Negotiating research in the Emergency Department: a qualitative study of staff experience of the Distal Radius Acute Fracture Trial CAst versus SPlint (DRAFT3-CASP) RCT for distal radius fractures

Aims We sought to explore staff experience of conducting an orthopaedic trauma randomized controlled trial (RCT) in the Emergency Department (ED). The Distal Radius Acute Fracture Trial: CAst versus SPlint (DRAFT3-CASP) RCT explores the effectiveness of two treatment pathways for patients with a fracture of the distal radius that does not require manipulation. These are, a plaster cast which is removed four to six weeks later in a fracture clinic, and discharge from emergency care with a wrist splint that patients remove themselves. Methods A total of 20 multidisciplinary staff recruiting to the DRAFT3-CASP RCT from 14 NHS trusts across England took part in a telephone/online qualitative interview. Interviews were informed by Heideggerian Phenomenology and data were analyzed using thematic analysis. Results The findings highlight the struggle to undertake research in emergency settings through the overarching theme ‘negotiating research’. Staff identified three enablers of research: 1) fitting within clinical practice; 2) finding meaning; and 3) being supported. The fast pace of work and high service demand in emergency care prevented clinical staff from fully engaging with the study. Research delivery staff were vital and supported screening, recruitment, and data collection. Finding meaning in the research question by linking it to patient benefit helped staff to maintain enthusiasm despite the challenges encountered. Conclusion Negotiating research in the ED is challenging. Protected time is essential for clinical staff to undertake research training and recruitment. Research delivery teams with research expertise are vital for successful recruitment. Increased investment in research delivery staff can ensure patients are given the opportunity to take part in research studies and can promote enthusiasm for research. Cite this article: Bone Jt Open 2026;7(5):667–673.