Implementation Scientists in Clinical Trials – an opportunity for expanding trial workforce collaborations

Science has long been good at discovering what works. Researchers run careful experiments to find new medicines, better therapies, and improved ways to care for patients. But there is a persistent gap between what science proves is effective and what actually happens in a hospital or a clinic. This gap, often called the "know-do gap," means that even when a treatment is proven to save lives, it can take years, or sometimes never, to become a standard part of daily medical practice. The time and money spent on research can feel wasted if the results sit on a shelf instead of helping people. To fix this, a field called implementation science has grown up. It focuses not on whether a treatment works in a perfect lab setting, but on how to get that treatment working in the messy, complex reality of real-world healthcare.

Recently, the world of clinical trials—the large studies that test new treatments—has begun to realize it needs help from this field. A new study from Australia and New Zealand explores what happens when these two worlds collide. The researchers wanted to understand the people who bridge this gap: implementation scientists. These are experts who know how to take a proven idea and make it stick in a real hospital. The study asks a simple but vital question: Who are these people, what do they actually do inside a research team, and does their presence make the research better? The findings suggest that when these specialists join a team, they do more than just offer advice; they help ensure that the hard work of research actually changes how patients are treated.

The researchers conducted a large survey of people who work on clinical trials across Australia and New Zealand. They asked 353 professionals about their experience with implementation science. Out of this group, they identified 52 people who considered themselves experts in this field. These experts were not newcomers to the world of research. They were seasoned veterans, many with over twenty years of experience in running trials. Most of them worked in universities and came from backgrounds in nursing or allied health, such as physiotherapy or occupational therapy. They were almost all based in major cities, reflecting a concentration of specialized expertise in urban centers.

When the researchers looked at how these experts worked with trial teams, they found that their involvement was highly valued. About one-third of all the people surveyed had worked with an implementation scientist, and those who had described the experience as very useful. The experts were most active at the very beginning of a trial, helping to design the study and write the grant applications needed to fund it. However, their work did not stop there. They stayed involved throughout the entire life of the project. They helped solve problems as the trial was running, attended meetings with doctors and nurses, and helped write the final reports. Their role was not just to check a box for funding; they were active partners in shaping how the research was done.

One of the most significant roles these experts played was that of a teacher and mentor. The survey found that 42% of the implementation scientists provided mentorship to their teams, helping other researchers learn the skills needed to make their studies more practical. This was a two-way street, as about one-third of all respondents said they wanted more training in this area to improve their own work. The experts helped the team think about the "real world" from day one, asking questions like, "Will this actually work in a busy hospital?" or "How do we make sure doctors will keep using this after the study ends?"

The impact of having these specialists on a team was clear to the people surveyed. The most common theme was that trials led with implementation science in mind were more likely to result in faster and more effective changes in patient care. Respondents noted that when a trial is designed with the end goal of real-world use in mind, the results are more likely to be adopted by healthcare providers. One person described it as ensuring that the effort put into high-quality research does not go to waste. If the findings are not translated into practice, the time, money, and trust of the patients involved in the study are lost. By bringing in an implementation scientist, teams could build a bridge between the discovery of a new treatment and its daily use, making the entire process more efficient and meaningful.

Despite these clear benefits, the study also highlighted a significant hurdle: access. Because almost all the implementation scientists were located in major cities, researchers working in regional, rural, or remote areas often could not find them. This creates an uneven playing field where some teams have access to this crucial expertise while others do not. Furthermore, the study noted that while many people wanted to learn more about implementation science, they often lacked the time or resources to do so. The field is complex, and without dedicated training and career paths, it remains difficult for many clinicians to become experts in this area.

The researchers concluded that the role of the implementation scientist is becoming essential, yet it is still in its early stages of professional recognition. Unlike fields such as statistics, which have clear career tracks and professional titles, implementation science is still often treated as a skill added on top of a clinical job rather than a distinct profession. The study suggests that for the full potential of these collaborations to be realized, the sector needs to invest in dedicated training and create clear career paths for these specialists. By doing so, the medical community can ensure that the discoveries made in clinical trials do not just remain as data on a computer, but become the standard of care that improves lives.