Researcher Development

Developing as a Researcher:

You might bring clinical training, data or methological expertise from a paediatric critical care or a different field or you may have yet limited experience. Research questions in paediatric critical care are broad, complex and are best addressed by multi-disciplinary teams endowed with mutual respect and willing to learn. Your skillsets will need to evolve over time as knowledge and technologies advance, so engaging proactively with learning is essential. Want already to know more about research training and personal funding? For an overview of what support may be available, please feel free to look at
these resources:

NIHR Academy:

Whose aim is to provide attract, train and support Health & Social Care Researchers across the UK, https://www.nihr.ac.uk/career-development/nihr-academy. Helpfully, the NIHR academy has developed slides capturing all NIHR-supported personal funding schemes across all career stages and professional backgrounds https: //drive.google.com/drive Resources and programmes for personal development include the NIHR Mentoring programme, offering doctoral and postdoctoral NIHR Academy Members the opportunity to seek a mentor drawn from NIHR the leadership community.

NIHR Research Support Service (RSS):

The RSS link https://www.nihr.ac.uk/explore-nihr/support/research-support-service/ provides free and confidential advice to develop funding applications within the remit of the NIHR, including clinical, applied health and social care research, and post-award advice to award holders. Access to support, advice and expertise is available for all researchers across England applying to NIHR research programmes or research training awards as well as to non-NIHR funders such as charities.

Growing your Skills:

Several resources for personal development & training programmes are available including the NIHR-devised Leadership Development resources, a series of e-learning modules accessed via NIHR learn, as well as Webinars and virtual Workshops advertised via the NIHR Academy events page. Essential for working in clinical research is a comprehensive understanding of Good Clinical Practice (GCP), an international benchmark of ethical and scientific standard of design, conduct and recording of research involving humans. GCP applies to all clinical investigations that could impact the safety & well-being of human participants and course are available via https://www.nihr.ac.uk/career-development/clinical-research-courses-and-support/good-clinical-practice

Researchers Stories

Who are PCC Researchers? What motivates PCC professionals to do research? How do they go about it? Many may be at the start of their research journey , others have already acquired good research experience and some are at the top of their game. This is a space for all research career journeys. For inspiration, please read our Researchers Stories.

Sofia Cuevas-Asturias

Post-CCT
Paediatric intensive care doctor

Sofia.cuevasasturias106@imperial.ac.uk

Research field, title or question:
My research area is evolving within Paediatric Critical Care (PCC). I am currently studying for an MD(Res) in Children with complex critical illness in PCC at Imperial College London.

I have always questioned the evidence base of everything we do. In my early medical training, I applied unsuccessfully for an academic clinical training pathway in ST2. Following this, I delved more into quality improvement and management with poster presentations and looked for opportunities to develop research ideas. I applied to become chair of a national research trainee network (PICSTAR). I was successful and chaired for two years. This provided the learning in survey development, critical appraisal skills and collaborative working. Within my PICM Grid subspecialty training I developed a quality improvement project in children with complex critical illness in PICM. This led to a national survey of current practice. From this, I have now gone on to do an MD(Res).

It is a joy to be able to learn in depth about areas of work that I am enthusiastic about. Not only learn but in time have the potential to make a difference to patient management and care. I also enjoy the exciting opportunities to develop advances in areas of our specialty. I am at the beginning of my career within research and as one of the NIHR co-leads, I hope to be able to help shape the future of research within our specialty. Alongside this, I continue to be passionate about clinical work and I would like to increase the accessibility of research to clinicians from all professions within PCC.

Thus far, it has been getting funding, time and support to develop research skills and ideas, whilst balancing clinical commitments.

It has been a learning journey to balance clinical practice and development of research training skills. Part of the NIHR incubator work is to help develop pathways for all disciplines within PCC, including doctors such as myself but also nursing, pharmacists, physiotherapists and all allied health professions within PCC. I hope the NIHR incubator can be the first step in offering learning opportunities to highlight potential dual training opportunities at all clinical levels of practice.

Perseverance, mentorship, collaboration.

Research is filled with rejection alongside acceptance of papers/grants/ideas. Crucial to research is perseverance. Learning that rejection is not necessarily a step back, instead it is an opportunity to grow, change, try again.

Having mentorship has been key in my research journey to date. Both as ex-Picstar chair and as a current MD student, having a mentor that is an expert in your field, patient, kind and full of guidance is key.

Finally, I have found collaboration integral to my research development. Sharing of ideas, standards, protocols, working on data sets (with appropriate R&D approvals) has led to opportunities to be part of research that I would not have been able to do alone as an early career researcher. I have been grateful for all the collaborations to date and hope to continue both as future leader, participant and team-player.

Post my MD(Res) in children with complex critical illness in PCC, I hope to apply for funding for further research in this and other areas. I hope the future of my ongoing research will be collaborative with the end goal of optimizing the care and lives of children and their families within PCC and beyond.

Future steps will be to continue developing as a clinical academic, combining ongoing clinical work with innovative clinical research within PCC.

Jennie Balls

Paediatric Physiotherapist & PhD student at Imperial College London

j.balls@imperial.ac.uk

Research field, title or question:

My current research is focused on the use of physiotherapy-led lung ultrasound in PICU. I am specifically interested in using the lung ultrasound score as a semi-quantitative way to measure lung aeration and whether this could be a useful outcome measure for respiratory physiotherapy.

By accident! I completed my post-graduate MSc in Advanced Physiotherapy at University College London and really enjoyed the research development and dissertation modules. I was then successful in being awarded an NIHR Pre-Doctoral Clinical Academic Fellowship, swiftly followed by an NIHR Doctoral Clinical Academic Fellowship in 2023. I guess I boarded the research train and am enjoying the ride!

Everything we do clinically should be guided by robust research. I enjoy appraising literature and developing research questions that will benefit the children on PICU. It is great to be able to work alongside multi-professional groups who all share the same goal of improving patient care.

I have learned a lot about which study designs are relevant to answer specific research questions. The most complex aspect for me is the world of statistics, fascinating but daunting at times!

I question everything that I do now. Is it evidence-based, or just historical? I apply my research training and knowledge to my clinical decision making. Various opportunities and collaborations have also arisen since I started in research and I believe this will have a wider impact going forwards.

I have been fortunate to have a supportive manager who has encouraged me to apply for various fellowships. My supervisory team through-out have been exceptional. They continue to support and challenge me to progress as a clinical academic.

After I finish my PhD I would like to continue to develop my career as a clinical academic PICU physiotherapist and also support colleagues at the beginning of their own research journey.

Dr Hannah Mitchell

PICU GRID trainee – East of England

Hannahkmitchell@gmail.com

Research field, title or question: My research focuses on paediatric critical care epidemiology, using routine data to understand and improve outcomes in critically ill children. I am currently working on two projects the first using PICANet data to investigate how air pollution, child poverty, and ethnicity influence paediatric intensive care outcomes, and a second developing a risk prediction model for a range of complications following paediatric cardiac surgery.

After doing foundation programme I applied for a job as a clinical research fellow in Botswana. I worked as a study doctor in a clinical trial looking at high-dose Ambisome (an antifungal medication) for cryptococcal meningitis and on a study looking at epidemiology of cryptococcal meningitis. I really enjoyed being part of research testing therapies that could tangibly improve lives – with less toxic side effects and lower costs. I was inspired by this to do a masters in epidemiology. I picked epidemiology because I wanted to get practical research skills in study design and statistics and I loved it, learnt so much and met an amazing group of people. I then did an NIHR academic clinical fellowship and am currently hoping to get funding to continue work in a PhD.

I enjoy the process of solving problems and translating findings into meaningful improvements for patients. I think the PICU research community is really friendly and full of people doing really interesting work who are always happy to chat and collaborate. I love going to conferences and meeting people working in different places and hearing about their work.

Finding the time and the funding to do it! Right now, I am full time clinical and really find it hard to do justice to projects that I need to finish up.

I think a good understanding of statistics has made me much better at critically appraising evidence and spotting issues with study design. I think this has been helpful in thinking about how we should apply evidence to clinical care.

Without a doubt - fantastic mentors. I have been lucky to work with some inspiring researchers in PICU, who have taken time to teach me and help me improve.

I am currently applying for PhD funding. so I can try and combine academic with clinical work and develop as a researcher.

Emma Alexander

Paediatric ST3 OOPE, PICU Fellow

e.alexander@imperial.ac.uk

Research field, title or question: Implementation of Evidence in PICU, Paediatric Acute Liver Failure.

My first research experience was when I was a student and was asked to join a team to finish off a very complex systematic review. Thankfully the process of doing a systematic review is quite protocolised, so no knowledge was required, just determination! Since then I’ve participated in lots of different projects with lots of different teams and have developed my skills little by little. After I spent four months working in adult ICU, and a brief period shadowing on PICU at KCH, both of which I loved, I realised PICU was the specialty for me and I have focused on PICU research since then.

Different types of research are very different and enjoyable in different ways. For me, my initial research experience was mostly in writing systematic and narrative reviews. I have always loved writing and am happy to sit on the sofa and write for hours on end. I used these experiences to build my portfolio and I was mentored by some excellent consultants who then trusted me to take on more complex, statistical projects where I challenged myself. I love that research has given me greater understanding of clinical topics for critically ill children and given me skills in critical appraisal which are useful anywhere. Finally, research introduces you to some amazing passionate leaders both nationally and internationally, and amazing patients and members of the public who kindly help us with our work.

Navigating research when you don’t have formal dedicated research time. Lots of what I have done has required me to teach myself and use my days off to write and analyse results. I find it very satisfying but it can be hard too. When you teach yourself it is hard to develop really high-quality projects. That’s why mentors are so important. Hopefully in the future more PICU roles can have formal research time built-in. I also think other specialties e.g. respiratory, infectious diseases, oncology get more attention from major funders so there are more opportunities. Hopefully with the PCC Incubator that will change in future!

Research exposure gives you a lot of curiosity and helps you to ask questions. I’m not talking about research I have done - just being exposed to current PICU research, e.g. attending ESPNIC, PCCS conferences, reading the PCCM journal. This helps you to be familiar with controversies and ambiguities and gives you greater curiosity in why we make the management decisions that we do. I think it is quite empowering to make a management decision and know you are backed up by evidence.

This is a common answer but excellent mentors. Professor Akash Deep and Professor Padmanabhan Ramnarayan have been my main mentors in PICU and I am very grateful for all their support. I am amazed at how busy they are yet they have still had time to support and invest in my training. I also think as a researcher you have to have self-respect for your own time. That means trying to finish every project that you start – but not starting a project if you aren’t going to get something in return for your time.

I am currently applying for a PhD in PICU. Everyone always told me that this would be a time-consuming process but even as someone who is quite organised I have found it very hard! Even if I am not successful, I definitely want to be research-active throughout my career. I think it is a really exciting time for the PICU research community with activity growing so much year on year.

Want to know more? Please get in touch by e-mailing:

PCCResearch@imperial.ac.uk

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