Developing a Competency‐Based Educational Structure within Clinical and Translational Science

In the emerging field of clinical and translational science (CTS), where researchers use both basic and clinical science research methodologies to move discoveries to clinical practice, establishing standards of competence is essential for preparing physician–scientists for the profession and for defining the field. The diversity of skills needed to execute quality research within the field of CTS has heightened the importance of an educational process that requires learners to demonstrate competence. Particularly within the more applied clinical science disciplines where there is a multi‐ or interdisciplinary approach to conducting research, defining and articulating the unique role and associated competencies of a physician–scientist is necessary. This paper describes a systematic process for developing a competency‐based educational framework within a CTS graduate program at one institution.     

Vision,Identity, and Career in the Clinical and Translational Sciences: Building upon the Formative Years

This paper is the second in a five‐part series on the clinical and translational science educational pipeline. It focuses on the role that Clinical and Translational Science Award (CTSA) programs can play in supporting science, technology, engineering, and math (STEM) education in primary and secondary schools, as well as in facilitating these interests during transition to undergraduate training. Special emphasis should be placed on helping to form and sustain an identity as a scientist, and on instilling the persistence necessary to overcome numerous barriers to its actualization. CTSAs can contribute to cementing this sense of self by facilitating peer support, mentorship, and family involvement that will reinforce early educational decisions leading to clinical and translational science research careers. Meanwhile, the interests, skills, and motivation induced by participation in STEM programs must be sustained in transition to the next level in the educational pipeline, typically undergraduate study. Examples of CTSA collaborations with local schools, businesses, interest groups, and communities at large illustrate the emerging possibilities and promising directions with respect to each of these challenges.     

Solving the Puzzle of Recruitment and Retention—Strategies for Building a Robust Clinical and Translational Research Workforce

This paper is the first in a five‐part series on the clinical and translational science educational pipeline and presents strategies to support recruitment and retention to create diverse pathways into clinical and translational research (CTR). The strategies address multiple levels or contexts of persistence decisions and include: (1) creating a seamless pipeline by forming strategic partnerships to achieve continuity of support for scholars and collective impact; (2) providing meaningful research opportunities to support identity formation as a scientist and sustain motivation to pursue and persist in CTR careers; (3) fostering an environment for effective mentorship and peer support to promote academic and social integration; (4) advocating for institutional policies to alleviate environmental pull factors; and, (5) supporting program evaluation—particularly, the examination of longitudinal outcomes. By combining institutional policies that promote a culture and climate for diversity with quality, evidence‐based programs and integrated networks of support, we can create the environment necessary for diverse scholars to progress successfully and efficiently through the pipeline to achieve National Institutes of Health''s vision of a robust CTR workforce.     

Development,Implementation, and Evaluation of an Interprofessional Course in Translational Research

The advancement of research from basic science discovery to clinical application requires the extensive collaboration of individuals from multiple disciplines, therefore the ability to work as an effective interprofessional team is essential for researchers in clinical and translational science (CTS). Courses that build interprofessional skills are a key component in CTS education, but the development of these courses poses numerous administrative and educational challenges. This paper describes the processes of designing, implementing, and evaluating an innovative graduate‐level course that combines online lectures and in‐class facilitated group discussions to promote interprofessional interactions. The course offers students the opportunity to interact with and learn from individuals in a variety of disciplines, and it requires students to engage in interprofessional group work to meet the course objectives. During the past 4 years, 96 students from the schools of medicine, pharmacy, nursing, public health, and health and rehabilitation sciences at a large urban university have completed the course. The course has been well‐received, with 87% of students rating its overall quality as excellent, good, or satisfactory. The course offers educators a model to teach graduate students the skills that are essential for becoming effective CTS researchers. Clin Trans Sci 2012; Volume #: 1–7     

Mentoring in Clinical‐Translational Research: A Study of Participants in Master's Degree Programs

Research projects in translational science are increasingly complex and require interdisciplinary collaborations. In the context of training translational researchers, this suggests that multiple mentors may be needed in different content areas. This study explored mentoring structure as it relates to perceived mentoring effectiveness and other characteristics of master''s‐level trainees in clinical‐translational research training programs. A cross‐sectional online survey of recent graduates of clinical research master''s program was conducted. Of 73 surveys distributed, 56.2% (n = 41) complete responses were analyzed. Trainees were overwhelmingly positive about participation in their master''s programs and the impact it had on their professional development. Overall the majority (≥75%) of trainees perceived they had effective mentoring in terms of developing skills needed for conducting clinical‐translational research. Fewer trainees perceived effective mentoring in career development and work‐life balance. In all 15 areas of mentoring effectiveness assessed, higher rates of perceived mentor effectiveness was seen among trainees with ≥2 mentors compared to those with solo mentoring (SM). In addition, trainees with ≥2 mentors perceived having effective mentoring in more mentoring aspects (median: 14.0; IQR: 12.0–15.0) than trainees with SM (median: 10.5; IQR: 8.0–14.5). Results from this survey suggest having ≥2 mentors may be beneficial in fulfilling trainee expectations for mentoring in clinical‐translational training.     

Clinical and Translational Research Capacity Building Needs in Minority Medical and Health Science Hispanic Institutions

A preliminary needs assessment was conducted among faculty and students of three minority medical and health science institutions comprising the Puerto Rico Clinical and Translational Research Consortium (PRCTRC). The Web‐based survey was focused on evaluating the training interests in the clinical and translational research core areas and competencies developed by the National Institutes of Health‐Clinical and Translational Sciences Award. The survey was the result of a team effort of three PRCTRC key function''s leaderships: Multidisciplinary Training and Career Development, Tracking and Evaluation and Community Research and Engagement. The questionnaire included 45 items distributed across five content areas including demographics, research training needs, training activities coordination and knowledge about the services offered by the PRCTRC. Analysis of research needs includes a sample distribution according to professor, assistant/associate professor and graduate students. The thematic area with highest response rate among the three groups was: “Identify major clinical/public health problems and relevant translational research questions,” with the competency “Identify basic and preclinical studies that are potential testable clinical research hypothesis.” These preliminary results will guide the training and professional development of the new generation of clinical and translational researchers needed to eliminate health disparities.     

A Model for Developing,Evaluating, and Disseminating Best Practices in Education and Training

With the shift toward team‐based translational science came recognition that existing strategies for training individual investigators and retaining them in the biomedical workforce would be inadequate. To support this shift, it is important to: develop innovative strategies to educate and train diverse members of research teams; evaluate those programs; and disseminate best practices broadly. We have developed a four‐phase model to facilitate the development, evaluation, and widespread dissemination of innovative strategies to train the biomedical research workforce. Phase I (Innovate) involves small scale trials of programs to address perceived training needs or new methods of delivery. Phase II (Incubate) refines and evaluates promising Phase I activities on a larger scale. Phase III (Translate) seeks to replicate initial successes either locally (Phase IIIa) or with other interested institutions (Phase IIIb). Phase IV (Disseminate) assesses whether identified local best practices can have success on a broader scale. We present specific examples from our own experience that demonstrate the utility of this model, and then conclude with opportunities and challenges related to the education and training of this workforce.     

Educating the future sonographic workforce: membership survey report from the British Medical Ultrasound Society

The British Medical Ultrasound Society (BMUS), the Consortium for the Accreditation of Sonographic Education (CASE), education providers and the NHS are working together to review how best to develop education for the future sonographic workforce. There is currently a national vacancy rate of approximately 12% across NHS Trusts. Education course placements are often limited to the number of clinical training places available within departments, resulting in a disparity between vacancies and the numbers of qualified sonographers graduating. Clearly there is a need for education to match the service demand. A term often used as a solution to the workforce problem is ‘direct entry’ ultrasound education. Anecdotally this term has caused confusion amongst health care professionals and as such the aim of this work was to gain an understanding of the views and opinions of BMUS members and interested professionals about direct entry training and subsequent development of any future training programmes. BMUS undertook an online survey with 286 responses. The survey provided insight into the opinions of ultrasound practitioners and the complexities of developing a relevant educational programme for the future sonographer workforce. The results suggested a number of concerns with direct entry ultrasound programmes, including insufficient training places, lack of health care background knowledge, lack of imaging knowledge and no state registration specific to sonographers. Benefits of direct entry to ultrasound training were perceived to be increasing the number of sonographers trained each year, whilst training people in their first choice profession with skills developed specific to the sonographer role. Support for direct entry ultrasound training was limited to 51% of respondents who would advocate this form of ultrasound training if it led to qualified sonographers with the same skills as sonographers exiting from current CASE accredited programmes.     

Training the Translational Research Teams of the Future: UC Davis—HHMI Integrating Medicine into Basic Science Program

There is a need for successful models of how to recruit, train, and retain bench scientists at the earliest stages of their careers into translational research. One recent, promising model is the University of California Davis Howard Hughes Medical Institute Integrating Medicine into Basic Science (HHMI‐IMBS) program, part of the HHMI Med into Grad initiative. This paper outlines the HHMI‐IMBS program''s logic, design, and curriculum that guide the goal of research that moves from bedside to bench. That is, a curriculum that provides graduate students with guided translational training, clinical exposure, team science competencies, and mentors from diverse disciplines that will advance the students careers in clinical translational research and re‐focusing of research to answer clinical dilemmas. The authors have collected data on 55 HHMI‐IMBS students to date. Many of these students are still completing their graduate work. In the current study the authors compare the initial two cohorts (15 students) with a group of 29 control students to examine the program success and outcomes. The data indicate that this training program provides an effective, adaptable model for training future translational researchers. HHMI‐IMBS students showed improved confidence in conducting translational research, greater interest in a future translational career, and higher levels of research productivity and collaborations than a comparable group of predoctoral students.     

Pharmacology education: a theoretical framework of applied pharmacology and therapeutics

United Kingdom Government initiatives such as The NHS Plan (DoH 2000) identified the need for nurses to undertake multi-skilled professional roles. In the United Kingdom, the transition to a larger graduate nurse workforce continues, as Universities offer nurse pre-registration courses at diploma and degree levels. Concomitant with the change in educational standard is the need to teach student nurses the theoretical principles of medication management and to develop skills in clinical reasoning skills. Both elements are limited in current educational pre-registration nurse programmes, in order to develop the future, multi-skilled workforce such courses should incorporate the theory and skills of health assessment, physical examination, applied pharmacology and clinical reasoning. This paper aims to examine how knowledge of applied pharmacology and therapeutics can be integrated into an undergraduate pre-registration nursing programme. Discussion focuses on how this generic framework can provide educators with an outline of the theoretical constructs, their application, the teaching strategies involved and instruction on how to prepare nurses to clinically reason with regard to medication management issues. This framework can be adapted to accommodate nurses studying for all parts of the register.     

Teaching Research Ethics Better: Focus on Excellent Science,Not Bad Scientists

A recent report of the United States’ Presidential Commission for the Study of Bioethical Issues highlights how important it is for the research community to enjoy the “earned confidence” of the public and how creating a “culture of responsibility” can contribute to that confidence. It identifies a major role for “creative, flexible, and innovative” ethics education in creating such a culture. Other recent governmental reports from various nations similarly call for a renewed emphasis on ethics education in the sciences. We discuss why some common approaches to ethics education in the graduate sciences fail to meet the goals envisioned in the reports and we describe an approach, animated by primary attention on excellent science as opposed to bad scientists, that we have employed in our ethics teaching that we think is better suited for inspiring and sustaining responsible, trustworthy science.     

Collective intelligence for translational medicine: Crowdsourcing insights and innovation from an interdisciplinary biomedical research community

Abstract

Translational medicine bridges the gap between discoveries in biomedical science and their safe and effective clinical application. Despite the gross opportunity afforded by modern research for unparalleled advances in this field, the process of translation remains protracted. Efforts to expedite science translation have included the facilitation of interdisciplinary collaboration within both academic and clinical environments in order to generate integrated working platforms fuelling the sharing of knowledge, expertise, and tools to align biomedical research with clinical need. However, barriers to scientific translation remain, and further progress is urgently required. Collective intelligence and crowdsourcing applications offer the potential for global online networks, allowing connection and collaboration between a wide variety of fields. This would drive the alignment of biomedical science with biotechnology, clinical need, and patient experience, in order to deliver evidence-based innovation which can revolutionize medical care worldwide. Here we discuss the critical steps towards implementing collective intelligence in translational medicine using the experience of those in other fields of science and public health.

• Key Messages

• The scientific translation of biomedical research into clinical applications is protracted, despite the mass opportunity afforded by modern science.

• Barriers to translational medicine exist as a result of the impracticalities of research, organizational hurdles, and lack of an interdisciplinary workforce.

• Collective intelligence and crowdsourcing offer the potential to expedite the translational process by providing a platform upon which interdisciplinary workforces can communicate and collaborate, aligning biomedical research with clinical need revolutionizing health care worldwide.

     

Building Interdisciplinary Research Models Through Interactive Education

Background

Critical interdisciplinary research skills include effective communication with diverse disciplines and cultivating collaborative relationships. Acquiring these skills during graduate education may foster future interdisciplinary research quality and productivity.

Objective

The project aim was to develop and evaluate an interactive Toolbox workshop approach within an interprofessional graduate level course to enhance student learning and skill in interdisciplinary research. We sought to examine the student experience of integrating the Toolbox workshop in modular format over the duration of a 14‐week course.

Methods

The Toolbox Health Sciences Instrument includes six modules that were introduced in a 110‐minute dialogue session during the first class and then integrated into the course in a series of six individual workshops in three phases over the course of the semester.

Results

Seventeen students participated; the majority were nursing students. Three measures were used to assess project outcomes: pre–post intervention Toolbox survey, competency self‐assessment, and a postcourse survey. All measures indicated the objectives were met by a change in survey responses, improved competencies, and favorable experience of the Toolbox modular intervention.

Conclusion

Our experience indicates that incorporating this Toolbox modular approach into research curricula can enhance individual level scientific capacity, future interdisciplinary research project success, and ultimately impact on practice and policy.     

Opportunities and challenges in translational science

The mission of translational science is to bring predictivity and efficiency to the development and dissemination of interventions that improve human health. Ten years ago this year, the National Center for Advancing Translational Sciences was founded to embody, conduct, and support this new discipline. The Center’s first decade has brought substantial progress across a broad range of translational areas, from diagnostic and drug development to clinical trials to implementation science to education. The origins of the translational science and advances to this point are reviewed here and allow the establishment of an ambitious future research agenda for the field.     

Evaluating Various Areas of Process Improvement in an Effort to Improve Clinical Research: Discussions from the 2012 Clinical Translational Science Award (CTSA) Clinical Research Management Workshop

Emphasis has been placed on assessing the efficiency of clinical and translational research as part of the National Institutes of Health (NIH) goal to “improve human health.” Improvements identified and implemented by individual organizations cannot address the research infrastructure needs of all clinical and translational research conducted. NIH''s National Center for Advancing Translational Sciences (NCATS) has brought together 61 Clinical and Translational Science Award (CTSA) sites creating a virtual national laboratory that reflects the diversity and breadth of academic medical centers to collectively improve clinical and translational science. The annual Clinical Research Management workshop is organized by the CTSA consortium with participation from CTSA awardees, NIH, and others with an interest in clinical research management. The primary objective of the workshop is to disseminate information that improves clinical research management although the specific objectives of each workshop evolve within the consortium. The fifth annual workshop entitled “Learning by doing; applying evidence‐based tools to re‐engineer clinical research management” took place in June 2012. The primary objective of the 2012 workshop was to utilize data to evaluate, modify, and improve clinical research management. This report provides a brief summary of the workshop proceedings and the major themes discussed among the participants.     

The state of cartilage regeneration: current and future technologies

It is clear that mature human articular cartilage does not have the innate ability to regenerate. Due to this, much effort has been put forth to work on bestowing this ability. While early data focused on more basic outcomes such as percentage of defect fill, the tissue formed was a “cartilage scar” or “hyaline-like” tissue. Even with more advanced technologies, it is clear that no current procedure is able to reconstitute the native structure and function of true hyaline cartilage. As research advancement has somewhat plateaued in this regard, it is crucial that future work focuses on a multifactorial approach, treating the joint as an organ system. The purpose of this review is to update readers on the most recent literature and controversies surrounding articular cartilage regeneration. Specific focus will be placed on current technologies available in the USA and the basic science to support them.     

A Process for Teaching Research Methods in a Virtual Environment

Translating and integrating scholarship into practice is a difficult concept for students to embrace through a passive education model. Therefore, innovative teaching strategies were integrated into a translational science course for online graduate nursing students. The purpose of this project was to increase understanding of the research process and stimulate interest in translating nursing evidence into practice. The result was an effective educational strategy for teaching and learning about the research process in a virtual environment.     

The Importance of Managerial Competencies for New Graduates in Speech Pathology

The type and extent of management skills required by new graduate speech pathologists in the health care context is currently unknown. This study surveyed 47 experienced speech pathologists to investigate their perceptions of the relative importance of various management skills for new graduate speech pathologists. New graduate speech pathologists were defined as clinicians who had less than 2 years employment experience. The set of skills perceived to be most important related to management of future planning, and skills within this set included time management, prioritising work tasks, and planning goals for the work team. The second most important set of skills related to organisational practices such as being an advocate for the department/unit, and the third most important set of skills related to legislative knowledge. The implications of the results for undergraduate speech pathology education programs, professional associations, senior speech pathology managers, and public and private employers are discussed.     

From Genes to Community: Exploring Translational Science in Adolescent Health Research: Proceedings from a Research Symposium

Addressing complex adolescent health problems such as youth violence and teen pregnancy requires innovative strategies to promote protective social environments, increase healthier behaviors, and reduce the impact of health risk behaviors into adulthood. Multilevel, interdisciplinary, and translational approaches are needed to address these challenges in adolescent health. In May 2012, a group of adolescent health researchers participated in a 1‐day research symposium titled “From Genes to Community: Exploring Translational Science in Adolescent Health Research,” sponsored by the Clinical and Translational Science Institute (CTSI) of the University of Pittsburgh and the Division of Adolescent Medicine, Children''s Hospital of Pittsburgh of the University of Pittsburgh Medical Center. The research symposium offered opportunities for adolescent health researchers to share examples of translational research as well as to identify potential collaborations to promote translational research. This and subsequent issues of Clinical and Translational Science will include papers from this symposium. The studies and reviews presented range from how basic biobehavioral sciences such as functional neuroimaging and decision science can be made relevant for intervention development as well as improving strategies for community‐partnered knowledge transfer of cutting‐edge research findings to promote adolescent health and well‐being. Clin Trans Sci 2012; Volume 5: 480–481     

Achieving graduate outcomes in undergraduate nursing education: following the Yellow Brick Road

Nursing practice is a dynamic and constantly changing field within healthcare, with well-documented challenges to maintaining a suitably skilled workforce to meet the needs of the community it serves. Undergraduate nursing education provides the mandatory minimum requirements for professional registration. Each nursing program has clearly stated graduate attributes, qualities that their graduates will possess on graduation. The aim of this paper is to stimulate discussion about graduate attributes for nurses, a transferrable set of specific attributes that make nursing graduates work ready. This paper focuses on identifying specific attributes, the embedding of those attributes in nursing education, particularly through role modelling, with the aim of producing a future workforce that is knowledgeable, compassionate and confident. The graduate attributes are likened to the qualities sought by the characters in ‘The Wizard of Oz’; brains, heart and courage and the learning process as the ‘Yellow Brick Road’. There is a relative lack of discussion about role modelling by nurse educators for nursing students, a potentially undervalued learning experience that we believe must be brought to the forefront of discussions pertaining to undergraduate nursing education and achieving graduate outcomes.