Mapping the range and nature of clinical academic training opportunities for nurses – a scoping review

Technical Summary: Mapping the Range and Nature of Clinical Academic Training Opportunities for Nurses – A Scoping Review

Problem Statement
Despite the recognition of nursing as a "safety critical profession" founded on clinical practice, education, research, and leadership, there is a significant disparity in the number of nurses who successfully transition into clinical academic roles compared to other health professions, such as medicine and dentistry. While the UK National Health Service (NHS) employs approximately 360,000 nurses, the proportion of clinical academic nurses remains low (estimated at less than 1% in certain specialties), and nurses are underrepresented in research funding awards (e.g., only 8% of Research for Patient Benefit projects are led by nurses). Unlike the well-established Integrated Academic Training programmes in medicine, nursing lacks embedded structures and funding models to support this career pathway. Consequently, early-career nurses often face unclear entry routes, a lack of awareness regarding available opportunities, and structural barriers including insufficient managerial support and funding. This review addresses the gap in understanding the current landscape of training opportunities available to nurses aspiring to become clinical academics.

Methodology
This study employed a scoping review design guided by the methodological frameworks of Arksey and O'Malley and the Joanna Briggs Institute, reported according to the PRISMA-ScR extension.

• Search Strategy: The authors searched four electronic databases (CINAHL, MEDLINE, AMED, PROQUEST) from inception to March 2023, with an updated search conducted in May 2025. Grey literature was also sought from relevant organizations (e.g., NIHR, Health Education England) and professional networks.
• Eligibility Criteria: Using a PCC (Population, Concept, Context) approach, the review included English-language publications and grey literature focusing on registered nurses (excluding pre-registration students) involved in or aspiring to clinical academic development. "Clinical academic" was defined as concurrent engagement in clinical practice and research. Studies focusing solely on non-clinical academics or other professions were excluded.
• Data Analysis: Two researchers independently screened 20% of records, with the remainder screened by a single researcher. Data extraction was performed using a bespoke form covering programme design, aims, provider, funding, selection processes, mentorship, and outcomes. No formal risk of bias assessment was conducted, consistent with scoping review methodology.
• Scope: The review included 89 articles (38 peer-reviewed, 36 grey literature) from the initial search, plus 10 additional peer-reviewed publications from the updated search, and 15 strategic overview documents analyzed separately.

Key Contributions and Results
The review mapped 89 distinct sources to characterize the nature, range, and support mechanisms of clinical academic training for nurses.

• Geographical and Temporal Trends: Publications spanned from 1993 to 2025, with a marked increase in output between 2020 and 2025. The literature is heavily concentrated in the United States (n=29) and the United Kingdom (n=21), indicating a gap in global documentation.
• Study Design: The evidence base is predominantly exploratory. Published studies were largely case reports (37.5%) or qualitative evaluations (60.4%), with very few mixed-methods studies. Grey literature focused on guidance notes and programme descriptions rather than robust evaluations of effectiveness.
• Programme Characteristics:
  • Types: Opportunities range from short workshops and introductory courses to structured internships and fellowships (typically 6–12 months).
  • Target Groups: While some programmes are exclusive to nurses, many are open to mixed professional groups (midwives, allied health), suggesting nurses often compete for external opportunities.
  • Providers: Healthcare organizations (hospitals) are the primary providers (43%), followed by universities (12.1%) and collaborations (12.1%). Hospital-led programmes often focus on service priorities, while university-led ones emphasize academic infrastructure.
• Funding and Resources: Reporting on funding is inconsistent; 40% of published literature did not specify funding sources. Grey literature provided more detail on training budgets and salary support (backfill), though administrative mechanisms for releasing nurses for training were rarely described.
• Marketing and Dissemination: A significant gap exists in transparency; 65.1% of programmes did not report their marketing approach. Where reported, dissemination relied heavily on internal channels (meetings, staff forums) rather than open, competitive advertising. Digital channels were underutilized.
• Selection and Support:
  • Entry Requirements: Early-stage opportunities often prioritized clinical experience or were open to all grades, whereas advanced programmes required degrees or research proposals.
  • Mentorship: While 88% of programmes cited mentorship as a component, the operational details were poorly defined. Many programmes expected participants to self-select mentors, and few specified mentor qualifications (only 16.3% required doctoral-level mentors).
• Outcomes and Success Metrics: Outcome reporting was limited. Providers prioritized research dissemination (publications/presentations), while participant outcomes focused on professional development and skill acquisition. Only 7% of programmes explicitly tracked long-term career advancement.

Significance and Claims
The paper claims that the current landscape of clinical academic training for nurses is characterized by systemic inconsistencies that hinder equitable access and programme quality. The authors identify three critical areas shaping the effectiveness of these pathways:

1. Inconsistent Marketing: The reliance on informal, internal dissemination limits the reach of opportunities to those already embedded in specific networks, potentially disadvantaging others.
2. Managerial Gatekeeping: While line manager support is frequently cited as a prerequisite for participation, managers are rarely reported as a primary dissemination route. This suggests that managerial attitudes act as a critical, yet variable, gatekeeper to career progression.
3. Ambiguous Mentorship: The lack of clarity regarding mentor roles, qualifications, and allocation mechanisms suggests that mentorship is often assumed rather than intentionally designed, potentially compromising the quality of support for early-career researchers.

The authors conclude that addressing these issues requires a shift from locally driven, ad-hoc efforts to strategic, coordinated approaches. They argue that for a robust and equitable clinical academic nursing workforce to develop, healthcare organizations must improve the visibility of training programmes, establish clearer organizational expectations, and strengthen mentorship models. The review does not propose new experimental interventions but highlights the necessity for future research to evaluate the long-term impact of these programmes and the influence of managerial support and digital accessibility on participation.