Case study: Principal Investigator (PI) and Assistant Principal Investigator (API) encourage both health professionals and study leads to register for NIHR API scheme

The NIHR Associate Principal Investigator (API) Scheme aims to develop health and care professionals to become the Principal Investigators (PIs) of the future. From January to August 2023, Dr Carys Lim (pictured right), Anaesthetics Clinical Fellow, was part of the scheme for the Continuous rectus sheath Analgesia in eMErgency LaparOTomy (CAMELOT) study at North Bristol NHS Trust (NBT). She was supported by Jane Ashby-Styles (pictured left), Research Nurse, who is the Co-PI for the study, alongside Dr Ronelle Mouton.

The CAMELOT study is looking at pain management for patients following an operation called an emergency laparotomy, which involves a large vertical cut in the stomach. The study aims to find out whether adding Rectus Sheath Catheters (RSCs), a new method where two thin tubes are inserted on either side of the wound during the operation, provides better pain relief, fewer side effects and complications, and greater satisfaction for patients. It will also determine whether RSCs are safe and cost-effective.

The study team has 2 APIs, Carys whose specialty is anaesthetic and another covering surgical. Jane explains how they have been invaluable for the study:

“They honestly have made the difference between recruiting and not recruiting, and meeting our targets and not meeting our targets. They were our eyes and ears when my Co-PI Ronelle, and I were not there. I didn’t feel like I had to constantly be in the theatre because I knew that they were keeping me updated. They're approachable, dedicated, engaging and enthusiastic.”

​​The NIHR API Scheme is an in-work training opportunity, providing practical experience for healthcare professionals starting their research career. The scheme gives them the skills needed to take on responsibility for the conduct of a research study at a site.

People who would not normally have the opportunity to take part in research in their day-to-day role have the chance to experience what it means to work on and deliver an NIHR portfolio study under the mentorship of an enthusiastic local PI.

Carys told us that prior to her role as an API with CAMELOT, her only involvement with research was as a local collaborator for a trial during the COVID-19 pandemic. “As junior doctors, alongside our clinical commitment, we don't get taught a lot about research and what it means to be involved in it, so the API scheme was a really great learning experience.”

“With the scheme being a 6-month training opportunity, I gained a lot from the continuity of involvement with the trial. I learned about what it means to deliver a study from working with such an enthusiastic research team and PIs. I've learned so much from shadowing Ronelle and Jane.”

During their time on the API Scheme, the API trainees must complete a checklist of mandated study activities on NIHR Learn. This includes assisting the PI to ensure all staff working on the study are adequately trained. APIs are also involved in the recruitment, consenting and/or following up with participants.

Carys said, “As well as completing the checklist, I felt that it was up to me how much I  gained from the API scheme. I felt very early on that I wanted to help with teaching the different staff groups. As an anaesthetic trainee, and with my experience of looking after patients both during and after operations, I have a better understanding of their journey after an operation and how each staff group can be involved.”

Jane expressed her gratitude for this, “Carys has done a huge amount of teaching. There's no way that me and Ronelle could have delivered that kind of volume of teaching alongside our many other commitments.”

Carys was also grateful for the opportunity to teach and said, “through teaching sessions I got to know the intensive care teams, medi room staff (the staff who look after the patients immediately after an operation), ward staff and theatre staff.” Not only did this experience strengthen her confidence, Carys broadened and deepened her connections with different groups of staff which enabled her to raise the profile of research at the Trust. This work to embed research into health and care is important in ensuring patients have a better experience and greater access to research.

As well as all of these benefits of being on the API Scheme, Carys explains that “it's also helped my development in lots of other ways. When I first took on this role in January, I was an anaesthetic trainee doctor. Since then I've also got a new role in the Trust as a Clinical Fellow and as the Severn Trainees Anaesthetic Research Group (STAR) local lead. The API Scheme brought me to my next role and it's got me more involved in research.”

Jane would love to see more ward nurses join the API scheme. “As a department we strive to try and get research more embedded in clinical practice, yet it can often remain somewhat isolated. The severe pressures that are part of working in the NHS on a daily basis also play a significant role. Nurses taking part in the API scheme is part of the step to getting it truly embedded in the clinical environment.”

She also shared her advice for those considering registering their study for the API scheme, “I would really encourage it. Having an API makes a real difference for us. We would have an API for every single trial if we could - they're invaluable.”

If you are a health professional and Carys’ experience has inspired you, you can find out more about registering for the Associate PI scheme.

If you are running a study, you can also find out more about registering your study for the Associate PI scheme.