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Bench to Bedside? Boundary Spanning in Academic Health Science Centres

French, CE; (2016) Bench to Bedside? Boundary Spanning in Academic Health Science Centres. Doctoral thesis , UCL (University College London). Green open access

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Abstract

The problem of mobilising research generated knowledge into practice has received increasing attention from policy makers and scholars internationally. Academic Health Science Centres (AHSCs) are partnerships between universities and hospitals which aim to use research discoveries to improve patient care. Despite their complexity and recent international spread, they have not received much attention from social science. This thesis, as a study of this emergent organisational form, contributes to addressing this gap. It conceptualises the ‘bench to bedside’ knowledge mobilisation process within two English AHSC cases as ‘boundary work’ between the domains of research and clinical practice. By analysing qualitative data collected through semi structured interviews (48), observations (130+ hours) and documentary analysis at micro (research/clinical teams) and meso (organisational) levels, it addressed the research question: What boundary processes mobilise knowledge within Academic Health Science Centres? Epistemic, professional and organisational framings were all important conceptualisations of the research/clinical practice boundary. Epistemic elements motivated knowledge mobilisation, with organisational boundaries often proving least permeable. The most effective boundary work encompassed all three. Networked forms of governance prevailed at the organisational level. Joint fields of practice emerged at the micro level with key (instrumental and symbolic) spanning mechanisms including professional hybrids as boundary spanners (e.g. clinician scientists), and objects (e.g. shared data). The ‘bench to bedside’ heuristic operated as an overarching boundary concept, motivationally powerful yet vague enough to bring together diverse groups. This study is one of few to consider the early development of AHSCs from a social science perspective. It contributes empirically and theoretically to the knowledge mobilisation and boundary literature by focussing analysis on the research and clinical practice boundary (as a space for new practice) and the people and objects that work across it, particularly centring on the under-researched role of organisation in this process.

Type: Thesis (Doctoral)
Title: Bench to Bedside? Boundary Spanning in Academic Health Science Centres
Event: UCL
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Third party copyright material has been removed from ethesis.
Keywords: Academic Health Science Centre, translational research, professional boundaries, epistemic boundaries, organisational boundaries, boundary spanning, boundary objects
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Applied Health Research
URI: https://discovery.ucl.ac.uk/id/eprint/1529301
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