Sustaining collaborative research in nursing and health care: reflections on six South African case studies

Aim A learning health system relies on continuous research using practice-based data to improve healthcare delivery and health outcomes. Given the complexity of healthcare systems and challenges in South Africa, collaborative research provides an important mechanism for producing relevant knowledge by integrating expertise from multiple professions and disciplines. However, collaborative research initiatives are not inherently successful, and unmet objectives may lead to strained relationships and inefficient use of resources. In South Africa, nurses play a central role in healthcare delivery. This study explores how individual, team, leadership, and contextual factors influence sustained commitment and outcomes in collaborative research in nursing and health care. Method A multiple case study approach with narrative reflections was used to explore influencing factors from six different research collaborations. Two nursing-qualified academics wrote narrative reflections, adopting the: describe, examine and articulate learning framework of successful and unsuccessful cases of research collaboration. The narratives were co-coded and a cross-case thematic analysis was conducted. Findings The findings identified five interconnected themes: collaboration dynamics; research outcomes; individual engagement; team performance, and leadership. Successful collaborations were characterised by commitment, trust, role clarity, expertise, effective leadership, and productive team functioning, leading to knowledge dissemination and capacity building. Unsuccessful collaborations were associated with unclear roles, disengagement, power imbalances, inadequate leadership, and contextual barriers that hindered progress and achievement of intended outcomes. Conclusion The themes informed the development of a conceptual framework to provide guidance for healthcare practitioners, researchers, nurse educators, and policymakers to enhance the effectiveness and sustainability of research collaborations to support learning, knowledge generation, and mobilisation for continuous improvement within South African health systems.