Knowledge of research ethics guidelines in Darling Downs health clinical staff

Knowledge of research ethics guidelines in Darling Downs health clinical staff

Health care practitioners are increasingly expected to engage in research to enhance patient outcomes and ensure evidence-based care. To conduct valid research, an investigator requires academic skills, knowledge of the behaviours expected of the research profession, and knowledge of the guidelines that govern the ethical conduct of research. This work-based project investigated the knowledge of research ethics guidelines among clinical staff in a public health service. The study utilised an objective measure to evaluate and quantify the level of knowledge about research ethics guidelines of health care practitioners employed within a public health service in regional Queensland.

A descriptive, cross sectional prospective research design was used. The setting was the Darling Downs Hospital and Health Service; a public health service in south-east Queensland which serves a population of around 280,000 people across 90,000 square kilometres, through services provided at 29 facilities including hospitals, outpatient clinics, multipurpose health centres and aged care facilities. The working population (N = 3,726) consisted of all clinical staff employed by the Hospital and Health Service under the Medical Officers, Health Professional and Dental Officers, and Nursing and Midwifery awards. A custom questionnaire was utilised to measure: knowledge of research ethics guidelines as described in the National Statement; confidence in knowledge about research ethics; interest in conducting research in the future; and interest in attending training in research ethics, along with demographic variables. Knowledge of research ethics guidelines was measured by posing 5 multi-option questions (choose all that apply) across research-specific topics. Confidence about knowledge of four research-specific topics was measured on Likert-type scales where respondents responded to a statement (I am confident I understand the requirements for) on a 5-point scale (Strongly Disagree – Strongly Agree). Interest in conducting research was measured on a single 5-point Likert-type scale and interest in attending research ethics training was measured as a dichotomous (yes/no) response. Participants completed an anonymous web-based survey between November 2018 and February 2019. An 11.6% response rate provided a final sample size of n = 432 consisting of 85% females with a median age of 46 years (range 20-74 years). Overall, demonstratable knowledge of research ethics guidelines was low-to-medium; with no participant able to correctly answer all 5 knowledge questions, and 27% failing to correctly answer any of the knowledge questions. Individuals’ confidence in their knowledge of research ethics guidelines was also measured and compared to actual (demonstrated) knowledge. The proportion of respondents believing they understood a topic was higher than the proportion who could demonstrate knowledge about the topic, across all topics. There was a significant relationship between demonstratable knowledge and research experience, however confidence was not related to either demonstratable research ethics knowledge or research experience.

Although knowledge levels within this sample are comparable to previous findings, responses to additional questions suggest that respondents do not know the whereabouts of the pertinent information, and would therefore struggle to source the information on their own should that be required. Overconfidence also replicated previous findings. In this sample, at least part of the explanation for overconfidence may lie in the similarity of the clinical and research terminology, thus leading clinicians to think they know about a research topic because it has the same name as a clinical topic.

Despite less than half of respondents expressing interest in conducting research in the future, interest in attending training was extremely high. This suggests that many of those who were ambivalent about conducting research may nevertheless be interested in attending training. Notwithstanding high interest in training, comments indicated that organising time away from clinical practice to attend training could be a barrier to attendance. A number of those respondents not interested in research (and subsequently not interested in research ethics training) expressed a concern that mandatory indiscriminate research ethics training would add to the perceived burden of unnecessary training imposed upon already time poor staff.

A number of demographic variables were found to have a relationship with the main variables of interest. Relationships were found between professional stream (i.e. Allied Health, Medicine, and Nursing and Midwifery) and knowledge (p = .005), confidence (p < .001) and interest in research (p < .001). Those respondents with a research-specific tertiary qualification (i.e., a Higher Degree by Research qualification) demonstrated higher levels of knowledge (p < .001), confidence (p = .001), and interest in conducting research in the future (p = .001). Generalisability is limited by the non-representativeness of the sample. This may be particularly so in the Medical stream where the high proportion of adjunct appointments in this group (43% compared to an estimated 15% within the working population) may be indicative of recruitment of a non-representative sample biased toward research interest and activity.

This research offers an initial contribution to the area of quantifying knowledge of research ethics guidelines in the Australian context, and amongst a population of health care practitioners in a regional public health service. The findings indicate further education is warranted, although this should be focused on those clinicians intending to conduct research, rather than mandated for all staff. A report of findings will be prepared for the Executive of the Darling Downs Hospital and Health Service to inform funding forecasting for future training.