The HEE/NIHR ICA Clinical Lectureship and Senior Clinical Lectureship Chairs' Report - Round 6 (2020)
The Health Education England (HEE) / National Institute for Health Research (NIHR) Integrated Clinical Academic (ICA) Programme provides research training awards for health and social care professionals (excluding doctors and dentists), who wish to develop careers that combine research and research leadership with continued practice and professional development.
The HEE/NIHR ICA Clinical Lectureship (CL) and Senior Clinical Lectureship (SCL) schemes offer post-doctoral practitioner academics the opportunity to undertake fully funded clinical research, research training and tailored professional development whilst maintaining professional practice and current salary.
The numbers of applications received and awards made for the latest (Round 6) competition are detailed in the table below.
On the completion of the 6th Round of CL and SCL competitions, the Chair and Deputy Chair of the CL and SCL Selection Committee made the following observations.
The Chairs’ Observations
The Chairs agreed that applications received in 2020 were again very competitive, despite the challenges experienced by practitioner academics last year. Applicants took full advantage of the chance to simultaneously propose comprehensive professional development plans and research projects of excellent quality and value.
Having noted some common weaknesses within unsuccessful applications (both in the written application and at any subsequent interview), the Chairs would like to remind prospective applicants of the following:
The ICA Programme welcomes applications utilising any scientific methodologies, but these must always be justified and evidenced as those most appropriate to answer the research questions posed.
It was noted that:
- A lot of applications proposed an intervention development – while these are welcomed, the Selection Committee would equally welcome diagnostic and prognostic research proposals.
- Several applications involved the analyses of existing large epidemiological datasets. It is recommended that such applications show clearly that they have included support from those with expertise in the analyses of such data.
- Some applicants had, by the time of interview, made sensible adjustments to offset the effects of the COVID 19 pandemic and the related changes in health services on their proposed study. We would expect Round 7 applications to also include such considerations where appropriate.
Whilst most applicants underpinned their proposals with the relevant theory base, the Selection Committees observed:
- A number of predominately quantitative-focused research proposals included a warranted, but poorly developed, qualitative research element.
- Qualitative and mixed methods project designs where the theoretical grounding and methodologies were not of the same high standard as those for quantitative research proposals.
- There was some confusion between whether a pilot or feasibility trial was proposed.
- Applications proposing development of, and application of, empirical or theoretical models without due consideration of the need to validate them (overlooking the different stages of prognostic research and research developing new interventions). Such applicants should consider specific training in model development and validation, and ensure that their supervisory team includes specific research expertise in this area.
- Poor or unclear rationale for the choice of specific patient reported outcome measures. Careful consideration and justification must be given to instrument selection.
Using training awards to develop new methodological skills
Applicants to research training awards are encouraged to take advantage of the opportunity to gain experience of methodologies that they have not used previously, and to always propose the most appropriate methodological approach to answer their research question, rather than merely one that is familiar.
The Selection Committee will still, however, expect applicants to possess sufficient understanding of the proposed methodologies to justify their choice and, following appropriate timely training, to lead their research project (demonstrating ownership of the research in its entirety). The training plan should incorporate sufficient support and training to ensure expertise will be demonstrable at the end of the award as they commence the next step towards being an independent researcher.
The NIHR recognises that developing towards a practitioner academic career may involve some personal development in the teaching side of an academic career. Applicants should be mindful however that these are research awards and that any teaching should be limited to that underpinning demonstrable personal development.
At the post-doctoral level, applicants are expected to demonstrate emergence as a practitioner academic leader. If applicants have not undertaken leadership training, they are advised to consider inclusion of this in their training and development plan. Careful thought should be given to the appropriate course for the individual and the availability of courses.
The need for advanced planning and proposal development
It usually takes between 6 months and a year to work up a competitive application. Successful proposals have, at the very least, been under development for a couple of months prior to the competition launch, during which time they have enjoyed the support of research mentors (research support) and prospective host organisations.
Where carefully planned, most applications are able to provide a sound framework for the proposed work. It is however equally important that applicants, particularly at interview, are able to articulate with some precision the operational aspects of how the work plan will be implemented.
Where minor failings are identified with an otherwise strong application funding can be awarded with either recommendations or with conditions attached. Applicants awarded conditional funding should be careful to comply fully with the conditions.
The considerations that should be made if proposing a linked project
Research projects can link with broader, existing research programmes, but applicants must demonstrate a consideration of both the advantages and disadvantages of this approach. In addition, applicants must describe how ownership of the project will be achieved (e.g. will the awardee take on PI responsibilities?) and detail the contingencies in place to ensure the success of the project if issues arise with the linked research and/or its funding.
The need for strong statements of support from the hosting organisations
The supporting statements submitted by an applicant’s proposed hosting organisations are often weak and generic, and fail to convey a reassuring level of support for, and understanding of, the proposal and the aspirations of the applicant. Given the vital importance of organisational support to the development of a practitioner academic career, the Selection Committees require these statements to demonstrate meaningful integration around the applicant and clearly articulate an ongoing and post-award commitment to the applicant’s academic career.
Applicants and their heads of department are advised to refer to the new Principles and Obligations document for non-medical clinical academics.
The need to be ambitious whilst remaining realistic
When formulating the scope of the research proposal, prospective applicants need to ensure that the research project can be completed within the period of the award, predominantly by themselves with a view to maximising their personal development. Early identification of, and guidance from, experienced mentors will be invaluable to achieving this.
At the post-doctoral level, there is an expectation that the proposed project will take the applicant’s career forward and applicants are therefore, advised to consider the benefits of deciding between e.g. a feasibility study vs undertaking a full RCT, especially given that Support Staff can now be costed into the application.
The need for PPI
The PPI element of applications is improving steadily as the processes bed in across the sector. The Selection Committee were disappointed however, to observe very poor PPI in a number of applications. Applications that have paid only lip service to Patient and Public Involvement, but not effectively incorporated it, are easily identifiable as such, and are invariably weaker as a result.
Common issues noted:
- Confusion between Patient Engagement and Patient Involvement.
- PPI proposed for one specific element of the project (e.g. research development) but neglected elsewhere, most notably within the data analysis and dissemination phases.
- Extremely poor PPI costing.
Applicants are reminded that the NIHR takes PPI very seriously. PPI is one of the assessment criteria used by the Selection Committee when reviewing all applications and PPI members sit on the interview committees.
Applicants are referred to the comprehensive resource available from the INVOLVE website, which includes guidance on writing Plain English summaries and budgeting for PPI involvement.
Plain English Summaries
The Plain English summary submitted as part of the application is assessed by the Selection Committee. If the summary does not provide a clear explanation of the proposed research to clinicians and researchers who do not have specialist knowledge of your field, as well as to members of the public, this will impact on the competitivity of the application when shortlisting decisions are made.
Applicants are advised to use the support available from NIHR INVOLVE and the Research Design Service in the development of their Plain English summaries.
Frequent weaknesses in the Plain English Summaries submitted to the Round 6 competitions:
- Poor structure with large blocks of text and a lack of headings
- Poor explanations/use of terminology
- Overuse of abbreviations
Further guidance on writing in plain English is available via the NIHR Involve webpages.
For further support and advice on writing a plain English summary, please contact your local Research Design Service.
The cost of the project, including any NHS support and treatment costs
Proposals are required to be fully costed before shortlisted applicants attend for interview. Whilst inappropriate or erroneous costings within successful applications will be amended with the support of the NIHR during the subsequent contracting process, these are noted by the Selection Committee during assessment. Such mistakes are indicative of poor planning by the applicant and limited engagement with/from the hosting organisations. It is worth remembering that value for money is an aspect of the application that the panel will consider.
Support from the NIHR Research Design Service (RDS)
The Selection Committee noted that several applicants were not accessing the support available to them through the NIHR RDS. RDS staff regularly observe Selection Committee meetings and they are well placed to provide advice and helpful feedback on applications prior to submission.
The opportunity for personal development as an academic, within your professional practice and as a practitioner academic leader
Prospective applicants are reminded that an award represents an opportunity to undertake training and development that will further both their career as a practitioner academic and the service they afford their patients/service users. Whilst the principal purpose of the proposed training and development plan should be to provide the fellow with the skills needed to successfully undertake the Lectureship, it is permissible that limited elements of the plan serve primarily to support their wider and longer-term career aspirations as an academic, health/care professional and practitioner academic leader.
Finally, applicants should bear in mind that a Clinical Lectureship application should include plans for developing a critical mass around the researcher, while applications at the higher Senior Clinical Lecturer level should also be clear and explicit about how they aim to develop capacity in others.
The Selection Committees have identified a variety of resources that prospective applicants might find useful in relation to some of the weaknesses identified above.
- Mixed Methods Study Designs
Prospective applicants are advised to consider this article, and particularly the 10 resources highlighted within it.
- NIHR Clinical Trials Guide
The NIHR has produced a Clinical Trials Guide, and recommends that prospective applicants intending to propose a trial consult it at the earliest opportunity.
- Feasibility and Pilot Trials and the value of each:
NIHR definitions can be found here.
- Whitehead, A.L., Sully, B.G., Campbell, M.J. Pilot and feasibility studies: is there a difference from each other and from a randomised controlled trial? Contemp Clin Trials. 2014 May; 38(1): 130-3.
- MRC Guidance on Complex Interventions
The MRC's standalone guidance document is more detailed than the often cited BMJ paper.
- Patient Reported Outcomes
The University of Birmingham’s Centre for Patient Reported Outcomes Research has a freely available NIHR funded information resource on PROs of potential use to prospective applicants, and more broadly, to those involved in PROs.