Despite being the largest health workforce in the country, nurses and midwives receive only a tiny proportion of research funding in Australia, according to a UniSA-led study published today in the Medical Journal of Australia.
"Nurses and midwives are the frontline workers in hospitals and communities and are well positioned to lead research addressing clinical and health priorities, but there are serious inequities in the system," according to Professor Marion Eckert, Director and Professor of Cancer Nursing at the Rosemary Bryant AO Research Centre at the University of South Australia.
Prof Eckert is the lead author of the MJA paper, "Harnessing the nursing and midwifery workforce to boost Australia's clinical research impact," with contributions from researchers across Australia and New Zealand.
"Nurses and midwives work across all aspects of health care delivery, across all age groups, and from metropolitan to rural and remote areas, making their reach and potential impact substantial," Prof Eckert says.
"To achieve meaningful and sustained impacts on health care outcomes, greater engagement with, and investment in, nursing- and midwifery-led research is needed."
There are more than 479 000 working nurses and midwives in Australia, comprising 57 per cent of registered health professionals.
However, of the 200 National Health and Medical Research Council (NHMRC) grants funded to clinical trials networks between 2004 and 2014, only nine (five per cent) involved nursing and midwifery-specific research; in 2020, the NHMRC Investigator Grants scheme saw only seven of 238 grants (3 per cent) awarded to nursing and one to midwifery (0.4 per cent); and only one NHMRC 2020 postgraduate scholarship was awarded in nursing (1.6 per cent).
"Notably, of all NHMRC 2020 grant round applications, only five of 673 successful applications (0.74 per cent) were nursing or midwifery focused, and only 30 of 5221 total applications (0.57 per cent) identified nursing or midwifery as the primary field of research.
"A severe lack of nursing and midwifery applicants is a major issue."
Eckert and colleagues detailed strategies needed to boost nursing- and midwifery-led research, including the need to develop research skills:
- by further improving undergraduate level research skills and enabling conversion to honours programs;
- by bolstering doctoral and postdoctoral research training opportunities and ensuring suitability of programs for nurses and midwives, including those who remain clinically active;
- by increasing resources and improving the quality of nursing and midwifery research outputs;
- by funding opportunities and embedding career frameworks for nurses and midwives to undertake research that is clinically embedded; and
- by creating nursing and midwifery roles that are part clinical and part research and providing clinicians with dedicated time alongside their care duties to undertake clinical research and translation work (akin to medical colleagues).
Eckert and colleagues wrote that inequalities in research funding across gender and discipline divides "should be considered by government and funding bodies when creating funding priorities and grant criteria".
"We look forward to seeing how recent changes may begin bridging these divides," the researchers say.
"Nurses and midwives comprise most of Australia's regulated health care workers. They should therefore be key players in the design, development and leadership of clinical research, and their support as future research leaders is a sound economic investment."
The paper has been published ahead of the Australasian Nursing and Midwifery Clinical Trial Network Summit hosted by the University of South Australia this Wednesday 9 November. The summit will discuss how to increase nurse and midwife-led research and improve evidence-based care to the community.
