In this episode I am joined by clinical researchers Gillian Campbell, Katherine Mcnabb, and Virginia Rivers Bulkeley, 3 brave souls taking on the challenge of balancing clinical work and research in physiotherapy. In a wonderfully honest conversation, Katherine, Gillian and Virginia tell me about their motivations, their challenges, and the rewards of pursuing a clinical academic career, plus some tips for clinicians considering research.Key themes in this epsiodeInspiration: We discuss what inspired each guest to pursue clinical research, from addressing gaps in evidence to a desire to improve patient care and challenge existing norms.Work-Life Balance: The realities of juggling clinical practice with research, including time management, headspace, and the importance of a supportive network.Challenges & Rewards Insights into the difficulties of securing funding, overcoming imposter syndrome, and navigating the publication process, alongside the joys of discovery and contributing to the physiotherapy community.Advice for Aspiring Researchers: Valuable tips for clinicians considering a move into research, including the importance of mentorship, following your curiosity, and developing a thick skin.Future of Physiotherapy Research: Guests' perspectives on the key questions that need answering in physiotherapy research, with a focus on personalised treatment and integrating technology for better patient outcomes.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:01):
Hello and welcome to this latestedition of You Matter.
Hi there. So this latest edition is a
panel discussion with three physiotherapists who have
combined their clinical work with clinical research.
My guests are Gillian Campbell, Virginia Rivers Bulkley, and
(00:22):
Catherine McNabb and I'm interested in the the clinical
field, having never gone down that route myself other than a a
masters degree. I wasn't brave enough like these
ladies, these ladies, to extend it to a PhD, but I'm interested
in that world. But as ever, I'm interested in
how being in that world affects clinician well-being.
And you'll see that within the discussion we were, we were able
(00:46):
to talk about lots of interesting aspects of what goes
on in that world, what the, whatthe positive and perhaps more
challenging aspects are, but also how that might influence
the well-being of the the clinician in the process.
And ultimately the well-being ofthe people who we are delivering
our services to. So I hope you enjoy this
(01:07):
essentially quite niche conversation.
But the fact that we were able to bring it back to more general
principles of, of well-being andfulfilment, leaving a legacy,
making things better, the thingsmany of us are are trying to do
out there. Hello and welcome to this latest
episode of You Matter. Today's episode is a panel
(01:28):
discussion and I'm thrilled to welcome Julian Campbell,
Catherine McNabb, and Virginia Rivers Buckley.
Now I've invited these ladies along because they all share the
fact that they are clinical researchers and that basically
means they juggle or have juggled clinical work and
(01:51):
research work. You matter is obviously
dedicated to discussions around clinician well-being.
And I was really interested to talk to these ladies about
exactly that juggle because it presents a slightly different
challenge, I'm sure to to I'm going to say just clinical work.
I don't mean to insult anybody by saying that, but it's it's a
(02:14):
a different challenge that I'm quite intrigued to hear about.
So I'm going to go straight in and ask Virginia, Catherine and
Gillian just to give us all. Could you give us just a quick
insight as to where you're at clinically and research wise,
where that where you are on thatjourney at the moment?
Could I start with you, Virginia?
(02:37):
Hello, yes, thank you for havingme do so.
I am at the very early stages ofa clinical academic career so
I'm a slight newbie to the academic side.
I'm an advanced practice pelvic health physio in the NHS and
private practice where my specialist clinical area is
pelvic pain and that is now alsomy specialist research area.
(02:58):
And I'm just starting an NIHR pre doctoral fellowship, which
is fantastic because there's a new initiative from the NIHR to
try and make sure they support clinical academics so that we
don't lose people from the workforce and that we can
develop both clinically and academically and prepare as
people listening might know those really big applications
for doctoral projects and other grant worked actually have some
(03:21):
protected time to do that. Yeah.
And just to be clear, are you currently still doing clinical
work as well? So the fellowship is designed so
that you've got 20% available toclinical time and 80% to your
academic work. But the clinical work covers
quite a few different interpretations.
So that's peer supervision, peermentoring and supporting my
(03:42):
clinical colleagues as well as MDTS.
So it doesn't have to be entirely you in clinic for that
20%, but yes, still a member of the clinical team.
OK. Thanks, Virginia.
Catherine. Hi.
Hi everybody. So yeah, I'm a musculoskeletal
physio and I have done my research in a little bit of a
(04:02):
different way. I am I'm a private, I've been
working in a private clinic and so I have juggled doing the PhD
alongside private work for about7 years now.
It's taken a long time when you do it part time.
And I can continue to do that. So I'm still just right at the
end of my PhD journey and still doing the research, still
(04:23):
writing up, still trying to publish in papers, and still
seeing patients every week. Wow, that sounds like a lot.
Maybe we'll come to that in the discussion later.
Thanks, Catherine and Gillian. Same question.
Yeah. Thanks again for having me.
Yeah. I'm much more like Catherine
(04:44):
actually, because I'm not sure there were clinical academic
careers when I started, which was quite a long time ago now.
And I stumbled into doing my PhDmany years ago and it was a long
process alongside being a clinician in private practice.
But I've gone back in more recently as I'm currently I've
(05:06):
got a postdoctoral fellowship. I'm on my third postdoctoral
fellowship in the clinical academic pathway, which has been
fantastic compared to doing the PhD when when I first did it,
but it's a little challenges. So I still work clinically one
day a week, but my academic contract is 80% so.
(05:27):
OK. Yeah.
So it sounds from talking to three of you that things have
evolved or certainly Gillian through the longer period of
time you've been involved in anykind of research.
The the way things can be structured sounds like it's
evolving and there is at least some understanding of how
difficult it is to try and keep going with clinical career and
(05:48):
as Virginia says, get these massive application documents
completed. So question to all three of you
and feel free to jump in rather than me necessarily directing it
to anybody, but I'm just really intrigued as to what inspired
each of you to pursue clinical research alongside physiotherapy
(06:09):
practice. Can you all remember the moment
when you decided to? To take that fork in the road,
shall I start? Because mine was a bit OK, I
stumbled into it to be brutally honest, which which is probably
not what you wanted to hear. I, I thought I needed to have a
postgraduate degree to be able to work abroad.
(06:31):
And I was going to do a master'sand then a friend went, what are
you doing a master's for? Here's a PhD you could be doing.
And I thought, Oh yes, I'll do that.
And so that was why I did the PhD in the 1st place.
It wasn't very well thought through at all.
It was funded. So I was really lucky there.
And then I sort of fell out. It was such a hard process that
(06:53):
I decided not to do any more research at the end of it.
But I came back into research now, which is a bit more kind
of, I would, maybe it's the morenormal route.
I, I was more passionate about kind of working in clinical
practice and basically I'm quiteold and being sent down the
(07:15):
edicts from NICE guidelines and all the other sort of, you know,
NHS, we have a large NHS contract.
All the other things that were being made to do that I felt
weren't particularly well thought through.
And I got frustrated with peoplenot not really critically
appraising the evidence and looking at stuff that they were
(07:40):
seeing as evidence of one thing.And it really wasn't.
And I decided now, if there's noevidence that it's really
showing what I need to be able to inform my practice, maybe I
should go back in and do it. So that was why I went back in.
Yeah, I get that and that so combination of stumbling first
(08:02):
and goodness Gillian, I think most of my career decisions have
been a stumble of some sort due to life circumstances.
I totally get that. But then yeah, also I completely
understand this slight frustration that research and
the pragmatic day-to-day side ofbeing a practising clinician
when those two things were not necessarily talking to each
(08:23):
other. Yeah, Thank you.
Virginia or Catherine, have you got a a moment when you decided
this was where I'm going? I'm not sure about a moment, but
definitely kind of a repeating pattern.
Like Gillian, it was absolutely not my plan to begin with.
And you can see that in the factthat I was a straight clinician
for 15 years. I wasn't that person who
(08:44):
finished my undergrad and was like, yeah, more research.
That wasn't me. Absolutely.
And then as I specialized more in pelvic health and then pelvic
pain, the gaps became more and more evident.
And I had relied heavily on the great work done in the space by
pelvic health researchers. As I started to do more pelvic
pain work, the gaps became apparent.
(09:06):
But I also found as a clinician,so much of my clinic, so many of
my interactions were apologizingto our women.
They'd come with frustrations about the difficult journey to
get there, the difficult healthcare interactions being
dismissed or potentially not even believed in their
experience of persistent pain. And then we spend my time
complaining to colleagues about frustrations about the gender,
(09:27):
gender pain gap and other things, and realized actually I
should probably be part of this change rather than just being
frustrated by it, so I did. AI didn't do a straight research
masters. It wasn't an M res, It was an
ACP, Advanced practice masters, a Brunel, where they'd offer
pelvic health masters. And the modules I took there and
(09:48):
the dissertation I took there, because of what was going on in
our service at the time, was really clinically relevant.
But actually for a small mastersproject had quite a lot of
impact. So I actually felt like I had
the wife and the women in the clinic, but also that kind of
short dipping my toe in, which was a positive experience.
And through colleagues like Gillian at the POGP, which is
(10:10):
our pelvic health special interest group, they created
smaller research grants to help newbies like me dip our foot in,
find out how we could do it if we weren't ready to take on
enormous projects and that gently.
Those little positive experiences with the whys from
the women in clinic helped me look at something that was a bit
more pragmatic and offered protected time to actually kind
(10:33):
of do a little bit more of this.So in both your answers there, I
think I hear, well, I mean, if, if I'm just thinking, you know,
as I said, bringing this back toclinician well-being, you've
both described frustration seeing something not functioning
as you want it to and almost despite yourself thinking, well,
(10:57):
OK, looks like I better be the person to step up and try and
change that. I know that one of the main
reasons it's often cited for clinician Bernard is
experiencing moral injury. Now, you know, I'm not
suggesting that the two of you have expressed anything to that
(11:20):
degree, but potentially it couldbe if you're day-to-day
experiencing something that you feel is worse than just not very
good, but actually detrimental and you're having to go in and
keep repeating that pattern, then you know that's going to
take its toll. But I think what I heard from
the two of you was slightly lesser than that in that it was,
(11:44):
it was frustration. And I want things to be better.
And to me, from a clinician well-being point of view, that
speaks more to a sense of fulfilment.
And I want this career to mean something.
I want to have changed somethingfor the better.
Would would that be fair? Yeah, absolutely, definitely.
From the NHS experience, I know that talking to colleagues on my
(12:04):
own experience, you know that onyour own, we're responsible for
our own practice. We can make little wins there,
little gains. But I know that talking to
colleagues on my own experience,if you're looking at service
level change, unless that's going to be backed by national
guidance, the commissioners are not going to be able to fund
something where there isn't a clear guidance at national level
to do that. And so it can be quite
(12:26):
isolating. And I know colleagues who felt
like exactly, as you said, kind of remoral injury in that sense
of isolated practice where if you're the one trying to drive
change but you're repeatedly unsuccessful in that, then
people can feel defeated and quite low about that experience.
Yes, Catherine, have you got anything to add?
(12:46):
Yes, So it's really interesting to hear both those stories
because actually I've never really sort of heard anyone else
say that. And it's actually really similar
for for myself, but in just a different field.
I was obviously working privately and experienced
exactly the same way you were getting patients asking you
questions about what you're doing.
And you get to the point. I think it's just a journey
(13:08):
through your career. You know, early on you think,
you think you know it, don't you?
You think you've got it sorted. And then the more you work, the
more you realise you just haven't and that those questions
that you're answering, whilst there might be, you know, fairly
educated guess on, on, on their treatment and, and what they're
doing, you really know from yourheart, you feel a bit of a
fraud. You know, you haven't got that
back back up. And if you are a clinician that
(13:29):
cares about that, which I think we all are, then that is
something that bothers you. Just like you say, Joe, it
becomes frustrating. So I, I definitely had a bit of
a Oh yes, this is not right. I'm, I'm think I need to be part
of that journey. Yes, I'm definitely like the two
of you. I'm going, I'm going to do it.
And I was really naive and just went and rang a physio professor
(13:50):
who I'd met many years earlier and said hi there, Remember Me?
Do you think I could do some research?
I think, Oh my goodness, why didhe not just put the phone down?
Unfortunately, he was patient enough to say to me, OK,
Catherine, let's explore that a little bit further.
Now knowing coming from the private sector, I really don't
know quite how I've managed to do it because unless you have
(14:11):
funding and NIHR is a wonderful,a wonderful pathway, it's very
one sided. You know, there aren't many
private physios that can actually do research, which I
think is a real shame because they have a lot to offer.
I love that though, Catherine, and I think there's something
really refreshing about that just barefaced ask the question
(14:37):
rather than the the convoluted pathways you sometimes decide or
have to follow. So another sort of aspect of
well-being that's talked about so much is work life balance.
And as I alluded to when I was introducing all you guys, I mean
on, on the face of it, to me this seems like quite a juggle
you guys are pulling off. How do you do that?
(15:01):
Nothing with difficulty very much.
Well, I don't think any of us would deny that this is the, you
know, the epitome of juggling. They do I think actually
complement each other very well.My clinical side of my research
are really do, but the actual practical nature of trying to.
(15:22):
So for example, I've done 3 studies within my PhD and two of
them were patient facing. So I was going to either the
university or the hospital for another one to see each
participant. Each one had 30 people in it and
one of them studies I had to seethem twice.
So that was 60 visits to the hospital.
I don't live near the hospital at all.
So logistically you have to juggle things like that.
(15:45):
And I think sometimes when people say you're doing research
or you see research being done, you don't actually appreciate
what's happened behind that research.
And it's family life, isn't it at the end of the day, whether
that's partners, children, whatever.
And I think it's more of a test of of the people supporting you
around and how you manage that. And I know a lot of people drop
(16:08):
out purely because life events happen.
And I would actually say to a lot of people, I've managed to
be successful in my PhD purely through luck of not having a
huge life event that's stopped me because my time is so
stretched. Yeah, yeah.
Thanks for your honesty. I I would completely agree with
that Catherine. Like that, that was the main
(16:30):
reason I dropped out of the PhD.You know, I well, I didn't drop,
I completed it, but afterwards thought enough because, you
know, I had a baby that well, wedidn't expect, which was lovely,
but I had parents were both very, very ill and I lost both
(16:51):
parents during it. And it's just if everything else
is ticking on and thank goodnessfor my husband who's really
supportive, but if everything else takes long, it's absolutely
fine. Well, it's not absolutely fine.
It's a juggle, but you really need a lot of support, I would
say to put people off. But it is.
And, and it's not just about thethe time management.
(17:13):
I don't know if the others agree, but it's the headspace,
you know, it's like you suddenlyhave to swap your hat and that's
really difficult. I know it sounds like it you're
working in the same field. You know, my research is the
same it as as the work I do in clinic.
It's kind of sport and pelvic health.
(17:34):
And my research is that but to suddenly change mindsets, you
know, I've got a I've got a mentor who got me back in and
the number of times she said to me, you you have to take your
clinician hat off. You're not a clinician here.
And and you, yeah, you just can't wear the same hat in both.
(17:56):
And that's really tricky, I think it.
Is tricky, particularly given what you've described about why
you went into research preciselyto sort of keep your clinical
hat on while you were doing it. Yeah, and new ladies have got
more experience further down this journey than I have.
But already, even just with masters and pre doc, I'm working
on trying to accept that I can'tdo everything at the same time.
(18:17):
And as Catherine said, I'm stretching my research out by
doing my pre doc part time and Iwould do my doctorate part time,
which suddenly takes it to six years or so.
But that's not just to do with juggling with private practice
and mentoring that I do at one end of the week when I'm not in
my NHS role, but also to do withthe headspace that Gillian
alluded to. The fact that actually the hours
(18:40):
of my pre doc are the same, who's as someone else who does
it full time, but actually allowing me to take a bit longer
to think about things to work out, who I need on side to help
me with this. Who's going to help me with that
next step, how I'm going to compose this, how I'm going to
do that actually gives me a little bit of headspace.
Even though I know the journey will take much longer and I've
(19:01):
accepted that I'm not in a hurry.
I can't be in a hurry. That's not realistic, but also
that I will miss out on some things.
You know, I can't say yes to every opportunity.
I can't attend every event. There are so many things,
particularly when you're a bit green and enthusiastic like me,
where I'm like, yes, I should dothat.
Oh no, that's at 6:00 PM on thatday.
I'm going to be picking up so and so and dropping off so and
(19:22):
so. And that's not going to be
pragmatic. So it's accepting the
compromise. But that's still very much a
work in progress because I know so many of us want to do the
things that we know sound great,but also have to say no to some
projects that aren't going to fit into the time we've got to
allocate to it either. You're reminding me Virginia of
(19:42):
a talk and my husband and I wentto last week with Oliver Bookman
who wrote 4000 weeks. I don't know if anyone read it.
The general premise is that 4000weeks is the average spam
lifespan. That's how many weeks we have to
to play with. And a large part of what he
talks about is really what you've just said, Virginia
accepting that it's it's one lifetime and you will have to
(20:05):
make choices about the things you can't do, which, you know, I
don't know about you guys, but Ifind that.
Such a a. Hard thing to accept, you know,
there's so many exciting things and opportunities and one tends
to lead to another. And how do you decide how
really, really understand what you all say about the, the
discipline involved in, in needing, as you say, Virginia to
(20:29):
accept what you can and what youcan't do.
And from all three of you, try and have a a supportive home
life and not a big life event while you're doing your research
if if you can help it, can I? I think I'm just going to say, I
think for me, actually COVID was, was, you know, with
(20:49):
everything been locked down madesuch a difference for me.
And it made me reassess, assess the way I conduct my clinic
actually. So, you know, when everybody
went into longer appointment times to have the wiping down
and all the rest of it airing the room, suddenly I realized
actually that made my my well-being so much better.
(21:14):
And I'm such a privileged position with where I work, you
know, the person that runs the clinic is very flexible and
allows me to continue effectively having that extra
space. And that has made a huge
difference for me. I don't know if anybody else
finds the same, but it just gives me the time to spend in
(21:37):
between patients but also thinking about patients because
I'm not doing it all the time and I can't just go Bang, Bang,
bang. No, I'd, I'd totally concur with
that. In my own clinics, we've done
the same. You know, people are running all
sorts of different lengths Diaries now according to what's
worked for them. And I agree, I think COVID,
albeit for, you know, reasons none of us would have chosen,
(21:58):
was just sort of a wake up call like, yeah, that that wasn't
really realistic, that wasn't working.
Why were you expecting yourself to be able to cope with that?
And it's still challenging now. But I agree, having recognised
that what a difference it made to quite a lot of us to have
that extra 10 minutes was reallyeye opening wasn't it?
(22:19):
Pace is so important, isn't it? Like slowing down, just getting
there, but just doing it at a slower pace.
Yes, like you say, not being in a rush and just accepting that
that has to be the choice. I think that's actually
Virginia. Why doing it part time, I think
is actually one of personally one of the better ways to do it.
Just for what you said. You need a lot of time within
(22:40):
research to actually process things in your subconscious.
You know, you get some really difficult times where you go, I
just can't do this. I cannot get there.
I don't know what this means. Your analytical thinking skills
are being developed and that really takes a lot of time that
you, we don't appreciate. I think when you start the
journey and sometimes actually then when you've got a couple of
(23:02):
days clinic where you suddenly your confidence is boosted again
because you've been doing that job for ages.
You know, you just go in and do it and then you come back to it
and it's like, oh, actually no. Oh, OK, I can see something
different or I know who to look to, to ask for help.
So the part time element of it is actually really good.
But you almost feel that, oh, I only do it part time.
You know, you feel like you apologise for it, but actually
(23:24):
don't it, it'll help you. I realised as I went on.
Fingers crossed. Thank you, Catherine.
So just perhaps to move into a slightly more positive line of
questioning, I'd love to know what's been the most rewarding
thing. Is there anything that surprised
you in a good way about being involved in research?
(23:48):
We can definitely start with a positive surprise.
Absolutely. I'm sure we'll come to the
challenges later. Something that I was warned
about as I'm someone who's so used to working with a
fantastically close team and have really thrived having a
team around me rather than beingkind of solo practitioner.
I was warned that it might be a little bit lonely suddenly
(24:09):
predominantly working from home and running your own plan of
action, but actually, as somebody moving from clinic to
clinical academic work, I have been so thrilled to be so
supported by a fantastic research community.
Everyone has been so supportive of the fact that I've turned up
being totally transparent about how fresh and novice I am and
(24:33):
how I'm looking to benefit from everyone else's wisdom in the
room. And they've been fantastic.
Whether that be the POGP, our special interest group, the
university where I did my masters and I'm looking to do my
doctoral work, the NHS Trust, finding people who are already
doing it and they have such a passion for doing it that
(24:54):
they've been really welcoming tosomeone else at the beginning of
their journey so. No credit to you that you've
clearly gone in, you know, very prepared to say I'm feeling a
bit vulnerable here and you. So that's what I would say to
anyone who might be listening, who's thinking, well, I'm used
to kind of knowing what I do. And I know that familiarity of
being a senior clinician. And I'm a bit nervous about
(25:16):
going back to the beginning or what feels like the beginning in
a new element of our practice, actually.
So many of the relationships you've already built and how
you're going to find your way, like Catherine said, and so much
of your experience, people who went into academic life much
earlier appreciate our clinical experience and what that can add
to the conversation and insightsand even conversations for some
(25:38):
of my PPIE, some of my patient and public involvement and
engagement. I already have relationships
with quite a few charities who've been fantastic from the
work I've done as a clinician and building to that community
of the projects I'm looking to take forward.
So if one of the things that worries people is that idea of
it being isolating, I'm sure everyone's experience is
(25:58):
different, but that is definitely one of the pleasant
surprises I've found is that there was a great community to
support me. Brilliant.
I'm glad. Thanks Virginia, Gillian and
Catherine, any nice surprises for either of you?
I'd quite like to echo, I think you're absolutely right,
Virginia, you know, and the, the, the people giving of their
(26:21):
time, you know, and senior researchers, you know, I'd never
have done it if it hadn't been for the women.
I went to one of you trying to inspire clinicians into research
phase. And I think I was one of only
two people that had a PhD and this woman who's really
frightening, she was an OT, saidyou need a mentor.
(26:44):
And I, I contacted her and said,would you do this?
And we've had had some frank exchanges of views over the
years. But she's been so supportive.
And honestly, they and they givetheir time just so selflessly
and they're so passionate, like you say.
I think the other thing I would say is that it's just, it's
(27:06):
really good fun. Do you know what I mean?
When, when you discover something.
So I've done one of the projectsI did, the outcome was
completely not what I expected. And actually after the initial
kind of like, oh, no, this wasn't what we were hoping to
find out. Actually, it was really
(27:28):
exciting. And you think, oh, this is
brilliant, you know, and it, it,it's quite inspiring.
And it, well, I feel like a kid really sometimes It's so it's
good to hear because, you know, you read.
Still, but I've never reading a bit geeky, the Watson and Crick
book, you know, about describingdouble Helix and you know stuff
(27:50):
about Einstein and things like that.
And naively you sort of imagine these Eureka moments and you
kind of hope that's what research is.
But it's kind of nice to hear that there is a bit of that,
Julian. I think it's at a very low
level. I'm sure already have lovely
Catherine, have you got a nice surprise?
I think that's lovely to hear Jolene said that.
(28:12):
You do definitely get when you get your results, don't you?
You can't wait to have a look atthem and kind of process them.
It does sound really sad, doesn't it?
But it is. You work so focused.
But I think actually it's a combination of both those
things. And you become, you start your
research quite broad and gradually you get narrower and
narrower and narrower and you become so detailed into such a
small niche area. Nobody else understands what
(28:35):
you're doing, nobody else is interested in it.
And so that's the it's a lonely part of it.
You kind of think, oh, my goodness, what am I doing?
And then again, like Virginia says, suddenly someone will come
along and I want to chat to you about it.
Who also has that interest? And then, yeah, there's
conversations that you then haveon a level that, you know, where
you both appreciate the work that you're doing is, is a
really lovely feeling. It's it was quite unexpected,
(28:59):
but definitely maybe fulfilling for that mental.
Just really feeling like you expert in that area and when
you're asked about it, you really get to show your
knowledge. I can, I can understand that.
So yes, the flip question was going to come, wasn't it?
What have you found the most challenging?
(29:19):
You know, I know from talking toall of you in the past that
there there's a whole set of requirements along the process.
Isn't there any different phasesand different challenges
presented to you at each phase? I wonder each of you, which
which of you found personally the most challenging?
It's when doing it as a career, I think I find I love doing the
(29:46):
PhD. You know, the X8 was all about
what I wanted to do as a career,particularly as what's called an
early career researcher. So I don't have tenure, you
know, everything is about short term contracts.
It's, it's so difficult. You're constantly, you know, I'm
(30:06):
halfway through a fellowship andI remember when I got it, it
was, it was such a struggle to get.
You go through it. There's a pretty loose accessory
when you apply for these things.And when, when I got it, I said
to my husband, I'm never doing this again.
This is the end. And he went, yeah, whatever.
(30:28):
And then, then, then you, you'vegot the initial relation because
you think you can just concentrate on the research and
that's fantastic. But then being halfway through,
I'm suddenly thinking, what next?
How, how am I going to buy in the next bit of money?
And I, I think we're really lucky because we've always got
(30:49):
our clinical careers. So we're never never going to be
unemployed really, but it's actually really tough and you
have to be able to sell yourselfand that doesn't come easily.
I don't know what the others think, but this imposter
syndrome of selling yourself andsaying I am the best person,
which you never, well, I never feel like I am.
(31:11):
And but I'm sure there are otherpeople and you look at other
people's applications for thingsand you think, Oh my goodness,
what? What am I thinking here?
I'm nowhere near, near good enough to do that.
So that's the really, really challenging bit, certainly for
me. Yeah, the two of you, Catherine
and Virginia Bertha Dotting. Well, I'm at that stage, you
(31:33):
know, I'm coming to the end of my PhD and I've still got
research to write up, but I'm not funded for it or anything.
It's done in my own time. Is that and so I have, you know,
income at the end of the day is is important.
You know, we're not doing this for.
For. All for love.
And so, you know, we, like you said, we have our clinical
backgrounds to go back on. I have some teaching that I'm
doing like, but in terms of research, you have to find
(31:56):
somebody who will fund you to then do the research.
And then like Gillian says, halfway through that you're
worrying about where your next lot of money is going to come
from. So you're focusing and then
everybody you speak to in academia seems to feel this huge
pressure that most of your time time to spend looking for money
or funding. And so it is, I think that's
probably about the biggest stress or or juggle the
(32:19):
independence of having the research, but then becomes
independent in finding your yourwork.
And that's new, isn't it? As as clinicians, that's a new
challenge. And it's definitely something
that I found one of the biggest challenges, and I spoke about
this in coaching is that kind ofawareness of the low success
rate and the idea that lots of it's out of your control.
(32:41):
If you come from a background where you're used to thinking,
well, if I put in all my efforts, then really I'm likely
to get a reward for that effort that I've put in.
And it's almost a known entity that actually graft gets you
most of the way to know that youcan put your time and energy
into something. But in a competitive grant
application, fellowship application that really the odds
(33:01):
are against you is quite a confronting psychology for me.
And actually, when I looked at it more deeply, I realized that
one of my challenges was not just about not having control
over it, but the very public nature of it.
The fact that, you know, I had to tell everyone months ahead of
this fellowship, I'm applying for this fellowship, I'll need
(33:22):
everyone signed off. I know there's a high chance
that I won't get it, but I want to let you know.
And I realized actually, it wasn't that I was awkward about
saying I want to try something new.
It was almost that I was awkwardabout saying, I think I can do
it because unless you think you've got a chance of being
able to do it, you wouldn't apply for it.
(33:43):
But there's something a little bit awkward for me in my kind of
established clinical field to say, I know I'm unlikely to get
this, but I'm interested enough that I'm going to put myself out
there, but I'm probably going tofail at this.
And the kind of public element of that sphere is something very
different to other parts of our life.
And I found that pretty confronting.
(34:03):
Yeah, it's exposure on two fronts, isn't it?
I'm doing this thing which I might fail at, and by telling
you I've got to give the impression that actually I do
back myself, which is always just being bad, if not worse for
a self deprecating clinician. Yeah, exactly.
Very honest. Thank you, Virginia.
And would any of you be happy tospeak about something?
(34:26):
You know, I've had conversationswith all three of you.
I think about the, to me it sounded like quite a transition.
You've been beavering away doingyour research, you know, and
often, you know, self-directed and often on your own a lot of
the time. And then the research is done.
And then if I understand it correctly, there's this point
then where you've always got to sell it, which is a totally
(34:47):
different concept. Would anyone be able to speak
about that? Yeah.
Well, that is I think Joe, you know well, but that is my main
problem. Yes, exactly.
That having the confidence in your work, confidence in your
voice and amongst people that you know are highly intelligent
and of nature critical and analytical is it's very scary
(35:12):
and I struggle with with massively that kind.
And I think you everybody says it's scary, but the only way you
get through it is with practice.But I've had some very shaky
hands and shaky voice at times when I've had to start, and I
would say very early in my journey in that process.
(35:33):
Yeah, yeah, completely agree, Catherine.
It's it that is. That's probably one of the worst
bits, I think, for some of us do.
You think there should be more support within the process
around that part of it? Or could be.
I don't, I don't know, it's something that you just have to
(35:53):
do I think, to be able to do it because not everybody, not
everybody's the same. You know, I chaired a panel in
the autumn and I spoke to all the other presenters on, you
know, they were all physios. And we were chatting the night
before. And I said, you know, I was my
(36:15):
usual kind of shaky voice. I could feel my palm starting to
sweat. And I practised it about a
million and one times what I wasgoing to say.
And I was talking to them and they said, oh, right, just wing
it. And I'm like, God.
And I think some people do, you know, it's just the way they're
made and. I can understand that.
(36:37):
That's in quite contrast to the nature of a person drawn to
focused, factual results, evidence driven work to then
wing it. It's completely different
mindset, isn't it? I definitely have different
experiences when I'm presenting to fellow physios than other
members of the multidisciplinaryteam.
(36:57):
Quite often, I think maybe because of differences in
education, culture and that kindof thing, is that if I'm
presenting to obviously smaller,better, gradually getting
bigger, but if I'm speaking to aroom of physios, then I worry
about the judgement of my peers.I want to do a good job
representing the work I've done,and I also want to represent,
(37:19):
you know, if anyone's invested in my time, I want to do a good
job on behalf of them as well. But I definitely know that from
positive experiences. I generally find that the
questions are curious and that the questions put to you from
people who want to understand more.
They're not trying to trip you up.
They want to understand more about your work, what's coming
next. Often they're clinicians talking
(37:41):
to our clinical groups. They want to know actually,
well, how can this change my practice?
What should I do differently on Monday based on this information
that you're sharing? Whereas I know when I go to some
multidisciplinary conferences, Iget a bit nervous of some of the
more challenging approaches to discussion after presentation
for likelihood. I think as well we spent our
(38:04):
days, particularly if you're a clinician, you spend your days
on a one to one basis. You're very good.
You get very skilled at being. And also I found I spend my life
making the word simpler. You know, that's what we do.
We don't want to complicate things for patients.
And then the academic field, it's the exact opposite.
You know, you speak to more thanone person and you're meant to
use big fancy words and understand what they mean.
(38:25):
Or when you hear other people use big fancy, you're so
impressed by them that you want to try and be like that.
And that is a skill and it's a practice, but you're kind of
thrown into it and you're not very practiced at it.
I think you have to think, sorry, no, I think you have to
develop a really tough skin actually, which is, I don't know
(38:50):
about the others. I find that really, really
tricky. It's a bit like it's the
publishing as well, you know, you, you, you've spent all this
time working on this and somebody is going to be critical
about it and that's their job. And some, some, sometimes it's
fair and sometimes it's really useful and sometimes it's really
(39:10):
unfair actually, you know, and Ithink presenting can be a bit
like that. You know, the first presentation
I gave it was multidisciplinary,actually.
And, and this book stood up and I asked this question that I
thought, I have no idea what you, what you're asking me.
And you think it's just because you're, you're being stupid.
(39:31):
And it wasn't until afterwards and some of the other physios
came up and said, what was that question about?
And I thought, no, but you do. It's developing that ability to
kind of go, actually, it's not about me, it's maybe the person
not understanding or you know, and if you get a peer review or
(39:52):
a paper, you kind of have to step back and go, OK, they're
not, this is not a direct criticism with me.
It's just, it's some, it's a different point of view.
Yeah, that's really good, reallygood point, Gillian.
And actually, my next question to all of you was going to be if
there's any advice you'd give toany other clinicians thinking of
(40:13):
going into research. And it sounds like that would be
a really important one. Julian, just what you've just
articulated, being able to separate a question that is
about the work rather than how you've done the work is what I
heard. Then is is there anything else
any of you in addition that you would want or that you would
(40:36):
have wanted to know if someone had been kind enough to share
with you before you started yourresearch journey?
Find a great mentor. Definitely.
Was it this occupational therapist?
Yeah, yeah, absolutely. I had supervisors from my PhD
who were lovely people, but not particularly useful, not
(40:59):
particularly helpful in buildingan academic career.
And my, the current mentor has been fantastic.
She's really, she's a really tough cookie and she holds me to
account, but she is like a, she's, she's like a terrier and
has been fantastic. And I, I would never have
(41:21):
carried on as long as I have. And you need somebody like that
on your side. They make a big difference.
And I think out of my supervisors in my PhD, PhD,
we're both male. And I know it's quite sexist to
say, but I think having a woman and a therapist as a mentor has
(41:42):
been really helpful as well because they understand kind of
some of the other challenges in academia, which is, which can be
quite a tough world, I think. Yeah, and it sounds, you know, I
don't hear you saying you just want to have your hand held and
someone say they're there. You you want someone who is
going to give you a realistic representation of what you're
(42:03):
getting into and some idea of how to manage that.
Absolutely. And they and they you know that
if what they say you follow whatthey say, it might be a tough
process because they can actually can be quite tough with
me. But at least I know if I submit
something, it's got got a fighting chance because you've
(42:25):
already gone through the period.So it's a.
Good mentor is 1 great piece of advice and anything else.
I think it's, yeah, just along those lines with the Gilly F,
the the whole process is very much you don't know what's ahead
of you. It's a really weird thing you
you have to find out what you'regoing to find out.
(42:48):
And so very much you don't know what you don't know.
So that's where the mentor or friend, as it were, that's been
there before helps. But even within, like we've
mentioned, Virginia's like the, the research community is very
helpful. But when I would say when people
are looking at research and reading research is actually
look behind the, the paper and actually go and look at the
(43:09):
person that's written the research.
Because usually it's somebody like one of us 3 and it's on a
journey. So you might read the research
and go, what was the point in that?
That that's just silly. And why did they do it like
that? And then when you look and you
see the rest of their research, it puts it into context of that
person and suddenly, Oh wow. Well, they, they were doing a
whole load of research that was at the beginning and then they
learnt from that and they moved on.
(43:30):
But what that then does it, it helps you feel less, just like
we were talking about before, sort of less personal about it,
you know, as if somebody was, you know, when you can engage
with the people behind the research, you understand it much
better. And it it helps desensitize
those kind of negative emotions,I think a little bit.
Yeah, yeah. And I would say follow your
(43:52):
curiosity because these are longjourneys.
If it's something you're genuinely interested in, you're
going to have managed better with some of the ups and downs,
but also that will probably leadyou to the people you want to
have conversations with. I've got a fantastic team of
supervisors who are well suited to the project that I'm doing,
the area I'm particularly curious in.
But my mentor is a clinical academic because I, you know,
(44:14):
she's very well positioned living the life, the work life
that I'm interested in in the future.
She's juggling both clinical practice and her academic life.
And she's walked that path. So that not just in terms of, oh
gosh, I've got this application,but also as Cynian said, So when
that fellowship finishes and I suddenly have to work out that
(44:35):
next step, how do I have that conversation with my manager?
Things you know, the actual practicalities of walking that
path. Definitely follow your curiosity
on subjects, but also actually investigate what would you like
that future job to look like if you are a clinician looking at
dipping your toe in. And then start those
conversations because you don't have to know exactly where you
(44:56):
want it to be, but those people are normally really approachable
and happy to have those conversations about what you're
interested in and what you mightbe curious to investigate.
Yeah, really good advice becausethe curiosity I hear is the fun
bit and alongside the discoveries and but keeping that
a bit of a sort of future plan in mind.
Because I'm sure I imagine that research is full of rabbit holes
(45:18):
that you could go down just because and never emerge from
them and sort of lose sight of of the the reason you and the
reason you're excited about going to research to start with.
All right, I'm going to ask you hopefully an easier question
because it's more general and not necessarily about you guys
personally or your own research,although it might be.
(45:39):
I'm just from a nosiness point of view.
Curious from each of you, if there was a question that you
could get answered for physiotherapists in the next 5
years, what would you love somebody out there to research
and find an answer to? Who's going first on that?
(46:06):
That's a really difficult one because I think physiotherapy is
so broad, isn't it? And I think it's, there's so
many different areas. I as a general thing, I think I
would love research to help physiotherapy in the future to
find out which people benefit from which treatments the best.
(46:28):
I do feel that technology and data could be useful to us, you
know, rather than just opposing it, we need to find out how we
can use it to integrate so that we can then make the most of the
resources that we have. But you know, there's the
people, we have all these massesof people that need our help,
(46:49):
but then we know that each one needs more personalized care and
but not everybody needs everything.
So surely data and new technologies can help us direct
that, and it's so the research could look at how we personalise
our treatments, which patients will have the best outcomes
from. Which treatments?
And that could almost be potentially in every sector,
(47:11):
couldn't it? Physiotherapy.
Yeah, Yeah. That's a great answer.
That's such a brilliant answer, Catherine.
I thought about this. I thought this was the hardest
question. Sorry I tried to kid you.
As easy you weren't going to askand I was thinking, God, it's so
broad and all, all I could come back back with was evidence
(47:35):
based. The the current gold standard
for evidence based medicine. It's just not really fitting
kind of what we do and that n = 1.
How do we how do we approach that?
And I know things are changing in terms of complex
interventions and the frameworksand all the rest of it, but
(47:56):
looking at actually what what's best for each patient.
That's fantastic. I love that.
Thank you, Catherine. Absolutely.
I can completely agree because we all want to know what's best
for us, don't we? If we were in that patient seat,
we would want to know what does the evidence say that I'm going
to benefit most from as me as anindividual.
(48:17):
And if we can subgroup and phenotype our patients more so
that the right person gets the right treatment at the right
time is what clinicians always strive for.
But if we haven't got the evidence to give them that
information, sometimes it feels like you're a little bit blind
in that process. When I heard the question, I did
think of a slightly cheeky answer, which is probably not
(48:38):
the answer you wanted, but it's almost a shout out to all of our
community that we can all shape these priorities.
I recently went to a priority setting partnership run by the
James Lind Alliance for Fecal Incontinence, where I was there
as a clinician, I wasn't there as a researcher.
And they invite clinicians, researchers, and people with
lived experiences to set the priorities for the direction of
(49:01):
research for different conditions and different
treatment aspects. So I would say if you're a
clinician, even if you don't want to be doing the research,
you're very happy on the front line looking after the patients
in front of you. But if you want to get involved
in steering the direction of this kind of research, if you
see those calls for the prioritysetting partnership, I would
absolutely say jump in, say yes,come along because then you can
(49:25):
directly influence what is funded next.
So I've never personally been aware of any of those.
Virginia, where are they advertised?
How would people know if they were going on?
So the James Lind Alliance does have a website.
Often it will be disseminated through your special interest
group, that kind of thing. So often, for example, us in
pelvic health, they'll share it with the POGP or others.
(49:47):
So again, if you when you're kind of building that community,
if you let people know you mightbe interested and if you keep an
eye out on the websites and they're open calls, it's a great
way for clinicians to get involved in setting those
priorities. OK.
Thank you. I don't know if the other guys
would have any other extra tips of how you see the.
Calls. No, I, I don't think it's really
interesting because I'd actuallythought of the same sort of
(50:08):
answer because this question isn't really, you know, about
what do you think research should be?
It's not really for us to answer.
Are people much cleverer than usthat have done this before?
And I know within musculoskeletal physio, there's
a lot of people that come together, experts in the field
and follow frameworks and they, you know, decide these research
priorities. And the Jamesland is one of them
particularly, but there is specific ones for each areas.
(50:31):
So it's great as a new researcher to actually look at
those as a starting point and because they tend to be quite
broad and then go, where's my clinical problem?
Where does that fit in? And often, invariably, the
clinicians can go, oh, wow, yeah, that's a good.
I think that that research is that, that that's important.
And that's what I'm seeing on the ground.
How can the two marry together? And it's this integration of
(50:52):
clinical work with research thatis so important for the future,
just to make the research actually useful and beneficial
to the people on the ground. Yeah, and I think that's the
thing that's come across so loudand clear from all three of you,
you know, as to why you went into it, what you hope to
achieve from it, what you want the outcome to be for recipients
of care, but also the fulfilmentoutcome for people delivering
(51:16):
it, feeling like they're really delivering the best, the best
standard of care. But also, as all three of you
said, now that the best standardof care and the most appropriate
version of that for the individual in front of them.
I'd wholeheartedly agree with. I, I would love to see that,
(51:36):
that really positive use of technology.
You know, I think when we first started talking about AI and you
know, the the Daily Mail articleabout exercise sheets, I think
our fear around that, as much asa recipient of care as anything
else is, oh, I'm not being seen as an individual.
(51:57):
They're going to just slap something generic on me.
Whereas to flip that on its headand use technology to do the
opposite. And as one of you said, to
recognise the individual and tailor it, that's to me is a
really nice 180° flip of what wepotentially had some fears
around. And I'm not saying of course
(52:18):
that resolves it. There are huge issues and checks
and balances that need to be held in place all along this
process. But let's hope it does lead to
this, this place of more genuineperson centred care and more
fulfilment for clinicians. So I'm going to wrap the episode
up with a huge thank you to all three of you.
(52:39):
It's been a really interesting discussion and I've loved the
fact that we have been able to keep bringing it back to
clinician well-being and purpose.
And I love the fact that you allhad smiles on your faces and
were able to describe very positive aspects of what you do
as well as a real honesty aroundthe challenges.
So thank you. Just before we close up, I would
(53:02):
love all of you to share the easiest ways for people to get
hold of you or check out your research if if they've heard you
talk about something that they're interested in, if that's
OK. Gillian, can I start with you?
I'm more than happy I've got a real passion for clinicians
coming back into research or going into research as a first
(53:24):
step and I and more than happy If anybody wants just to have a
chat and you can contact me on my university e-mail, which is
gillian.campbell@nottingham.ac.uk.There's a web are unfortunately
(53:45):
our university website is not the best for navigating.
I'm so sorry about that. And I think everybody at the
university will agree sadly. So probably the best thing is
just e-mail or I'm actually, I'mthe current research lead at the
peer GP. So if it's pelvic health
related, we've got a research network and you can contact me
(54:08):
on that on research at the pogp.co dot UK and please join
us. If you're pelvic health and a
member, certainly a member of POGP, please join the research
network. The whole aim of that it is for
(54:29):
collaboration and and mentoring and peer support.
Yeah, and having not being a public health physio myself, but
having given talks and been in some way involved in the POGP, I
I really and makes me want to bea pelvic health physio.
It is a really, really nice community.
You're always welcome, Joe. What were those 4000 weeks for
(54:51):
again? I need 8000.
Catherine, how do people get a hold of you?
So I think probably the easiest way is through X or through
LinkedIn and just go with X. I'm at K McNab Physio and
LinkedIn, obviously just throughmy name, Catherine McNabb,
working at Manchester Metropolitan University, and
I've got the private practice aswell.
(55:13):
So those are the two best ways and then I can contact people
back through that. Can I congratulate you on not
going X or Twitter or whatever we call it finally got over
there. It's.
Like happy new year, how long doyou leave it?
Do you prefer? Exactly, exactly.
We don't have to say that anymore, Virginia.
How do people get hold of you? Well, given what we've just said
(55:35):
about X, normally social media might be easier, although I
don't know how long I'll stay onX and I need to work on my
LinkedIn. And my e-mail that's the
shortest and easier to remember is probably my private practice
e-mail, which would be Virginia at pelvicpainnetwork.co.uk.
Do feel free to. Get in touch.
Lovely. Thank you so much to all of you.
I really enjoyed the conversation and I'm sure people
(55:57):
are going to get huge amounts whether or not they're
considering going into research or already embarking on it and
wondering about the journey ahead.
So thank you ever so much for being fantastic guests.
Thank you. Thank you.
Hello and welcome to this latestedition of You Matter.
Hi there. So this latest edition is a
panel discussion with three physiotherapists who have
combined their clinical work with clinical research.
My guests are Gillian Campbell, Virginia Rivers Bulkley, and
(00:22):
Catherine McNabb and I'm interested in the the clinical
field, having never gone down that route myself other than a a
masters degree. I wasn't brave enough like these
ladies, these ladies, to extend it to a PhD, but I'm interested
in that world. But as ever, I'm interested in
how being in that world affects clinician well-being.
And you'll see that within the discussion we were, we were able
(00:46):
to talk about lots of interesting aspects of what goes
on in that world, what the, whatthe positive and perhaps more
challenging aspects are, but also how that might influence
the well-being of the the clinician in the process.
And ultimately the well-being ofthe people who we are delivering
our services to. So I hope you enjoy this
(01:07):
essentially quite niche conversation.
But the fact that we were able to bring it back to more general
principles of, of well-being andfulfilment, leaving a legacy,
making things better, the thingsmany of us are are trying to do
out there. Hello and welcome to this latest
episode of You Matter. Today's episode is a panel
(01:28):
discussion and I'm thrilled to welcome Julian Campbell,
Catherine McNabb, and Virginia Rivers Buckley.
Now I've invited these ladies along because they all share the
fact that they are clinical researchers and that basically
means they juggle or have juggled clinical work and
(01:51):
research work. You matter is obviously
dedicated to discussions around clinician well-being.
And I was really interested to talk to these ladies about
exactly that juggle because it presents a slightly different
challenge, I'm sure to to I'm going to say just clinical work.
I don't mean to insult anybody by saying that, but it's it's a
(02:14):
a different challenge that I'm quite intrigued to hear about.
So I'm going to go straight in and ask Virginia, Catherine and
Gillian just to give us all. Could you give us just a quick
insight as to where you're at clinically and research wise,
where that where you are on thatjourney at the moment?
Could I start with you, Virginia?
(02:37):
Hello, yes, thank you for havingme do so.
I am at the very early stages ofa clinical academic career so
I'm a slight newbie to the academic side.
I'm an advanced practice pelvic health physio in the NHS and
private practice where my specialist clinical area is
pelvic pain and that is now alsomy specialist research area.
(02:58):
And I'm just starting an NIHR pre doctoral fellowship, which
is fantastic because there's a new initiative from the NIHR to
try and make sure they support clinical academics so that we
don't lose people from the workforce and that we can
develop both clinically and academically and prepare as
people listening might know those really big applications
for doctoral projects and other grant worked actually have some
(03:21):
protected time to do that. Yeah.
And just to be clear, are you currently still doing clinical
work as well? So the fellowship is designed so
that you've got 20% available toclinical time and 80% to your
academic work. But the clinical work covers
quite a few different interpretations.
So that's peer supervision, peermentoring and supporting my
(03:42):
clinical colleagues as well as MDTS.
So it doesn't have to be entirely you in clinic for that
20%, but yes, still a member of the clinical team.
OK. Thanks, Virginia.
Catherine. Hi.
Hi everybody. So yeah, I'm a musculoskeletal
physio and I have done my research in a little bit of a
(04:02):
different way. I am I'm a private, I've been
working in a private clinic and so I have juggled doing the PhD
alongside private work for about7 years now.
It's taken a long time when you do it part time.
And I can continue to do that. So I'm still just right at the
end of my PhD journey and still doing the research, still
(04:23):
writing up, still trying to publish in papers, and still
seeing patients every week. Wow, that sounds like a lot.
Maybe we'll come to that in the discussion later.
Thanks, Catherine and Gillian. Same question.
Yeah. Thanks again for having me.
Yeah. I'm much more like Catherine
(04:44):
actually, because I'm not sure there were clinical academic
careers when I started, which was quite a long time ago now.
And I stumbled into doing my PhDmany years ago and it was a long
process alongside being a clinician in private practice.
But I've gone back in more recently as I'm currently I've
(05:06):
got a postdoctoral fellowship. I'm on my third postdoctoral
fellowship in the clinical academic pathway, which has been
fantastic compared to doing the PhD when when I first did it,
but it's a little challenges. So I still work clinically one
day a week, but my academic contract is 80% so.
(05:27):
OK. Yeah.
So it sounds from talking to three of you that things have
evolved or certainly Gillian through the longer period of
time you've been involved in anykind of research.
The the way things can be structured sounds like it's
evolving and there is at least some understanding of how
difficult it is to try and keep going with clinical career and
(05:48):
as Virginia says, get these massive application documents
completed. So question to all three of you
and feel free to jump in rather than me necessarily directing it
to anybody, but I'm just really intrigued as to what inspired
each of you to pursue clinical research alongside physiotherapy
(06:09):
practice. Can you all remember the moment
when you decided to? To take that fork in the road,
shall I start? Because mine was a bit OK, I
stumbled into it to be brutally honest, which which is probably
not what you wanted to hear. I, I thought I needed to have a
postgraduate degree to be able to work abroad.
(06:31):
And I was going to do a master'sand then a friend went, what are
you doing a master's for? Here's a PhD you could be doing.
And I thought, Oh yes, I'll do that.
And so that was why I did the PhD in the 1st place.
It wasn't very well thought through at all.
It was funded. So I was really lucky there.
And then I sort of fell out. It was such a hard process that
(06:53):
I decided not to do any more research at the end of it.
But I came back into research now, which is a bit more kind
of, I would, maybe it's the morenormal route.
I, I was more passionate about kind of working in clinical
practice and basically I'm quiteold and being sent down the
(07:15):
edicts from NICE guidelines and all the other sort of, you know,
NHS, we have a large NHS contract.
All the other things that were being made to do that I felt
weren't particularly well thought through.
And I got frustrated with peoplenot not really critically
appraising the evidence and looking at stuff that they were
(07:40):
seeing as evidence of one thing.And it really wasn't.
And I decided now, if there's noevidence that it's really
showing what I need to be able to inform my practice, maybe I
should go back in and do it. So that was why I went back in.
Yeah, I get that and that so combination of stumbling first
(08:02):
and goodness Gillian, I think most of my career decisions have
been a stumble of some sort due to life circumstances.
I totally get that. But then yeah, also I completely
understand this slight frustration that research and
the pragmatic day-to-day side ofbeing a practising clinician
when those two things were not necessarily talking to each
(08:23):
other. Yeah, Thank you.
Virginia or Catherine, have you got a a moment when you decided
this was where I'm going? I'm not sure about a moment, but
definitely kind of a repeating pattern.
Like Gillian, it was absolutely not my plan to begin with.
And you can see that in the factthat I was a straight clinician
for 15 years. I wasn't that person who
(08:44):
finished my undergrad and was like, yeah, more research.
That wasn't me. Absolutely.
And then as I specialized more in pelvic health and then pelvic
pain, the gaps became more and more evident.
And I had relied heavily on the great work done in the space by
pelvic health researchers. As I started to do more pelvic
pain work, the gaps became apparent.
(09:06):
But I also found as a clinician,so much of my clinic, so many of
my interactions were apologizingto our women.
They'd come with frustrations about the difficult journey to
get there, the difficult healthcare interactions being
dismissed or potentially not even believed in their
experience of persistent pain. And then we spend my time
complaining to colleagues about frustrations about the gender,
(09:27):
gender pain gap and other things, and realized actually I
should probably be part of this change rather than just being
frustrated by it, so I did. AI didn't do a straight research
masters. It wasn't an M res, It was an
ACP, Advanced practice masters, a Brunel, where they'd offer
pelvic health masters. And the modules I took there and
(09:48):
the dissertation I took there, because of what was going on in
our service at the time, was really clinically relevant.
But actually for a small mastersproject had quite a lot of
impact. So I actually felt like I had
the wife and the women in the clinic, but also that kind of
short dipping my toe in, which was a positive experience.
And through colleagues like Gillian at the POGP, which is
(10:10):
our pelvic health special interest group, they created
smaller research grants to help newbies like me dip our foot in,
find out how we could do it if we weren't ready to take on
enormous projects and that gently.
Those little positive experiences with the whys from
the women in clinic helped me look at something that was a bit
more pragmatic and offered protected time to actually kind
(10:33):
of do a little bit more of this.So in both your answers there, I
think I hear, well, I mean, if, if I'm just thinking, you know,
as I said, bringing this back toclinician well-being, you've
both described frustration seeing something not functioning
as you want it to and almost despite yourself thinking, well,
(10:57):
OK, looks like I better be the person to step up and try and
change that. I know that one of the main
reasons it's often cited for clinician Bernard is
experiencing moral injury. Now, you know, I'm not
suggesting that the two of you have expressed anything to that
(11:20):
degree, but potentially it couldbe if you're day-to-day
experiencing something that you feel is worse than just not very
good, but actually detrimental and you're having to go in and
keep repeating that pattern, then you know that's going to
take its toll. But I think what I heard from
the two of you was slightly lesser than that in that it was,
(11:44):
it was frustration. And I want things to be better.
And to me, from a clinician well-being point of view, that
speaks more to a sense of fulfilment.
And I want this career to mean something.
I want to have changed somethingfor the better.
Would would that be fair? Yeah, absolutely, definitely.
From the NHS experience, I know that talking to colleagues on my
(12:04):
own experience, you know that onyour own, we're responsible for
our own practice. We can make little wins there,
little gains. But I know that talking to
colleagues on my own experience,if you're looking at service
level change, unless that's going to be backed by national
guidance, the commissioners are not going to be able to fund
something where there isn't a clear guidance at national level
to do that. And so it can be quite
(12:26):
isolating. And I know colleagues who felt
like exactly, as you said, kind of remoral injury in that sense
of isolated practice where if you're the one trying to drive
change but you're repeatedly unsuccessful in that, then
people can feel defeated and quite low about that experience.
Yes, Catherine, have you got anything to add?
(12:46):
Yes, So it's really interesting to hear both those stories
because actually I've never really sort of heard anyone else
say that. And it's actually really similar
for for myself, but in just a different field.
I was obviously working privately and experienced
exactly the same way you were getting patients asking you
questions about what you're doing.
And you get to the point. I think it's just a journey
(13:08):
through your career. You know, early on you think,
you think you know it, don't you?
You think you've got it sorted. And then the more you work, the
more you realise you just haven't and that those questions
that you're answering, whilst there might be, you know, fairly
educated guess on, on, on their treatment and, and what they're
doing, you really know from yourheart, you feel a bit of a
fraud. You know, you haven't got that
back back up. And if you are a clinician that
(13:29):
cares about that, which I think we all are, then that is
something that bothers you. Just like you say, Joe, it
becomes frustrating. So I, I definitely had a bit of
a Oh yes, this is not right. I'm, I'm think I need to be part
of that journey. Yes, I'm definitely like the two
of you. I'm going, I'm going to do it.
And I was really naive and just went and rang a physio professor
(13:50):
who I'd met many years earlier and said hi there, Remember Me?
Do you think I could do some research?
I think, Oh my goodness, why didhe not just put the phone down?
Unfortunately, he was patient enough to say to me, OK,
Catherine, let's explore that a little bit further.
Now knowing coming from the private sector, I really don't
know quite how I've managed to do it because unless you have
(14:11):
funding and NIHR is a wonderful,a wonderful pathway, it's very
one sided. You know, there aren't many
private physios that can actually do research, which I
think is a real shame because they have a lot to offer.
I love that though, Catherine, and I think there's something
really refreshing about that just barefaced ask the question
(14:37):
rather than the the convoluted pathways you sometimes decide or
have to follow. So another sort of aspect of
well-being that's talked about so much is work life balance.
And as I alluded to when I was introducing all you guys, I mean
on, on the face of it, to me this seems like quite a juggle
you guys are pulling off. How do you do that?
(15:01):
Nothing with difficulty very much.
Well, I don't think any of us would deny that this is the, you
know, the epitome of juggling. They do I think actually
complement each other very well.My clinical side of my research
are really do, but the actual practical nature of trying to.
(15:22):
So for example, I've done 3 studies within my PhD and two of
them were patient facing. So I was going to either the
university or the hospital for another one to see each
participant. Each one had 30 people in it and
one of them studies I had to seethem twice.
So that was 60 visits to the hospital.
I don't live near the hospital at all.
So logistically you have to juggle things like that.
(15:45):
And I think sometimes when people say you're doing research
or you see research being done, you don't actually appreciate
what's happened behind that research.
And it's family life, isn't it at the end of the day, whether
that's partners, children, whatever.
And I think it's more of a test of of the people supporting you
around and how you manage that. And I know a lot of people drop
(16:08):
out purely because life events happen.
And I would actually say to a lot of people, I've managed to
be successful in my PhD purely through luck of not having a
huge life event that's stopped me because my time is so
stretched. Yeah, yeah.
Thanks for your honesty. I I would completely agree with
that Catherine. Like that, that was the main
(16:30):
reason I dropped out of the PhD.You know, I well, I didn't drop,
I completed it, but afterwards thought enough because, you
know, I had a baby that well, wedidn't expect, which was lovely,
but I had parents were both very, very ill and I lost both
(16:51):
parents during it. And it's just if everything else
is ticking on and thank goodnessfor my husband who's really
supportive, but if everything else takes long, it's absolutely
fine. Well, it's not absolutely fine.
It's a juggle, but you really need a lot of support, I would
say to put people off. But it is.
And, and it's not just about thethe time management.
(17:13):
I don't know if the others agree, but it's the headspace,
you know, it's like you suddenlyhave to swap your hat and that's
really difficult. I know it sounds like it you're
working in the same field. You know, my research is the
same it as as the work I do in clinic.
It's kind of sport and pelvic health.
(17:34):
And my research is that but to suddenly change mindsets, you
know, I've got a I've got a mentor who got me back in and
the number of times she said to me, you you have to take your
clinician hat off. You're not a clinician here.
And and you, yeah, you just can't wear the same hat in both.
(17:56):
And that's really tricky, I think it.
Is tricky, particularly given what you've described about why
you went into research preciselyto sort of keep your clinical
hat on while you were doing it. Yeah, and new ladies have got
more experience further down this journey than I have.
But already, even just with masters and pre doc, I'm working
on trying to accept that I can'tdo everything at the same time.
(18:17):
And as Catherine said, I'm stretching my research out by
doing my pre doc part time and Iwould do my doctorate part time,
which suddenly takes it to six years or so.
But that's not just to do with juggling with private practice
and mentoring that I do at one end of the week when I'm not in
my NHS role, but also to do withthe headspace that Gillian
alluded to. The fact that actually the hours
(18:40):
of my pre doc are the same, who's as someone else who does
it full time, but actually allowing me to take a bit longer
to think about things to work out, who I need on side to help
me with this. Who's going to help me with that
next step, how I'm going to compose this, how I'm going to
do that actually gives me a little bit of headspace.
Even though I know the journey will take much longer and I've
(19:01):
accepted that I'm not in a hurry.
I can't be in a hurry. That's not realistic, but also
that I will miss out on some things.
You know, I can't say yes to every opportunity.
I can't attend every event. There are so many things,
particularly when you're a bit green and enthusiastic like me,
where I'm like, yes, I should dothat.
Oh no, that's at 6:00 PM on thatday.
I'm going to be picking up so and so and dropping off so and
(19:22):
so. And that's not going to be
pragmatic. So it's accepting the
compromise. But that's still very much a
work in progress because I know so many of us want to do the
things that we know sound great,but also have to say no to some
projects that aren't going to fit into the time we've got to
allocate to it either. You're reminding me Virginia of
(19:42):
a talk and my husband and I wentto last week with Oliver Bookman
who wrote 4000 weeks. I don't know if anyone read it.
The general premise is that 4000weeks is the average spam
lifespan. That's how many weeks we have to
to play with. And a large part of what he
talks about is really what you've just said, Virginia
accepting that it's it's one lifetime and you will have to
(20:05):
make choices about the things you can't do, which, you know, I
don't know about you guys, but Ifind that.
Such a a. Hard thing to accept, you know,
there's so many exciting things and opportunities and one tends
to lead to another. And how do you decide how
really, really understand what you all say about the, the
discipline involved in, in needing, as you say, Virginia to
(20:29):
accept what you can and what youcan't do.
And from all three of you, try and have a a supportive home
life and not a big life event while you're doing your research
if if you can help it, can I? I think I'm just going to say, I
think for me, actually COVID was, was, you know, with
(20:49):
everything been locked down madesuch a difference for me.
And it made me reassess, assess the way I conduct my clinic
actually. So, you know, when everybody
went into longer appointment times to have the wiping down
and all the rest of it airing the room, suddenly I realized
actually that made my my well-being so much better.
(21:14):
And I'm such a privileged position with where I work, you
know, the person that runs the clinic is very flexible and
allows me to continue effectively having that extra
space. And that has made a huge
difference for me. I don't know if anybody else
finds the same, but it just gives me the time to spend in
(21:37):
between patients but also thinking about patients because
I'm not doing it all the time and I can't just go Bang, Bang,
bang. No, I'd, I'd totally concur with
that. In my own clinics, we've done
the same. You know, people are running all
sorts of different lengths Diaries now according to what's
worked for them. And I agree, I think COVID,
albeit for, you know, reasons none of us would have chosen,
(21:58):
was just sort of a wake up call like, yeah, that that wasn't
really realistic, that wasn't working.
Why were you expecting yourself to be able to cope with that?
And it's still challenging now. But I agree, having recognised
that what a difference it made to quite a lot of us to have
that extra 10 minutes was reallyeye opening wasn't it?
(22:19):
Pace is so important, isn't it? Like slowing down, just getting
there, but just doing it at a slower pace.
Yes, like you say, not being in a rush and just accepting that
that has to be the choice. I think that's actually
Virginia. Why doing it part time, I think
is actually one of personally one of the better ways to do it.
Just for what you said. You need a lot of time within
(22:40):
research to actually process things in your subconscious.
You know, you get some really difficult times where you go, I
just can't do this. I cannot get there.
I don't know what this means. Your analytical thinking skills
are being developed and that really takes a lot of time that
you, we don't appreciate. I think when you start the
journey and sometimes actually then when you've got a couple of
(23:02):
days clinic where you suddenly your confidence is boosted again
because you've been doing that job for ages.
You know, you just go in and do it and then you come back to it
and it's like, oh, actually no. Oh, OK, I can see something
different or I know who to look to, to ask for help.
So the part time element of it is actually really good.
But you almost feel that, oh, I only do it part time.
You know, you feel like you apologise for it, but actually
(23:24):
don't it, it'll help you. I realised as I went on.
Fingers crossed. Thank you, Catherine.
So just perhaps to move into a slightly more positive line of
questioning, I'd love to know what's been the most rewarding
thing. Is there anything that surprised
you in a good way about being involved in research?
(23:48):
We can definitely start with a positive surprise.
Absolutely. I'm sure we'll come to the
challenges later. Something that I was warned
about as I'm someone who's so used to working with a
fantastically close team and have really thrived having a
team around me rather than beingkind of solo practitioner.
I was warned that it might be a little bit lonely suddenly
(24:09):
predominantly working from home and running your own plan of
action, but actually, as somebody moving from clinic to
clinical academic work, I have been so thrilled to be so
supported by a fantastic research community.
Everyone has been so supportive of the fact that I've turned up
being totally transparent about how fresh and novice I am and
(24:33):
how I'm looking to benefit from everyone else's wisdom in the
room. And they've been fantastic.
Whether that be the POGP, our special interest group, the
university where I did my masters and I'm looking to do my
doctoral work, the NHS Trust, finding people who are already
doing it and they have such a passion for doing it that
(24:54):
they've been really welcoming tosomeone else at the beginning of
their journey so. No credit to you that you've
clearly gone in, you know, very prepared to say I'm feeling a
bit vulnerable here and you. So that's what I would say to
anyone who might be listening, who's thinking, well, I'm used
to kind of knowing what I do. And I know that familiarity of
being a senior clinician. And I'm a bit nervous about
(25:16):
going back to the beginning or what feels like the beginning in
a new element of our practice, actually.
So many of the relationships you've already built and how
you're going to find your way, like Catherine said, and so much
of your experience, people who went into academic life much
earlier appreciate our clinical experience and what that can add
to the conversation and insightsand even conversations for some
(25:38):
of my PPIE, some of my patient and public involvement and
engagement. I already have relationships
with quite a few charities who've been fantastic from the
work I've done as a clinician and building to that community
of the projects I'm looking to take forward.
So if one of the things that worries people is that idea of
it being isolating, I'm sure everyone's experience is
(25:58):
different, but that is definitely one of the pleasant
surprises I've found is that there was a great community to
support me. Brilliant.
I'm glad. Thanks Virginia, Gillian and
Catherine, any nice surprises for either of you?
I'd quite like to echo, I think you're absolutely right,
Virginia, you know, and the, the, the people giving of their
(26:21):
time, you know, and senior researchers, you know, I'd never
have done it if it hadn't been for the women.
I went to one of you trying to inspire clinicians into research
phase. And I think I was one of only
two people that had a PhD and this woman who's really
frightening, she was an OT, saidyou need a mentor.
(26:44):
And I, I contacted her and said,would you do this?
And we've had had some frank exchanges of views over the
years. But she's been so supportive.
And honestly, they and they givetheir time just so selflessly
and they're so passionate, like you say.
I think the other thing I would say is that it's just, it's
(27:06):
really good fun. Do you know what I mean?
When, when you discover something.
So I've done one of the projectsI did, the outcome was
completely not what I expected. And actually after the initial
kind of like, oh, no, this wasn't what we were hoping to
find out. Actually, it was really
(27:28):
exciting. And you think, oh, this is
brilliant, you know, and it, it,it's quite inspiring.
And it, well, I feel like a kid really sometimes It's so it's
good to hear because, you know, you read.
Still, but I've never reading a bit geeky, the Watson and Crick
book, you know, about describingdouble Helix and you know stuff
(27:50):
about Einstein and things like that.
And naively you sort of imagine these Eureka moments and you
kind of hope that's what research is.
But it's kind of nice to hear that there is a bit of that,
Julian. I think it's at a very low
level. I'm sure already have lovely
Catherine, have you got a nice surprise?
I think that's lovely to hear Jolene said that.
(28:12):
You do definitely get when you get your results, don't you?
You can't wait to have a look atthem and kind of process them.
It does sound really sad, doesn't it?
But it is. You work so focused.
But I think actually it's a combination of both those
things. And you become, you start your
research quite broad and gradually you get narrower and
narrower and narrower and you become so detailed into such a
small niche area. Nobody else understands what
(28:35):
you're doing, nobody else is interested in it.
And so that's the it's a lonely part of it.
You kind of think, oh, my goodness, what am I doing?
And then again, like Virginia says, suddenly someone will come
along and I want to chat to you about it.
Who also has that interest? And then, yeah, there's
conversations that you then haveon a level that, you know, where
you both appreciate the work that you're doing is, is a
really lovely feeling. It's it was quite unexpected,
(28:59):
but definitely maybe fulfilling for that mental.
Just really feeling like you expert in that area and when
you're asked about it, you really get to show your
knowledge. I can, I can understand that.
So yes, the flip question was going to come, wasn't it?
What have you found the most challenging?
(29:19):
You know, I know from talking toall of you in the past that
there there's a whole set of requirements along the process.
Isn't there any different phasesand different challenges
presented to you at each phase? I wonder each of you, which
which of you found personally the most challenging?
It's when doing it as a career, I think I find I love doing the
(29:46):
PhD. You know, the X8 was all about
what I wanted to do as a career,particularly as what's called an
early career researcher. So I don't have tenure, you
know, everything is about short term contracts.
It's, it's so difficult. You're constantly, you know, I'm
(30:06):
halfway through a fellowship andI remember when I got it, it
was, it was such a struggle to get.
You go through it. There's a pretty loose accessory
when you apply for these things.And when, when I got it, I said
to my husband, I'm never doing this again.
This is the end. And he went, yeah, whatever.
(30:28):
And then, then, then you, you'vegot the initial relation because
you think you can just concentrate on the research and
that's fantastic. But then being halfway through,
I'm suddenly thinking, what next?
How, how am I going to buy in the next bit of money?
And I, I think we're really lucky because we've always got
(30:49):
our clinical careers. So we're never never going to be
unemployed really, but it's actually really tough and you
have to be able to sell yourselfand that doesn't come easily.
I don't know what the others think, but this imposter
syndrome of selling yourself andsaying I am the best person,
which you never, well, I never feel like I am.
(31:11):
And but I'm sure there are otherpeople and you look at other
people's applications for thingsand you think, Oh my goodness,
what? What am I thinking here?
I'm nowhere near, near good enough to do that.
So that's the really, really challenging bit, certainly for
me. Yeah, the two of you, Catherine
and Virginia Bertha Dotting. Well, I'm at that stage, you
(31:33):
know, I'm coming to the end of my PhD and I've still got
research to write up, but I'm not funded for it or anything.
It's done in my own time. Is that and so I have, you know,
income at the end of the day is is important.
You know, we're not doing this for.
For. All for love.
And so, you know, we, like you said, we have our clinical
backgrounds to go back on. I have some teaching that I'm
doing like, but in terms of research, you have to find
(31:56):
somebody who will fund you to then do the research.
And then like Gillian says, halfway through that you're
worrying about where your next lot of money is going to come
from. So you're focusing and then
everybody you speak to in academia seems to feel this huge
pressure that most of your time time to spend looking for money
or funding. And so it is, I think that's
probably about the biggest stress or or juggle the
(32:19):
independence of having the research, but then becomes
independent in finding your yourwork.
And that's new, isn't it? As as clinicians, that's a new
challenge. And it's definitely something
that I found one of the biggest challenges, and I spoke about
this in coaching is that kind ofawareness of the low success
rate and the idea that lots of it's out of your control.
(32:41):
If you come from a background where you're used to thinking,
well, if I put in all my efforts, then really I'm likely
to get a reward for that effort that I've put in.
And it's almost a known entity that actually graft gets you
most of the way to know that youcan put your time and energy
into something. But in a competitive grant
application, fellowship application that really the odds
(33:01):
are against you is quite a confronting psychology for me.
And actually, when I looked at it more deeply, I realized that
one of my challenges was not just about not having control
over it, but the very public nature of it.
The fact that, you know, I had to tell everyone months ahead of
this fellowship, I'm applying for this fellowship, I'll need
(33:22):
everyone signed off. I know there's a high chance
that I won't get it, but I want to let you know.
And I realized actually, it wasn't that I was awkward about
saying I want to try something new.
It was almost that I was awkwardabout saying, I think I can do
it because unless you think you've got a chance of being
able to do it, you wouldn't apply for it.
(33:43):
But there's something a little bit awkward for me in my kind of
established clinical field to say, I know I'm unlikely to get
this, but I'm interested enough that I'm going to put myself out
there, but I'm probably going tofail at this.
And the kind of public element of that sphere is something very
different to other parts of our life.
And I found that pretty confronting.
(34:03):
Yeah, it's exposure on two fronts, isn't it?
I'm doing this thing which I might fail at, and by telling
you I've got to give the impression that actually I do
back myself, which is always just being bad, if not worse for
a self deprecating clinician. Yeah, exactly.
Very honest. Thank you, Virginia.
And would any of you be happy tospeak about something?
(34:26):
You know, I've had conversationswith all three of you.
I think about the, to me it sounded like quite a transition.
You've been beavering away doingyour research, you know, and
often, you know, self-directed and often on your own a lot of
the time. And then the research is done.
And then if I understand it correctly, there's this point
then where you've always got to sell it, which is a totally
(34:47):
different concept. Would anyone be able to speak
about that? Yeah.
Well, that is I think Joe, you know well, but that is my main
problem. Yes, exactly.
That having the confidence in your work, confidence in your
voice and amongst people that you know are highly intelligent
and of nature critical and analytical is it's very scary
(35:12):
and I struggle with with massively that kind.
And I think you everybody says it's scary, but the only way you
get through it is with practice.But I've had some very shaky
hands and shaky voice at times when I've had to start, and I
would say very early in my journey in that process.
(35:33):
Yeah, yeah, completely agree, Catherine.
It's it that is. That's probably one of the worst
bits, I think, for some of us do.
You think there should be more support within the process
around that part of it? Or could be.
I don't, I don't know, it's something that you just have to
(35:53):
do I think, to be able to do it because not everybody, not
everybody's the same. You know, I chaired a panel in
the autumn and I spoke to all the other presenters on, you
know, they were all physios. And we were chatting the night
before. And I said, you know, I was my
(36:15):
usual kind of shaky voice. I could feel my palm starting to
sweat. And I practised it about a
million and one times what I wasgoing to say.
And I was talking to them and they said, oh, right, just wing
it. And I'm like, God.
And I think some people do, you know, it's just the way they're
made and. I can understand that.
(36:37):
That's in quite contrast to the nature of a person drawn to
focused, factual results, evidence driven work to then
wing it. It's completely different
mindset, isn't it? I definitely have different
experiences when I'm presenting to fellow physios than other
members of the multidisciplinaryteam.
(36:57):
Quite often, I think maybe because of differences in
education, culture and that kindof thing, is that if I'm
presenting to obviously smaller,better, gradually getting
bigger, but if I'm speaking to aroom of physios, then I worry
about the judgement of my peers.I want to do a good job
representing the work I've done,and I also want to represent,
(37:19):
you know, if anyone's invested in my time, I want to do a good
job on behalf of them as well. But I definitely know that from
positive experiences. I generally find that the
questions are curious and that the questions put to you from
people who want to understand more.
They're not trying to trip you up.
They want to understand more about your work, what's coming
next. Often they're clinicians talking
(37:41):
to our clinical groups. They want to know actually,
well, how can this change my practice?
What should I do differently on Monday based on this information
that you're sharing? Whereas I know when I go to some
multidisciplinary conferences, Iget a bit nervous of some of the
more challenging approaches to discussion after presentation
for likelihood. I think as well we spent our
(38:04):
days, particularly if you're a clinician, you spend your days
on a one to one basis. You're very good.
You get very skilled at being. And also I found I spend my life
making the word simpler. You know, that's what we do.
We don't want to complicate things for patients.
And then the academic field, it's the exact opposite.
You know, you speak to more thanone person and you're meant to
use big fancy words and understand what they mean.
(38:25):
Or when you hear other people use big fancy, you're so
impressed by them that you want to try and be like that.
And that is a skill and it's a practice, but you're kind of
thrown into it and you're not very practiced at it.
I think you have to think, sorry, no, I think you have to
develop a really tough skin actually, which is, I don't know
(38:50):
about the others. I find that really, really
tricky. It's a bit like it's the
publishing as well, you know, you, you, you've spent all this
time working on this and somebody is going to be critical
about it and that's their job. And some, some, sometimes it's
fair and sometimes it's really useful and sometimes it's really
(39:10):
unfair actually, you know, and Ithink presenting can be a bit
like that. You know, the first presentation
I gave it was multidisciplinary,actually.
And, and this book stood up and I asked this question that I
thought, I have no idea what you, what you're asking me.
And you think it's just because you're, you're being stupid.
(39:31):
And it wasn't until afterwards and some of the other physios
came up and said, what was that question about?
And I thought, no, but you do. It's developing that ability to
kind of go, actually, it's not about me, it's maybe the person
not understanding or you know, and if you get a peer review or
(39:52):
a paper, you kind of have to step back and go, OK, they're
not, this is not a direct criticism with me.
It's just, it's some, it's a different point of view.
Yeah, that's really good, reallygood point, Gillian.
And actually, my next question to all of you was going to be if
there's any advice you'd give toany other clinicians thinking of
(40:13):
going into research. And it sounds like that would be
a really important one. Julian, just what you've just
articulated, being able to separate a question that is
about the work rather than how you've done the work is what I
heard. Then is is there anything else
any of you in addition that you would want or that you would
(40:36):
have wanted to know if someone had been kind enough to share
with you before you started yourresearch journey?
Find a great mentor. Definitely.
Was it this occupational therapist?
Yeah, yeah, absolutely. I had supervisors from my PhD
who were lovely people, but not particularly useful, not
(40:59):
particularly helpful in buildingan academic career.
And my, the current mentor has been fantastic.
She's really, she's a really tough cookie and she holds me to
account, but she is like a, she's, she's like a terrier and
has been fantastic. And I, I would never have
(41:21):
carried on as long as I have. And you need somebody like that
on your side. They make a big difference.
And I think out of my supervisors in my PhD, PhD,
we're both male. And I know it's quite sexist to
say, but I think having a woman and a therapist as a mentor has
(41:42):
been really helpful as well because they understand kind of
some of the other challenges in academia, which is, which can be
quite a tough world, I think. Yeah, and it sounds, you know, I
don't hear you saying you just want to have your hand held and
someone say they're there. You you want someone who is
going to give you a realistic representation of what you're
(42:03):
getting into and some idea of how to manage that.
Absolutely. And they and they you know that
if what they say you follow whatthey say, it might be a tough
process because they can actually can be quite tough with
me. But at least I know if I submit
something, it's got got a fighting chance because you've
(42:25):
already gone through the period.So it's a.
Good mentor is 1 great piece of advice and anything else.
I think it's, yeah, just along those lines with the Gilly F,
the the whole process is very much you don't know what's ahead
of you. It's a really weird thing you
you have to find out what you'regoing to find out.
(42:48):
And so very much you don't know what you don't know.
So that's where the mentor or friend, as it were, that's been
there before helps. But even within, like we've
mentioned, Virginia's like the, the research community is very
helpful. But when I would say when people
are looking at research and reading research is actually
look behind the, the paper and actually go and look at the
(43:09):
person that's written the research.
Because usually it's somebody like one of us 3 and it's on a
journey. So you might read the research
and go, what was the point in that?
That that's just silly. And why did they do it like
that? And then when you look and you
see the rest of their research, it puts it into context of that
person and suddenly, Oh wow. Well, they, they were doing a
whole load of research that was at the beginning and then they
learnt from that and they moved on.
(43:30):
But what that then does it, it helps you feel less, just like
we were talking about before, sort of less personal about it,
you know, as if somebody was, you know, when you can engage
with the people behind the research, you understand it much
better. And it it helps desensitize
those kind of negative emotions,I think a little bit.
Yeah, yeah. And I would say follow your
(43:52):
curiosity because these are longjourneys.
If it's something you're genuinely interested in, you're
going to have managed better with some of the ups and downs,
but also that will probably leadyou to the people you want to
have conversations with. I've got a fantastic team of
supervisors who are well suited to the project that I'm doing,
the area I'm particularly curious in.
But my mentor is a clinical academic because I, you know,
(44:14):
she's very well positioned living the life, the work life
that I'm interested in in the future.
She's juggling both clinical practice and her academic life.
And she's walked that path. So that not just in terms of, oh
gosh, I've got this application,but also as Cynian said, So when
that fellowship finishes and I suddenly have to work out that
(44:35):
next step, how do I have that conversation with my manager?
Things you know, the actual practicalities of walking that
path. Definitely follow your curiosity
on subjects, but also actually investigate what would you like
that future job to look like if you are a clinician looking at
dipping your toe in. And then start those
conversations because you don't have to know exactly where you
(44:56):
want it to be, but those people are normally really approachable
and happy to have those conversations about what you're
interested in and what you mightbe curious to investigate.
Yeah, really good advice becausethe curiosity I hear is the fun
bit and alongside the discoveries and but keeping that
a bit of a sort of future plan in mind.
Because I'm sure I imagine that research is full of rabbit holes
(45:18):
that you could go down just because and never emerge from
them and sort of lose sight of of the the reason you and the
reason you're excited about going to research to start with.
All right, I'm going to ask you hopefully an easier question
because it's more general and not necessarily about you guys
personally or your own research,although it might be.
(45:39):
I'm just from a nosiness point of view.
Curious from each of you, if there was a question that you
could get answered for physiotherapists in the next 5
years, what would you love somebody out there to research
and find an answer to? Who's going first on that?
(46:06):
That's a really difficult one because I think physiotherapy is
so broad, isn't it? And I think it's, there's so
many different areas. I as a general thing, I think I
would love research to help physiotherapy in the future to
find out which people benefit from which treatments the best.
(46:28):
I do feel that technology and data could be useful to us, you
know, rather than just opposing it, we need to find out how we
can use it to integrate so that we can then make the most of the
resources that we have. But you know, there's the
people, we have all these massesof people that need our help,
(46:49):
but then we know that each one needs more personalized care and
but not everybody needs everything.
So surely data and new technologies can help us direct
that, and it's so the research could look at how we personalise
our treatments, which patients will have the best outcomes
from. Which treatments?
And that could almost be potentially in every sector,
(47:11):
couldn't it? Physiotherapy.
Yeah, Yeah. That's a great answer.
That's such a brilliant answer, Catherine.
I thought about this. I thought this was the hardest
question. Sorry I tried to kid you.
As easy you weren't going to askand I was thinking, God, it's so
broad and all, all I could come back back with was evidence
(47:35):
based. The the current gold standard
for evidence based medicine. It's just not really fitting
kind of what we do and that n = 1.
How do we how do we approach that?
And I know things are changing in terms of complex
interventions and the frameworksand all the rest of it, but
(47:56):
looking at actually what what's best for each patient.
That's fantastic. I love that.
Thank you, Catherine. Absolutely.
I can completely agree because we all want to know what's best
for us, don't we? If we were in that patient seat,
we would want to know what does the evidence say that I'm going
to benefit most from as me as anindividual.
(48:17):
And if we can subgroup and phenotype our patients more so
that the right person gets the right treatment at the right
time is what clinicians always strive for.
But if we haven't got the evidence to give them that
information, sometimes it feels like you're a little bit blind
in that process. When I heard the question, I did
think of a slightly cheeky answer, which is probably not
(48:38):
the answer you wanted, but it's almost a shout out to all of our
community that we can all shape these priorities.
I recently went to a priority setting partnership run by the
James Lind Alliance for Fecal Incontinence, where I was there
as a clinician, I wasn't there as a researcher.
And they invite clinicians, researchers, and people with
lived experiences to set the priorities for the direction of
(49:01):
research for different conditions and different
treatment aspects. So I would say if you're a
clinician, even if you don't want to be doing the research,
you're very happy on the front line looking after the patients
in front of you. But if you want to get involved
in steering the direction of this kind of research, if you
see those calls for the prioritysetting partnership, I would
absolutely say jump in, say yes,come along because then you can
(49:25):
directly influence what is funded next.
So I've never personally been aware of any of those.
Virginia, where are they advertised?
How would people know if they were going on?
So the James Lind Alliance does have a website.
Often it will be disseminated through your special interest
group, that kind of thing. So often, for example, us in
pelvic health, they'll share it with the POGP or others.
(49:47):
So again, if you when you're kind of building that community,
if you let people know you mightbe interested and if you keep an
eye out on the websites and they're open calls, it's a great
way for clinicians to get involved in setting those
priorities. OK.
Thank you. I don't know if the other guys
would have any other extra tips of how you see the.
Calls. No, I, I don't think it's really
interesting because I'd actuallythought of the same sort of
(50:08):
answer because this question isn't really, you know, about
what do you think research should be?
It's not really for us to answer.
Are people much cleverer than usthat have done this before?
And I know within musculoskeletal physio, there's
a lot of people that come together, experts in the field
and follow frameworks and they, you know, decide these research
priorities. And the Jamesland is one of them
particularly, but there is specific ones for each areas.
(50:31):
So it's great as a new researcher to actually look at
those as a starting point and because they tend to be quite
broad and then go, where's my clinical problem?
Where does that fit in? And often, invariably, the
clinicians can go, oh, wow, yeah, that's a good.
I think that that research is that, that that's important.
And that's what I'm seeing on the ground.
How can the two marry together? And it's this integration of
(50:52):
clinical work with research thatis so important for the future,
just to make the research actually useful and beneficial
to the people on the ground. Yeah, and I think that's the
thing that's come across so loudand clear from all three of you,
you know, as to why you went into it, what you hope to
achieve from it, what you want the outcome to be for recipients
of care, but also the fulfilmentoutcome for people delivering
(51:16):
it, feeling like they're really delivering the best, the best
standard of care. But also, as all three of you
said, now that the best standardof care and the most appropriate
version of that for the individual in front of them.
I'd wholeheartedly agree with. I, I would love to see that,
(51:36):
that really positive use of technology.
You know, I think when we first started talking about AI and you
know, the the Daily Mail articleabout exercise sheets, I think
our fear around that, as much asa recipient of care as anything
else is, oh, I'm not being seen as an individual.
(51:57):
They're going to just slap something generic on me.
Whereas to flip that on its headand use technology to do the
opposite. And as one of you said, to
recognise the individual and tailor it, that's to me is a
really nice 180° flip of what wepotentially had some fears
around. And I'm not saying of course
(52:18):
that resolves it. There are huge issues and checks
and balances that need to be held in place all along this
process. But let's hope it does lead to
this, this place of more genuineperson centred care and more
fulfilment for clinicians. So I'm going to wrap the episode
up with a huge thank you to all three of you.
(52:39):
It's been a really interesting discussion and I've loved the
fact that we have been able to keep bringing it back to
clinician well-being and purpose.
And I love the fact that you allhad smiles on your faces and
were able to describe very positive aspects of what you do
as well as a real honesty aroundthe challenges.
So thank you. Just before we close up, I would
(53:02):
love all of you to share the easiest ways for people to get
hold of you or check out your research if if they've heard you
talk about something that they're interested in, if that's
OK. Gillian, can I start with you?
I'm more than happy I've got a real passion for clinicians
coming back into research or going into research as a first
(53:24):
step and I and more than happy If anybody wants just to have a
chat and you can contact me on my university e-mail, which is
gillian.campbell@nottingham.ac.uk.There's a web are unfortunately
(53:45):
our university website is not the best for navigating.
I'm so sorry about that. And I think everybody at the
university will agree sadly. So probably the best thing is
just e-mail or I'm actually, I'mthe current research lead at the
peer GP. So if it's pelvic health
related, we've got a research network and you can contact me
(54:08):
on that on research at the pogp.co dot UK and please join
us. If you're pelvic health and a
member, certainly a member of POGP, please join the research
network. The whole aim of that it is for
(54:29):
collaboration and and mentoring and peer support.
Yeah, and having not being a public health physio myself, but
having given talks and been in some way involved in the POGP, I
I really and makes me want to bea pelvic health physio.
It is a really, really nice community.
You're always welcome, Joe. What were those 4000 weeks for
(54:51):
again? I need 8000.
Catherine, how do people get a hold of you?
So I think probably the easiest way is through X or through
LinkedIn and just go with X. I'm at K McNab Physio and
LinkedIn, obviously just throughmy name, Catherine McNabb,
working at Manchester Metropolitan University, and
I've got the private practice aswell.
(55:13):
So those are the two best ways and then I can contact people
back through that. Can I congratulate you on not
going X or Twitter or whatever we call it finally got over
there. It's.
Like happy new year, how long doyou leave it?
Do you prefer? Exactly, exactly.
We don't have to say that anymore, Virginia.
How do people get hold of you? Well, given what we've just said
(55:35):
about X, normally social media might be easier, although I
don't know how long I'll stay onX and I need to work on my
LinkedIn. And my e-mail that's the
shortest and easier to remember is probably my private practice
e-mail, which would be Virginia at pelvicpainnetwork.co.uk.
Do feel free to. Get in touch.
Lovely. Thank you so much to all of you.
I really enjoyed the conversation and I'm sure people
(55:57):
are going to get huge amounts whether or not they're
considering going into research or already embarking on it and
wondering about the journey ahead.
So thank you ever so much for being fantastic guests.
Thank you. Thank you.
Popular Podcasts
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
The Joe Rogan Experience
The official podcast of comedian Joe Rogan.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.