Integrating Research into the Culture of Allied Health Professions: The Background and a Review of Issues in the United Kingdom

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This article reviews the challenges and barriers to change associated with development of a research culture in allied health professions within the higher education sector. We address the cultural upheaval and alterations in ways of working experienced by higher education and the health professions in recent times as a result of government policy as it applies to education and the National Health Service in the United Kingdom. Cooperation between higher education and the National Health Service in developing a culture of research in the health professions is fundamental to achieving evidence-based practice in health care. Improving research capability is hampered, however, by lack of funding and institutional barriers to change and barriers within individuals. Engendering a sense of identity and ownership in relation to change and a strategic approach to the next Research Assessment Exercise are essential if allied health professional programs are to survive within higher education. J Allied Health. 2004; 33:132-138.

HEALTH CARE AND higher education, as major areas of British government funding, became prime targets of . . . reform during the 1980s and . . . 1990s. Those workers involved in both sectors, therefore, have experienced a continual revolution over this period which they will have found exciting, threatening and tiresome in varying measure. . . .1

In the United Kingdom, the 1990s witnessed the transfer of many allied health professions, such as occupational therapy and physiotherapy, into the higher education sector. With a past deeply rooted in National Health Service culture, with an emphasis on vocational training and apprenticeship, transition into higher education has not always been easy, particularly for those allied health professionals entering "old" universities. Nevertheless, educators within the professions face a twofold responsibility. On the one hand, they must provide preregistration and postregistration education compatible with health service priorities, as outlined in successive government policies. On the other hand, they must be seen to support and meet the expectations for research and scholarship within the academic community of which they have strived to be a part.

The 1990s also were a period of profound change for universities, requiring cultural upheaval and alterations to traditional ways of working:

The recent changes to higher education, arguably as dramatic as any that have occurred in the whole history of the university, have led to a repositioning of higher education in society . . . this . . . has been policy driven with governments demand- ing higher education modernize itself and align itself to the economic needs of the contemporary nation state.2

As universities and the health professions within the United Kingdom traverse the straits of transition into the 21st century, the research challenge provides a common focus for effort. For the former, establishment of new and sustainable research partnerships with external organizations is an increasingly powerful theme in government funding arrangements.3 For the latter, universities are now the only place where funded, curiosity-driven research about professional practice can be done.4

Engendeting a passion arid capacity for research within the allied health professions is an institutional and an individual responsibility. This article has two sections. The first section focuses on changes in higher education and the National Health Service in the United Kingdom and the implications of these changes for the new communities of health professional academics within the higher education sector, in terms of research and development. The second section focuses on some of the institutional and individual barriers to successful integration of research into the cultural perspectives of allied health professions, using physiotherapy as an example.

Changes in Higher Education and the National Health Service

There were four main aspects of changes in higher education in the United Kingdom in the 1990s,5 as follows:

Increased size and diversity of the student population

Increased expectations of quality by stakeholders

Greater accountability of academic functions (e. …