Clinical Academics in Nursing: Vital but Under-Recognised

Abstract

Nursing careers have traditionally followed a single path of clinical practice, education or research, occasionally a combination of two and rarely of all three elements. Yet, if nursing is to realise its full potential to improve the quality and safety of healthcare it is surely incumbent on the nursing profession, healthcare and academic institutions and policy makers to develop and implement a nursing career model that blends these elements of clinical practice, education and research, and provide support and resources for such roles.

In order to overcome traditional career path silos in nursing, a variety of innovative roles and titles have been designed to bridge or combine them, including clinical academics (Aspinall et al. 2024; Council of Deans of Health 2020). Clinical academic roles in nursing are comparatively well-established in the UK (Carrick-Sen et al. 2019), developing in limited ways in Australia (Carrick-Sen et al. 2019) and New Zealand (McKillop et al. 2016), and emerging in European countries such as the Netherlands (Henderikx et al. 2026). However, definitions and development of the term clinical academic vary widely (Carrick-Sen et al. 2019), and significant challenges to establishing, progressing and sustaining such a role remain (Avery et al. 2022; Thamm et al. 2026). While such roles show potential to be impactful, this has been hampered by haphazard development and support and overlapping or blurred boundaries. Also, direct international comparisons of such roles are limited due to structural differences in healthcare systems, regulatory environments and funding mechanisms. Thus, the focus of this editorial is on the UK clinical academic in nursing.

Clinical academics in nursing are nurses working in clinical practice who have a dual career in research, teaching or leadership—or a combination of these—employed across healthcare and academic institutions. They mainly have a dual role combining their clinical career with a research or teaching career in an academic institution. They usually work in health and social care while researching ways to improve patient outcomes and teaching and mentoring nurses and other healthcare professionals (Gillespie et al. 2026; Henshall et al. 2021; Thamm et al. 2026). Their purpose is to drive positive change in nursing and health care.

Such roles are usually funded by government initiatives such as research training awards, internships and fellowships. They may also be funded by an agreement between a university and health care facility. Their aim is to develop research ideas, gain research training and experience and serve as a basis for doctoral and post-doctoral awards which enable the awardee to be an independent early career researcher. However, such career paths and awards are limited, opportunistic and highly competitive in nursing. Success depends on leadership, supervision and mentorship and commitment from the organisations involved (Olive et al. 2022). There can be real tensions meeting the expectations and demands of institutions that often have different, sometimes conflicting, functions, values and cultures.

Nevertheless, such innovative roles have been promoted because they appear to strengthen practice-research integration, improve care delivery, contribute to the recruitment and retention of nurses and help build research capacity and capability (Henshall et al. 2021) while elevating the stature of the nursing profession. Other benefits that can accrue include improved scholarly productivity, role visibility and mentorship capacity. Anticipated or plausible benefits, such as improved patient outcomes, workforce retention and system-level efficiency appear less firmly established in the literature. It is likely that the potential benefits of the clinical academic in nursing have not been fully realised.

Nursing is dependent on a robust pipeline of research to advance evidence-based care, inform policy and address the health needs of people and communities. A strong, diverse scientific workforce with decisive leadership would advance health equity and nursing capacity to tackle the often multiple and complex health needs and social issues, including inequities, of society.

A key challenge for nursing is to successfully bridge the persistent gap between practice and research (Thompson and McKenna 2025). Strategies to address this gap include joint support from clinical and academic institutions, joint institutional academic-clinical forums for exchanging ideas and identifying pressing clinical questions requiring research attention aligned with institutional strategic priorities, joint roles that blend clinical practice and research, flexible working, protected research time and funding opportunities.

The clinical academic in nursing role is promising and often highly valued, but the evidence base in terms of impact, process and outcomes—clinical and economic—needs to be consistently defined and robustly evaluated. Also, the importance of leadership, diversity, equity and organisational commitment in clinical academic pathway development needs to be emphasised. It has been recognised that there is a national absence of coordinated, equitable academic pathways for nurses, despite longstanding policy commitments (Vamadevan et al. 2025).

Despite the actual or potential benefits of such roles, there are very few nurses working in them (Gibson 2019) and the situation is likely to worsen with an ageing and declining clinical academic workforce (Medical Research Council 2025). A report by the Nursing, Midwifery and Allied Health Professions Task and Finish Group (2025) on clinical academic roles in the UK stated ‘The clinical academic workforce forms a very small percentage of the overall health and care workforce. An Association of UK University Hospitals (AUKUH) resource from 2017 stated that the clinical academic workforce only makes up 0.1% of the total nursing, midwifery and allied health professions workforce (compared to the 2022 estimate of 3% of the senior medical clinical workforce UK-wide with the objective to return to a level of 6%) and numbers are declining for all healthcare professions’ (p. 6).

Also, clinical academics have difficulties balancing expectations and competing demands of two or more employers (Kehoe et al. 2022) and duplicating efforts with annual appraisals and mandatory training (Gillespie et al. 2026). Supportive leadership and appropriate resources and policy commitment from the organisations and profession, and sustainable and equitable access to clinical-academic training and career structures, opportunities, recognition and remuneration are vital for them to flourish (Aspinall et al. 2024; Gillespie et al. 2026).

Although the literature around the clinical academic role continues to grow, challenges remain as to how to embed this as an essential position in the nursing and healthcare culture. For the role to continue to grow and be sustainable, there is a need for targeted recruitment, development and retention of staff who understand and value the importance of research and innovation in their clinical practice and the establishment of a research culture within the workplace (Olive et al. 2022). Initiatives such as clinical academic internships for nurses can yield tangible benefits for patient care, professional development, team collaborations and institutions. Key enablers of success and sustainability are support from senior clinical leaders and established academic and healthcare partnerships, commitment to research capacity building and investment in resources (Olive et al. 2022).

One approach to addressing these challenges is to adopt the ‘Follett Principles’. Follett (2001) led a UK government review to produce guidelines for the management and joint employment of clinical academics in universities and clinical settings. The stimulus for this was the Alder Hey organ retention scandal which brought to light serious failures in the management and accountability of clinical academic medical staff. The Follett report expressed an expectation that the principles should extend to all joint appointments with clinical and academic responsibilities.

Follett's recommendations provided clear, unambiguous, jointly agreed arrangements with joint oversight and accountability for the entirety of a clinical academic's job. These included joint recruitment and appointment, jointly agreed induction, joint job planning, joint appraisal and agreed processes for management of performance and conduct. These safeguards are essential because the individual works across two sectors, for two employers, but they have one job. The clinical part and the academic part of their job are interdependent and linked. As such, the two employers must work together to facilitate the joint nature of the role and ensure appropriate accountability. The Nursing, Midwifery and Allied Health Professions Task and Finish Group (2025) report called for the Follett guidelines (specifically regarding nursing, midwifery and allied health professions) to be widely adopted as part of the development of the career pathway.

There is a need to ensure nurses are able to navigate and access training and clinical/academic career opportunities and to make senior clinical academic roles attractive. One way to achieve this is by embedding academic practice in undergraduate curriculums and ensuring that training and career pathways are equitable, flexible, permeable, and individualised and appropriately remunerated (Aspinall et al. 2024; Avery et al. 2022; Gillespie et al. 2026).

Such actions will require support from clinical and academic leaders and institutions as well as policymakers. This will include supportive leadership, resources to build infrastructure, collaborations, flexibility and recognition (Aspinall et al. 2024; Avery et al. 2022; Vamadevan et al. 2025).

The clinical academic in nursing model described above has the potential to contribute to improved healthcare delivery and health outcomes through integration of research and innovation impacting on clinical practice. Research drives improved clinical practice, which enhances patient outcomes by ensuring that nursing care is underpinned by appropriate evidence.

Nursing makes a major contribution to health outcomes and expectations of people and communities. Clinical academics in nursing bridge the perennial gap between clinical practice and research. Their success will depend on being able to attract and nurture talent, having an integrated career framework, access to research mentors, fast track to leadership positions, protected time for academic and clinical activity and alignment between healthcare and academic institutions. Key enablers to success will be an inclusive institutional culture, visible role models, supportive leadership, supportive infrastructure, including resources and collaboration. Very soon there will be no reasons left why clinical academics in nursing are not ubiquitous in the health service; there will only be excuses.

David R. Thompson: writing – review and editing, writing – original draft, conceptualisation. Hugh P. McKenna: writing – review and editing, writing – original draft, conceptualisation. Mi Ja Kim: writing – review and editing, writing – original draft, conceptualisation.

The authors have nothing to report.

The authors declare no conflicts of interest.

Data sharing is not applicable to this article, as no datasets were generated or analysed during the current study.