact of research on patients and their families. The placement allowed me to see behind the scenes of a research study and parts of the hospital that I did not even know existed. I had never considered clinical research as a potential career before the placement, and [it] opened my eyes to a completely different area of nursing. I cannot stress enough the importance of more student nurses having the opportunity to undertake clinical research placements. Many student nurses do not even know about research as a career path, and this needs to be publicised through lectures and seminars.”
Cherelle, undergraduate nurse
“I spent four weeks with clinical research teams and I found it very enjoyable. I was able to spend a week [each with the] renal, oncology, breast and – my favourite – haematology teams. Throughout my nurse training, my placements [had previously] focused on the clinical aspect of the profession and the clinical techniques required during interactions with patients. However, spending time in research allowed me to see the other side of nursing. A lot of the work [research nurses] do supports the way in which we all practise. The clinical trials conducted provide the evidence base we use for practice, as [the] data is utilised to benefit the patients as well as ourselves throughout our professional career.
“As a student nurse, I found it very useful to spend time with the research team. I fully support the idea that all students should have the opportunity to have a placement in research, as it encourages the use of critical thinking, which we will always need in this career. It has also been beneficial as it allowed me to take Guideline for Good Clinical Practice and informed-consent training, which I think all students should have.”
Challenges of research placements
There are some challenges around student nurses undertaking placements with clinical research teams; considering these can maximise the success of placements.
As these placements do not offer conventional, ward-based experiences, they need to be offered to students at a point when they can make the most of the opportunities provided. This is, ideally, when students can build on existing clinical knowledge and skills; if they do these placements too early, they may not be able to make the most of the opportunities available. However, if done too late, the placements may not enable students to meet any remaining competencies that are required to complete their undergraduate programme.
Research placements work best when the research team thinks creatively about how competencies can be met and learning opportunities maximised. Planning for students to work across different teams can result in a better placement and distribute the workload. This requires collaboration and cross-team working, but the wider benefit of this is that it can improve routine working relationships between teams.
To improve placements, research teams need to develop additional resources to support students during quieter times or while research staff are doing administrative tasks that have minimal learning opportunities. This ensures learning is maximised and students are continually educationally challenged while on placement. Additional resources could include:
- Online learning;
- Exercises to practise research skills, such as screening for study eligibility;
- Project work that benefits the clinical area.
Using case-study exercises to promote learning is widely advocated (Heale and Twycross, 2018; Popil, 2011) and can be used to good effect in research placements.
As with most practice placements, engaged, enthusiastic and motivated students are the ideal candidates and gain the most benefit from their experience. Managing student expectations is crucial, and some students may be initially disappointed to not be allocated a ward-based placement. However, any issues can usually be overcome by:
- Identifying the learning opportunities;
- Emphasising the freedom students will have to tailor their experiences to their interests;
- Showing the enthusiasm that staff have for their work.
This is in line with the ethos of the NMC’s (2018b) standards, which advocate that practice learning not only supports the diverse needs of individual students but also empowers students to be proactive and take responsibility.
Box 3 lists practical ways to overcome barriers to arranging research placements.
Box 3. Practical tips for clinical research teams arranging research placements
- Consider for how long the team can support a single student, bearing in mind that good-quality, shorter placements can be more sustainable
- Consider the timing of research placements: students may benefit from them most when they can build on existing skills but are under less pressure to achieve specific clinical proficiencies
- Prepare well and develop meaningful activities that students can do while the team is carrying out administrative activities
- Give students time with a range of research teams; consider research as a speciality and give students a chance to see how it is undertaken across various clinical areas
- Arrange insight visits into clinical research-support functions (such as regulatory approvals) to show students the multidisciplinary nature of clinical research
- Allow students to develop their clinical knowledge by arranging placements in clinical specialities where research is being undertaken
Clinical research practice placements for undergraduates are an underused resource with benefits for individuals, organisations and the profession. Successful placements can enthuse students about the possibilities a research-active nursing career provides and empower them to seek out opportunities in this field post registration.
Clinical research is a core element of healthcare, and student nurses should have the chance to be exposed to it if they are to understand the importance and potential of research, both for patients and as a career option for nurses. To truly be the core business of the NHS, clinical research delivery must be offered to student nurses.
- Clinical research has been identified as part of the NHS’s core business
- Placements with research teams teach students how clinical research is carried out across the NHS
- Research placements promote the field of clinical research and support workforce recruitment and retention
- Planning for students to work with a variety of research teams can improve placements and distribute workload
Council of Deans of Health (2021) Becoming Research Confident.: Research in Pre-registration Curricula for Nursing, Midwifery and Allied Health Programmes in the UK. CDH.
Heale R, Twycross A (2018) What is a case study? Evidence Based Nursing; 2018; 21: 1, 7-8.
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (2016) Integrated Addendum to ICH E6(R1): Guideline for Good Clinical Practice E6(R2). ICH.
Lafleur AK, White BJ (2010) Appreciating mentorship: the benefits of being a mentor. Professional Case Management; 15: 6, 305-311.
Naylor GA et al (2014) Nursing student placements in clinical research. Nursing Standard; 29: 2, 37-43.
NHS (2021) Making Research Matter: Chief Nursing Officer for England’s Strategic Plan for Research. NHS.
NHS (2019) The NHS Long Term Plan. NHS.
Nursing and Midwifery Council (2018a) Future Nurse: Standards of Proficiency for Registered Nurses. NMC.
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Popil I (2011) Promotion of critical thinking by using case studies as a teaching method. Nurse Education Today; 31: 2, 204-207.