Navigating the role of clinician-researcher: Insights from a Constructivist Grounded Theory study in traumatic brain injury

Stephen Kivunja, J. Pryor, Jo River, J. Gullick
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Abstract

Abstract Using the case of traumatic brain injury, this paper explores 1) challenges to academic and ethical integrity when in the role of clinician-researcher, and 2) potential strategies to enhance ethical qualitative research involving people with possible physical and/or emotional trauma and temporary or permanent cognitive disruption. When undertaking qualitative research with patients, families, and/ or health professionals, a researcher’s clinical background may stimulate insightful and relevant research questions, interviews, and/or field observations of care to inform meaningful and translatable practice improvements. However, there may be tension between clinician versus researcher values, and these priorities affect what the clinician sees and interprets in the field. A clinician’s ingrained values and professional socialisation can make it difficult to hold their professional assumptions about various phenomena at bay. The principles of human research merit and integrity, justice, beneficence, and respect, along with methodological clarity, can provide a rigorous foundation for discussion of ethical research in traumatic brain injury. This paper discusses challenges and strategies through: 1) examining clinical assumptions; 2) determining capacity for consent; 3) considering dependent or unequal power relationships; 4) determining the scope for field observations; 5) responding to unprofessional practice; 6) discriminating between research interviews and clinical conversations; and 7) critically reflecting on research data. Implications for clinical research are evident: seeing past one’s own construct of understanding is challenging for clinician-researchers aiming to illuminate both patient and family experiences of care, and nuanced clinical skills. Careful ethical and methodological planning can protect participants while illuminating elements of specialist practice.
引导临床医生-研究人员的角色:从创伤性脑损伤的建构主义扎根理论研究的见解
摘要:本文以创伤性脑损伤为例,探讨了临床研究者在学术和伦理诚信方面面临的挑战,以及在涉及可能存在身体和/或情感创伤以及暂时或永久性认知障碍的人群时加强伦理定性研究的潜在策略。在对患者、家属和/或卫生专业人员进行定性研究时,研究人员的临床背景可能会激发有见地和相关的研究问题、访谈和/或护理现场观察,从而为有意义和可转化的实践改进提供信息。然而,在临床医生和研究人员的价值观之间可能存在紧张关系,这些优先级影响临床医生在该领域的观察和解释。一个临床医生根深蒂固的价值观和专业社交使得他们很难控制自己对各种现象的专业假设。人类研究的优点和完整性、正义、仁慈和尊重原则,以及方法的清晰性,可以为创伤性脑损伤的伦理研究讨论提供严格的基础。本文通过以下途径讨论了挑战和策略:1)检查临床假设;(二)确定同意行为能力;3)考虑依赖或不平等的权力关系;(四)确定野外观测范围;5)应对不专业的行为;6)区分研究访谈和临床对话;7)批判性地反思研究数据。对临床研究的影响是显而易见的:对于旨在阐明患者和家庭护理经验以及细致入微的临床技能的临床研究人员来说,看到过去自己的理解结构是具有挑战性的。仔细的道德和方法规划可以保护参与者,同时照亮专业实践的元素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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