It is not often that we have an opportunity to discuss the integrity of research with our colleagues, and it's even more uncommon to be presented with the opportunity to travel to the continent of Africa to discuss such issues. Yet that is where we, together with our expert panel, found ourselves in December 2009--speaking at the University of Botswana and interacting with our medical, nursing, and allied health colleagues.
We welcomed the chance to discuss research integrity, not with a regulatory eye, but with the aim of elucidating integrity as a necessary element of and, indeed, as synonymous with the conduct of excellent research. Why? Because research integrity requires a cultural shift in thinking beyond compliance; it includes excellence in scientific method, honesty in the selection of the test statistic, rigor in data collection and analysis, and the straightforward dissemination of findings and their realistic implications.
The Integrity of Research
A variety of definitions of research can be found in the scientific literature. As a framework for this discussion, health research was conceptualized as a formal, rigorous process requiring planned, systematic activity to discover new knowledge for the benefit of patients and society, including the study of the translation and application of evidence from research to clinical and public health or population-based practice (otherwise known as evidence based practice). This definition assumes that healthcare providers have a responsibility to ensure their patients receive care that reflects the most current knowledge available, and to understand the individual and larger societal-cultural matrix within which care is provided and research is conducted. This cultural matrix includes the learned and shared beliefs and values embedded in religion, kinship, politics, and language expression where the "individual and group identity" culture changes along predictable lines with changes in social, historical, physical, geographical, or technical realms of life.
First, Know Yourself
Fay (1996) provides us with additional tools as we strive to know ourselves, to care for others, and to conduct excellent research that demonstrates integrity. He asks us not to hide behind an illusory facade of neutrality to convince ourselves and others that we are objective, to acknowledge the intellectual equipment that we bring to the care and study of others, to be aware of the way we change those with whom we interact, to be accountable to those we are researching and caring for, to act in a way that is responsive to the evidence as best we can determine it, to assess explicitly what others do, and finally and perhaps most importantly, to seek out the criticisms of others with regard to our own research and care-giving activities. We put Fay's recommendations into action during the Botswana conference.
We asked participants to turn to the person on their left, state their name and describe for that person whatever it was that made them distinctly who they were. They could not use the usual descriptors (e.g., sex/gender, race/ethnicity, marital status, or occupation); rather, they were encouraged to use experiences, activities, and relationships in their lives that they believed made a significant contribution to who they are. This was supposed to be a five-minute exercise, but the audience asked for additional time, and we finally had to rather forcefully bring everyone back to the formal lecture. The exercise was an enjoyable one and, even more importantly, it provided examples of how significant experiences, activities, and relationships had affected individuals' lives--in some cases profoundly.
One participant shared his experience of having his original ideas and written materials "stolen" and later published in a peer reviewed journal. These events encouraged him to pursue a doctoral degree in the field of ethics. His comments could not have been more appropriate had he been "planted" as an overture to, the next topic of discussion.
Research Integrity and Misconduct
Integrity has become a priority for universities, science foundations, academies, and health care organizations conducting research. The goal for healthcare research is the acquisition and application of new knowledge for the benefit of patients and society as a whole. Goal achievement requires excellence in scientific methods, honesty in data collection and analysis, and realistic interpretations of findings.
A simple yet encompassing definition of research integrity includes justice and honesty in proposing, conducting, and reporting research. A...