Design research is a genre of research that is collaborative and suitable for the design and construction of tools that are required to solve practical problems [16]. It contributes to existing theory [16], in this case, the theory on the visibility and professionalisation of the CS broker role. Design research attempts to balance research rigour with practical relevance.
We invited all CSs and managers from within the academic network to form a design-group together with an external independent researcher (MB), with the aim of designing a tool that allows CSs to make their broker role visible. We implemented the three phases of design research [16]. Phase 1, the orientation phase, consisted of a literature review, a context analysis and a needs analysis to explore the needs of the academic network, in order to draft a design requirements and a design proposition [16]. Phase 2 consisted of the cyclical process of design, construction and evaluation of a broker-activity logging tool, that fulfilled the design requirements drafted in phase 1. Phase 3 entailed evaluation of the final tool designed. These three phases and the concomitant data collection activities are summarised in Fig. 1.
The literature review in phase 1 was conducted from May to August 2017 according to the realist review method and was published separately [5]. The literature review served as a starting point from which the design-group worked collaboratively during the remainder of the project, which entailed six-weekly meetings from July 2018 to July 2019. The final evaluation extended to March 2020.
In Phases 1 and 2, data were collected during design-group meetings, individual interviews with CSs, participant observation of supervision meetings between CSs and their manager, questionnaires, walkthroughs, micro-evaluation of elements of the designed tool and try-outs of the tool. Data were in the form of minutes of meetings, sociograms, notes in the researchers logbook and member checked notes taken during interviews and conversations. Key assertions by participants were documented verbatim and member checked. In phase 3 an anonymous online questionnaire was distributed to CSs. They rated their perception of the tool’s effect on their ability to make their broker role visible, on a seven-point Likert scale ranging from ‘a lot worse’ to ‘a lot better', compared to a situation without the tool. CSs also indicated on a multiple-choice question how they planned to use the tool. An individual discussion and reflection was conducted with the manager after the final try-out of the tool.
We analysed data collected in phase 1 using framework analysis [17], which is suitable for research that develops new plans and actions. The independent researcher analyzed the raw textual data following the steps of coding, indexing, charting, mapping and interpretation [17] using a framework in Microsoft Excel. The codes comprised the inner- and outer context factors necessary for effective CS brokerage as identified in the literature review [5]. To enhance credibility, a critical friend and co-author (AP) read the populated framework, to determine whether she agreed with the categorization of quotes under the existing codes. The interpretations arising from the framework analysis were shared and discussed with the entire design group.
During phase 2 (design and construction), data were collaboratively translated into changes required for the prototypes of the tool during design-group meetings. The CSs and the managers made practical suggestions. The answers from the online evaluation questionnaire in phase 3 were numerically tallied and reported in raw numbers.
Throughout all three phases, the researcher compared group discussion topics to available literature on the same topics. This assisted the researcher in interpreting the conversations through a theoretic lens and led to drafting, discussing, re-drafting and finalising the conceptual model.
Reflexivity and authors’ positionality
The first author (M.B), an occupational therapy lecturer, was an independent researcher from an external academic institute. She planned and executed this research in collaboration with the design group. M.B was not a colleague of the CSs nor their managers and did not know them prior to the commencement of this research. M.B used a researcher’s logbook to capture her observations and assumptions throughout the research process. She shared her assumptions with the design group in order to maintain a focus on their practical interest in this research process. The third author (A.P) was a CS and a member of the design group, who’s contribution to the writing process, extended the participatory character of this design research into the writing of this article. The remaining authors (W.K, senior researcher, L.N, professor of education and N.S, general practitioner and associate professor) were senior researchers who provided consultancy and assistance to the independent researcher in planning and executing the research from the proposal stage to the writing of this article. They had no contact with participants of the design group.