Innovative strategic Canadian research training from TomorrOw's Research Cardiovascular Health Care Professionals (TORCH)

Cardiovascular research training is experiential, and "skills" are traditionally acquired through a master-apprentice paradigm. The complexity of contemporary clinical research requires a new model for research training. Facilitated through a Strategic Training Program Initiative, the Canadian Institutes of Health Research (CIHR), with its partners the Alberta Heritage Foundation for Medical Research and the Heart and Stroke Foundation, supported the Universities of Alberta and Calgary to create a new and innovative training model. Tomorrow's Research Cardiovascular Health Professionals (TORCH) is an integrated 2-year program for health care professionals from diverse disciplines to be mentored toward careers as leaders in translational cardiovascular research, applying discovery to human health. This report describes the vision, mission, core values, objectives, design and curriculum of the program. Our vision is the development of a new generation of cardiovascular research clinician-scientists, with particular emphasis on thought, leadership and collaboration. The program incorporates 4 core values: innovation and discovery, a translational and transdisciplinary focus, an emphasis on collaboration and integration of research concepts, and the teaching of a core body of research knowledge coupled with real-world "survival" skills. The core curriculum, organized according to a cluster concept, traverses the 4 pillars of the CIHR. Through the medium of 1-hour weekly videoconferences, the curriculum cycles through case studies, seminars and a journal club in focused areas of cardiovascular research. Mentors in the TORCH program have diverse backgrounds that epitomize the transdisciplinary translational aspects of the program and are chosen for their proven record of research accomplishment and prior history of successful mentoring. The program has recruited 19 trainees from a broad cross-section of disciplines, integrating 2 University of Alberta campuses. The preliminary experience has been both favourable and gratifying.     

Clinician-scientist trainee: a German perspective

Clinician-scientists are particularly well positioned to bring basic science findings to the patient's bedside; the ultimate objective of basic research in the health sciences. Concerns have recently been raised about the decreasing workforce of clinician-scientists in both the United States of America and in Canada; however, little is known about clinician-scientists elsewhere around the globe. The purpose of this article is two-fold: 1) to feature clinician-scientist training in Germany; and 2) to provide a comparison with the Canadian system. In a question/answer interview, Rory E. Morty, director of a leading clinician-scientist training program in Germany, and Katrin Milger, a physician and graduate from that program, draw a picture of clinician-scientist training and career opportunities in Germany, outlining the place of clinician-scientists in the German medical system, the advantages and drawbacks of this training, and government initiatives to promote training and career development of clinician-scientists. The interview is followed by a discussion comparing the German and Canadian clinician-scientist development programs, focusing on barriers to trainee recruitment and career progress, and efforts to eliminate the barriers encountered along this very demanding but also very rewarding career path.     

Predicting citation impact from altmetric attention in clinical and translational research: Do big splashes lead to ripple effects?

Publications are commonly used to evaluate the productivity and impact of research programs. Traditional metrics examine publication impact through slowly accumulating academic citations. “Altmetrics” are a new way to describe early publication influence in nonacademic media/community spheres (news, tweets, and blogs). Articles with significant altmetric attention make a big splash of immediate impact, whereas papers with high rates of academic citation reflect ripple effects of influence over time. Past research has found weak associations between altmetrics and academic citations. However, no previous research has focused on clinical/translational research, which aims to translate scientific discoveries to public use. Further, no previous research has assessed the relationship between altmetrics and modern citation impact factors like the National Institutes of Health (NIH)’s Relative Citation Ratio (RCR). It is also unclear whether publication in journals with higher journal impact factors (JIFs) may drive both public attention and academic impact. We investigated whether early altmetric indicators of splash predict citation ripples, beyond the effect of the JIF. For a portfolio of 2188 publications supported by the NIH’s Georgia Clinical and Translational Science Alliance from 2007–2020, we collected 2020 Altmetric Attention Scores (AAS), 2020 JIFs, and 2021 RCRs. All three were significantly correlated with one another. Regression analyses revealed that AAS significantly predicts later RCR, controlling for JIF and publication year. Findings indicate that in clinical/translational science, articles that make a big splash of altmetric attention have ripple effects through increased citation influence, which is not entirely due to publication in higher impact journals. Altmetric attention may be a useful early indicator of eventual influence and potential for translational advancement.

Study Highlights

• WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?

Past research, in many fields of research, has found weak associations between publication altmetrics and raw academic citation count. It unclear whether any association is due to publication in higher impact journals.

• WHAT QUESTION DID THIS STUDY ADDRESS?

We investigated whether, within clinical/translation publications, early altmetric scores predict later citation influence (using the Relative Citation Ratio, a citation impact factor adjusted for field and time since publication), beyond the effect of the journal’s impact factor.

• WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?

Using regression analyses, we found that in clinical/translational science, articles that make a big splash of altmetric attention have ripple effects through increased citation influence, which is not entirely due to publication in higher impact journals.

• HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE?

Altmetric attention may be a useful early tool for gauging the eventual influence and potential for translational advancement of published clinical/translational research.     

Teaching Translational Research to Medical Students: The New York University School of Medicine's Master's of Science in Clinical Investigation Dual‐Degree Program

To develop the next generation of translational investigators, New York University School of Medicine (NYUSOM) and the NYU‐NYC Health and Hospitals Corporation Clinical and Translational Science Institute (NYU‐HHC CTSI) developed the Master''s of Science in Clinical Investigation dual‐degree (MD/MSCI) program. This 5‐year program dedicates 1 year to coursework and biomedical research, followed by a medical school/research overlap year, to prepare students for academic research careers. This paper details the MD/MSCI program''s curriculum and approach to mentorship, describes the research/professional interests of students, and reports student productivity. In the first 4 years of the program (2010–2014) 20 students were matriculated; 7 (35%) were women, and 12 (60%) research projects were in surgical specialties. To date, 14 students have applied to residency, and half pursued surgical residency programs. Our students have produced 68 accepted abstracts, 15 abstracts in submission, 38 accepted papers, and 24 papers in submission. Despite the time‐limited nature of this program, additional training in research design and implementation has promoted a high level of productivity. We conclude that dual‐degree training in medicine and translational research is feasible for medical students and allows for meaningful participation in valuable projects. Follow‐up is warranted to evaluate the academic trajectory of these students.     

The National Institute of Nursing Research Graduate Partnerships Program (NINR-GPP): An opportunity for PhD students

The Institutional Graduate Partnerships Program (GPP) offered by the National Institute of Nursing Research (NINR) provides an exceptional opportunity for students who are enrolled in any PhD program in nursing across the nation to complete dissertation research on the premier research campus of the National Institutes of Health, Bethesda, MD. The goal of this doctoral fellowship program, which is up to 3 years in length, is to train promising doctoral students in basic and clinical research. This knowledge and skill set is necessary for the next generation of nurse scientists to ultimately conduct translational research. In this article, the authors describe the program, eligibility requirements, application procedures, and selection criteria for NINR-supported GPP nursing students. Also provided are tips for interested students and outcomes of current and former NINR-supported GPP students (NINR-GPP).     

Shifting into third gear: Current options and controversies in third-year postgraduate family medicine programs in Canada

Objective

To summarize current options for postgraduate third-year programs in family medicine in Canada and compile current controversies about the expanding number of programs available and the trend toward subspecialization in family medicine.

Design

A literature search was conducted by the Regina Qu’Appelle Health Region Library research staff for Canadian family medicine fellowships and residency programs using MEDLINE, PubMed, and the Cumulative Index to Nursing and Allied Health Literature from the beginning of 2005 to September 1, 2011. All available websites for programs offering third-year options were reviewed.

Setting

Canadian family medicine residency programs.

Methods

A list of current third-year residency programs was generated from the Canadian Post-MD Education Registry. In addition, the current Canadian Resident Matching Service website was reviewed, along with every program-specific website, for current third-year programs offered.

Main findings

More than 30 different options for third-year residency programs are available, including a number of community-influenced and resident-directed enhanced-skills programs. In 2010 to 2011 there were 237 postgraduate third-year family medicine residents compared with 128 in 2010 to 2011, an increase of 109 positions.

Conclusion

Controversies over the benefits to the patient population, the practice patterns of third-year residency graduates, and the influence of a subspecialty trend against a stated goal of comprehensive family medicine continue to exist, while the number of available third-year residency options continues to expand.     

Correction: Sustained delivery of anti-VEGF from injectable hydrogel systems provides a prolonged decrease of endothelial cell proliferation and angiogenesis in vitro

Correction for ‘Sustained delivery of anti-VEGF from injectable hydrogel systems provides a prolonged decrease of endothelial cell proliferation and angiogenesis in vitro’ by Nathan A. Fletcher et al., RSC Adv., 2018, 8, 8999–9005.

One of the funding sources (NIH) was inadvertently omitted in the published article; the corrected acknowledgements section is shown below.The authors gratefully acknowledge funding support from the Boettcher Foundation (#11219) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health (#1R03AR068087). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Boettcher Foundation.The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.     

Correction: A new family of fullerene derivatives: fullerene–curcumin conjugates for biological and photovoltaic applications

Correction for ‘A new family of fullerene derivatives: fullerene–curcumin conjugates for biological and photovoltaic applications’ by Edison Castro et al., RSC Adv., 2018, 8, 41692–41698.

The authors regret that the following funding information was mistakenly omitted from the acknowledgements in the original article: “Research reported in this article was partially supported by the National Institute of General Medical Sciences of the National Institutes of Health under linked Award Numbers RL5GM118969, TL4GM118971, and UL1GM118970. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.”The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.     

Alignment of a PhD program in nursing with the AACN report on the research-focused doctorate in nursing: A descriptive analysis

Those involved in preparing the next generation of nurse scientists face numerous challenges, including but not limited to: relatively older age at completion of doctoral studies, insufficient funding for full-time PhD students in nursing, inadequate funding for nursing research, and the limited number of well-funded mentors in nursing doctoral programs. These issues have limited the number of students enrolled in PhD nursing programs and graduates to supply the research faculty of the future and generate nursing science. This phenomenon persists despite numerous calls to increase the number of PhD doctoral students and graduates and expedite the PhD process without compromising educational integrity. This article describes the BSN-to-PhD Pathway and the Accelerated (3 year) Pathway to the nursing PhD at an established research doctoral program that required a shift in the approach to student recruitment, curriculum development, and timely progression. Implications for practice and research are discussed.     

Survey of the impact of National Institutes of Health clinical research curriculum awards (K30) between 1999 and 2004.

BACKGROUND: This report summarizes a survey conducted in 2004 by the Association of Clinical Research Training Program Directors' Evaluation Committee. The purpose of this survey was to determine the early capacity of the 59 National Institutes of Health (NIH) K30 programs (funded between 1999 and 2004) to produce clinical investigators trained in core skills required in clinical research. METHODS: In July 2004, a 37-item Web-based survey was distributed to institutions funded by the NIH K30 award mechanism. Frequencies and proportions were computed for each categorical response, and means were calculated for nominal responses using SPSS, version 11.5 (SPSS, Chicago, IL). Items 7 (funding year) and 8 (recruitment year) were cross-tabulated to ascertain the tempo at which programs were able to establish their enrolment processes. RESULTS: Forty-five of the 59 programs funded by the K30 award (76%) responded to this survey. The average number of active trainees in each program is 32. Women constitute 53% of active trainees, and 22% of them are underrepresented minorities. Ninety-six percent of active trainees have medical degrees. The average number of graduates over the 5-year funding period is 18. Of the graduates, 50% are women and 17% are underrepresented minorities. Fifty-six percent of them earned certificates, 44% earned master of science degrees, and 13% earned other degrees. Sixty-one percent of K30 program graduates have some extramural funding to support their research. The average number of publications per trainee for all trainees (active and graduate) is 2.3. CONCLUSION: The K30 program has been a catalyst at multiple US institutions for improving the pedagogy for clinical research training. It has successfully fulfilled the mandate set forth by the 1998 NIH Director's Panel on Clinical Research (Nathan Report).     

Clinician scientist training program: a proposal for training medical students in clinical research.

There is national alarm about a decline in the number of clinician scientists. Most of the proposed solutions have focused on housestaff and junior faculty. We propose a new national program for training medical students in clinical research. This program, coined "Clinician Scientist Training Program" (CSTP), would consist of a combined degree program in medicine (MD) and clinical research (eg, masters in translational research or masters in clinical epidemiology). Students could enroll in the program at any stage during medical school. After 3 years of medical school, students would spend at least 2 years in a combined didactic and mentored clinical research training program and then complete medical school. Students could elect to pursue more prolonged clinical research training toward a combined PhD and MD. The CSTP is designed to meet six critical challenges: 1) engage students early in clinical research training; 2) provide a didactic clinical research curriculum; 3) expose students to several years of mentored clinical research training; 4) promote debt prevention by providing tuition payments during medical education and a stipend during clinical research training; 5) facilitate prolonged exposure to a community of peers and mentors in a program with national and institutional identity and respect; and 6) permit enrollment in the program as students enter medical school or at any stage during medical school. If the success of the Medical Scientist Training Program in training medical students in basic research is a guide, the CSTP could become a linchpin for training future generations of clinician scientists.     

Barriers for BSN students to pursue a PhD in nursing and recommendations to address them: A scoping review

BackgroundIncreasing the BSN-PhD pipeline could address the shortage of nursing faculty to conduct research, develop nursing science, and train new nurses and faculty.PurposeTo identify barriers to BSN students’ pursuit of PhD education, and to compile recommendations to increase their numbers.MethodsThis scoping review follows PRISMA guidelines, including articles in English that discussed barriers to BSN students’ pursuit of PhD education and recommendations to address them.FindingsBarriers to pursuing a PhD include misunderstanding PhD education and its impact on population-level health, insufficient funding for PhD studies, and perceived need for clinical experience. BSN program recommendations include education on doctoral and postdoctoral options, mentorship, and hands-on research experiences. PhD programs should be accessible, fully funded, and address students’ perceived need for clinical experience.DiscussionThe nursing profession must take coordinated action across individual, interpersonal, program, policy, and cultural levels to increase the pipeline of well-prepared BSN-PhD students.     

Alignment of Emergency Medicine Research Efforts with Clinical and Translational Science Awards

The Clinical and Translational Science Awards (CTSA) represent a major new funding pathway for health science investigators seeking National Institutes of Health (NIH) funds. This new pathway provides institutional-level support for clinical and translational research and is not tied to one organ system or disease process, fitting well with emergency medicine (EM) research needs. These awards open unique opportunities for advancing EM research. The CTSA mechanism provides institutional support from the NIH to promote both clinical and translational science. Of the 60 expected awards, 38 sites are currently funded. EM investigators can benefit the institutions applying for these awards and simultaneously gain from involvement. Some opportunities for participation provided by the CTSA include research training programs, joining multidisciplinary research teams, seed grant funding, and use of the CTSA-developed research infrastructure. Involvement of EM can benefit institutions by enhancing acute care research collaboration both within and among institutions. Emergency medicine researchers at institutions either planning to submit a CTSA application or with funded CTSA grants are encouraged to become actively involved in CTSA-related research programs.     

Middle-down approach: a choice to sequence and characterize proteins/proteomes by mass spectrometry

Owing to rapid growth in the elucidation of genome sequences of various organisms, deducing proteome sequences has become imperative, in order to have an improved understanding of biological processes. Since the traditional Edman method was unsuitable for high-throughput sequencing and also for N-terminus modified proteins, mass spectrometry (MS) based methods, mainly based on soft ionization modes: electrospray ionization and matrix-assisted laser desorption/ionization, began to gain significance. MS based methods were adaptable for high-throughput studies and applicable for sequencing N-terminus blocked proteins/peptides too. Consequently, over the last decade a new discipline called ‘proteomics’ has emerged, which encompasses the attributes necessary for high-throughput identification of proteins. ‘Proteomics’ may also be regarded as an offshoot of the classic field, ‘biochemistry’. Many protein sequencing and proteomic investigations were successfully accomplished through MS dependent sequence elucidation of ‘short proteolytic peptides (typically: 7–20 amino acid residues), which is called the ‘shotgun’ or ‘bottom-up (BU)’ approach. While the BU approach continues as a workhorse for proteomics/protein sequencing, attempts to sequence intact proteins without proteolysis, called the ‘top-down (TD)’ approach started, due to ambiguities in the BU approach, e.g., protein inference problem, identification of proteoforms and the discovery of posttranslational modifications (PTMs). The high-throughput TD approach (TD proteomics) is yet in its infancy. Nevertheless, TD characterization of purified intact proteins has been useful for detecting PTMs. With the hope to overcome the pitfalls of BU and TD strategies, another concept called the ‘middle-down (MD)’ approach was put forward. Similar to BU, the MD approach also involves proteolysis, but in a restricted manner, to produce ‘longer’ proteolytic peptides than the ones usually obtained in BU studies, thereby providing better sequence coverage. In this regard, special proteases (OmpT, Sap9, IdeS) have been used, which can cleave proteins to produce longer proteolytic peptides. By reviewing ample evidences currently existing in the literature that is predominantly on PTM characterization of histones and antibodies, herein we highlight salient features of the MD approach. Consequently, we are inclined to claim that the MD concept might have widespread applications in future for various research areas, such as clinical, biopharmaceuticals (including PTM analysis) and even for general/routine characterization of proteins including therapeutic proteins, but not just limited to analysis of histones or antibodies.

Enhanced sequence coverage, better identification of combinatorial co-occurring PTMs and improved detection of proteoforms are key highlights of middle-down approach and hence, this can be a promiscuous approach for protein sequencing and proteomics.     

Looking at research through a different lens: the Canadian Institute of Gender and Health

In 2001, a national research institute devoted to the study of inter-relationships among sex, gender, and health was created by the Canadian Institutes of Health Research (CIHR) as the first of its kind in the world. Established with a vision "to transform understanding of the impact of gender and sex on health across the lifespan and ensure its application in health research in Canada," the Institute of Gender and Health (IGH) supports research to address how sex (biological factors) and gender (sociocultural experiences) interact with other factors that influence health to create conditions and problems that are unique, more prevalent, more serious, or different with respect to risk factors or effective interventions for women, men, girls, and boys.     

NIH Grant Awards as a Metric of Clinical and Translational Research Training Effectiveness

The number of clinical research training programs has increased over the past 5–10 years, but few studies have quantitatively evaluated the effectiveness of these programs. The goal of this study was to evaluate the clinical and translational research training program at the University of Cincinnati by comparing the number of National Institutes of Health grants awarded to pediatric fellows who graduated from the MS degree program between 1995 and 2013 versus fellows who did not pursue an MS degree. Among 394 pediatric fellows, 16 of 81 (20%) MS alumni were awarded at least one NIH grant, as compared with 28 of 313 (9%) fellows who did not obtain an MS degree (p < 0.02). In multivariable analysis, MS alumni were more than three times as likely to have received at least one grant than were non‐MS fellows (OR = 3.5, 95% CI [1.7–7.2]; C‐statistic = 0.71) and MS alumni were more likely to obtain at least one K‐series (OR = 4.1, 95% CI [1.6–10.2]; C‐statistic = 0.74), M‐series (OR = 11.8, 95% CI [3.4–41.4]; C‐statistic = 0.81), or R‐series (OR = 10.1, 95% CI [2.4–42.8]; C‐statistic = 0.74) grant than were non‐MS fellows. These findings suggest that graduate training in clinical and translational research prepares graduates for the highly competitive field of clinical and translational research.     

Residents as teachers: Survey of Canadian family medicine residents

Objective

To examine Canadian family medicine residents’ perspectives surrounding teaching opportunities and mentorship in teaching.

Design

A 16-question online survey.

Setting

Canadian family medicine residency programs.

Participants

Between May and June 2011, all first- and second-year family medicine residents registered in 1 of the 17 Canadian residency programs as of September 2010 were invited to participate. A total of 568 of 2266 residents responded.

Main outcome measures

Demographic characteristics, teaching opportunities during residency, and resident perceptions about teaching.

Results

A total of 77.7% of family medicine residents indicated that they were either interested or highly interested in teaching as part of their future careers, and 78.9% of family medicine residents had had opportunities to teach in various settings. However, only 60.1% of respondents were aware of programs within residency intended to support residents as teachers, and 33.0% of residents had been observed during teaching encounters.

Conclusion

It appears that most Canadian family medicine residents have the opportunity to teach during their residency training. Many are interested in integrating teaching as part of their future career goals. Family medicine residencies should strongly consider programs to support and further develop resident teaching skills.     

Federally Qualified Health Centers’ Capacity and Readiness for Research Collaborations: Implications for Clinical‐Academic‐Community Partnerships

Background:

Federally qualified health centers (FQHCs) provide a health care safety net for underserved populations and contribute unique expertise to research that could further enhance quality of patient care. The purpose of this research was to assess interest in, readiness to, and capacity for conducting research in FQHCs in South Carolina (SC).

Methods:

A Web‐based survey was administered to 20 FQHCs across SC. Fourteen representatives of FQHCs completed the 39‐item survey that assessed research experience and interest, partnerships and funding, barriers and benefits to research participation, training and technical assistance needs, and research capacity.

Results:

FQHCs are interested in conducting research. FQHCs reported that health center leadership, organizational benefit, active engagement of staff, and clear roles for partners were important factors for successful partnerships. Inequity of budget and resources were the greatest challenges encountered. Improved patient outcomes, additional resources for the center, reduction in disparities, and academic partnerships were considered benefits for participation. FQHCs were interested in training and technical assistance opportunities for research funding and best practices for the use of research to inform programs and services.

Conclusions:

FQHCs are willing to collaborate on research. For successful research partnerships, collaborators should understand FQHCs’ challenges and barriers to participation.