Participating in a musculoskeletal randomised controlled trial: identification of education training needs by occupational therapists and physiotherapists in the UK

Abstract

Background
There is an association between clinical teams engaging with research and improvement in the delivery of health services1. Randomised controlled trials (RCTs) provide strong evidence to influence practice in musculoskeletal services. For occupational therapists (OTs) and physiotherapists (PTs) implementing RCTs is not yet commonplace. As part of a multi-centred clinical effectiveness and efficacy RCT of splints for thumb base osteoarthritis (OTTER II Trial) we established an education training programme to support clinical therapists deliver the trial across 15 UK hospitals.

Objectives
To evaluate the content of trial training to educate and support OTTER II Trial clinicians in undertaking clinical research roles.

Methods
Two trial training days were run in the North and South of England. Therapists provided details of their clinical trial experience. They were asked to identify one area in which they felt confident and one in which they were not confident in participating in a RCT. These perceived facilitators and barriers were summarised using descriptive statistics and content analysis.

Results
Thirty five clinicians (20 OTs,15 PTs) attended a training day, 13 (37%) had no previous experience with clinical trials; 19 (54%) had been involved with at least one previous clinical trial. Clinicians considered they were already confident in; delivering the trial standardised assessment and treatment to patients n=21 (60%); trusting the OTTER II trial team and their own hospital research departments to support their research role n=11 (31%); understanding the trial protocol and what needed to be delivered n=6 (17%) and, being convinced that the trial asked a relevant question 3 (9%). Areas in which clinicians considered they did not have confidence included; the logistics and time management of delivering a RCT in their own hospital n=18 (51%); the associated trial paperwork to be completed n=8 (23%); NHS computer access/wifi access for randomisation procedure n=7 (20%); recruiting participants to time and target n=6 (17%) and staff capacity to deliver a RCT in the NHS alongside clinical commitments n=5 (14%).

Conclusions
Well documented trial protocols and support from a trusted research team and local hospital research departments were identified as key areas that help clinicians become confident to engage with a national clinical RCT. Clinicians are less confident about managing the practical logistics, staff time and trial paperwork involved in delivering a national RCT. Clinicians identify that they possess core clinical assessment and treatment skills that already equip them to recruit and treat patients as part of a national trial. The logistics of delivering a trial requires ongoing negotiation and support from clinical service managers and the clinical trial teams to ensure clinicians are supported to deliver the RCT to time and target.


References
1. Boaz et al 2015 BMJ Open 5:e009415 doi:10.1136/bmjopen-2015-009415.

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Identifiers

ORCID for Joanna Adams: orcid.org/0000-0003-1765-7060

ORCID for Kelly Hislop Lennie: orcid.org/0000-0001-8242-8665

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