Interventions to support under-represented nurses, midwives and allied health professionals into research careers: A realist synthesis of what works, for whom, and under what circumstances
Year: 2026
Type: preprint
Abstract: Background Nurses, midwives and allied health professionals (NMAHPs) remain under-represented within clinical academic careers relative to the medical workforce, and existing evidence largely describes barriers and facilitators without explaining how, why, for whom and under what circumstances interventions succeed. The review aimed to develop and refine programme theory explaining how interventions support under-represented NMAHPs to access, progress and sustain clinical academic careers. Methods A realist synthesis, prospectively registered with the Open Science Framework (DOI: 10.17605/OSF.IO/JS9CH) and reported in accordance with RAMESES standards, was conducted. Six electronic databases (PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, CINAHL and Embase) were searched from database inception to May 2026, supplemented by website and citation searching. Eligible qualitative, quantitative, mixed-methods and grey literature sources were appraised using design-specific tools and synthesised iteratively into context-mechanism-outcome configurations using abductive and retroductive reasoning. Results Seventeen studies met the inclusion criteria. Forty-two context-mechanism-outcome configurations were consolidated into sixteen programme theories across four higher-order explanatory domains: initiating clinical academic careers; sustaining progression and retention; the organisational and funding circumstances under which interventions succeed or fail; and equity, recognition and embedded clinical academic practice. Progression was found to depend on cumulative interaction between individual, organisational and system-level resources, including research internships, structured career pathways, fellowships, mentoring, funding support and embedded research roles, rather than on isolated interventions or individual motivation alone. Conclusions Equitable clinical academic progression for under-represented NMAHPs requires coordinated, longitudinal interventions that combine individual capability-building with organisational commitment, transparent funding pathways and inclusive leadership. This programme theory offers an evidence-informed basis for designing and evaluating future clinical academic career interventions.
Source: Research Square
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225831884