Real-world activities of clinician-researchers in perioperative medicine: an ethnographic qualitative case study embedded in a single-centre clinical trial

Background Clinician-researchers play a key role in bridging clinical care and research, yet their day-to-day activities remain poorly described. This study aimed to characterise the range of activities undertaken by clinician-researchers in a perioperative clinical trial and explore how these activities are experienced by patient-participants. Methods We conducted an ethnographic qualitative case study embedded in an RCT in a tertiary hospital. In phase 1, clinician-researchers (physicians and nurses) were observed in situ over 10 days using shadowing and time-motion analysis to document their activities. In phase 2, we conducted interviews with patient-participants. Data were analysed using an abductive approach informed by activity theory. Results The study was conducted between October and November 2021 and included observation of seven clinician-researchers and eight patient-participants. Clinician-researchers engaged in a variety of activities extending past traditional research tasks. Time spent on supportive tasks was nearly three times as much as that spent on core RCT activities, with many tasks occurring before or after primary research procedures. Non-RCT activities accounted for one-third of observed time. Patient-participants reported that interactions with clinician-researchers contributed to their perioperative experience, particularly through (1) alleviation of boredom and (2) provision of a perceived sense of safety. Conclusions Clinician-researchers undertook a wide range of activities that extended beyond protocol-driven research tasks encompassing significant coordination and relational work. These activities were perceived by patient-participants to positively influence their perioperative experience in this specific context. These findings highlight the importance of considering the full scope of clinician-researchers' work when designing and implementing prospective clinical trials.