Collaborative research that grows clinical practice
Dr Sophie Fletcher, a Respiratory Consultant at University Hospital Southampton NHS Foundation Trust, was interviewed for the summer 2020 issue of VISION magazine, which focuses on the contribution that those early in their research career make to research delivery in Wessex. In this interview, she discusses the important role that clinical fellows play in supporting the delivery of respiratory research.
"I am a respiratory consultant that loves research. It’s interesting and satisfying but it’s not just good for me; it’s also good for my patients.
"It gives my patients access to drugs and treatments that they wouldn’t normally have and opportunities to help shape the work that we do.
"In my role as a consultant physician, this is particularly important. One of the conditions that I spend a lot of time working with is idiopathic pulmonary fibrosis (IPF). It’s a chronic progressive respiratory disease and currently there are limited therapeutic options and a poor prognosis for people suffering from it.
“We’re always looking to signpost them towards opportunities to grow their experience and knowledge of research.”
"We’re unsure exactly what causes it and we don’t yet have any clear treatment pathways so research helps everyone to become involved in how we learn about the causes and management of the disease.
The Idiopathic Pulmonary Fibrosis Job Exposure Study (IPF JES) aimed to investigate the role of occupational exposures and the development of IPF.
"It’s an observational study where we’re trying to understand the lifestyles and occupations of those with the disease so that we can gain a better understanding of the potential causes.
"As it seems to affect far more men (80%) than women (20%), and seems clustered around locations where there are high industrial vocations, we knew that this was important data to gather as it has the potential to frame prevention as well as treatment opportunities.
"Within the study I supervise clinical fellows, many of them at a very early stage in their careers, helping me to recruit patients and to do a lot of the day-to-day running of the trial– including highlighting potential recruits from the clinical service and talking to patients about what the study is and what is involved.
"I couldn’t have done the research without fellows. There is no defined time for research in my job role, having them alongside me is an invaluable resource and enables me to continue to take part in research alongside my clinical work whilst providing them with mentorship while they grow their skills.
"The fellows that join us are funded from a variety of sources, including the NIHR Clinical Research Network, and are multinational in their background. They develop clinical expertise in this specialist area alongside in-depth and hands on research experience. They learn how to understand and interpret trials and papers and also learn about the trials’ limitations and begin to see how they can fit into the clinical picture.
"For some, it’s their first taste of research. It can feel like a bit of a whirlwind because we’re a big team and there are so many opportunities for them to get involved in research and trials, but they get a taste of everything.
"They receive a lot of teaching through their roles and time with us in the respiratory team – there are regular meetings with the whole research team to discuss the progress of studies, they undertake poster presentations for presentation at international conferences and regular training for statistics.
"We’re always looking to signpost them towards opportunities to grow their experience and knowledge of research. Our fellows also get to be representatives on medical studies with pharmaceutical companies, which sometimes involves travelling internationally.
"I couldn’t have done the research without fellows."
"Alongside this, we encourage them to meet with the small network of researchers for lung conditions in the UK because it grows their knowledge and gives them access to collaboration opportunities.
"It’s difficult for clinicians to do research, time can prohibit the opportunities. But by connecting to a network of researchers and clinical fellows, it’s an excellent opportunity to get outside your comfort zone and keep the research relevant to clinical practice. It also enables the research to continue while you maintain your clinical practice.
"I think this blend of clinical practice and research is really important. The balance of the two is key to continuing to make an impact and have support while doing so. Creating pathways where this balance can be achieved for clinicians is essential and offering these opportunities to clinicians needs to become easier if we’re to reap the benefits.
"The IPF JES results are currently being collated and analysed, with the results to be published later this year.
"We’re hoping that this collaborative approach to the study will give us a greater understanding of the disease that will lead us to more advanced treatment pathways. The team at UHS was the top recruiter nationally to this study – thanks to the fellows."