Association of Learning Styles with Research Self‐Efficacy: Study of Short‐Term Research Training Program for Medical Students

Purpose

With a growing need for developing future physician scientists, identifying characteristics of medical students who are likely to benefit from research training programs is important. This study assessed if specific learning styles of medical students, participating in federally funded short‐term research training programs, were associated with research self‐efficacy, a potential predictor of research career success.

Method

Seventy‐five first‐year medical students from 28 medical schools, selected to participate in two competitive NIH‐supported summer programs for research training in aging, completed rating scales to evaluate learning styles at baseline, and research self‐efficacy before and after training. We examined associations of individual learning styles (visual‐verbal, sequential‐global, sensing‐intuitive, and active‐reflective) with students’ gender, ranking of medical school, and research self‐efficacy.

Results

Research self‐efficacy improved significantly following the training programs. Students with a verbal learning style reported significantly greater research self‐efficacy at baseline, while visual, sequential, and intuitive learners demonstrated significantly greater increases in research self‐efficacy from baseline to posttraining. No significant relationships were found between learning styles and students’ gender or ranking of their medical school.

Conclusions

Assessments of learning styles may provide useful information to guide future training endeavors aimed at developing the next generation of physician‐scientists.     

Community Representatives’ Involvement in Clinical and Translational Science Awardee Activities

Objectives

To understand the formal roles of community representatives (CRs) in Clinical and Translational Science Awardee (CTSA) activities, to evaluate the extent of integration into the organizational and governance structures and to identify barriers to effective integration.

Methods

The inventory tool was distributed to each of the 60 CTSAs using a secure web application.

Results

Forty‐seven (78%) completed the inventory. The mean number of CRs per CTSA is 21.4 (SD: 14.8). Most CTSAs had community advisory boards (89%) and 94% included CRs in Community Engagement (CE) cores. Only 11% reported a CR being a member of the CTSA leadership team and 19% reported that CRs advise core programs beyond CE.CRs are compensated by 79% of CTSAs. Mean annual compensation is $753 (median: $400). Compensation directly correlated with the number of hours that CRs worked in CTSA activities (r = 0.64; P = 0.001).

Conclusions

This inventory allows CTSAs to better understand how CRs have engaged in activities and brings attention to the limited representation among cores and in leadership roles. CTSAs should, with substantive input from CRs, develop strategies to provide the resources and compensation necessary to better integrate the community in CTSA activities and fully realize the goals of the CTSA vision.     

Understanding the Supports of and Challenges to Community Engagement in the CTSAs

Background

The Clinical and Translational Science Award (CTSA) program has raised the profile and the available funding for engagement in biomedical research. Such increased funding and attention may address known barriers to engagement. However, little work has been done to describe experiences across multiple CTSAs, especially how the CTSA structure supports or challenges engagement.

Objective

We sought to understand the supports and challenges experienced by multiple CTSAs as they pursued community engagement. This knowledge may help guide future efforts to support and enhance community engagement in biomedical research.

Methods

We conducted semi‐structured, in‐depth interviews with CTSA community engagement core leaders and staff from the 2006 cohort of CTSAs (n = 12).

Results

A total of 17 interviews with respondents from nine institutions identified three support themes, including: funding, existing relationships with communities, and leadership and a partnership approach at the institution. Six challenge themes arose: need for capacity development, lack of positive relationships with communities, lack of leadership, funding constraints, time and staff constraints, and unsustainable models.

Conclusion

The CTSAs have brought much‐needed attention to community engagement in research, but more can be done to adequately support engagement. Challenges remain that need to be addressed to achieve the potential benefits of engagement.     

Enhancing Dissemination,Implementation, and Improvement Science in CTSAs through Regional Partnerships

Background and Importance

Challenges in healthcare policy and practice have stimulated interest in dissemination and implementation science. The Institute of Medicine Committee on the Clinical Translational Science Award (CTSA) program recommended expanding the CTSA program''s investment and activity in this domain. Guidance is needed to facilitate successful growth of DII science infrastructure, activity and impacts.

Objectives

Several CTSAs in Southern California collaborated to identify and respond to local challenges and opportunities to expand dissemination, implementation and improvement research by strengthening capacity and relationships between DII researchers and community, health system, and population health partners.

Main outcomes

Planning and outreach by the Southern California CTSAs increased awareness and interest in DII research and generated recommendations for growth. Recommendations include: increasing strong partnerships with healthcare and population health systems to guide policy research agendas and collaborative DII science; promoting multi‐sector partnerships that involve researchers and delivery systems throughout DII processes; bringing together multiple disciplines; and addressing national and international barriers as well as opportunities in DII science.

Implications

CTSAs through regional collaboration can increase their contributions to improved community health via skill‐building, partnership development and enhanced outreach to local healthcare and public health agencies and delivery systems.     

Dissemination,Implementation, and Improvement Science Research in Population Health: Opportunities for Public Health and CTSAs

Importance

The complex, dynamic nature of health systems requires dissemination, implementation, and improvement (DII) sciences to effectively translate emerging knowledge into practice. Although they hold great promise for informing multisector policies and system‐level changes, these methods are often not strategically used by public health.

Objectives and Methods

More than 120 stakeholders from Southern California, including the community, federal and local government, university, and health services were convened to identify key priorities and opportunities for public health departments and Clinical and Translational Science Awards programs (CTSAs) to advance DII sciences in population health.

Main Outcomes

Participants identified challenges (mismatch of practice realities with narrowly focused research questions; lack of iterative learning) and solutions (using methods that fit the dynamic nature of the real world; aligning theories of change across sectors) for applying DII science research to public health problems. Pragmatic steps that public health and CTSAs can take to facilitate DII science research include: employing appropriate study designs; training scientists and practicing professionals in these methods; securing resources to advance this work; and supporting team science to solve complex‐systems issues.

Conclusions

Public health and CTSAs represent a unique model of practice for advancing DII research in population health. The partnership can inform policy and program development in local communities.     

Assessing Research Interest and Capacity in Community Health Centers

Objective

Community health centers (CHCs) have great potential to participate in the development of evidence‐based primary care but face obstacles to engagement in clinical translational research.

Methods

To understand factors associated with CHC interest in building research infrastructure, Harvard Catalyst and the Massachusetts League of Community Health Centers conducted an online survey of medical directors in all 50 Massachusetts CHC networks.

Results

Thirty‐two (64%) medical directors completed the survey representing 126 clinical sites. Over 80% reported that their primary care providers (PCPs) were slightly to very interested in future clinical research and that they were interested in building research infrastructure at their CHC. Frequently cited barriers to participation in research included financial issues, lack of research skills, and lack of research infrastructure. In bivariate analyses, PCP interest in future clinical research and a belief that involvement in research contributed to PCP retention were significantly associated with interest in building research infrastructure.

Conclusion

CHCs critical role in caring for vulnerable populations ideally positions them to raise relevant research questions and translate evidence into practice. Our findings suggest a high interest in engagement in research among CHC leadership. CTSAs have a unique opportunity to support local CHCs in this endeavor.     

A Research Mentor Training Curriculum for Clinical and Translational Researchers

Purpose

To design and evaluate a research mentor training curriculum for clinical and translational researchers. The resulting 8‐hour curriculum was implemented as part of a national mentor training trial.

Method

The mentor training curriculum was implemented with 144 mentors at 16 academic institutions. Facilitators of the curriculum participated in a train‐the‐trainer workshop to ensure uniform delivery. The data used for this report were collected from participants during the training sessions through reflective writing, and following the last training session via confidential survey with a 94% response rate.

Results

A total of 88% of respondents reported high levels of satisfaction with the training experience, and 90% noted they would recommend the training to a colleague. Participants also reported significant learning gains across six mentoring competencies as well as specific impacts of the training on their mentoring practice.

Conclusions

The data suggest the described research mentor training curriculum is an effective means of engaging research mentors to reflect upon and improve their research mentoring practices. The training resulted in high satisfaction, self‐reported skill gains as well as behavioral changes of clinical and translational research mentors. Given success across 16 diverse sites, this training may serve as a national model. Clin Trans Sci 2013; Volume 6: 26–33     

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.     

Effectiveness of a Community Research Registry to Recruit Minority and Underserved Adults for Health Research

Background

Recruiting minorities and underserved populations into population‐based studies is a long standing challenge. This study examined the feasibility of recruiting adults from a community research registry.

Methods

Ethnically diverse, bilingual staff attended health fairs, inviting adults to join a registry. We examined rates of successful contact, scheduling, and participation for studies that used the registry.

Results

Five studies queried 6,886 research registry members (48% Hispanic and 38% black) and attempted to contact 2,301 potentially eligible participants; eligibility criteria varied across studies. We successfully contacted 1,130 members, 51.9% were scheduled to participate and of those, 60.8% completed their study appointment. Non‐Hispanic whites were less likely than Hispanics to be interested, but among those scheduling an appointment, participation did not differ by race/ethnicity.

Conclusion

Community research registries are a feasible and efficient method for recruiting minority and underserved adults and may address disparities in access to and participation in health research.     

Strategies to Build Trust and Recruit African American and Latino Community Residents for Health Research: A Cohort Study

Background

This study used Community Partnered Participatory Research (CPPR) to address low participation of racial and ethnic minorities in medical research and the lack of trust between underrepresented communities and researchers.

Methods

Using a community and academic partnership in July 2012, residents of a South Los Angeles neighborhood were exposed to research recruitment strategies: referral by word‐of‐mouth, community agencies, direct marketing, and extant study participants.

Results

Among 258 community members exposed to recruitment strategies, 79.8% completed the study. Exposed individuals identified their most important method for learning about the study as referral by study participants (39.8%), community agencies (30.6%), word‐of‐mouth (17.5%), or direct marketing promotion (12.1%). Study completion rates varied by recruitment method: referral by community agencies (88.7%), referral by participants (80.4%), direct marketing promotion (86.2%), word of mouth (64.3%).

Conclusions

Although African American and Latino communities are often described as difficult to engage in research, we found high levels of research participation and completion when recruitment strategies emerged from the community itself. This suggests recruitment strategies based on CPPR principles represent an important opportunity for addressing health disparities and our high rates of research completion should provide optimism and a road map for next steps.     

Public Participation in,and Awareness about,Medical Research Opportunities in the Era of Clinical and Translational Research

Context

In the United States, levels of public participation in medical research in the era of Clinical and Translational Science Awards (CTSAs) are unknown.

Methods

In 2011, a household survey was administered to a sample of U.S. adults, asking whether they (and children <18 years old) had participated, or were aware of opportunities to participate, in medical research. Respondents living within 100 miles of CTSA sites were identified. Regression analyses of participation and awareness (PA) were performed, applying sampling weights to permit nationally representative inferences.

Results

Overall, 2,150 individuals responded (completion rate = 60%); 65% of adults and 63% of families with children resided within 100 miles of ≥1 CTSA location. Research participation rates were 11% among adults and 5% among children. Among nonparticipants, awareness rates were 64% among adults and 12% among parents of children. PA among adults was associated with higher income and education, older age, presence of chronic conditions, and living within 100 miles of four specific CTSA locations. For children, PA was associated with higher household income and parents’ chronic health conditions.

Conclusions

PA of medical research opportunities is substantially higher for adults than children. Higher PA levels near specific CTSAs merit investigation to identify their successful approaches.     

Genotyping HLA‐B*5801 for Allopurinol‐Induced Severe Cutaneous Adverse Reactions: An Accurate and Prompt Method

Objectives

A new method of HLA‐B*5801 genotyping was compared with sequence‐based typing (SBT) to find an accurate and prompt method in genotyping HLA‐B*5801.

Methods

Two groups of patients from allopurinol‐induced cutaneous adverse reactions (SCARs) and allopurinol‐tolerant were both genotyped with PG5801 kit and SBT method. The genotyping results of HLA‐B*5801 were compared between the two groups.

Results

The PG5801 detection kit results were 100% (79/79) in agreement with the SBT genotyping results for identifying the HLA‐B*5801 (+) patients. No false‐positive or false‐negative errors were found. The sensitivity, specificity, rate of adherence, positive predictive value (PPV) and negative predictive value (NPV) were 100%.

Conclusion

The potential fast screening method is an ideal tool to rule out the high‐risk allopurinol‐induced SCARs patients.     

Promotion and Tenure for Community‐Engaged Research: An Examination of Promotion and Tenure Support for Community‐Engaged Research at Three Universities Collaborating through a Clinical and Translational Science Award

Introduction

Community‐engaged health research, an approach to research which includes the participation of communities, promotes the translation of research to address and improve social determinants of health. As a way to encourage community‐engaged research, the National Institutes of Health required applicants to the Clinical and Translational Science Award (CTSA) to include a community engagement component. Although grant‐funding may support an increase in community‐engaged research, faculties also respond to the rewards and demands of university promotion and tenure standards. This paper measures faculty perception of how three institutions funded by a CTSA support community‐engaged research in the promotion and tenure process.

Methods

At three institutions funded by a CTSA, tenure track and nontenure track faculty responded to a survey regarding perceptions of how promotion and tenure committees value community‐engaged research.

Results

Faculty view support for community‐engaged research with some reserve. Only 36% agree that community‐engaged research is valued in the promotion and tenure process.

Discussion

Encouraging community‐engaged scholarship requires changing the culture and values behind promotion and tenure decisions. Institutions will increase community‐engaged research and more faculty will adopt its principles, when it is rewarded by promotion and tenure committees.     

Provider's Perspectives on Building Research and Quality Improvement Capacity in Primary Care: A Strategy to Improve Workforce Satisfaction

Objectives

Safety‐net populations are underrepresented in research and quality improvement (QI) studies despite the fact that safety‐net providers are uniquely positioned to engage in translational research. This study aimed to understand the current level of interest in, experience with, predicted career satisfaction associated with, and barriers experienced in conducting research and QI among primary care providers (PCPs) at 18 safety‐net practices in the Boston, Massachusetts area.

Methods

The Harvard Catalyst Safety‐net Infrastructure Initiative partnered with staff at a large academic public hospital system, including 15 primary care sites, to develop and administer an online survey. This survey was then adapted and administered at three other academically affiliated community health centers.

Results

Of the 260 providers surveyed, 136 (52%) responded. Nearly 80% reported interest in conducting either QI projects or clinical research and 95% of them believed it would enhance their career satisfaction. However, 63% did not report prior experience or training in research or QI and 93% reported at least one barrier to engagement.

Conclusion

While supporting safety‐net PCPs’ engagement in research and/or QI may improve career satisfaction there are numerous barriers that must be addressed to achieve this goal.     

Improving the Proficiency of Research Consent Administrators

Objective:

To describe the development and testing of a module to improve consent administrators’ skills when obtaining research consent from culturally and linguistically diverse and low literacy populations.

Design:

Development and psychometric testing of video module including community vignettes.

Methods:

Following initial content, face, and construct validity testing by experts, a field trial was conducted with pre‐ and postknowledge tests and satisfaction surveys completed by 112 consent administrators.

Results:

Mean score out of a possible 10 on pretest was 8.6 (±standard deviation [SD], 1.55) and on posttest was 9.1 (±SD, 1.2; paired t‐test 95% confidence interval of difference: –0.18 to –0.88; two‐tailed p = 0.003). The average years of experience with obtaining consent was 6.42 years (range: 0–35), but years of experience was not significantly associated with either pre‐ or posttest scores (p = 0.82 and 0.44, respectively). Most user evaluations were positive, although suggestions for improvements were made.

Conclusion:

Although pretest scores were relatively high, training needs of research consent administrators for consenting diverse and low literacy populations may be unmet. We urge that institutional review boards, researchers, policymakers, educators, and bioethicists address the training needs of research consent administrators and we offer this training module as one potential resource and adjunct to such training.     

Real‐Time RT‐PCR Ct Values for Blood GAPDH Correlate with Measures of Vascular Endothelial Function in Humans

Purpose

To date, there is a wide range of methods in use to assess endothelial function, each with its own advantages and limitations. Here, we tested hypothesis that real‐time RT‐PCR threshold value (Ct), which is reflective of mRNA level, for Glyceraldehyde‐3‐phosphate dehydrogenase (GAPDH) from whole blood is indicative of endothelial function in humans.

Materials and Methods

To assess vascular function, we measured baseline skin perfusion, postocclusion reactive hyperemia (PORH), and brachial artery flow‐mediated dilatation (FMD) and tested for a possible correlation between vascular responses and blood GAPDH real‐time RT‐PCR Ct value in 75 healthy volunteers.

Results

Tests known to measure, at least in part, endothelial function such as baseline skin perfusion, the 2‐minute recovery PORH, and FMD exhibited significant positive correlations with blood GAPDH Ct values. In contrast, there was no significant correlation between Ct values for blood GAPDH and peak PORH, an endothelium‐independent parameter.

Conclusions

Based on these findings, we report that GAPDH mRNA level in the blood correlates with vascular function in healthy subjects. This suggests that GAPDH mRNA level could be a potential biomarker of vascular endothelial function.     

Community Engagement Strategies in the Original and Renewal Applications for CTSA Grant Funding

Purpose

The Clinical and Translational Science Award (CTSA) program has highlighted community engagement in research by requiring institutions to develop bidirectional relationships with communities to obtain funding. Little is known about how institutions have operationalized that requirement. This study aimed to describe the strategies proposed by the first institutions to receive CTSA funding and to undergo the CTSA renewal process.

Methods

The authors conducted a qualitative document analysis of the community engagement section of 12 original and 10 renewal grant applications of the 12 institutions awarded CTSA funding in 2006 and renewed in 2010.

Results

Institutions employed ‐ and research engagement strategies. Capacity‐building strategies included education, pilot grants, connecting potential partners, and community research centers. Research engagement strategies ranged from those that allowed for very little input from communities, such as announcements, to those that allowed for a high amount of input from communities, such as community‐researcher teams.

Conclusion

CTSA funding has supported capacity‐building for institutions and communities to partner. Engagement strategies employed by the institutions are largely known from prior community‐engaged research. Based on the grants from these institutions, the CTSA funding has largely enabled institutions to develop capacity to engage.