Clinical Research—It’s Relevant
Audiologists are evidence-based practitioners. We are challenged to work in an evolving field with rapid advances in technology and changes in health care practices. It is imperative that clinicians remain abreast of current research in audiology to ensure the highest quality of hearing services to our patients. Yet, the translation of research into clinical practice proves to be difficult. Studies show that hearing health care does not always meet best practice guidelines for the verification of hearing devices, the administration of tests, and utilization of patient-centered care. We are not alone in this regard. Health care professionals in a variety of disciplines and settings often fall short of the best practice model. The result is that quality of care may fail to improve over time.
Barriers to Change—What’s Stopping Us?
Despite our emphasis on evidence-based practice and patient-centered care, implementation of innovation into practice historically has been slow. The traditional “top-down” approach serves to advance results achieved in a laboratory—removed from the clinical setting and delivered to practitioners through research journals. Practitioners are then expected to translate this work into clinical procedures. Although there are merits to this traditional approach, work in a clinical practice setting often is multifaceted and may involve coordination of these activities with other disciplines. As a result, unique challenges for the working clinical audiologist may not be considered. Reports indicate that barriers to adopting clinical change include lack of internal support, no clear leadership, challenges involved with integrating change into existing programs or protocols, and the need to maintain momentum in order to sustain changes (Bradley, Schlesinger, Tashonna, Baker, & Inouye, 2004). With this in mind, it would seem that active engagement of clinicians and researchers is essential for the development of new practices.
It’s a Partnership
In a partnership, each party contributes in unique but equally valuable ways. The researcher brings knowledge about the scientific method, study design, data collection and analysis; the clinician brings knowledge about hearing impairment, service delivery, patient care, and the realities of work in a practice setting. A partnership is a true collaboration between the researcher and the clinician, whereby contributions of both are necessary to best inform clinical practice and change. Together, the researcher and clinician function more effectively to deliver a higher level of patient care than either would do in isolation. This partnership is the cornerstone of successful hearing health care.
To achieve a successful partnership, several conditions need to exist—including sharing, genuine collaboration, and interdependence (D’Amour, Ferrada-Videla, Rodriguez, & Beaulieu, 2005). Sharing means that each professional is working to achieve a common goal. In the context of clinical research, this might mean that both parties are working with a similar patient population or toward improving the quality of patient care in a particular area. Partnership means that the clinician and researcher agree to open and honest communication, mutual trust and respect, and pursuit of the common goal. Furthermore, overall success relies on interdependence; professionals share responsibility for patient outcomes.
Putting Practice Into Action
Implementing collaborative research can have a positive impact on clinical outcomes, but is not without its challenges. The collaborative process really begins with the educational preparation of future clinical providers. Fortunately, many universities support this process by engaging their students in capstone research. Students learn firsthand through this process the value of collaborative clinical research; how to develop a study, including navigation of the Institutional Research Board (IRB); and how to critically examine the results of that study. The hope is that students will gain an appreciation of the research process, understand how clinicians can inform research practice, and, perhaps, engage in further collaborative clinical research themselves. Without direct research experience, practicing audiologists may find this task rather daunting. Resources are available to facilitate the research process. One example of such a resource is the Clinicians and Researchers Collaborating (CLARC) program developed by the American Speech-Language-Hearing Association. CLARC facilitates clinician–researcher partnerships through online networking.
As we move forward, clinician–research partnerships can significantly contribute to the advancement of hearing health care. The challenges faced by audiologists in everyday practice need to drive research agendas—and, similarly, research innovations need to inform clinical practice. Successful collaborations between clinicians and researchers are key to achieving the primary goal of the audiology profession: to improve outcomes and quality of life for our patients with hearing loss and their families.
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