29 de nov. 2013

the relevance gap between researcher's interests and society: A proposals open to criticism

Paul Nightingale and Alister Scott from the University of Sussex at the Science Policy Research Unit  published in 2007 the article Peer review and the relevance gap: ten suggestions for policy-makers

The paper explores how academic research becomes divorced from wider society and the consequences of this for both society and academia.

They suggest 10 suggestions for policy-makers:
  1. Do not fund research again that comes to the conclusion that ‘more research is needed’.
  2. Funders should recognise the distinction between relevance and academic impact.
  3. Within peer review, encourage and protect research that aims to be relevant and interdisciplinary, and ensure that protection is effective.
  4. Stop using interdisciplinarity as a proxy for relevance and focus on relevance itself.
  5. Funders should end the ‘closed shop’ whereby academics have a monopoly on research funding.
  6. Funding bodies should insert explicit relevance criteria within the peer-review process, and provide guidance to reviewers on what those criteria are and how they should be treated.
  7. Only fund research that shows a clear and rigorous understanding of the diverse actors involved in the field of enquiry, and their questions and needs.
  8. Funding agencies should recognise that relevant research is intensive and requires long-term commitment.
  9. Funding agencies should recognise the inherent limitations of ‘knowledge transfer’.
  10. Policy-makers should recognise vested interests within the existing research community, and how they might invoke the three Sirens of: academic objectivity; academic autonomy; and academic quality, to avoid having to deal with relevance criteria.
Last sentence of the article: "Put a closer focus on society’s real research needs, rather than those agendas currently being defined and appropriated by a small coterie of professionals." 
Ed Clark—Time & Life Pictures/Getty Images. View across the Pont Alexandre III bridge toward the Grand Palace, Paris, 1946.

10 de nov. 2013

clinical governance, clinical management, clinical practice

Do "clinical governance" definitions adequately distinguish between governance, management and practice functions?

The article published by Niamh M. Brennan, Maureen A. Flynn (2013) introduces three definitions to put the term in the correct place.

Clinical governance has benn viewed by many authors as an "umbrella term" and too ambiguous. The study finds 29 different definitions.

Definitions of clinical governance, clinical management, clinical practice proposed by the authors:
  • Clinical governance. Structures, systems, and standards applying to create a culture, and direct and control clinical activities. Clinical accountability and responsibility, a sub-set of clinical governance, involves the monitoring and oversight of clinical activities, including regulation, audit, assurance and compliance by governors (such as boards of directors), regulators (such as governments and professional bodies), internal auditors and external auditors.
  • Clinical management. Processes and procedures, including resourcing clinical staff, by managers to efficiently, effectively and systematically deliver high quality, safe clinical care.
  • Clinical practice. Delivery by clinicians of high quality, safe clinical care in compliance with clinical policies and performance standards, in the interests of patients.
Two important questions to consider for those health care institutions that are trying to define who want to be:

"For effective governance, it is important that there be division of duties between governance roles and management and practice roles. It is a fundamental principle of governance that governors cannot oversee and monitor their own work."

"Clinical quality will not improve unless governors, managers and practitioners take personal responsibility for the positions they hold and the functions they perform."

photo: (*) Photosolde