A report on the contemporary assessment of occupational therapy research in the UK

Executive Summary The purpose of this report is to offer a Contemporary Assessment of Occupational Therapy Research in the UK. It is over a decade since Building the evidence for occupational therapy: Priorities for research (College of Occupational Therapists 2007) last benchmarked the state of occupational therapy research in the UK. The current report is based on a multi-method approach comprising telephone interviews with representatives from RCOT accredited pre-registration degree programmes, a research performance indicators literature review, a general UK health research literature review, and an online survey with the profession’s membership working within the UK or carrying out UK-based research. This work was carried out by a team of researchers and research associates from Sheffield Hallam University, College of Health, Wellbeing and Life Sciences. Data collection aimed for a broad approach so that early career researchers and occupational therapists based in practice could be included alongside researchers located in universities or research centres. Literature published before 2014 was not included. Ethical approval was given by Sheffield Hallam University’s research ethics committee and regular meetings were held with an RCOT Steering Group for feedback and comment on progress. This approach was used because occupational therapy research can be hard to identify as: it is often published in journals dealing with specific conditions; professional credentials of the authors are rarely listed, and occupational therapy is not well indexed in research publication databases. The multi-method approach included: 1. multiple literature search strategies which looked for: a. (1) occupational therapy research, and (2) key performance indicators. b. (1) allied health professionals, and (2) key performance indicators, and (3) within a UK context. c. (1) occupational therapy research and (2) research about UK practice. 2. interviews to identify the scope and the scale of occupational therapy research institutions in the UK. Participants were recruited from the professional /programme leads of all the UK higher education institutions offering occupational therapy qualifications; promotion of the research project at the annual RCOT conference, and snowballing. 3. An online survey promoted through the RCOT annual conference, social media and an advertisement in OT News. Key Findings Findings indicated the extreme breadth of occupational therapy research amongst the UK body of just over 31,000 practitioners in England (https://www.hcpc-uk.org/resources/freedom-of-informationrequests/2019/statistics-on-occupational-therapists---february-2019/). For example, the literature searches, and information provided in the survey, identified:  Over 3,000 keywords,  387 articles in 149 journals at an average of 50 per year.  41% of papers were in occupational therapy or rehabilitation journals, of which the British Journal of Occupational Therapy was the most frequent (n=78); no other individual journal had more than 15 papers.  The remaining 59% were in a wide array of journals covering health conditions/states such as aging, neurology, mental health, and dementia. This group of journals also contains general medical journals such as BMJ Open and 'trials registration' journals. 8 | P a g e  Of 31 funded research projects identified in the survey 14 were worth over £50,000.  80% of the research was located in the UK. Significantly there appeared to be a lack of studies originating from academic institutions or faculty only. The bulk of the selected papers were from a clinical setting, with papers from occupational therapists in academia focussing on student-related outcomes which were not perceived by the reviewers to meet the inclusion criteria and project objectives. We were not able to identify Research Performance Indicators (RPI) that assessed impact. This is something that needs to be addressed. The interviews (n=36) were conducted with an academic at 31 out of 36 UK Higher Education Institutions (HEIs) that educate entry-level occupational therapists. A further five were carried out with researchers who were not affiliated with pre-registration occupational therapy programmes. These included one institution which had occupational therapy researchers in two different departments:  The number of doctoral students since 2014 varied from none (13.9%) to 12 (see Table 8). The institutions with none included Russell Group and post-92 universities. Those educating four or more doctoral students were predominantly pre-registration occupational therapy educating institutions.  One quarter of institutions had no staff with funded research since 2014. Although one of those had staff completing funded research where funding was granted prior to 2014. Five institutions had staff working on research consultancy.  In total 30 institutions had staff working on at least one of research consultancy, secondments and/or research.  The sources of research funding were consistent with the occupational therapy remit and, outside of the usual higher education research funders such as the National Institute for Health Research (NIHR), included charities, local authorities, the NHS, and consultancy.  One third of institutions reported receiving funding from occupational therapy or Allied Health Professions (AHP) professional organisations and one quarter accessed internal university funds intended to initiate larger research projects.  Most interviewees reported research collaboration with other UK HEIs  There were relatively few collaborations with NHS organisations.  Staff with sources of research funding, total amount of research funding, and type of research collaborators (see Table 12) were not systematically more common in institutions which are research intensive, except for the proportion reporting using internal university funds.  In a separate set of interviews at the 2019 RCOT annual conference, participants pointed to a desire both from themselves and their colleagues to undertake research but emphasised the challenges that stood in their way. The online survey was live for just over two months:  109 people met the inclusion criteria with 95% providing their name, 84% their email and 41% a link to their institutional profile page. The most common reason for exclusion is that they were not active researchers. It is not possible to calculate the representativeness of the sample as the number of occupational therapists actively engaged in research is unknown.  Respondents were 87% female, one-third were aged 51-50 and 83% were based in England. 9 | P a g e  One half had qualified since the millennium and one-third had a doctorate.  Two-thirds of the respondents worked in an academic setting and two-fifths in clinical settings. Sixteen respondents reported that their "primary working areas" were in both an academic and clinical setting.  Most of the survey respondents were RCOT members (105/109) with seven listing membership of more than one RCOT Specialist Section. Just under half did not select a Specialist Section.  The majority of respondents to this survey were familiar with the Research Excellence Framework but only 10% were submitted in 2014. However, 40% expect to be submitted to the Research Excellence Framework in 2021 (see Table 17).  Two-thirds of those with a doctorate and one-third of respondents with a master's degree were expecting to be submitted in 2021.  Responses to questions about sources of research funding suggested that a mixed portfolio of funding is typical in occupational therapy research. Occupational therapists work with many other professional groups and across a wide range of conditions and services. Many interventions are individually tailored around specific needs, while a context of considerable change, widening need, and the development of services seems to encourage opportunistic and underground research which is largely unfunded or self-funded. The scope of the research was found to be diverse; but few of the occupational therapists in this study were found to have doctorates. Likewise, of the occupational therapy research identified in this study, very little was linked to doctoral study. Diffusion of scope may work against individual researchers within a profession, or their profession as a whole, developing a significant critical mass of expertise in any field. However, occupational therapy research has a value in supporting early career researchers and multi-site research projects. The majority of studies involve small numbers of people who access services and study participants from a wide variety of conditions, because occupational therapy offers interventions for all types of people with different health and care needs. This breadth is reflected in the outcome measures which include both quantitative measures of well-being but also qualitative measures including those such as social participation or life satisfaction. One significant issue identified was the need to improve occupational therapists’ research skills, and to encourage greater involvement in research.