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Nurses and midwives, the frontline workers across hospitals and communities, 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.

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 study led by Professor Eckert, ‘Harnessing the nursing and midwifery workforce to boost Australia’s clinical research impact’, published in the Medical Journal of Australia this week.

With contributions from researchers across Australia and New Zealand, the study argues that nurses and midwives, who work across all aspects and settings of healthcare delivery, can have a substantial impact.

“To achieve meaningful and sustained impacts on healthcare outcomes, greater engagement with, and investment in, nursing and midwifery-led research is needed,” Professor Eckert said.

There is more than 479,000 nurses and midwives in Australia, making up 57% 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 (5%) involved nursing and midwifery-specific research; in 2020, the NHMRC Investigator Grants scheme saw only seven of 238 grants (3%) awarded to nursing and one to midwifery (0.4%); and only one NHMRC 2020 postgraduate scholarship was awarded in nursing (1.6%).

“Notably, of all NHMRC 2020 grant round applications, only five of 673 successful applications (0.74%) were nursing or midwifery focused, and only 30 of 5,221 total applications (0.57%) identified nursing or midwifery as the primary field of research,” Professor Eckert explained.

“A severe lack of nursing and midwifery applicants is a major issue.”

Within the paper, Eckert and her colleagues detailed strategies needed to boost nursing and midwifery-led research, including the need to develop research skills.

They include:

  • further improving undergraduate level research skills and enabling conversion to honours programs;
  • bolstering doctoral and postdoctoral research training opportunities and ensuring suitability of programs for nurses and midwives, including those who remain clinically active;
  • increasing resources and improving the quality of nursing and midwifery research outputs;
  • funding opportunities and embedding career frameworks for nurses and midwives to undertake research that is clinically embedded; and
  • 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).

Inequalities in research funding across gender and discipline divides “should be considered by government and funding bodies when creating funding priorities and grant criteria”, Eckert argued.

“We look forward to seeing how recent changes may begin bridging these divides.

“Nurses and midwives comprise most of Australia’s regulated healthcare 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.”

Read the paper here