What Drives Breast Cancer Clinical Research and Practice in Spain? Barriers and Facilitators for Achieving Best Professionalism in a Time of Crisis

High variability in clinical research and recruitment in clinical trials in oncology has generated a growing interest in the scientific literature. There are limited studies on factors affecting the performance of professionals involved and how they perceive their work. This is especially important to enable behavior patterns improvement. This study assesses Spanish multidisciplinary health professionals’ perception on clinical and translational research based on a new combination of theoretical frameworks focused on identifying variables which play a significant role on trial management and professionalism. A mixed multicenter study which included in-depth interviews (n=11), four discussion groups (n=33) and an individualized questionnaire with validated scales associated with the theoretical corpus: situation awareness, sensemaking, professional self-perception and resource scarcity. The participants, selected by theoretical sampling carried out all over Spain, included: oncologists, radiotherapists, radiologists, surgeons, pathologists, study coordinators, nurses, monitors, pharmacists, IEC members and managers. The overall items analyzed were: current and preferential participation in clinical trials; breast oncology training; hours dedicated to study; beliefs associated with oneself (professional self-image, personality, control and self-efficacy, social status); work beliefs (mindfullness, attitude, effort/satisfaction balance, burnout; workflow and recruitment; work team, coordination and cooperation; training and learning; resolution and readjusting of problems and decision making). The results of the questionnaire were compared with the participants’ narrative discourse. The psychosocial factors that impacted the most on job performance were multidimensional. Interdependent variables with a greater influence for achieving professionalism were the self-perception and personality. Professional identity and full attention to work performance were negatively affected by the number of work stressors, emotional vulnerability, resource scarcity and job insatisfaction. This was especially recurrent in coordinators, monitors and pharmacists. These results will allow designing transformative strategies to improve more target-oriented professional performance and the creation of more dynamic and effective teams and organizations in research and recruitment.