Sir,
High-quality research forms the basis of evidence-based medicine. A strong grasp of the fundamental principles of research is essential for all doctors of all grades. Studies have shown that research training embedded within clinical training programmes helps to promote trainees’ critical thinking and analysis, improve quality of patient care and facilitate post-training academic output.1
Unlike other surgical trainees, participation in research activities is not mandated—albeit highly recommended—within the ophthalmology training programmes in the UK. However research participation is often deterred by the lack of time and inadequate research skills.2, 3 In 2017 we sent out a 26-item questionnaire-based survey to all the ophthalmology trainees in the North East of England to examine their research attitudes and perceived barriers to conducting research. Trainees were asked to rank the utility of RSTA—a dedicated session allocated for Research, Study, Teaching, and Audit (or Administrative)—against 6 activities (1 (least common activity) to 6 (most common activity)) and the barriers to conducting research against 10 barriers (1 (least common barrier) to 10 (most common barrier)).
A high response rate of 90% (26/29) was received. RSTAs (mean 1.6 (SD 0.5)) were most commonly utilised for administration (4.3 (SD 2.0)) followed by study (4.0 (SD 1.6)), clinical work (3.6 (SD 1.8)), audit (3.4 (SD 1.4), research (2.6 (SD 1.8)) and teaching (2.4 (SD 1.2)). Positive research attitudes were observed amongst the trainees (Figure 1); the majority of the trainees strongly agreed/agreed (SA/A) that they are interested in research (81%) and that research training is important (88%). Lack of time (8.4), clinical training being too intensive (8.0) and lack of mentorship (6.4) were reported to be the three most common barriers to conducting research (Figure 2). Other reported barriers included the lack of funding and the 6-monthly migratory nature between hospitals during training.
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We believe this represents the first study exploring the research attitudes and perceived barriers to research amongst the ophthalmology trainees in the UK. We observed a positive attitude towards research participation amongst the trainees. Our survey findings are consistent with several other studies where lack of time and lack of mentoring were reported as the common barriers to conducting research.2, 3, 4 We observed a low utility of RSTA for research; this might be attributed to the lack of confidence and opportunity in conducting/participating in research (Figure 1), and the non-mandatory nature of research within the ophthalmology training programmes.
With the vast expansion of ophthalmic literature, having the competency to critically appraise the literature and practice robust evidence-based medicine are particularly important in the field of ophthalmology. In addition, there is a rising expectation for senior trainees and consultants in the UK to participate in NIHR portfolio adopted studies within the National Health Service (NHS) setting (https://www.nihr.ac.uk/research-and-impact/nihr-clinical-research-network-portfolio/). Recently we have reported the positive attitude towards the establishment of NETRiON (accepted for publication in Eye—Ting et al).5 We hope that this network could serve as an effective framework to address the research barriers described in this survey.
References
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Canadian Plastic Surgery Research Collaborative (CPSRC). Barriers and attitudes to research among residents in plastic and reconstructive surgery: A National Multicenter Cross-Sectional Study. J Surg Educ 2017; pii: S1931-7204(16)30319-1.
Ting DSJ, Vrahimi M, Varma D, Steel DHW . North East Trainee Research in Ophthalmology Network (NETRiON). Trainee-led research networks in ophthalmology: is this the way forward? Eye 2018; 32: 168–175.
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Members of North East Trainee Research in Ophthalmology Network (NETRiON) are listed: Members of NETRiON who had contributed to the data set (listed in alphabetical order): Tejaswi Bommireddy, Yan M Chen, Alan Cunningham, Karim El-Assal, Michael Grinton, Christin Henein, Elizabeth Hill, Deva Loganathan, David Lunt, Haifa Madi, Mark C Markham, Ibrahim Masri, Christopher Matthew, Michael McKenna, Ankur Mehta, Jia Y Ng, Yewande Olaoye, Kadambari Oswal, Romeela Rana-Rahman, Jaswant Sandhu, Audrey Shwe-Tin, Javid Suleman, Darren SJ Ting, Esther Ting, Maria Vrahimi, Gar Y Wong.
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Ting, D., Vrahimi, M., Varma, D. et al. Research attitudes and perceived barriers to conducting research among ophthalmology trainees. Eye 32, 653–655 (2018). https://doi.org/10.1038/eye.2017.221
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DOI: https://doi.org/10.1038/eye.2017.221
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