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Exploring the effectiveness of audit and feedback to target healthcare professionals recruitment and retention behaviour in RCTs

   Institute of Applied Health Science

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  Dr K Gillies  No more applications being accepted  Competition Funded PhD Project (Students Worldwide)

About the Project

Despite the incredible volumes of research activity and collective trial experience, trials still routinely take longer (and cost more) than originally proposed, often due to challenges with recruitment and/or retention. For example, only 56% of UK National Institute for Health Research Health Technology Assessment funded trials recruited the number of people they needed, and some suffered loss to follow up of up to 77%. In efforts to improve recruitment and retention most trials share data on these activities with sites. This typically involves offering comparisons with other sites, comparisons with the best recruiting and retaining sites, or comparisons in relation to targets. Trialists often feed back this information in the form of newsletters or reports. This assessment of recruitment and retention activity compared to a ‘standard’ and reported back to sites can be considered as audit and feedback.

Audit and feedback is a widely used foundational component of quality improvement in healthcare. It aims to change professional and organisational behaviour through feeding back information on performance and directing attention towards areas requiring action (e.g. prescribing, test ordering). A Cochrane review of 140 randomised trials of audit and feedback found that it produced a median 4% absolute improvement in compliance with desired practice. This is a modest effect, but cumulative incremental gains through repeated audit cycles can deliver transformative change. The existing target driven strategies to improve trial recruitment and retention described earlier are not currently conceptualised as audit and feedback behaviour change strategies and as such the potential for effectiveness has not been maximised. This studentship aims to address this gap by investigating the key uncertainties and developing recommendations for developing and implementing strategies of this type.

This studentship aims to explore the effectiveness of audit and feedback that targets healthcare professionals’ (HCPs) recruitment and retention behaviour in RCTs. Specifically, it will:

1.   Determine whether and how audit and feedback is currently used to target HCPs recruitment and retention behaviours in RCTs;

2.   Identify key opportunities and challenges for audit and feedback interventions to target HCPs recruitment and retention behaviour;

3.   Develop an audit and feedback intervention to target HCPs recruitment and retention behaviour and establish feasibility and acceptability;

4.   Produce a ‘how-to’ guide for trial teams on how to develop and implement audit-and-feedback intervention targeting recruitment and/or retention.

Dr Katie Gillies (trials methodologist, mixed-methods researcher, with expertise in applying behavioural science to trials) will act as lead supervisor for the student with co-supervision from Dr Eilidh Duncan (health psychologist with expertise in development of audit and feedback interventions) and Prof Robbie Foy (general practitioner with expertise in audit and feedback intervention development and evaluation).

The PhD project will be a mixed-methods study with some of the qualitative components requiring interview and/or focus group data collection from a wide geographical spread of trial teams. Ideally, some of these will be conducted in person (to aid training in these methods) but the majority will be done remotely (as both a cost and carbon reduction strategy). The student will spend time at Leeds University learning from experts in audit and feedback intervention design and evaluation.

The student will be supported (by the supervisory team and a PPIE coordinator at HSRU) to interact with the HSRU Public/patient Involvement Partnership (PIP). The PIP group will be consulted at key project milestones for input into the objectives and/or findings from the work.

Ideally knowledge or experience of health psychology (or psychology more broadly) and qualitative methods is required; however, training will be provided. A first degree or Masters in a health sciences subject is required. 


You are applying for a PhD studentship from the MRC TMRP DTP. A list of potential projects and the application form is available online at:

Please complete the form fully. Incomplete forms will not be considered. CVs will not be accepted for this scheme.

Please apply giving details for your first choice project. You can provide details of up to two other TMRP DTP projects you may be interested in at section B of the application form.

Before making an application, applicants should contact the project primary supervisor to find out more about the project and to discuss their interests in the research.

The deadline for applications is 4pm (GMT) 18 February 2022. Late applications will not be considered.

Completed application forms must be returned to: [Email Address Removed]

Informal enquiries may be made to [Email Address Removed]

Funding Notes

Studentships are funded by the Medical Research Council (MRC) for 3 years. Funding will cover tuition fees at the UK rate only, a Research Training and Support Grant (RTSG) and stipend (stipend to include London Weighting where appropriate). We aim to support the most outstanding applicants from outside the UK and are able to offer a limited number of bursaries that will enable full studentships to be awarded to international applicants. These full studentships will only be awarded to exceptional quality candidates, due to the competitive nature of this scheme.
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