Neurosurgeons’ experiences of conducting and disseminating clinical research in low-income and middle-income countries: a reflexive thematic analysis

Objectives Low-income and-middle-income countries (LMICs) are increasing investment in research and development, yet there remains a paucity of neurotrauma research published by those in LMICs. The aim of this study was to understand neurosurgeons’ experiences of, aspirations for, and ability to con...

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Main Authors: Angelos G Kolias, Tom Bashford, Anthony Figaji, Brandon George Smith, Charlotte Jane Whiffin, Ignatius N Esene, Claire Karekezi, Muhammad Mukhtar Khan, Davi Jorge Fontoura Solla, Peter John Hutchinson, Wellingson S Paiva
Format: Article
Language:English
Published: BMJ Publishing Group 2021-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/9/e051806.full
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author Angelos G Kolias
Tom Bashford
Anthony Figaji
Brandon George Smith
Charlotte Jane Whiffin
Ignatius N Esene
Claire Karekezi
Muhammad Mukhtar Khan
Davi Jorge Fontoura Solla
Peter John Hutchinson
Wellingson S Paiva
author_facet Angelos G Kolias
Tom Bashford
Anthony Figaji
Brandon George Smith
Charlotte Jane Whiffin
Ignatius N Esene
Claire Karekezi
Muhammad Mukhtar Khan
Davi Jorge Fontoura Solla
Peter John Hutchinson
Wellingson S Paiva
author_sort Angelos G Kolias
collection DOAJ
description Objectives Low-income and-middle-income countries (LMICs) are increasing investment in research and development, yet there remains a paucity of neurotrauma research published by those in LMICs. The aim of this study was to understand neurosurgeons’ experiences of, aspirations for, and ability to conduct and disseminate clinical research in LMICs.Design This was a two-stage inductive qualitative study situated within the naturalistic paradigm. This study committed to an interpretivist way of knowing (epistemology), and considered reality subjective and multiple (ontology). Data collection used online methods and included a web-based survey tool for demographic data, an asynchronous online focus group and follow-up semistructured interviews. Data were analysed using Braun and Clarke’s Reflexive Thematic Analysis supported by NVivo V.12.Setting LMICs.Participants In April–July 2020, 26 neurosurgeons from 11 LMICs participated in this study (n=24 in the focus groups, n=20 in follow-up interviews).Results The analysis gave rise to five themes: The local landscape; creating capacity; reach and impact; collaborative inquiry; growth and sustainability. Each theme contained an inhibitor and stimulus to neurosurgeons conducting and disseminating clinical research, interpreted as ‘the neurosurgical research potential in LMICs’. Mentorship, education, infrastructure, impact and engagement were identified as specific accelerators. Whereas lack of generalisability, absence of dissemination and dissemination without peer review may desensitise the impact of research conducted by neurosurgeons.Conclusion The geographical, political and population complexities make research endeavour challenging for neurosurgeons in LMICs. Yet in spite of, and because of, these complexities LMICs provide rich opportunities to advance global neurosurgery. More studies are required to evaluate the specific effects of accelerators of research conducted by neurosurgeons and to understand the effects of desensitisers on high-quality, high-impact clinical research.
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spelling doaj-art-5d0085c0d5624568bfe2c92c3ddd4a462025-08-20T02:18:35ZengBMJ Publishing GroupBMJ Open2044-60552021-09-0111910.1136/bmjopen-2021-051806Neurosurgeons’ experiences of conducting and disseminating clinical research in low-income and middle-income countries: a reflexive thematic analysisAngelos G Kolias0Tom Bashford1Anthony Figaji2Brandon George Smith3Charlotte Jane Whiffin4Ignatius N Esene5Claire Karekezi6Muhammad Mukhtar Khan7Davi Jorge Fontoura Solla8Peter John Hutchinson9Wellingson S Paiva10Division of Neurosurgery, Addenbrooke`s Hospital, Cambridge, UK1 International Health Systems Group, Department of Engineering, University of Cambridge, Cambridge, UKDivision of Paediatric Neuroscience (Neurosurgery), School of Child and Adolescent Health, University of Cape Town, Cape Town, South AfricaInternational Health Systems Group, Department of Engineering, University of Cambridge, Cambridge, UKCollege of Health Psychology and Social Care, University of Derby, Derby, UKUniversity of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UKDepartment of Neurosurgery, Rwanda Military Hospital, Kigali, Kigali City, RwandaYoung Neurosurgeons Committee, World Federation of Neurosurgical Societies, Nyon, Switzerland4 Department of Neurosciences and Behaviour Sciences, University of São Paulo, Ribeirao Preto, BrazilDepartment of Clinical Neurosciences, University of Cambridge, Cambridge, UKNIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UKObjectives Low-income and-middle-income countries (LMICs) are increasing investment in research and development, yet there remains a paucity of neurotrauma research published by those in LMICs. The aim of this study was to understand neurosurgeons’ experiences of, aspirations for, and ability to conduct and disseminate clinical research in LMICs.Design This was a two-stage inductive qualitative study situated within the naturalistic paradigm. This study committed to an interpretivist way of knowing (epistemology), and considered reality subjective and multiple (ontology). Data collection used online methods and included a web-based survey tool for demographic data, an asynchronous online focus group and follow-up semistructured interviews. Data were analysed using Braun and Clarke’s Reflexive Thematic Analysis supported by NVivo V.12.Setting LMICs.Participants In April–July 2020, 26 neurosurgeons from 11 LMICs participated in this study (n=24 in the focus groups, n=20 in follow-up interviews).Results The analysis gave rise to five themes: The local landscape; creating capacity; reach and impact; collaborative inquiry; growth and sustainability. Each theme contained an inhibitor and stimulus to neurosurgeons conducting and disseminating clinical research, interpreted as ‘the neurosurgical research potential in LMICs’. Mentorship, education, infrastructure, impact and engagement were identified as specific accelerators. Whereas lack of generalisability, absence of dissemination and dissemination without peer review may desensitise the impact of research conducted by neurosurgeons.Conclusion The geographical, political and population complexities make research endeavour challenging for neurosurgeons in LMICs. Yet in spite of, and because of, these complexities LMICs provide rich opportunities to advance global neurosurgery. More studies are required to evaluate the specific effects of accelerators of research conducted by neurosurgeons and to understand the effects of desensitisers on high-quality, high-impact clinical research.https://bmjopen.bmj.com/content/11/9/e051806.full
spellingShingle Angelos G Kolias
Tom Bashford
Anthony Figaji
Brandon George Smith
Charlotte Jane Whiffin
Ignatius N Esene
Claire Karekezi
Muhammad Mukhtar Khan
Davi Jorge Fontoura Solla
Peter John Hutchinson
Wellingson S Paiva
Neurosurgeons’ experiences of conducting and disseminating clinical research in low-income and middle-income countries: a reflexive thematic analysis
BMJ Open
title Neurosurgeons’ experiences of conducting and disseminating clinical research in low-income and middle-income countries: a reflexive thematic analysis
title_full Neurosurgeons’ experiences of conducting and disseminating clinical research in low-income and middle-income countries: a reflexive thematic analysis
title_fullStr Neurosurgeons’ experiences of conducting and disseminating clinical research in low-income and middle-income countries: a reflexive thematic analysis
title_full_unstemmed Neurosurgeons’ experiences of conducting and disseminating clinical research in low-income and middle-income countries: a reflexive thematic analysis
title_short Neurosurgeons’ experiences of conducting and disseminating clinical research in low-income and middle-income countries: a reflexive thematic analysis
title_sort neurosurgeons experiences of conducting and disseminating clinical research in low income and middle income countries a reflexive thematic analysis
url https://bmjopen.bmj.com/content/11/9/e051806.full
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