Imperial College Healthcare is a great place to pursue clinical research

Imperial College Healthcare is a great place to pursue clinical research

A blog post by Rowan Boyles

Physiotherapist Rowan Boyles has recently been awarded an NIHR Imperial BRC PhD Fellowship to research the use of transcranial magnetic stimulation, a type of brain stimulation, in spinal cord injury.  Rowan spoke to the team at Imperial College Healthcare NHS Trust, to tell them more about his PhD thesis and how he is planning on using his research to improve patient outcomes. You can view the original article on the Trust website.

What is your role at the Trust and how long have you been at Imperial College Healthcare NHS Trust?
I’m a band 6 physiotherapist on the acute rehab rotations which is a mixture of neurology (mostly) and acute medicine. I started at the Trust in July 2020, mid-pandemic!

What do you love most about this role?
I love the variety in the caseload and the opportunity to work with an amazing multidisciplinary team (MDT). I’ve always been drawn to neurology because of my background in neuroscience and experiences in neuro rehab as a junior physio, so this role was an ideal fit.

You are currently on secondment at Imperial College London whilst completing your PhD, which was funded by the BRC. Tell us a bit about your PhD thesis and what sparked your interest in this particular area of research.
My PhD thesis is investigating the possibility of using a type of brain stimulation (transcranial magnetic stimulation, TMS) to assess the extent of damage to the spinal nerves after spinal cord injury. We think that this could be used to predict functional recovery, something which is really important to patients and clinicians. Alongside this, I plan to carry out mixed methods research on the current state of clinical practice for upper limb rehab in spinal cord injury (SCI). This will help us understand how our prognostic tool might be integrated into care pathways. 

I’m passionate about developing the evidence base for neuro rehab interventions and improving our understanding of complex conditions. I have a keen interest in trauma as well as neurology, so was drawn to this work on spinal injuries. In a previous career in neuroscience, I published work which used TMS, which has been really useful for this project! 

How did you first learn about the BRC funding and what was the application process like?
I learnt about the funding through Prof Caroline Alexander, lead clinical academic for allied health professionals, who was co-supervisor for my Imperial Health Charity Pre-Doctoral Fellowship. For this fellowship, I was seconded to a lab at Imperial College London for one year which allowed me to develop a project for doctoral research and gave me time to write my application.

My current PhD application process was pretty challenging! I was supported through it by my supervisory team; Caroline, who I’ve mentioned, as well as Dr Paul Strutton who will be my primary supervisor for the PhD, and Dr Athina Belsi who will support me with the mixed methods investigation. It was a lot of work to pull together all the different strands, literature review, statistical plan, patient and public involvement (PPI) work, all alongside the research I was doing for the fellowship.

I was also able to get help from the NIHR Research Design Service (RDS)* which was valuable. Several people from the RDS reviewed my application and gave feedback. They were very helpful in writing the lay summary and had a statistician and qualitative expert review the relevant parts of my proposed methods. They provide mock interviews but I couldn’t take them up on this because of scheduling issues. The RDS also provides money to fund PPI work and I was fortunate enough to get a small grant from them for this purpose.

*NB - The Research Design Service is changing. From December 2023 they will become the Research Support Service. More info can be found on the NIHR website. 

How are you hoping to use the findings of your research to improve patient care and/or ways of working at the Trust? 
I think that TMS could be a valuable component of clinical assessment post spinal injury and it would be great to see this integrated into clinical practice to enable more personalised prediction of recovery potential. Our work in spinal injury is novel but this technique has been used successfully in stroke in New Zealand so there is potential for this to be used in different conditions.

Why would you encourage other staff to pursue research at the Trust?
I think Imperial College Healthcare is a great place to pursue clinical research as there are plenty of opportunities and structures in place to support you. I’ve really enjoyed this fellowship year. I’ve learnt a lot and met lots of interesting people; it’s a great way to expand your horizons. Having more staff pursuing research careers means that we have a more skilled workforce with a better understanding of the evidence underpinning their profession. Questioning how and why we do things drives progress and hopefully improves the care we provide which is so important. It’s also important for clinicians to be able to have time to reflect, consolidate their knowledge and tread new ground. Research roles can offer flexibility in working patterns which can be refreshing coming from an exclusively clinical role.

What have you found most challenging or rewarding about your PhD so far?
I have only just started my PhD so it’s hard to comment! In my pre-doctoral fellowship, the bureaucratic side of research has been challenging at times; it took a while for us to get ethical approval for example. Projects also have a way of expanding and it’s easy to take on too much! Project management skills are really helpful. The most rewarding aspect for me is all the opportunities for learning. I’ve carried out patient and public involvement work, a survey of clinical practice and used Covidence for a literature review for the first time, all alongside learning about spinal cord injury, neurophysiology and neuronavigated TMS.

What is something someone might find surprising or interesting about you?
I’ve been a member of an acapella choir since September 2019! I really enjoy singing but prior to joining KT6 Vocal Group, I was last in a choir in primary school! Other than singing, I enjoy cycling, the outdoors and travel, amongst other things. Computer games are my guilty pleasure, especially anything made by FromSoftware!

Find out more about the NIHR Imperial Biomedical Research Centre.
Find out more about Imperial Health Charity Pre-doctoral Fellowships (which Rowan did before his PhD).