Being a Clinical Academic Physiotherapist

Deborah Antcliff Honorary Clinical Research Fellow Keele University

My role as a clinical academic physiotherapist commenced through my undertaking of a part-time PhD (2009-2014) while continuing my role as a musculoskeletal physiotherapist. My clinical and research specialism is in the management of chronic pain, and my PhD enabled my exploration into activity pacing as a coping strategy for chronic pain. Many people living with chronic pain describe altered behaviours due to their symptoms, including the avoidance of activities due to fear of increased symptoms, excessive persistence with activities to distract from symptoms, or fluctuating between overactivity and underactivity (boom-bust cycling). Activity pacing provides an alternative approach to undertaking meaningful activities at more consistent levels, while helping the individual to better manage their symptoms. My PhD and subsequent HEE/NIHR ICA Clinical Lectureship (2016-2020) developed an activity pacing questionnaire to measure pacing, and a framework to standardise the delivery of activity pacing in secondary care chronic pain services (respectively).

I was delighted to be awarded a NIHR SPCR post-doctoral award (2022-2024) to translate the activity pacing questionnaire and framework for use in primary care services to enable sooner access to these resources for chronic pain. Throughout this award, I have continued my clinical role as an Advanced Physiotherapy Practitioner in the Bury Integrated Pain Services, Northern Care Alliance NHS Foundation Trust. Within my Trust, I am recognised as a Clinical Research Fellow in the Trust’s Centre for Clinical and Care Research which is committed to supporting clinicians to become more research active and build research capacity. Alongside my clinical role, I am an Honorary Clinical Research Fellow at Keele University. I am privileged to be supported by mentors with expertise across primary care research, physiotherapy, behavioural medicine, long-term conditions and methods, including mentorship from Professor Melanie Holden, Professor Clare Jinks and Dr Gareth McCray (Keele University) and Dr Adam Geraghty (University of Southampton).

The challenges of being a clinical academic include fulfilling the responsibilities of two roles, and expanding my competencies as both a clinician and a researcher. Balancing two demanding roles involves regularly reviewing my work priorities and timescales, together with continually seeking funding to continue my research. Despite these challenges, I find my dual role extremely motivating, and I believe my clinical position complements my research in terms of improving its relevance and direct link to improving patient care. In turn, my development as a researcher is increasing my confidence as a clinician implementing evidence-based practice. My successes during my NIHR SPCR award include recruiting from primary care services to validate the activity pacing questionnaire across wider services, leading a systematic review into activity pacing interventions, and facilitating a series of stakeholder engagement and co-design workshops to agree how to adapt the pacing framework for primary care settings. The findings from these projects will be analysed and disseminated as peer-reviewed publications and presentations. This award has also enabled my protected time to prepare a successful application for a NIHR Senior Clinical and Practitioner Research Award. Securing my next grant enables my continued trajectory towards being a future leading clinical academic in the field of chronic pain management.