Hoffmann Amanda E, Leege Erin K, Plane Mary Beth, Judge Katherine A, Irwin Amy L, Vidaver Regina M, Hahn David L
From the Department of Family Medicine and Community Health, University of Wisconsin School of Medicine & Public Health, Madison, WI.
J Am Board Fam Med. 2015 Sep-Oct;28(5):639-48. doi: 10.3122/jabfm.2015.05.150038.
The success of practice-based research (PBR) depends on the willingness of clinicians and staff to incorporate meaningful and useful research protocols into already demanding clinic schedules. The impact of participation on those who implement multiple projects and how to address the issues that arise during this complex process remain incompletely described. This article reports a qualitative evaluation of the experiences of primary care clinicians and clinic staff who participated in multiple PBR projects with the Wisconsin Research and Education Network (WREN). Also included are their suggestions to researchers and clinicians for future collaborations.
For program evaluation purposes, WREN conducted 4 focus groups at its 2014 annual meeting. The main focus group question was, "How has participation in PBR affected you and your clinic?" A total of 27 project members from 13 clinics participated in 4 groups (physicians, nurses, managers, and other clinical staff). The 2-hour sessions were recorded, transcribed, and analyzed to identify recurring themes.
Five major focus group themes emerged: receptivity to research, outcomes as a result of participation, barriers to implementation, facilitators of success, and advice to researchers and colleagues. Focus group members find research valuable and enjoy participating in projects that are relevant to their practice, even though many barriers exist. They indicated that research participation produces clinical changes that they believe result in improved patient care. They offered ways to improve the research process, with particular emphasis on collaborative early planning, project development, and communication before, during, and after a project.
Clinics that participate in WREN projects remain willing to risk potential work constraints because of immediate or impending benefits to their clinical practice and/or patient population. Including a broader array of clinic personnel in the communication processes, especially in the development of relevant research ideas and planning for clinic implementation and ongoing participation in research projects, would address many of the barriers identified in implementing PBR. The themes and supporting quotes identified in this evaluation of WREN projects may inform researchers planning to collaborate with primary care clinics and clinicians and staff considering participating in research endeavors.
基于实践的研究（PBR）的成功取决于临床医生和工作人员是否愿意将有意义且有用的研究方案纳入本就繁忙的临床日程安排中。参与对那些实施多个项目的人员的影响以及如何解决这一复杂过程中出现的问题，目前仍描述得不够全面。本文报告了对参与威斯康星研究与教育网络（WREN）多个PBR项目的基层医疗临床医生和诊所工作人员的经历进行的定性评估。还包括他们对研究人员和临床医生未来合作的建议。
出于项目评估目的，WREN在其2014年年会上组织了4次焦点小组讨论。焦点小组的主要问题是：“参与PBR对你和你的诊所有何影响？”来自13家诊所的27名项目成员参加了4个小组（医生、护士、管理人员和其他临床工作人员）。为时2小时的讨论进行了录音、转录和分析，以确定反复出现的主题。
出现了五个主要的焦点小组主题：对研究的接受度、参与的成果、实施的障碍、成功的促进因素以及对研究人员和同事的建议。焦点小组成员认为研究很有价值，并乐于参与与其临床实践相关的项目，尽管存在许多障碍。他们表示，参与研究带来了临床变化，并认为这改善了患者护理。他们提供了改进研究过程的方法，特别强调在项目之前、期间和之后进行协作式的早期规划、项目开发和沟通。
参与WREN项目的诊所仍然愿意冒着可能出现工作受限的风险，因为这会给他们的临床实践和/或患者群体带来直接或即将到来的益处。让更广泛的诊所人员参与沟通流程，尤其是在提出相关研究想法、规划诊所实施以及持续参与研究项目方面，将解决实施PBR过程中发现的许多障碍。本次对WREN项目评估中确定的主题和支持性引语，可能会为计划与基层医疗诊所合作的研究人员以及考虑参与研究工作的临床医生和工作人员提供参考。
