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Barriers and facilitators to conducting research by early career psychiatrists: a literature review

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13 paź 2019

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Figure 1

The number of studies identified, screened, included and excluded at each stage.
The number of studies identified, screened, included and excluded at each stage.

Included studies_

AuthorsCountryStudy designN participants (response rate)Facilitators for researchBarriers for researchType of bias / limitation
Balon & Singh, 2001USA, CanadaCross-sectional survey70/126 (58.7%) chairs of departments of psychiatry

Trainees should be: - made aware of opportunities to join research tracks during their orientation to the program

- introduced to researchers in their department and made familiar with their work

- assigned to spend time in research labs to familiarise themselves with the ‘working conditions’ of research

- receive teaching about the clinical implications of research

- fears and apprehension about joining research tracks should be addressed

- research career opportunities should be discussed

- only ~ 60% of chairs returned the questionnaire

- questionnaire did not ask for the absolute number of residents, only for percentages (e.g., ‘How many % of residents joined a research track?’)

- only those curriculums with a reasonable training program in psychiatric research could have responded

- anonymous responses might include academic or non-academic institutions

- the university vs. non-university research training issue was not addressed

Bartels et al., 2010USAFindings and recommendations of an expert consensus workgroup

- establishing formal research methods teaching

- more funding for structured research tracks for medical trainees

- fostering of acceptance for clinical pathways by explicit inclusion of research tracks

The loss of promising researchers during the period of transition from research training to independent research funding-
Fitz-Gerald et al., 2001USACross- sectional survey399/815 (49.0%) trainees and faculty members- lack of appreciation of research in psychiatric curricula- the survey was sent to Training Directors, who might have chosen to not hand over questionnaires to the residents
Fogel, 2009WorldwideLiterature reviewMedical students, psychiatry trainees, psychiatry fellows/ postdoctoral, psychiatry faculty/ attending/consultant- participating in research when a medical student or psychiatry trainee - mentoring- focused on adult psychiatry, search terms ‘psychiatry’ AND ‘research’ were not followed-up due to the high number of hits
Iversen et al., 2014UKCross-sectional survey, interviews157/227 (69.2%) mentees (clinician scientist fellows and clinical lecturers) and mentors (professors)

Impact of mentoring:

- mentee’s age

- the frequency and duration of meetings

- mentee’s expectations

- the quality of the mentee

- mentor interaction

- the perceived role of the mentor

- as the survey was anonymous, pairing of mentor and mentee data was not possible

- investigation took place early in the mentoring process, better peer-mentor relationships might have been established later on

- data collected only cross-sectionally

Kuzman et al., 2009CroatiaCross-sectional survey66 trainees from 15 psychiatric hospitals, clinics and wards in general hospitalslack of practical psychotherapy inadequate functioning of the mentorship system lack of funding resources- variables other than the residency training were not assessed (e.g., socioeconomic, marital status, etc.) and may have influenced results
Laliberte et al., 2016CanadaCross-sectional survey207/853 (23.4%) psychiatry trainees

Exposing and engaging psychiatry trainees in research as early as possible appears key to promoting future research interest

Psychiatry residency programs and research tracks could consider:

- emphasising research training initiatives

- protected research time early in residency

Putatively: - lack of continuity in research time during potentially productive years

- competing for grants with graduating PhD students from other disciplines

- relative lack of research mentoring

- study was primarily aimed at residents with an interest in geriatrics

- some potential predictor variables (e.g., level of trainees’ debts, academic productivity) have not been collected in the study

- causality is difficult to infer from a cross-sectional study

- multiple comparisons may have contributed to alpha inflation

- response rate of 24.3%

Mitwalli et al., 2014Saudi ArabiaCross-sectional survey191/207 (92.3%) trainees registered with the Saudi Council of Health Specialty Programs

Lack of : - research training (93.2%)

time (89.5%)

- supervisors (73.3%)

- work-related stress (83.2%)

- high rate of male participants (M: 128, F: 63) might inhibit the generalisability of data
Myint et al., 2006UKCross-sectional survey122/400 (30%) trainee members of the British Geriatrics Society (BGS), 30% response rateSystematically provide basic information on how to enter into the early stages of researchno clear idea of a topic to research (70%) did not know how to develop an idea (64%) did not know how to get funding (62%) Difficulties during research: - funding - selection of project topicresponse rate of 30%
Pantovic et al., 2012SerbiaCross-sectional study51 ECPsgovernment support less overall challenges

- opinion that psychiatry is ́second best́ career

- no education on research

- small number of residents (51) participated

- residents of only one hospital

Pinto da Costa et al., 2013PortugalCross-sectional survey80/193 (41.5%) psychiatric trainees

- lack of access or support from supervisors, other consultants or professionals (75.0%)

- lack of time (15.4%)

- lack of interest (9.6%)

- most respondents from 1st or 2nd year of education
Schnitzlein et al., 2014USAOpinion paper

- mentorship

- scholarship

- research

- career planning and development

- openness to experience

- networking

- responsibility seeking

-
Silberman, 2012USACross-sectional survey127/189 (67%) senior traineesAllocating funding to ensure sustained and secure careersDebt load

- respondents were not explicitly asked about their research interest at the beginning of residency, but only toward the end

- bias: participants were researchers in a higher number of cases

- gender imbalance (F: 67.9%)

- only residents have been investigated

- not all programs have been investigated

- data not corrected for multiple comparisons

Torous & Padmanabhan, 2014USAEssayGetting experience in research early in training to balance research time as well as clinical work

- lack of (uninterrupted) time

- problems in finding a suitable research question

-
van Effenterre et al., 2014FranceCross-sectional survey 79/125 (63.2%) teachers, professors, hospital practitionersInsufficient number of academic practitioners

- bias: overrepresentation of residents with interest in research

- satisfaction with education reflects an individual perception and is therefore less objective

Williams & Curran, 1998UKCross-sectional survey57/99 (57.6%) senior registrars working in psychiatry

- clinical work intrudes (54%)

- lack of time (53%)

- uncertainty on how (30%) to proceed

- lack of support from senior staff (30%)

- lack of resources (30%)

- own lack of interest (21%)

- put off by the idea of writing a protocol (12%)

- bias: respondents may over-represent those actively taking part in research