Clinical research in emergency medicine is a cornerstone of progress in emergency care. Novel research evidence forms the basis for improvements in bedside patient care and healthcare policy.
In spite of the need for research evidence to inform clinical practice, the conduct of research in the emergency department (ED) setting can be challenging. ED crowding and workload, among other issues, can limit the ability and willingness of clinicians to participate in subject enrolment and data collection. Research activities, if not done thoughtfully, can interfere with ED clinical operations. Nonetheless, there is evidence that clinicians and institutions that participate in clinical research may see better overall patient outcomes.
Strategies to encourage clinician engagement in clinical research are essential for the evaluation of novel, potentially practice-changing diagnostic and therapeutic interventions in emergency care.
The 2017 Canadian Association of Emergency Physicians (CAEP) Academic Symposium focused on improving Canadian emergency research output and impact by charging three expert panels to develop recommendations. This paper reviews recommendations of Panel 2 for the engagement of clinicians, primarily physicians and nurses (Box 1), in clinical and implementation research in Canadian EDs. Additional recommendations from the panel on strategies for conducting implementation trials and multicentre studies in the ED are reported in a companion paper.
The target audience of these recommendations is both new and experienced clinician scientists seeking to optimize patient recruitment and data collection in the setting of a busy ED.
Box 1. Recommendations to improve ED staff engagement with research studies
1) Establish a strong, research-supportive culture in the ED.
2) Ensure that local recruitment infrastructure exists.
3) Identify and address barriers to research prior to the study launch.
4) Ensure clear communication between the research team and ED clinical staff.
5) Optimize data collection material and strategies.
6) Monitor recruitment rates and address recruitment problems.
7) Engage ED nurses and allied health staff.
8) Establish and leverage personal relationships with noncompliant clinical staff.