ARCS model, breastfeeding, complex intervention, goals, motivation, theory, evidence-based midwifery

Welcome to the first edition of EBM in 2014 – the year theICM Congress is held in Prague. A staggering 1360 abstractsfrom midwives in 85 countries were peer reviewed and overa 1000 papers selected for presentation (ICM, 2014). Weare delighted that research is gaining an even higher profilewithin the profession and that midwifery researchers have anincreasingly visible role. However, with this elevation comesincreased accountability and the need for midwives to developa research integrity code of practice, if we are to maintainpublic trust and confidence in a research world that is beingtorn apart by frequent exposure of plagiarism, lies and fraud.The new ‘Retraction Watch’ publication data providessober reading about the number of research papers that havebeen removed from prestigious journals because of datafalsification or interpretation. Top science scandals for 2012included biomedical researcher Eric Smart, who fabricated10 years of data using laboratory mouse models that neverexisted; work that contributed to our scientific knowledgebase on cardiac disease and diabetes; Annie Dookhan, aforensic chemist from Massachusetts, was exposed forfabricating records on samples she never processed, leadingto possible wrongful imprisonment (Zielinska, 2012).However, the record for retraction of scientific papershas been set by Japanese anaesthesiologist Yoshitaka Fujii,who pulled 172 papers after being exposed for fabricationof clinical research data, operating without ethical approvaland claiming to have seen patients that he did not (Zielinska,2012). Furthermore, the highly publicised work of Dong-PyouHan (Iowa University funded by the US NIH for over $19m)brought us a breakthrough vaccine for AIDS in 2012, but itwas faked by spiking rabbit blood with human antibodies tocreate a false belief that the vaccine was creating the desiredimmune defence (Leys, 2014).In 2010, the American Senate introduced the WhistleBlower’s Enhancement Protection Act. According to theUnion of Concerned Scientists (2010), this was to protectresearchers who found themselves either having to upholdtheir research integrity in order to protect the public (andconsequently losing their job), or keeping quiet about issuesof observed untruthfulness, fraud, abuse and illegality(sacrificing their integrity), in order to remain employed.Although the opportunity to whistleblow is now a protectedoption in the UK, concerned researchers continue to driveforward a culture of integrity and transparency that preventsthe reputational damage associated with whistleblowing.Taking a lead on the need for future researchers and innovatorsto act with integrity, Harvard Business School reported thefindings of a survey of 2000 US psychology researchers, whowere asked to report on the prevalence of questionable researchpractices and incentives for truth-telling (Johnston, 2012).The results revealed that research integrity was questionableon a larger scale than previously thought, with one in 10researchers owning up to falsification of data and three in10 doubting the integrity of their own research. Fortunately,there are no midwives identified yet. However, we must beproactive not reactive. Midwives can be brought down likeany other researcher who is tempted by money, prestige or theneed to achieve academic or professional status in a restrictedeconomic climate, where competitiveness and ambition canlead to decision-making that brings quick, short-term gains,but harms, disrupts and fails public confidence in the long term.Overall, reports of dishonest healthcare researchers indicatethat the research community is under the microscope.Consequently, in 2014, the term ‘honest broker’ is becomingincreasingly familiar, as researchers aim to restore publicconfidence and trust related to the use of data and alignmentof politics, policy, research and practice (Pielke, 2010). Asmidwives, there is a reality that women now act as their ownhonest brokers, when they turn to other women in chat rooms,social networks and tweets to seek the truth and deliberatelyavoid professional, evidence-based resources. A loss ofconfidence in midwives’ advice may be understandable; butperhaps it is time for midwives who may have been motivatedto misrepresent or mislead through the way in which theygenerate or direct evidence-based practice, to respond to thecall for truth-telling and re-direct their innovation towardsexcellence in women-centred care, before either ‘big brother’software finds them out or a whistleblower emerges.Professional, legal and moral research training is not aluxury, it is a necessity as midwives and the public need to haveconfidence in evidence that was honestly and transparently