How I overcame my scholionophobia... a clinical pharmacist in an academic world

By Rachel Berry, Specialist Antibiotic Pharmacist, County Durham and Darlington NHS Foundation Trust, and Health Education England (HEE) and National Institute for Health Research (NIHR) Intern 2016/17

“Scholionophobia* – A fear of school, college or university”

So, I want you to picture the day ….. It was a sunny September morning and there I was, a clinical pharmacist currently working in hospital, standing by the River Tees at Queen’s Campus Stockton about to enter Durham University. And I was terrified. Honestly, the last time I was this scared walking into a university building was in 2004 and I was about to sit my Registration Assessment to become a qualified pharmacist. I was obviously suffering from scholionophobia.

Courtesy of mothmediatech & the creators of The adventures of Worrisome Wilf books

“But why were you so scared?” I hear you ask. Well, the answer is that I was just about to start my Health Education England (HEE) and National Institute for Health Research (NIHR) Integrated Clinical Academic Internship programme.

The HEE/NIHR funded internship is a programme to enable Healthcare Professionals working in clinical practice to gain research experience and skills by working alongside a university academic. I had ahead of me, 30 days away from my clinical commitments that I could use to gain an introduction into clinical academic research.

My fear was based on the fact that I didn't know anything about research or universities. Not one bit. And I definitely wouldn't be able to do it myself. In my mind, research was only done by brilliantly clever people who know everything. I was only a lowly hospital pharmacist. I was pretty sure that I would be the most stupid person there!

Fortunately for me, I was about to meet my amazing academic mentor, and go on an adventure into the unknown world of research. I have gained experience and skills in literature searches and critical appraisal, project design and data collection, statistics, statistical analysis software (SPSS) and writing for publication. I have met so many talented, lovely people who have been interested and willing to help me, even when I probably was the most stupid one there (try explaining Poisson regression and statistics to a person who doesn’t have A-level maths!). It really has opened my eyes to the world of research, and the possibilities for clinical practitioners. My mentor has helped me realise that the skills and experience I have from clinical practice are just as important in clinical research as the skills of doing the research.

I am now coming to the end of my time. I have completed my project, which will be disseminated to local Clinical Commissioning Groups (CCGs) to enable them to focus on key target areas to improve patient safety within antibiotic prescribing. I am also planning on publishing it, and hopefully this will allow the work to have wider impact. I have been able to take what I have learnt about research and its impact on patients back to my clinical work too. This has meant that I am more reflective and research-aware when doing my job. I have also shared this with the colleagues in my department, and hopefully encouraged them to be more research aware and active, to enable us to provide better care to our patients.

In the future I would love to do more research in conjunction with the School of Pharmacy as I have realised that blending our skills and experiences, whether they are clinical or research based, can lead to more relevant patient-focussed clinical research being undertaken. I am also trying to get other members of my department to apply for the Internship next year.

The 30 days spent at Durham University were some of the most challenging, interesting, frustrating and rewarding I have ever spent at work. My scholionophobia has been cured, with no medicines required. If you are a sufferer in clinical practice, I would recommend talking to academics in your clinical speciality and applying for the Internship; there is no need to be scared. And if you are an academic in health research there is a wealth of experience that you could utilise within the clinical teams; they would probably love to be involved, they just might be too scared to ask.


My thanks go to the team at North West Research and Development who ran the 2016/17 Internship Programme on behalf of HEE/NIHR. Also thanks to my managers at County Durham and Darlington Foundation Trust, and especially to Professor Cate Whittlesea and the School of Medicine, Pharmacy and Health at Durham University.

*Also known as Didaskaleinophobian or Scolionophobia.

Image credit: Thank you to mothmediatech and Séan Baldwin & Martin Gordon the creators of The adventures of Worrisome Wilf books.

A day in the life of a 'Pracademic'

Guest post by Natalie Connor, PhD student and Healthy Communities Officer at Groundwork North East

It was at the Fifth Fuse Physical Activity Workshop in Durham a couple of months ago that Istvan Soos, a Reader in Sport and Exercise Sciences from the University of Sunderland introduced me to the term ‘Pracademic’. I had been trying to explain to a delegate what my role was and who I worked for, when Isvtan shouted across the room, "Natalie, you are a Pracademic!" I actually can’t believe it has taken me five years of being a PhD student before finally hearing this term. Cue frantic Googling of the term as soon as I got home, to find a plethora of information on the phrase, which even boasts an entry on the Urban Dictionary website from 2007. I am clearly way behind the times. But maybe it’s because I'm spending so much of my time delivering a PhD intervention that includes scrambling around outdoors in the dirt trying to get rid of some pesky weeds, or building a raised bed in the freezing cold, that the phrase hadn't had time to register.

So I wanted to give you a taste of what it is like to be someone who is still involved in working as a practitioner, as well as studying for a PhD, which qualifies me as a Pracademic.

Gardening selfie!

There are some cons to working out in the field as a practitioner:

• Always looking like I've been dragged through a bush backwards; 
• My blood must taste delicious as I am forever being bitten by ravenous midges; 
• Rogue tomatoes that I find in the car boot two months after being picked; 
• If I were stopped by the police, my boot containing spades, shovels, rope, duct tape and bin liners would look a little suspicious. Although the rogue tomatoes might actually help me explain myself here. 

Working on the ground delivering community projects can have a number of obstacles that perhaps are not encountered as much in the academic world: payment on result targets, political pressures and economic difficulties for the third sector to name a few. Occasionally, funding will become available at the very last minute. Although this may sound great, the time required to develop and then implement a robust service is lacking. In the academic world, it can sometimes take years to get funding through to deliver a research project. In that time frame, political and organisational objectives have often changed direction. Sometimes, things that sound great in theory are actually nigh on impossible to deliver, whether that’s due to lack of engagement within a community, resources or the lack of a particular skill set. On the other hand, sometimes programmes that are delivered aren't based on any real evidence or theory to justify them. So the two worlds need to come together to try to address these issues. Collaborative practice therefore is a necessity.

 

Not only are there practical and logistical barriers to navigate, but also the challenge of being an impartial researcher, when I am so heavily involved in the project being evaluated. I have found it very important to reflect after every single intervention session that I have delivered; to think about what has been said by participants, but also to think about what I have said. I need to ensure that I am recognising any potential bias on my part and be mindful of it. I also need to acknowledge that there could be the problem of participants not being completely honest, for fear of upsetting me due to the trusting relationships that have developed. I make sure that when I am collecting data, I remind the participants to be completely honest, as their honest answers are what will ultimately help to shape a better service in the future. I think these are the main issues that a Pracademic will face, but as long as we can continually reflect, and acknowledge that this could potentially affect data, we can do our best to prevent this from happening.

To balance all of this, there are some pretty amazing positives to working on the ground, which allow me to get a real insight into community life. Access to participants does not feel like a barrier to me, and is something that I know other researchers sometimes face. I am able to build a relationship with local people, who will then share their thoughts and views with me, as there is trust. I am not just seen as a researcher, but someone who is working for a local charity that is trying to make a difference to the participant’s local community. Carrying out research in the field means that there is a connection to what is happening in the real world. Getting ‘out there’ to deliver an intervention has been the easier part of this PhD, and for me, definitely the most enjoyable. I also seem to walk away with an abundance of fresh fruit and vegetables. Not a bad perk!

It has been a demanding journey so far as a Pracademic, filled with many ups and downs, many moments of self-doubt, and countless barriers that I've had to dig deep (got to get one pun in!) to overcome. But I’ll take rogue tomatoes in the boot of my car any day.

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