Facilitators and barriers of research engagement in a large teaching hospital in the Netherlands: a narrative reflection

Abstract

Background

Healthcare organisations are facing major challenges, including workforce shortages, rising costs, and an aging population. Research engagement in hospitals plays a central role in addressing these challenges through quality improvement, innovation, and research aimed at more effective healthcare delivery. This study aims to identify facilitators and barriers for research engagement in a large non-academic Dutch teaching hospital.

Methods

A qualitative design was employed. Semi-structured interviews were conducted in April–May 2025 with 16 healthcare professionals from 10 hospital departments, all actively involved in research. Interviews were audio-recorded, transcribed, and analysed in Atlas.ti. A combined deductive–inductive approach guided by the Capability-Opportunity-Motivation-Behaviour (COM-B) model was applied, with coding in three stages (open, axial, selective).

Results

Findings were framed using the COM-B model. Capability: Engagement in research depends on having essential knowledge and skills, including practical skills related to research procedures, knowledge on how to use new digital tools and performing data analysis. Rapid digitalisation introduced new knowledge gaps related to Artificial Intelligence and data infrastructure, which act as barriers for research participation. Opportunity: Research opportunities depend on environmental factors such as access to practical assistance of research staff, protected research time, funding, and support services. A modern data infrastructure, along with appropriate systems and programmes, including Artificial Intelligence, also facilitates research engagement. A motivating research culture with recognition and interdisciplinary collaboration facilitates engagement in research. Barriers may include high clinical workload, insufficient funds, outdated software, and an unsupportive or negative environment. Motivation: Participants were driven by intrinsic motivation, valuing collaboration and the improvement of patient care and education. Demotivators may include repeated grant rejections, lack of perceived progress, and inadequate departmental support.

Conclusions

Fostering a hospital-wide research culture where research is valued, promoted, and blended with learning is recommended. Practical solutions include providing the assistance of research staff, allocating protected research time, support with finding and obtaining funding and technical support, and encouraging collaboration across departments and disciplines. Limited understanding of digital infrastructures and Artificial Intelligence was identified as a novel barrier for conducting research. Addressing this gap is critical for sustainable innovation and patient outcome improvement.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-026-14493-3.

Background

Healthcare systems worldwide are facing several major challenges, such as labour market shortages [1–3], rising healthcare expenditure [1], and an ageing population [1, 3, 4], resulting in an increasing pressure on healthcare services and workforce capacity.

Scientific research is essential in addressing the current challenges in healthcare. By enabling implementation of evidence-based practices and promoting more effective healthcare delivery [5, 6], research helps improve the quality and efficiency of care, thereby contributing to better patient outcomes, workload reduction, and more sustainable healthcare spending [7–9]. Recent evidence further supports this association between research engagement and health care quality. Boaz et al. systematically reviewed 95 studies and found that 86 reported positive or mixed-positive associations between research activity and healthcare outcomes, including 37 studies that specifically reported improvements in patient outcomes, such as reduced morbidity or mortality [10]. These findings suggest that research-active clinicians and institutions may contribute to better patient care and more effective healthcare delivery [10].

In this study, research engagement refers specifically to healthcare staff taking the initiative to design and carry out their own clinical research projects, including both qualitative and quantitative studies. Optimising research engagement among professionals working within hospital departments, including medical specialists, residents, research nurses, data managers, and other research staff, is therefore essential, not only to foster innovation and continuous improvement in care delivery, but also to build a resilient and sustainable healthcare system.

To understand the factors that influence research engagement, this study applies the COM-B model, which examines how individual capabilities (e.g. research skills and knowledge), opportunities (e.g. external influences such as access to resources and institutional support), and motivational factors shape research participation (i.e. behaviour) [11].

In terms of capability, previous studies have identified several facilitators and barriers to conduct research in a hospital setting. Facilitating factors include prior research experience, participation in training or education, and relevant research skills [12, 13]. Additionally, professional competencies such as time management and networking, as well as practical knowledge of research procedures and available support, have also been identified as facilitators. Barriers include a lack of research skills, experience, or understanding of research procedures [13].

Opportunity for research engagement is created on both social and environmental levels. Social factors include support from managers and colleagues, and a positive research culture [5, 13]. In contrast, a lack of recognition, negative attitudes towards research, and insufficient support hinder research involvement [5, 12, 13]. On an environmental level, facilitators include having dedicated research time, access to funding, institutional support (e.g. statistical or administrative assistance), and experienced research personnel [5, 12, 14]. Access to infrastructure, such as libraries or research software, likewise supports research [12]. Barriers include high clinical workloads, lack of time and staffing, and difficulty to find replacement staff to cover clinical duties [5, 12, 13]. In addition, challenges related to securing funding, due to competitive grant processes or unclear application pathways, have also been reported [5, 12]. A shortage of experienced research staff, unclear collaboration opportunities, and inadequate infrastructure, support, and resources pose additional barriers take part in research [5, 12, 14].

Motivational drivers for conducting research include the development of skills, the enhancement of cognitive abilities, improvement of patient outcomes, contribution to amelioration in healthcare, and the pursuit of greater job satisfaction [12, 13]. In addition, personal goals such as strengthening one’s reputation and improving career prospects may also play an important role [12]. Other motivators include solving practical problems, expanding knowledge, staying up to date in the field, and gathering evidence relevant to daily practice [12].

While several studies have identified facilitators and barriers to research engagement, most have focused on particular clinical areas like emergency healthcare [14], specific patient populations [15], specific treatments [16], or specific professions, such as nursing and allied health professionals [5, 12, 13]. The current study transcends this more narrow approach by investigating which facilitators and barriers play a role in conducting research in a large non-academic Dutch teaching hospital, across disciplines, departments, patient groups and treatments. This is especially relevant in non-academic hospitals, where research is not embedded as a core mission and resources, infrastructure, and organizational support may be more limited.

Based on the insights gained, targeted recommendations will be formulated to promote and support scientific research in a hospital.

Methods

Aim, design and setting of the study

This study explored facilitators and barriers for conducting research in a large non-academic teaching hospital setting in the Netherlands. A qualitative research design was applied by conducting semi-structured interviews to gain deeper insights into the research experiences of healthcare professionals. Research engagement in this study refers specifically to staff initiating and conducting their own clinical research projects, including both qualitative and quantitative studies.

The institutional review committee of the Albert Schweitzer hospital approved the design of the research proposal (#2025.025). The committee confirmed that the rules laid down in the Medical Research Involving Human Subjects Act (also known by its Dutch abbreviation WMO), were not applicable with respect to this research proposal. The study was approved by the Board of Directors of the Albert Schweitzer Hospital.

Data collection

Participants

To select participants, purposive sampling was used to invite 19 hospital departments with a moderate-to-high research output to take part in the study. Seven departments did not respond, one declined participation, and another cancelled due to scheduling conflicts. Consequently, ten departments participated in the study.

Eligible participants included medical specialists and healthcare professionals with active involvement in research. Individuals without a direct role in research activities, such as administrative staff, were excluded from the study.

Participants were research-active professionals across hospital departments, including medical specialists, a resident, a research nurse, and a data manager, with variation in seniority and prior research experience.

The interviews were attended by one to three staff members from each department. Out of a total of ten interviews, five were conducted with one member of a department present, four with two members present, and one with three members present.

Interviews

The interviewer (CG) and the supervising interviewer (ST) were present at all interviews. In addition, the Dean of Science (MK) of the hospital attended eight interviews, and the Staff Manager of Quality, Safety and Innovation attended three. The Dean of Science and the Staff Manager were present as observers during the interviews.

The interviews were conducted in April and May 2025. Prior to each interview, the interviewer introduced the purpose of the interview and explained how the participants’ privacy would be protected. Participants provided written informed consent for participation and publication prior to the interview. The participants were then asked to complete a short questionnaire to acquire data on their age, sex, work experience and research experience. The interviews were conducted in a private room to ensure confidentiality.

On average the interviews lasted between 25 and 50 min and were audio-recorded. All data were securely stored in a restricted-access digital environment, approachable only to the interviewer and supervising interviewer. Audio recordings were retained for eight weeks, after which all records were deleted.

After each interview, a full transcript of the conversation was made. In the case of group interviews, transcripts were structured to distinguish between individual speakers in order to preserve personal views. Subsequently, all participants were assigned a unique identifier (P01-P16) to ensure anonymity.

The unit of analysis for this study was at the individual participant level, meaning that each participant’s contributions were analysed independently, regardless of whether they were interviewed individually or in a group setting.

The transcripts were anonymised by removing participants’ names and assigning a unique identification number to each transcript. A key linking participant names to these identification numbers was kept separately in a secure digital location to ensure confidentiality, only accessible to the interviewer and the supervising interviewer.

Topic list

A semi-structured topic list with open-ended questions was used to guide the interviews. The semi-structured design ensured that all relevant topics were discussed, while also allowing the input of participants’ personal experiences, thereby providing in-depth insights.

The topic list was based on existing literature identifying known facilitators and barriers and on the COM-B model. It covered the following main themes: the participant’s personal connection with research, the organisational context, the role of research within their department, the practical steps involved in conducting research, and their future regarding research (see Supplementary Material 1 – Topic List. Throughout all themes, participants were asked about motivators, enablers and barriers to research engagement.

The topic list was subsequently reviewed by three experts. Based on their feedback, several adjustments were made, which improved the consistency and clarity of the questions.

In addition, a pilot interview was conducted prior to the main interviews to test the clarity of the questions by ascertaining the opinion of two members of the hospital staff. Several questions appeared to be too broadly formulated or unclear. Subsequently, the list of question was adjusted accordingly.

Data analysis

Recordings of the interviews were coded using Atlas.ti software version 23 (16). The data were then analysed both deductively and inductively. A deductive approach was applied to elements of the COM-B model and to facilitators and barriers derived from the literature [17]. An inductive approach was applied to fragments that did not fit the chosen model or did not reflect known factors.

The three phases of open, axial, and selective coding were followed, according to the inductive approach in grounded theory [17]. In the open coding phase, two authors (CG and LS) independently analysed and coded the first two transcripts. This phase involved assigning codes to fragments of text. After coding independently, the results were compared and discussed until consensus was reached. This consensus formed the basis for a preliminary codebook. The remaining transcripts were then coded by one researcher (CG), using the agreed-upon codebook as a guide. When relevant new concepts emerged, additional codes were created and incorporated into the coding scheme. After all interviews had been open coded, axial coding was conducted to group related codes within a common theme. Finally, resulting categories were compared in the selective coding phase. Their relationships were examined and grouped according to the COM-B model.

Results

A total of ten interviews were conducted with sixteen healthcare professionals. Participants were medical specialists (n = 13) or other healthcare professionals actively engaged in research (n = 3), including a data manager, a research nurse and, a PhD candidate. An overview of participants´ characteristics is presented in Table 1.

Table 1.

Demographics (N = 16)

Characteristics	Total population
Age, average (SD)
Age in years	45.7, range 29–61, (8.9)
Sex, n (%)
Male	4 (25%)
Female	12 (75%)
Profession, n (%)
Medical specialist	13 (81.3%)
Other1	3 (18.8%)
Completed PhD, n (%)
Yes	13 (81.3%)
No	3 (18.8%)
Years working in this hospital, average (SD)
Years working in this hospital	9.2, range 0–22 (6.7)
Years working as a researcher in this hospital, average (SD)
Years working as a researcher in this hospital	4.7, range 0–11, (4.0)

Note: SD = Standard Deviation

n (%) = percentage of total population

¹Other: other healthcare professionals actively participating in research

The results are structured within the three components of the COM-B model: capability, opportunity, and motivation.

Capability

Having the necessary knowledge, skills, and abilities to conduct research was mentioned as a facilitating factor (Table 2). This involves knowledge of practical matters such as submission procedures, having the skills to set up databases and to perform statistical analyses, the ability to draft proposals and submit them in the study management system, and structuring the participant inclusion and follow-up. In this context, one interviewee mentioned the digital developments in research over the past 10 years: “During the 10 years in which I wasn’t involved in research, it all became digital. So, I actually would’ve needed a basic course on the digital tools and technologies used in the hospital.” (P01).

Table 2.

Factors influencing capability, opportunity and motivation

Capability	Opportunity	Motivation
Facilitators	Facilitators	Motivators
Research knowledge (e.g. of practical matters)	Assistance of trained, experienced, and enthusiastic research personnel	Improvement of health care
Research skills (e.g. setting up databases and statistical analyses)	Protected research time	Importance of research in education (e.g. stimulating residents in their education and career development and obtaining a license to offer specialist training)
Research related abilities (e.g. drafting proposals)	Research support services (e.g. statistical support)	The enjoyment of scientific research
	A motivated and ambitious environment
Barriers	Barriers	Demotivators
A lack of research skills (e.g. setting up databases)	A lack of protected time (due to high production pressure, low staffing levels, and irregular work schedules).	Intangibility of research
A lack of knowledge (e.g. of new software or systems, applying AI and data infrastructures)	Distractions (e.g. work-related phone calls and patient care)	Practical barriers (e.g. a lack of adequate digital infrastructure, such as databases or tools, or sufficient time)
	Limited availability of financial resources	Rejections for grant applications
	Insufficient research support services from dedicated research personnel (e.g. limited availability of statistical support or a lack of support in building databases)	A lack of support for science within the department and the hospital
	Outdated software, suboptimal programmes and a need for modern data infrastructures and software (e.g. AI)
	A lack of motivation within the department
	A negative attitude from colleagues

Note: The table reflects the responses from the interviews, meaning that some factors are mentioned both as a facilitator and as a barrier, depending on their presence or absence

As reported by participants, a factor can serve as a facilitator or a barrier and may also be experienced as a demotivator when its absence negatively impacts motivation

On the contrary, a lack of knowledge and skills, such as setting up databases, working with new software or systems, applying Artificial Intelligence (AI), and selecting an appropriate data infrastructure, was considered a barrier to conduct research. Regarding databases, one interviewee noted: “Finding the time to actually create that database, to delve deeper into how it all works, that’s simply not possible with the daily clinical workload.” (P03) In another interview, an interviewee commented the following on AI and data infrastructure: “[AI] would be fantastic, but what infrastructure should we use? What programmes are we going to use for it?” (P13) The interviewee then continued: “And then, of course, there’s a single pipeline with all kinds of biodata. How are we going to structure that? We really need help with that.” The interviewee concluded: “Because at some point, once you have the right infrastructure, the right people, and everything is properly organised, it becomes a system that keeps running.”

Opportunity

Environmental factors

Several environmental factors for conducting research were mentioned. The presence and assistance of trained, experienced, and enthusiastic research personnel was frequently mentioned as a facilitating factor supporting the initiation and continuation of scientific research. When talking about the departments’ research nurse, one interviewee commented: “And that really is, well, that’s our gold…if that falls away, then I do not know how to properly continue.” (P05) Another interviewee mentioned the role of time in this context as well: “These people should be fully dedicated to research. If you want to conduct high quality research, you can’t keep trying to do something in your spare time.” (P13).

Protected research time during working hours is a major facilitator, while its absence is one of the most significant barriers. This is caused by factors such as high production pressure for patient-related care, low staffing levels, and irregular work schedules. Regarding the high production pressure, an interviewee said, “There is just constantly a knife at your throat: you have to meet your production numbers, you have to get rid of the waiting lists.” (P06) Additionally, an interviewee mentioned being continuously distracted by phone calls or questions from colleagues about patient care during attempts to do research. Another interviewee indicated: “There isn’t really any room [for research] within the hospital and that’s partly because it is, understandably, very focused on patient care and production.” (P07).

Another commonly mentioned factor affecting research opportunities is the limited availability of financial resources to cover the salaries of research staff or fund certain research processes. Respondents noted a general lack of available funding, both internally within the hospital and externally through grants, and even when funding is secured, it is frequently insufficient to complete the research. Applying for research funding was described as highly time-consuming and burdensome, with a low success rate, which may discourage some from pursuing it. Moreover, limited awareness of the available funding opportunities that do exist further hampers access, and participants expressed a clear need for support or guidance in identifying and navigating these options.

In addition, research support services at the hospital are considered a facilitating factor. For example, not receiving enough statistical support and/or support in writing grant applications was perceived as a barrier. On a more technical level, interviewees experienced problems with outdated software, suboptimal programmes, and a lack of support in building databases. Barriers in this area are often linked to time issues, with one interviewee stating that building a database is necessary but takes up too much of their time: “… it just takes a lot of time to do it yourself and that is the biggest hurdle to get started…” (P03) Furthermore, there is also a need for new programs that could expand the current range of options and investments in modern data infrastructures and software, for example in the field of AI.

Social factors

A motivated and ambitious work environment plays a major role in stimulating scientific research. An interviewee indicated that when the medical department attaches importance to science and supports employees in conducting research, an inspiring environment is created in which other employees can also join in. Subsequent influences are enthusiasm, appreciation, and support from colleagues, even when they are not conducting research themselves. An interviewee stated: “Not everyone needs to become a scientific expert, but…well, it would be helpful to receive support from the department.” (P05) Another facilitating factor is having contact with researchers from other departments, especially when one’s own department cannot provide this.

A lack of motivation within the department or a negative attitude from colleagues is perceived as a barrier to conduct scientific research. This manifests itself in grumbling, for example. An interviewee explained: “And that grumbling is mainly in ‘yeah, gosh, she’s on the work floor so little and the waiting times for that person are running so high.’ " (P06) Another interviewee indicated: “There are also people who do not see the point. They say, you only do research for yourself.” (P12).

Motivation

Several motivators to conduct research were mentioned. Many interviewees experience research as a moral obligation to improve care for patients, and to contribute to the further development of their profession. An interviewee indicated: “My drive to perform research is really to see, if we can treat patients in a better way.” (P01) Another interviewee explained: “I just want to know if what I’m doing…is working well and if it is helping patients adequately.” (P04) Another interviewee stated: “I think that’s one of the most important things in the future of medicine: that we continue to evaluate whether what we’re doing is best, and to look at new innovative ways to optimize patient care.” (P14) A number of interviewees also indicated that they see research as an opportunity to address bottlenecks they encountered in their daily work.

Another motivation that was mentioned several times is the importance of research in education, as research was seen as an essential part of education. One interviewee indicated: “I really enjoy stimulating analytical thinking in residents, because that happens a lot in research.” (P02) Furthermore, scientific output is one of the requirements that must be met by a department in order to train doctors to become specialists in the Netherlands. For certain departments, this serves as a motivation to improve their research activities in order to obtain this license. Another interviewee indicated: “Yes, I also think it is important for educational reasons, because doing research really stimulates thinking differently… looking differently at guidelines, providing an evidence-based support for prescription behaviour.” (P06) Several interviewees indicated that research contributes to an attractive workplace due to its impact on career development and its role in meeting the requirements necessary to educate doctors to become specialists. Finally, in depth research skills were mentioned as a positive impact for young people on their career opportunities.

The majority of interviewees indicated that they find scientific research fun, interesting, and enjoyable. An interviewee explained: “Just out of intrinsic motivation, because it simply gives energy and it is fun to do.” (P14) Some see collaboration in the scientific field with colleagues from other departments and disciplines as stimulating and enriching. For example, an interviewee stated: “And I also find the collaboration hospital-wide just really fun and useful.” (P09) Another interviewee added: “Of course, every specialty just has its own capabilities as well as its own gaps, but where we complement each other, the gain is greater than you anticipated in advance.” (P10).

Despite the many different motivations for research, some demotivating factors have also been identified. For example, research is sometimes seen as something intangible. That is, it is not always clear what progress has been made. Practical barriers, such as a lack of databases or adequate infrastructure and, sufficient time, regularly lead to frustration and demotivation. Repeated rejections for grant applications are also perceived as demotivating. An interviewee stated: “It is too much effort for the chance of rejection and there are so many other things lying around that it is not worth the energy leak to me.” (P06) Finally, a lack of support for science within the department and the hospital was mentioned as a demotivating factor.

Discussion

This study has demonstrated that researchers within departments of this large non-academic teaching hospital experience both facilitating and hindering factors that affect their ability to conduct research, reflecting both their individual experiences, their perceptions of departmental practices, and the hospital-wide research culture.

Principal findings

Capability

Capability to engage in research was related to having the necessary knowledge and skills, such as familiarity with submission procedures, setting up databases, performing data analyses, and structuring the participant inclusion process. These findings are consistent with previous findings [5, 12–14], which also identifies skills and knowledge to be insufficiently present with respect to conduct research.

Some interviewees highlighted that the rapid digitalisation of scientific research over the past decade has influenced their capability to engage in research. This was related to, for example, practical knowledge of applying AI. These digital gaps appear to represent a novel barrier, since these were not mentioned in previous literature. AI and shared databases are playing an increasingly important role in healthcare, leading to a growing need for knowledge in the field of data management and data security.

These findings imply that efforts to promote research engagement within hospitals should focus on providing training and support in practical research skills and knowledge (e.g. statistical analyses). Additionally, strengthening education and support in areas such as digital research tools and emerging technologies (e.g. AI tools) is essential to ensure healthcare professionals acquire and maintain the necessary knowledge and skills to participate in research activities and keep them up to date with the advancements in research tools.

Opportunity

Research opportunity is created by several environmental factors. Our findings, consistent with the existing literature [5, 12–14], highlight the importance of support such as the availability of trained and experienced research staff, receiving dedicated research time, having access to financial resources, and having support services available (e.g. statistical support and help with grant writing).

Furthermore, our study identified the need for modern data infrastructure, including AI tools, as a factor influencing research opportunities. This finding extends current knowledge by highlighting the emerging challenges and needs related to the advancement of digital technologies in healthcare research.

In addition, a motivating research environment, characterized by recognition and appreciation from colleagues and opportunities for interdisciplinary research collaboration, also plays a key role in the opportunity to take part in research activities. This aligns with prior studies [5, 12, 13], which emphasizes the importance of an open research culture for taking part in research activities.

Previous literature also discussed problems surrounding the lengthy ethical regulatory process [5], but this issue did not emerge in the present study. One possible explanation is that the participating large non-academic teaching hospital revised the ethical process regarding consent in the previous year. The lead time for consent has since been reduced from several months to several weeks and is therefore no longer considered a barrier for this organisation. This underlines the importance of a smooth ethical process which has a clear submission procedure and a minimal approval time duration.

Our findings highlight the importance for hospitals to create a research culture in which research findings are broadly displayed and appreciated, where co-workers support each other in doing research and where researchers are interdisciplinary collaborating. Such connections help researchers seek mentorship, peer support, and opportunities to learn and share ideas. A previous study demonstrated that a positive research culture within a healthcare service will lead to greater engagement in research within the organization [18]. Another study noted that research networks can support collaboration between clinicians and institutions, which helps promote research activity, strengthen a research-oriented culture, and facilitate the adoption of innovations in healthcare [10].

Motivation

The interviewed healthcare professionals were found to be primarily intrinsically motivated. Many emphasized that they see scientific research as a way to improve the quality of care, optimize patient outcomes, and contribute to the innovation and efficiency of care.

The connection between research and education was also mentioned as a motivator, where research offers an opportunity to train young professionals and provide a stimulating place to work. Demotivators include time constraints, lack of visible progress, insufficient infrastructure, and repeated grant rejections.

The literature shows a similar picture, but additionally highlights skill development, career advancement, and reputation as motivators for research engagement [12, 13]. These motivations were rarely mentioned by respondents in the current study. This may be explained by the fact that this study took place in a non-academic hospital, where conducting research is rather a choice than an obligation. One interviewee confirmed this view, expressing a preference for a less competitive and academic environment, and stated that the competition often seen in academia was not something she desired. Future research is needed to further explain this finding.

To support and strengthen motivation for research engagement, hospitals should actively communicate the contributions of research to healthcare improvements. Additionally, the crucial link between research and education must be emphasized. Practical measures could include providing students with structured research opportunities and ensuring that supervisors have sufficient protected time and resources to offer effective guidance.

These findings have important implications for hospitals to further optimize their research activities, by focusing on the mentioned enablers and minimizing the barriers.

Receiving dedicated research time appeared to influence capability, opportunity, and motivation to engage in research. For example, having time to learn how to create databases influenced capability. Without protected time, balancing research activities with clinical duties becomes challenging, which can limit the quality of the study as well. These findings highlight the importance of providing healthcare professionals with sufficient time away from patient care to focus primarily on research, enabling them to develop necessary skills and professionalize their capability to execute their studies.

Strengths and limitations, and recommentations for future research

Several considerations may have influenced the research and its findings. The first consideration relates to the sample selection and study setting. The use of purposive sampling may have introduced selection bias, which could limit the generalisability of the findings, particularly to hospitals or departments without established research activity. However, the 10 departments included in the study cover a wide range of clinical specialties, thereby broadening the scope of the study. Additionally, the study was conducted in a single non-academic hospital. This specific institutional context may limit the generalisability of the findings to other hospitals.

Secondly, the presence of the Dean of Science and the Staff Manager during some of the interviews may have influenced participants’ willingness to express critical views. Although considerable attention was paid to creating a confidential and safe interview environment, and both individuals adopted a background role during the interviews, their presence may nevertheless have affected the openness of responses.

However, a wide range of facilitators and barriers were mentioned, from which a depth of knowledge on how to support research engagement could be retracted. Future research could focus on including departments with minimal research activity to further explore barriers to conducting research and to identify strategies for promoting research in these contexts. Second, comparative studies across multiple hospitals, including academic, non-academic, and non-teaching settings, could enhance understanding of contextual differences in research engagement. Finally, future research could investigate how research networks and inter-organizational collaboration facilitate and strengthen the conduct of research in hospital settings, exploring the potential impact on both research activity and the integration of research into clinical practice.

Key recommendations

• Provide research training focused on practical skills, while strengthening support in digital research tools and emerging technologies to ensure healthcare professionals acquire the necessary knowledge and skills to engage in research.

• Provide dedicated research time, practical assistance from research staff, and access to research support services (e.g. statistical analyses, help with grant writing).

• Provide the necessary digital infrastructure, tools, and software to enable effective research practices.

• Foster a research culture that promotes recognition and appreciation for research efforts and offers opportunities for interdisciplinary collaboration.

• Actively communicate the impact of research on healthcare improvements to motivate engagement.

• Emphasize the link between research and education by offering structured opportunities for students and ensuring supervisors have protected time for guidance.

Conclusions

This study underscores the critical need for hospitals to actively foster a broad and inclusive research culture. Such a culture promotes collaboration across departments and disciplines, disseminates research findings, and motivates healthcare professionals to engage in research activities by actively recognizing and appreciating efforts.

Research participation can be strengthened through the provision of dedicated protected research time, practical assistance from research staff, access to financial resources, and support with grant applications. Furthermore, modern data infrastructure and digital tools, such as AI programmes, should be available, alongside adequate education, training, and expertise to use these technologies.

Additionally, a strong connection between research and education is essential: students should be encouraged to participate in research, and supervisors must receive allocated time for effective guidance.

Addressing these areas will enable hospitals to overcome emerging challenges and foster a sustainable, innovative research environment that drives healthcare improvement.

Supplementary Information

Below is the link to the electronic supplementary material.

Abbreviations

AI

Artificial Intelligence

COM-model

Capability, Opportunity, Motivation, Behaviour model

SD

Standard deviation

Author contributions

CG was responsible for the study process, including the conceptualization and design, data collection by conducting interviews, data analysis & interpretation, and writing the main manuscript. MK conducted interviews for the data collection and provided substantial feedback on the manuscript. MK also contributed to the design of the interview topic list. LS assisted with the data analysis & interpretation of two interviews and later provided feedback on the manuscript. ST supervised the entire study and contributed to the design and conceptualization, conducted interviews, and provided substantial feedback throughout the whole process.

Funding

This research received no funding.

Data availability

Due to confidentiality, full transcripts are not shared but are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

The institutional review committee of the Albert Schweitzer hospital has positively reviewed the research proposal (#2025.025). The committee confirms that the rules laid down in the Medical Research Involving Human Subjects Act (also known by its Dutch abbreviation WMO), do not apply to this research proposal. The study was approved by the Board of Directors of the Albert Schweitzer Hospital. All participants provided written informed consent prior to their involvement in the study. Our research was conducted in accordance with the Declaration of Helsinki.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.