Emma has been a Registered Dietitian for over 17 years and has experience in adult and paediatric dietetics. She has been the Editor of NHD for seven years, steering the editorial content and supporting the production process. Emma currently works in industry.

Emma Coates, RD

Research matters...

Research is that awesome thing that we base our practice, guidelines and other important stuff on! Our evidence base is vital to us and it’s important that we continue to grow and strengthen it.

Earlier this month I attended the BDA’s Specialist groups, sub-groups and branches volunteer support day. An annual event that brings BDA volunteers together to share, discuss and celebrate the BDA’s diverse range of groups and branches. Each year, the event offers group, sub-group and branch committee members an opportunity to discuss activity and challenges, plans for the future and celebrate successes.

If you’re a member of a BDA specialist group, sub-group or branch, you’ll know that you get all sorts of useful information, resources and support from them. Research updates or opportunities to share or be part of research projects are areas that the BDA would like to encourage and offer where possible.

Why is research important?

Research plays a huge role in knowing what we know (and what we don’t!), and it can also raise further questions along the way. bIt drives us to explore and find answers, to sort fact from opinion or debunk straight-up old wives tales!

In many circumstances, research is key to innovation, safe practice and a greater understanding of the area of interest. It can significantly improve clinical and care outcomes and can mean better staff satisfaction, as recruitment and retention within the NHS is reported to be higher amongst those involved in research.(1)

Research has many benefits for patients/clients, you and our profession:(2)

It's a tool for building knowledge and facilitating learning.
It's a means to understand issues and increase public awareness.
It helps us succeed in clinical practice/business.
It allows us to disprove lies and support truths.
It is a means to find, gauge and seize opportunities.
It promotes confidence in reading, writing, analysing and sharing valuable information.
It provides nourishment and exercise for the mind.

What counts as research?

Research comes in all forms and can come from many different sources, including clinical trials, case studies, systematic or literature reviews, audits, surveys/questionnaires – feel free to add your own thoughts here!

It’s all useful stuff but as you may know, not all research is created equally. There is a hierarchy of research, which intends to guide us when considering the strength of evidence available to us.

The hierarchy of evidence supports us in identifying the most robust evidence applicable to our practice. However, hierarchies of evidence have been criticised over the years as they can be viewed as inflexible and limit the scope of including a wide variety of evidence.(3)

Having said that, flexibility can be integrated into the way we utilise the evidence available. Depending on the research or clinical question, study design and methodology may vary to ensure that the question is answered in the most appropriate way.(4) Randomised controlled trials may be the gold standard in evidence hierarchies but they aren’t always the most appropriate method for answering all research questions.

In some instances, there won’t always be a great deal of high-level evidence like randomised controlled trials or systematic reviews. Therefore, other levels of evidence may become more relevant to your evidence base.(4) The pyramid above shows the hierarchy of evidence if we’re considering the effectiveness of many healthcare interventions.(4)

Utilising the best available evidence is a common approach and allows some flexibility, but most experts agree that the higher up the hierarchy, the more robust and rigorous the methodology.(5) Whilst research can provide a wealth of information and answer some of our questions, it’s important to consider how this translates into reality. Research environments can be quite different to the real world!

There are some important key elements to consider when thinking about the application of the evidence in practice. Evans (2002) discusses these factors in the paper Hierarchy of Evidence: a framework for ranking evidence evaluating healthcare interventions.(6)

The table below is adapted from Evans (2002)6

Effectiveness	Appropriateness	Feasibility
This relates to whether the intervention achieves the intended outcomes.	This addresses the impact of the intervention from the patient or client’s perspective.	This considers the wider environment in which the intervention takes place and determines whether it can be or should be implemented.
Does it work?	What is the experience for the patient/client?	What resources are need to successfully implement the intervention?
What are the potential benefits and/or harm?	What health issues are important to the patient/client?	Will it be accepted and adopted by healthcare staff? How should it be implemented? -
Who will benefit from it?	Do they view the outcomes as beneficial?	What are the financial implications?

BDA research officer roles

In light of all of this good stuff, the BDA is encouraging its specialist groups, sub-groups and branches to consider including a research officer on their committees. Where this role isn’t already included and allocated, it’s a great opportunity for groups and branches to gather and share research updates with members. Also, it's a way to encourage the group or branch’s committee and members to engage in research projects and share the outputs - aiming to build on the current evidence base.

A research officer doesn’t need to be a senior dietitian or an experienced researcher, just someone with a passion for research. Perhaps you’ve just completed some research and you’ve discovered the love of your life!n If you’re interested in research, you could be the ideal person for a role like this. Here are some of the things you could be doing:

Act as a voice of research expertise for and on behalf of your specialist group, sub-group or branch.
Facilitate members of the group or branch to employ best/evidence-based practice.
Act as a resource and communication forum for the exchange of evidence-based practice relevant to your group or branch members.
Direct members to relevant research papers and latest publications.
Be a contact for research queries.

These are just a few benefits of including a research officer as part of a BDA group, sub-group or branch. The benefits can be shared wider than the group or branch - the whole profession can benefit. Growing our evidence base is vital to ensure our expertise develops and moves with the times. It can support better patient/client outcomes, drive innovation and foster a lifelong learning ethos.

If you have a passion for research, why not reach out to your local BDA branch or the groups you’re a member of to enquire about a research officer role? Or if you’re a committee member for a BDA group or branch, consider adding this role to support research within your specialism.

Zora Neale Hurston was a globally recognised writer and anthropologist in the 1800s, and she had a great take on research:

‘Research is formalised curiosity. It is poking and prying with purpose’.

Curiosity is a great thing and something we can harness, focusing on areas we want to develop and innovate. Let’s get poking and prying with purpose!

References