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Understanding the Broker Role of Clinician-Scientists

A Realist Review on How They Link Research and Practice

Barry, Margot MSc; de Groot, Esther PhD; Baggen, Yvette PhD; Smalbrugge, Martin MD, PhD; Moolenaar, Nienke PhD; Bartelink, Marie-Louise E.L. MD, PhD; Damoiseaux, Roger A.M.J. MD, PhD; Scherpbier-de Haan, Nynke MD, PhD; Kluijtmans, Manon PhD

doi: 10.1097/ACM.0000000000002819
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Purpose: Clinician-scientists are said to be well-placed to connect research and practice, but their broker role has been underexplored. This review sought to gain an understanding of the broker role of clinician-scientists.

Method: The authors conducted a realist review to describe context-mechanism-outcome (CMO) configurations associated with the broker role of clinician-scientists. CINAHL, PubMed, PsycINFO, Web of Science, and Embase were searched between May and August 2017. Data were analyzed qualitatively; data synthesis was focused on assembling findings into CMO configurations.

Results: Of an initial 2,241 articles found, 9 were included in the final review. Included papers show that clinician-scientists, in their broker role, achieve two organizational-level outcomes: an increased volume of clinically relevant, practically applicable research and increased evidence application to improve care. They also achieve the individual-level outcome of professional development as a researcher, clinician, and broker. Multidimensional skills and management support are necessary context factors. Mechanisms that contribute to outcomes include balancing economic and scientific interests and performing boundary-crossing activities. Four CMO configurations by which clinician-scientists achieve outcomes in brokering a connection between research and practice were identified. Useful program theories for explaining these are boundary crossing, social network, communities of practice, and diffusion of innovation theory.

Conclusions: The mechanisms found may provide insight for interventions aiming to support clinician-scientists in their broker role. The authors expect that if more attention is paid to learning multidimensional skills and management support for the broker role is strengthened, stronger links between research and practice could be forged.

M. Barry is lecturer and researcher, Department of Occupational Therapy, HAN University of Applied Sciences and Open University of the Netherlands, Nijmegen, the Netherlands; ORCID: http://orcid.org/0000-0001-9554-3726.

E. de Groot is assistant professor in the learning sciences, Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; ORCID: http://orcid.org/0000-0003-0388-385X.

Y. Baggen is post-doctoral researcher in the area of learning in organizations, Department of Education, Utrecht University, Utrecht, the Netherlands; ORCID: http://orcid.org/0000-0001-6284-3925.

M. Smalbrugge is elderly care physician and head of the training center for residents in elderly care medicine, Department of General Practice & Elderly Care Medicine, Amsterdam University Medical Centers, location VUmc, and senior researcher, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; ORCID: http://orcid.org/0000-0003-0538-4843.

N. Moolenaar is inspector of education, Dutch Inspectorate of Education, Ministry of Education, Culture and Science, Utrecht, the Netherlands; ORCID: http://orcid.org/0000-0001-5899-929X.

M.-L.E.L. Bartelink is associate professor in general practice, Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; ORCID: http://orcid.org/0000-0001-9278-1163.

R.A.M.J. Damoiseaux is professor in family medicine, Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.

N. Scherpbier-de Haan is associate professor and head of the primary care specialty training department, Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands; ORCID: http://orcid.org/0000-0002-4818-3382.

M. Kluijtmans is professor in education to connect science and professional practice, University Medical Center Utrecht, and academic director, Centre for Academic Teaching, Utrecht University, Utrecht, the Netherlands; ORCID: http://orcid.org/0000-0001-6601-7639.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A692.

Acknowledgments: The authors would like to acknowledge the contribution of the three anonymous peer reviewers in strengthening this article.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Correspondence should be addressed to Margot Barry, Kapittelweg 33, 6525EN Nijmegen, the Netherlands; telephone: +31-6-8399-3244; email: margot.barry@han.nl.

© 2019 by the Association of American Medical Colleges