Exploring resistance and avoidance behaviours at the research delivery, clinical practice interface: group concept mapping through a critical realist lens

Background: Clinical research drives health improvement. Perceptions of clinical research by healthcare professionals practising outwith research structures may impact relationships at the research delivery, clinical service, interface and therefore the success of research. Aims: To establish factors generating resistance/avoidance behaviours displayed by healthcare professionals at the clinical research delivery, clinical service interface. Methods: Group Concept Mapping from a critical realist perspective was adopted. Participants responded to an open-ended statement, then sorted, rated and interpreted the resulting dataset. Results: The final concept map contained 99 statements sorted into six conceptual clusters (1) ‘We value & understand the importance of research’; (2) ‘How it should be & how we could work together’; (3) ‘Behaviours, beliefs & missed opportunities’; (4) ‘Dissonance & disengagement’; (5) ‘Time & capacity affects our ability to engage’ and (6) ‘I keep thinking of ways to facilitate research as everyone’s business but it is hard’. Three clusters were rated most likely to generate resistance/avoidance (3, 4 and 5). Two clusters were rated most important to address (2, 5). Conclusion: This paper contributes previously unheard perspectives on clinical research, indicating several factors generate resistance/avoidance behaviours. Time to engage, opportunities to support studies, improved communication between clinical research and clinical service, and improving awareness from earlier in clinical careers were considered pivotal to success.