Practical Tips for Supporting Clinicians Undertaking a Part-time PhD

Background: Part-time PhD students are often neglected in research and policy. Clinicians who decide to undertake a PhD usually do so on a part-time basis. It is important that supervisors are aware of the unique challenges that parttime students face. Aim: The aim is to advise supervisors on the best ways to support clinicians who are completing, undertaking, or beginning a PhD. Methods: Literature on the topic, as well as critical reflection and feedback from students was used to develop these tips. Results: Practical tips are presented here to help when supporting part-time PhD students. Conclusion: Clinicians are skilled in many areas but may require additional supports in managing time, integrating into the research environment and developing an academic identity. Supervisors have a key role in supporting their development and advocating on behalf of students when required.


Introduction
Many clinicians who decide to undertake a PhD do so on a part-time basis. Part-time PhD students are often overlooked in research, policy and funding and have been found to feel less supported and have a more negative view of the research climate than full-time research students (Neumann and Rodwell, 2009). For clinicians they are dealing with shifting identifies (Watts, 2008) that comes with being a clinician and a student. Part-time students have also been found to struggle integrating into academic culture and require assistance in how to get the best from supervision, research training and participation in academic life (Deem and Brehony, 2000). The following tips are outlined to assist supervisors in supporting clinicians who are completing their doctoral research on a part-time basis.
Hynes S MedEdPublish https://doi.org/10.15694/mep.2020.000199.1 Page | 2 Some of the tips are specific to health-care professionals, while others are relevant to anyone supervising a part-time PhD student.

Tip 1-Help your student feel part of the community/team and university
Starting a PhD can be a daunting experience for any student. A Finnish study of 602 doctoral candidates found that 33% of students did not feel as though they were members of a scholarly community (Pyhältö, Stubb and Lonka, 2009). Integrating into the team or university community can be challenging. For part-time students, this transition is especially difficult. Many part-time PhD students work off-campus and do not have the same opportunities to attend group meetings, orientation events and other activities designed to help students settle into postgraduate life.
For supervisors of part-time students, it is vital to create opportunities that allow student to feel part of the community. This may mean changing or adapting scheduled meetings or journal clubs to allow everyone to participate. Supervisors can create initiatives and environments that focus on people and happiness. If students feel a sense of collegiality over competition from the beginning it can ensure that a culture of kindness (Ball and Crawford, 2020) is a feature of their PhD journey. Fostering a culture of kindness in the research group/ lab or supervisory relationship will improve overall experience for PhD students.

Tip 2-Identity shift and tethered autonomy
Clinicians undertaking a PhD come with experience and a strong professional identity. Our identities are said to be shaped by our abilities, roles, relationships, routines, values, interests, and environment (Kielhofner, 2008). Professional identities, as well as being shaped by the context of the work, are often linked with self-esteem and lifemeaning for people (Christiansen, 2000). Clinicians undertaking a PhD undergo an identity shift from skilled clinician to student. Role conflict can be a significant source of stress for doctoral students (Mackie and Bates, 2019). They must form a new identity as a PhD student and work on their abilities and relationships, as well as getting to know the important aspects of their new environment.
The first semester of a PhD has been found to be particularly difficult for health care professionals undertaking a PhD (Armstrong, McCurry and Dluhy, 2017) as many are working full-time and studying part-time. This can make developing an academic identity challenging, with a need for constant shifting of identity. Supervisors can help with this identity shift by having these discussions with students early in the PhD and identifying areas of identity that need development. The autonomy given to PhD students is tied to the supervisor and the project requirements. There will be more possibilities, as skills develop, to be independent and self-directed. This can help with developing an academic or clinician-academic identity.

Tip 3-Know each other's boundaries
For part-time PhD students the time that they can spend on their PhDs will vary. This is further compounded by the changeable work schedules that clinicians often have. Knowing what the boundaries are in relation to meeting times and supervisory sessions should be set out. If the student chooses to work at weekends does not mean that the supervisor does. Equally if a clinician is working when a lab meeting is taking place then there should not be an expectation of attendance.
Student and supervisor should be clear about the function of the supervisory relationship as well as what it should look like to both parties (Pyhältö, Vekkalia and Keskinen, 2015). Open communication should begin before the student registers for their PhD. Knowing each other's boundaries from the start will reduce any risk of future conflict. Close alignment of expectations ensures a strong supervisory relationship (Pyhältö et al., 2015), which in Hynes S MedEdPublish https://doi.org/10.15694/mep.2020.000199.1 Page | 3 turn can help students to progress well-supporting students in writing and manging their own project (Lindsay, 2015).

Tip 4-Help the student use their time well
Clinicians undertaking a part-time PhD are likely to have many demands on their time. When starting out, students often struggle in putting together a realistic and specific work plan. The supervisor can help them plan and make the most of the time that they have available. Having discussions around how long various tasks are likely to take can be useful for setting achievable goals and prioritising work.
When students do not have the luxury of having blocks of time that they can dedicate to writing, introduce them to "snack writing" . Supervisors should encourage their students to write early and write often. Writing regularly, particularly in the mornings, for even 45 minutes at a time, can impact productivity . Supervisors can help by being specific in the feedback that they provide so students can be productive in the time available. As well as snack writing, attending one writing retreat per year (even if that means protected days alone in the library) allows for exclusive focus on the PhD.
Having a writing plan can help busy clinicians to structure their work and to use their time well, producing useful and useable work. Although there will be many competing demands, PhD time needs to be blocked out and prioritised. Students and supervisors also need to ensure that they do not let the PhD overrule other professional and personal duties (Siddiqui and Jonas-Dwyer, 2012).

Tip 5-Exploit the student's clinical skills
PhD students who are also clinicians come armed with a fully developed skillset. Conducting interviews, completing assessments, or developing interventions with participants will be familiar to students. They are likely to use reflection as part of their clinical practice which can be used throughout their PhD as a powerful self-improvement tool. Professionalism does not need to be taught as this group. These PhD students are valued and valuable colleagues and contributors who can be expected to act with integrity.
As well as clinical skills that might be essential for their PhD research, students may have connections that could help with recruitment, access to equipment and clinical space, or colleagues who can assist with data collection. Clinician PhD students are also likely to have great passion and experience in the area that they are studying.
Having clinician-directed collaboration could be important for producing sustainable interventions and implementation of research. Part-time clinician PhD students have the potential to have greater impact with their research-they have longer to scope out the need, barriers, facilitators and implementation, as well as feasibility of any research intervention/assessment (Evans, 2002).

Tip 6-Get to know your hashtags
It is easy for part-time students to feel alone in their PhD struggles. Social isolation is often experienced by PhD students (Janta, Lugosi and Brown, 2014) and may be higher yet in part-time students. Online fora are often sought out by students who feel isolated (Janta et al., 2014) and can be a link with others who have similar challenges in getting to #PhDone.
Twitter can be useful in keeping up-to-date with key researchers, academics and relevant research groups. It is often a good way to learn about training or webinars that are upcoming. Though it has its' drawbacks, PhD students use Twitter to link and discuss the tribulations of PhD life through various hashtags. Some commonly used hashtags are: Hynes S MedEdPublish https://doi.org/10.15694/mep.2020.000199.1 Page | 4 #phdchat; #OTalk; #AcademicChatter; #phdlife; #AcademicTwitter; and #phdchatter Specific to part-time PhD students are: #phdweekend and #parttimephd. Linking into this international PhD community can go some way in bridging the isolation gap, or at least helping to feel as though your student is not alone in working on their PhD over the weekend!

Tip 7-Be clear on expectations
Do not make assumptions around what is known about undertaking a PhD. The student's expectations may be very different to the reality of a PhD. Lack of transparency of university processes and problems in the supervisory relationship have been found to contribute to stress in doctoral students (Mackie and Bates, 2019). Being clear around what constitutes a PhD, what the expectations are in relation to the supervisory relationship, and having a plan for managing conflict will help to prepare both student and supervisor. Having an understanding around the ground rules of the PhD can ease tensions and provide a stronger foundation for the supervisory relationship.
Part-time PhD students, who are likely to be working full-time, will need to know any expectations that the supervisor has with regards to travel for data collection, meetings, or attendance at conferences. This should be discussed early in the PhD. Supervisor expectations in relation to productivity, writing, and progress in the PhD should also be clear. Having these conversations at the beginning of the PhD will allow for compromises to be made and realistic goals to be set. The supervisor and student should also put together a shared plan around managing conflict within the relationship that is agreed by both parties, so it is clear what to do in predefined scenarios. This should help to reduce anxiety and save time for the clinicians if they experience challenging situations during their PhD.
For those in the later stages of their PhD, having an understanding around examiner expectations is important-"It's a PhD, not a Nobel Prize" (Mullins and Kiley, 2010). Students are often unsure about what examiners look for and when they are ready to submit (Hodgson, 2017) and benefit from reassurance and discussion on this during supervision sessions.

Tip 8-Funding
There are often limited funding opportunities for students who choose to complete their PhD on a part-time basis. Depending on the topic of the research, this may be even more limited, as some areas are generally better funded than others. For many clinicians, undertaking a PhD involves significant personal and financial sacrifice (Dowswell, Bradshaw and Hewison, 2000). Resultantly, those with limited resources, who are unable to contribute financially towards a PhD, are disadvantaged or excluded. This leads to inequalities in relation to access to PhD qualifications in healthcare settings and these economic barriers to access may limit career progression. Financial insecurity is a major source of stress in doctoral students (Mackie and Bates, 2019).
There is also some evidence to suggest that students who are funded in their PhD are more likely to enter a research profession and have a greater number of publications within a few years following graduation (Nisticò, 2018). Funded PhD students also have more opportunities to participate in research-oriented activities such as visiting research groups in other countries and spend less time working part-time than those who are not funded (Nisticò, 2018). Supervisors should help students source opportunities for which they are eligible to apply-funding for fees, travel bursaries or write-up bursaries. As well as encouraging students to apply for funding, supervisors and institutions should advocate on behalf of part-time PhD students to ensure that they are included in all funding opportunities.

Hynes S
MedEdPublish https://doi.org/10.15694/mep.2020.000199.1 Page | 5 Tip 9-Monitor progress Because part-time PhDs take longer, average six years, it is easy to lose track of where the student should be in relation to their year of study. Having a clear work plan devised from the beginning that is monitored and updated regularly can help here. Planning ahead works-it might be necessary to schedule supervision sessions 12 months at a time in order to maintain progress (Watts, 2008). Because part-time clinician doctoral students may have less contact with supervisors than full-time students, they should be encouraged to self-monitor progress. There needs to be an expectation of honesty and openness in communication for this to be useful.
Maintaining regular communication and checking in with students is important when supervisors may not see students as often. Students also need to know that their progress is not being compared with their full-time counterparts. Completing a PhD involves developing new skills and learning a new academic/research language. This can be daunting, and students may need to be directed to academic writing or other institutional supports to help with this.
Students may also need to be encouraged to take a break or a holiday away from their PhD if not doing so.

Tip 10-Prepare for setbacks and delays
Over the course of a PhD, life happens. Research also happens. The student may move jobs, take leave, or there may be significant advances made in their area of research that call for major adaptations to the PhD. Students should plan for but not expect delays. Beginning with a risk assessment for the project itself is a good starting point-what could go wrong, what will happen and what will the consequences be? Having an alternative plan for the research can reduce time lost and associated stress if something happens.
Given the impact that the global pandemic, COVID-19, has had on research worldwide it is more important than ever that students have thought through a contingency plan for their projects. They also need to be able to accept the frustrations that are a part of research process (Siddiqui and Jonas-Dwyer, 2012). Maintaining motivation over the period of the PhD requires effort on the part of the student. Low motivation can impact on productivity and delay student progress but there are methods of overcoming these challenges that students can implement such as breaking down large tasks, setting deadlines, and rewarding progress .

Tip 11-Don't underestimate the power of informal supports
Half of all PhD students experience psychological distress over the course of their studies, with female students at a higher risk (Levecque et al., 2017). Workload pressures have been found to be a major contributing factor (Mackie and Bates, 2019). For clinicians undertaking a PhD, they are balancing the workload demands of a clinical job and that of a PhD student so are likely to be under extra pressure. Maintaining open communication, being flexible and supportive of students may be helpful in reducing burden.
Informal supports can be a powerful coping mechanism. Encourage your students to seek out these supports (family/friends or peers) and take regular time for themselves. Linking with other PhD students can help with moral support. Persuade your student to attend networking events, seminars or workshops a few times a year so they can meet peers. Peer learning (formal or informal) has been found to help part-time students (Stracke, 2010), with a mix of online and in-person activities working best for this group.

Tip 12-Career and future-planning
A PhD is about developing the researcher and not just the research. Clinicians undertaking a PhD are likely to take a different path after graduation than other PhD students. For supervisors to support career planning they should find out why the student initially chose to complete a PhD. Knowing the motivations can help to plan the future and the next steps with the student. Find out if the PhD was a product or a process (Park, 2005) for the student. Typically, the final stages of the PhD are stressful for students as there are uncertain career prospects (Mackie and Bates, 2019) so students may appreciate guidance around opportunities that exist for them. Supervisors may also direct students to career planning sessions or centres within their institutions that students can avail of.

Conclusion
There is little focus in the literature on the challenges that are unique to students undertaking a part-time PhD, and less so again on clinicians undertaking a part-time PhD. Different clinicians have differing needs and the tips presented above may not be applicable to all settings, all formats of part-time study, or all healthcare professionals. There has been some debate in the literature about the impact and benefits of part-time students on knowledge economy and public good (Evans, 2002) but this has yet to be evaluated. It seems likely that clinicians undertaking a part-time PhD are a valuable resource as they are skilled, professional and have the potential to bridge the gap between research and practice. As supervisors we need to encourage clinicians to undertake PhDs, support them in the process and develop them as researchers.

Take Home Messages
Healthcare professionals require specific PhD supports when undertaking a PhD in order to be productive and have the best research training experience. Supervisors should be proactive in promoting funding opportunities for parttime research students and supporting career planning. Use formal and informal supports, be clear on expectation and boundaries and help students adjust to the transition to student. Clinicians undertaking a PhD have many skills and resources that will help them to succeed in their training.

Notes On Contributors
Sinéad M Hynes BSc (Hons), PhD is a lecturer in occupational therapy at the National University of Ireland Galway and is involved in supporting and supervising postgraduate students in health sciences. ORCID ID: http://orcid.org/0000-0002-3199-7355